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

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dc.contributor.authorRoss, Michael W.
dc.contributor.authorNyoni, Joyce E.
dc.contributor.authorLarsson, Markus
dc.contributor.authorMbwambo, Jessie
dc.contributor.authorAgardh, Anette
dc.contributor.authorKashiha, John J.
dc.contributor.authorMccurdy, Sheryl A.
dc.date.accessioned2016-07-12T13:01:53Z
dc.date.available2016-07-12T13:01:53Z
dc.date.issued2015-03
dc.description.abstractWe 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.en_US
dc.identifier.citationRoss, M.W., Nyoni, J., Larsson, M., Mbwambo, J., Agardh, A., Kashiha, J. and McCurdy, S.A., 2015. 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. Global health action, 8.en_US
dc.identifier.doi10.3402/gha.v8.26096
dc.identifier.urihttp://hdl.handle.net/20.500.11810/3130
dc.language.isoenen_US
dc.publisherCo-Actionen_US
dc.subjectMen who have sex with menen_US
dc.subjectHomosexualen_US
dc.subjectDiscriminationen_US
dc.subjectStigmaen_US
dc.subjectAfricaen_US
dc.subjectHIVen_US
dc.subjectSTIsen_US
dc.subjectTreatmenten_US
dc.titleHealth 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 Compromiseden_US
dc.typeJournal Article, Peer Revieweden_US
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