ArticleGlobal health action2015
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.
Article in Global health action, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 44 citations in OpenAlex.
- Prevalence of Human Papillomavirus (HPV) and HPV Vaccination Completion Rates Among Gay and Bisexual Men in Dar es Salaam, Tanzania.Venereology (Basel, Switzerland) · 2025Article
- Five different ways of reasoning: Tanzanian healthcare workers' ideas about how to improve HIV prevention among same-sex attracted men.BMC health services research · 2023Article
- A qualitative study to explore the healthcare-seeking experiences of men who have sex with men (MSM) and transgender women (TGW) in Rwanda.BMC health services research · 2023Article
- Perceptions of Sexual Healthcare Provision in Tanzania: a Key Informant Qualitative Study.Sexuality research & social policy : journal of NSRC : SR & SP · 2022Article
- Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania.African journal of primary health care & family medicine · 2022Article
- Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study.PloS one · 2022Article
- Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries.BMC public health · 2021Article
- Understanding and managing HIV infection risk among men who have sex with men in rural Uganda: a qualitative study.BMC public health · 2021Article
- Cultural and clinical challenges in sexual health care provision to men who have sex with men in Tanzania: a qualitative study of health professionals' experiences and health students' perspectives.BMC public health · 2021Article
- Mapping evidence of depression in HIV-seropositive MSM in sub-Saharan Africa: a scoping review protocol.Systematic reviews · 2021Article
- Providing Care to LGBT Patients in Guyana: An Assessment of Medical Providers' Knowledge, Attitudes and Readiness to Learn.International journal of sexual health : official journal of the World Association for Sexual Health · 2021Article
- Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men.Global health action · 2020Article
- Attitudes of medical students towards men who have sex with men living with HIV: implications for social accountability.International journal of medical education · 2020Article
- Legal and Ethical Considerations in the Delivery of Sexual Health Care in Tanzania.African journal of health, nursing and midwifery · 2020Article
- Low prevalence of syphilis infection among key populations in Togo in 2017: a national cross-sectional survey.Archives of public health = Archives belges de sante publique · 2019Article
- Anti-homosexual legislation and HIV-related stigma in African nations: what has been the role of PEPFAR?Global health action · 2017Article
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- The green shoots of a novel training programme: progress and identified key actions to providing services to MSM at Kenyan health facilities.Journal of the International AIDS Society · 2015Article
- Not a Problem at All or Excluded by Oneself, Doctors and the Law? Healthcare Workers' Perspectives on Access to HIV-Related Healthcare among Same-Sex Attracted Men in Tanzania.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
Abstract
We 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.