Project Lead(s): LaRon Nelson
Issue
HIV is continuing to spread among men who have sex with men (MSM) in Ghana because stigma remains a barrier to the uptake of clinic-based prevention services.
Solution
The project was implemented in Ghana to determine the feasibility of adapting social/sexual networks of MSM to accommodate a Kumasi & Accra Project to Prevent AIDS (KAPPA) model.
This model uses peer leaders in existing networks to link MSM to nurses and physicians who will be able to provide clinical support, and to supplement biomedical interventions with behavioural interventions that promote sexual risk reduction.
The project conducted in-depth ethnographic work, including interviews, focus groups and social observation designed to understand MSM experiences of homophobia in the health system, and their willingness to allow their networks to be utilized for intervention delivery.
They also interviewed nurses and physicians to assess their willingness to provide clinical care to MSM and barriers in medical practice.
Outcome
Results showed that social networks are useful in identifying and reaching out to MSM in Ghana and linking them to HIV/counselling services.
A total of 137 MSM were identified using this approach and linked to health providers who were willing to provide HIV/STD clinical prevention services in a discreet manner.
This is an important breakthrough finding because it points to the social network as a previously unrecognized target for public health education efforts.
Statistical analysis showed that MSM’s HIV/STD knowledge, attitudes and beliefs were predicted by their social network.
The project has resulted in identifying behavioural and social elements of MSM social networks in Ghana that can be used by public health officials and non-government organizations to better tailor prevention strategies to the needs of MSM.
The project team recruited 16 physicians who are willing to take the lead in creating clinical practice environments where the human rights of MSM patients are upheld, and where all the clinical staff support MSM patients’ health goals while respecting their autonomy.
This knowledge was disseminated through conference presentations and manuscripts are being prepared for publication.
The regional HIV/AIDS Directors of Ghana’s two largest municipalities now endorse the inclusion of pre-exposure prophylaxis as part of their regional HIV prevention strategy for MSM.