Perceptions and factors influencing access to health care services of men who have sex with men in Kigali city.

Abstract

Men who have sex with men have unique experiences and circumstances that affect their physical and mental health needs as well as their access to high-quality health services. This study examines perceptions and factors influencing access to health care services available to men who have sex with men in Kigali City. The study explores also the attitudes of health care providers, perceived benefits and barriers to access to health services as well as strategies to enhance this access. To make sure that the findings are robust, a participatory and anthropological methodology was used to build relationships of trust with 40 sampled men who have sex with men in Kigali City. Addtionally, 20 health care providers were interviewed to compliment the information received from men who have sex with men. The ages of men who have sex with men ranged from 20 to 35 years. The primary data showed that 55% of respondents reported having a secondary school level of education; 15% have had sex with other men for more than 10 years and only 27.5% report always using condoms, while 55% reported also being interested in having sex with women. In terms of factors influencing access to health care services, the findings revealed that stigma by other patients and health care providers was respectively 50% and 20%; 78.9% fear to be recognized as MSM when they access health services, and 40% complain about the long distance to reach an MSM-friendly health facility. In general, men who have sex with men are satisfied with the quality of health services (82.5%). Results from the study contribute to the literature on men who have sex with men and support the need for scaling up health services to MSM and its integration in the existing health system in Rwanda.