Predictors of uptake of HIV/AIDS prevention services among men who have sex with men aged 18 years and above in Nairobi county-Kenya

Abstract

Globally, gay men and other men who have sex with men are 19 times more likely to be living with HIV than the general population. The prevalence of HIV/AIDS among Men who have sex with men in Nairobi has been reported to be 18.2% which is a public health concern. This study determined factors affecting uptake of HIV/AIDS prevention services among MSM in Nairobi County. This was a cross sectional study that utilized mixed method of data collection. Study population included MSM (n=380), 6 managers who were in-charge of HIV/AIDS programmes in Public and Private Health facilities and Directors in charge of non-governmental organizations that supported MSM health needs. Participants were recruited through snowballing and purposive sampling respectively. Quantitative data was collected through a developed self administered questionnaire while qualitative data was collected through in-depth interviews. Uptake of HIV/AIDS testing as predicted by Pre and Post HIV counseling is 52.80%, other STI testing is reported at 31% and always use of condom is reported to be 22%. Being a student, a sex worker, and unmarried are predictors of HIV/AIDS prevention services uptake. Majority of MSM reported that TB drugs (70.1/%), antiretroviral drugs (71.6%), lubricants (79.5%), condoms (84.5%), and other STI treatment services (76.8%) were accessible. Barriers to HIV/AIDS prevention included personal negative attitudes, discrimination (31.6%) and stigma (26.3%) encountered at facility level. Alcohol and illicit drug consumption adversely affected health seeking as alcohol and drug usage accounted for 48.4% and 48.5% respectively. MSM specific health packages and policy guidelines are lacking and there is over reliance on donor funding for MSM health support. In conclusion, uptake of HIV/AIDS prevention services was low. Discrimination and stigma adversely affected HIV/AIDS health seeking practices by MSM, mostly encountered at the facility level. MSM engaged in alcohol and substance use that likely affected HIV/AIDS health seeking behaviour. MSM also engaged in risky behaviours that could negate the HIV/AIDS prevention efforts in Nairobi County. It is recommended that a policy on MSM health should be drawn. There is need for healthcare workers at facility level to be trained on MSM specific health needs.