Male sex workers who have sex with men (MSM-SW): marginalized and high risk population with poor access to STI/HIV health services in Nairobi, Kenya
G. Gakii1, J. Kimani1, L. Gelmon2, P. Izulla1, S.S. Swop Clinic1
1University of Nairobi/University of Manitoba, Nairobi, Kenya, 2University of Manitoba, Nairobi, Kenya
Background: In sub- Sahara Africa, same-sex relationships remains a taboo subject, highly stigmatized but there is a silver lining. Data on MSM is growing and the number of programs targe.
Methods: The sex workers outreach Program (SWOP) clinic in Nairobi opened its doors to MSM-SW in June 2009. A deliberate effort to mobilize and recruit them into a HIV prevention program was undertaken. Those enrolled are provided with a comprehensive care package that includes: health education, HIV information, risk factors for HIV acquisition and transmission, condom demonstration on correct use, counselling on risk reduction and substance abuse. A Provider Initiated Testing and Counseling (PITC) for HIV is always offered with same day results. Urine and blood samples are then collected for STI screening. All patients are managed syndromically in line with the National STI guidelines and follow-up visits emphasized and encouragedting members of this vulnerable group on the rise. This has greatly improved access to much needed health care services.
Results: A total of 164 MSM-SW have already been enrolled into the cohort, majority aged between 25 – 35 years with a median of 27 years. 78.7% of them use alcohol daily while 46.2% reported having had a blackout in the past 3 months. 29.9% of the men also used Khat and 7.9% used bhang frequently. Only 28.5% of the MSM -SW reported always using condoms for insertive and receptive anal intercourse while16.2% reported always using condoms for vaginal sex. The STIs rates are: Chlamydia at 26.1%, Gonoccoccal infection at 5% while 1% had Syphilis. 47.6% of the cohort is HIV infected with 33% those aged 15-19years already carrying the virus.
Conclusion: Condom use is low among MSM-SW but they have high rates of STD/HIV. Targeting MSM-SW with HIV interventions now seems feasible and should be brought to scale.