“For my safety and wellbeing, I always travel to seek health care in a distant facility”—the role of place and stigma in HIV testing decisions among GBMSM – BSGH 002

Abstract

Gays, bisexuals, and all other men who have sex with men (GBMSM) are heavily impacted by HIV in Ghana compared to the general population. In addition to HIV and same-sex intercourse stigma, barriers such as reduced privacy, lower-income status and limited health care facilities (HCF) affect HIV testing decisions among GBMSM. We employed a phenomenological research design to understand the role of place and stigma in HIV testing among GBMSM in slums. GBMSM (n = 12) from slums in Accra and Kumasi, Ghana, were recruited and engaged in face-to-face interviews. We used a multiple reviewer summative content analysis to analyze and organize our key findings. The HIV testing options we identified include 1. Government HCF, 2. NGO and community outreach 3. Peer-educated services. Factors influencing GBMSM to test for HIV at HCF outside their areas included 1. The location of HCF 2. HIV and sexual stigma from slum areas 3. Positive HCW attitudes at distant HCF. 4. Negative Healthcare worker (HCW) attitudes towards GBMSM. These findings highlighted how stigma from slums and HCW influence HIV testing decisions and the need for place-based interventions to address stigma among HCW in slums to improve testing among GBMSM.