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Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised.

Ross, Michael W; Nyoni, Joyce; Larsson, Markus LU ; Mbwambo, Jessie; Agardh, Anette LU ; Kashiha, John and McCurdy, Sheryl A (2015) In Global Health Action 8.
Abstract
We present a model for developing health services for men who have sex with men (MSM) in sub-Saharan Africa and other places where MSM are heavily stigmatized and marginalized. The processes of the SPEND model include Safe treatment for sexually transmissible infections (STIs) and HIV; Pharmacy sites for treatment of STIs in countries where pharmacies and drug stores are the source of medical advice and treatment; Education in sexual health issues for health professionals to reduce discrimination against MSM patients; Navigation for patients who have HIV and are rejected or discriminated against for treatment; and Discrimination reduction through educating potential leaders in tertiary education in issues of human sexuality. Supporting... (More)
We present a model for developing health services for men who have sex with men (MSM) in sub-Saharan Africa and other places where MSM are heavily stigmatized and marginalized. The processes of the SPEND model include Safe treatment for sexually transmissible infections (STIs) and HIV; Pharmacy sites for treatment of STIs in countries where pharmacies and drug stores are the source of medical advice and treatment; Education in sexual health issues for health professionals to reduce discrimination against MSM patients; Navigation for patients who have HIV and are rejected or discriminated against for treatment; and Discrimination reduction through educating potential leaders in tertiary education in issues of human sexuality. Supporting empirical evidence from qualitative and quantitative studies is summarized, and barriers to implementation are discussed. Health care for MSM is one of the casualties of anti-homosexual social and legal climates. There is no amnesty for MSM in health care settings, where the stigma and discrimination that they face in the rest of society is replicated. Such conditions, however, make it necessary to consider ways of providing access to health care for MSM, especially where rates of HIV and STIs in MSM populations are high, and stigma and discrimination encourages high proportions of MSM to marry. This in itself enhances the status of MSM as an important bridge population for STIs including HIV. Where anti-homosexual laws encourage, or are believed to encourage, the reporting of MSM to authorities, health care may be seen as an agent of authority rather than an agency for care. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Global Health Action
volume
8
publisher
Co-action Publishing
external identifiers
  • pmid:25787179
  • wos:000351695000001
  • scopus:84930671315
ISSN
1654-9880
DOI
10.3402/gha.v8.26096
language
English
LU publication?
yes
id
082de9c1-d3c3-4e6a-924b-02c44be06562 (old id 5258163)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25787179?dopt=Abstract
date added to LUP
2015-04-05 14:56:09
date last changed
2017-09-17 05:52:25
@article{082de9c1-d3c3-4e6a-924b-02c44be06562,
  abstract     = {We present a model for developing health services for men who have sex with men (MSM) in sub-Saharan Africa and other places where MSM are heavily stigmatized and marginalized. The processes of the SPEND model include Safe treatment for sexually transmissible infections (STIs) and HIV; Pharmacy sites for treatment of STIs in countries where pharmacies and drug stores are the source of medical advice and treatment; Education in sexual health issues for health professionals to reduce discrimination against MSM patients; Navigation for patients who have HIV and are rejected or discriminated against for treatment; and Discrimination reduction through educating potential leaders in tertiary education in issues of human sexuality. Supporting empirical evidence from qualitative and quantitative studies is summarized, and barriers to implementation are discussed. Health care for MSM is one of the casualties of anti-homosexual social and legal climates. There is no amnesty for MSM in health care settings, where the stigma and discrimination that they face in the rest of society is replicated. Such conditions, however, make it necessary to consider ways of providing access to health care for MSM, especially where rates of HIV and STIs in MSM populations are high, and stigma and discrimination encourages high proportions of MSM to marry. This in itself enhances the status of MSM as an important bridge population for STIs including HIV. Where anti-homosexual laws encourage, or are believed to encourage, the reporting of MSM to authorities, health care may be seen as an agent of authority rather than an agency for care.},
  articleno    = {26096},
  author       = {Ross, Michael W and Nyoni, Joyce and Larsson, Markus and Mbwambo, Jessie and Agardh, Anette and Kashiha, John and McCurdy, Sheryl A},
  issn         = {1654-9880},
  language     = {eng},
  publisher    = {Co-action Publishing},
  series       = {Global Health Action},
  title        = {Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised.},
  url          = {http://dx.doi.org/10.3402/gha.v8.26096},
  volume       = {8},
  year         = {2015},
}