Abstract:
Globally, gay men and other men who have sex with men are 19 times more likely to be
living with HIV than the general population. The prevalence of HIV/AIDS among Men
who have sex with men in Nairobi has been reported to be 18.2% which is a public
health concern. This study determined factors affecting uptake of HIV/AIDS
prevention services among MSM in Nairobi County. This was a cross sectional study
that utilized mixed method of data collection. Study population included MSM (n=380),
6 managers who were in-charge of HIV/AIDS programmes in Public and Private Health
facilities and Directors in charge of non-governmental organizations that supported
MSM health needs. Participants were recruited through snowballing and purposive
sampling respectively. Quantitative data was collected through a developed self
administered questionnaire while qualitative data was collected through in-depth
interviews. Uptake of HIV/AIDS testing as predicted by Pre and Post HIV counseling is
52.80%, other STI testing is reported at 31% and always use of condom is reported to be
22%. Being a student, a sex worker, and unmarried are predictors of HIV/AIDS
prevention services uptake. Majority of MSM reported that TB drugs (70.1/%),
antiretroviral drugs (71.6%), lubricants (79.5%), condoms (84.5%), and other STI
treatment services (76.8%) were accessible. Barriers to HIV/AIDS prevention included
personal negative attitudes, discrimination (31.6%) and stigma (26.3%) encountered at
facility level. Alcohol and illicit drug consumption adversely affected health seeking as
alcohol and drug usage accounted for 48.4% and 48.5% respectively. MSM specific
health packages and policy guidelines are lacking and there is over reliance on donor
funding for MSM health support. In conclusion, uptake of HIV/AIDS prevention
services was low. Discrimination and stigma adversely affected HIV/AIDS health
seeking practices by MSM, mostly encountered at the facility level. MSM engaged in
alcohol and substance use that likely affected HIV/AIDS health seeking behaviour.
MSM also engaged in risky behaviours that could negate the HIV/AIDS prevention
efforts in Nairobi County. It is recommended that a policy on MSM health should be
drawn. There is need for healthcare workers at facility level to be trained on MSM
specific health needs.
