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Like other areas of Africa, homosexuality is illegal in Kenya. Exact logistic regression models were used for survey data analysis. Efforts to provide facilities that offer safe and confidential Kisumu hookup services and health education for MSM is required. Continued community engagement Kisumu hookup the MSM population in Kenya is needed to guide Kisumu hookup practices for involving them in Kisumu hookup prevention research.

Some said they use word of mouth to find more welcoming clinics and prefer younger providers because they tend to be less homophobic. Perhaps because of this rejection of homosexuality in Africa, Kisumu hookup has been delayed compared to in North America and Europe; yet the prevalence of HIV Kisumu hookup sub-Saharan Africa is two to four times higher among MSM than in the general population Baral et Kisumu hookup. Kisumu is one of three Kisumu hookup cities in Kenya and is situated in Nyanza Province, where HIV prevalence is the Kisumu hookup in Kisumu hookup country: While there is a growing lesbian, gay, bisexual, transgender, intersex LGBTI movement in Kenya that is helping to make Kenya somewhat less dangerous for these minority groups than in other nearby countries Migiro,there is a dearth of information about MSM in Kisumu hookup, especially in Kisumu Kenya and especially with regard to health services.

Efforts to decrease risk behaviors and increase HIV testing among Kisumu hookup must include the assessment of structural factors, especially access to health services, as barriers or facilitators.

Moreover, with the high HIV prevalence Sanders et al. However, in the context of homosexuality being illegal, recruiting MSM may be difficult. Examining self-reported barriers and motivators to participation in HIV prevention studies Kisumu hookup useful in designing studies and recruitment strategies that can best accommodate their concerns and needs.

Thus, the purpose of this study was to 1 describe the proportion and characteristics of MSM not comfortable seeking health services at a public Kisumu hookup and Kisumu hookup describe MSM motivators and barriers Kisumu hookup participating in HIV research studies, including their willingness to be contacted for an HIV study and acceptability of fingerprinting for study identification purposes.

The Kisumu hookup was conducted in Kisumu, Kenya in Nyanza Province, which has a population of approximatelyresidents Central Bureau of Statistics, who are predominately of Kisumu hookup ethnicity Bailey et al. We conducted a two-phase, formative study that involved individual interviews Kisumu hookup a structured survey.

The inclusion criteria Kisumu hookup men, aged 18 to 64 years Kisumu hookup age, who self-identified Kisumu hookup hookup MSM. To confirm that men were truly MSM, Kisumu hookup enlisted the help of five self-identified MSM known to Kisumu hookup staff over a period of several months from different local MSM support groups and organizations. The reason for the confirmation is because during an earlier cohort study focusing on persons at high risk for Kisumu hookup hookup, some men posed as Kisumu hookup in Kisumu hookup to be recruited into the study and receive the transport reimbursement.

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When this was discovered, the men were dropped from the earlier study. All participants received information about the objectives of the study and were Kisumu hookup that the information Kisumu hookup hookup provided Kisumu hookup be kept confidential, that they could choose not to participate, and that they would not be identified when the information was reported.

Written consent was obtained from each person agreeing to participate in the interviews or survey. A purposive snowball sampling approach Kisumu hookup, was used to Kisumu hookup 15 MSM for individual interviews. Interviewers had extensive experience working Kisumu hookup local MSM groups and had undergone specific training for this study.

Other questions were asked, though not analyzed here, about topics such as Kisumu hookup support groups. Interviews lasted approximately 60 Kisumu hookup and were audio-taped. Interviewers completed a form for each interview that documented the strategies reported for contacting individuals at Kisumu hookup risk and supplemented the forms with their own notes.

The Kisumu hookup strategies were compared Kisumu hookup discussed by the interviewers at regular meetings during the data collection period. Interviewers scored each strategy based on perceived potential success in locating MSM then ranked Kisumu hookup. The three highest ranked strategies to contact MSM were selected based on the individual interviews and Kisumu hookup to recruit 51 men none Kisumu hookup the 51 also participated in the Kisumu hookup for the survey portion of the study.

The number of men recruited was not based on a power calculation. Staff attempted to use all three strategies; however, it was quickly determined that in Kisumu, Kenya, where homosexual behavior is illegal, MSM were most comfortable being recruited through other MSM they knew.

Participants were asked about their demographic characteristics and about health services and sexual identity issues. For the questions regarding acceptability of fingerprinting to identify persons in research studies, participants were first educated about fingerprinting technology, specifically that the images of the fingerprint would be stored in the form of numbers and could Kisumu hookup be transformed back to images.

The survey interview lasted approximately 30 minutes and was conducted by the staff in English, Dholuo, or Swahili using a handheld Kisumu hookup. For the purpose of this analysis, any response other than very was coded as indicating some discomfort with seeking services at a public hospital. Interviews were transcribed Kisumu hookup and translated from Dholuo or Swahili to English.

A codebook was developed by two of the coauthors Kisumu hookup and DG based on a Kisumu hookup categories, specifically the interview questions. Coding was carried out by one Kisumu hookup DG using Nvivo version 8, a QSR international qualitative data analysis program Kisumu hookup analyzed using grounded theory.

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Quotes were selected to represent typical responses by respondents regarding their perceptions of health services, whether they revealed to Kisumu hookup provider that they have sex with men and how learning their HIV test results influenced their future sexual behavior.

Initial comparisons were made using contingency table analysis and chi-square tests of significance. To address the issue of sparse data, variable categories were collapsed where appropriate.

Associations between each outcome and the factors of interest were measured using exact logistic regression models. Although our age eligibility was Kisumu hookup 18—64 years, the oldest Kisumu hookup was 34 Kisumu hookup of age.

One interviewee declined to provide information on income and one survey respondent refused to Kisumu hookup the sexual identity question. Percentages are Kisumu hookup to the nearest whole number, thus the total for each category may not add up to Only one factor was associated with reporting some discomfort in seeking health services at Kisumu hookup public hospital.

No demographic variables were significantly associated with reporting some discomfort seeking health services Table 2.

The major themes for the interaction with a health care provider question were 1 comfort with MSM-friendly providers, Kisumu hookup stigma, and 3 disclosing sexual orientation.

Kisumu hookup of 15 MSM interviewed reported they received good Kisumu hookup from a health care provider the last time they were HIV tested, Kisumu hookup two said they did not. To him, it was like I was not OK and that I was mad.

There was just one theme for the question about how learning your HIV Kisumu hookup results influenced your future sexual behavior more careful about using protectiongiven that of the 13 individual interview participants who responded to the question, all 13 responded that it made them want to be more careful in protecting themselves. The main barrier was having personal information made available to others in the community, accounting for nearly two thirds of responses When asked about the acceptability of Kisumu hookup fingerprints for identifying persons who participate in research studies in Kisumu, 49 out of 51 Furthermore, when the 49 MSM who thought it would be acceptable were asked how they thought participants would like it, Nearly two thirds of MSM in Kisumu Kenya reported having some discomfort when seeking health services at a public hospital.

Kisumu hookup only factor in our analysis associated with these men was a report of feeling people were staring at them. In a similar vein, the main barrier to participating in HIV research was having their personal information made available to others in the community. Receiving education that could help prevent HIV infection was the main motivator to taking part in an HIV research study. That a Kisumu hookup proportion of MSM Kisumu hookup Kisumu had some discomfort Among MSM in Malawi, Namibia, and Botswana, there was an association between fear of health care services and Kisumu hookup having experienced discrimination Fay Kisumu hookup al.

Kisumu hookup our study, 13 of 15 MSM interviewed reported they received good treatment from a health care provider Kisumu hookup last time they were HIV tested, and just two said they did not.

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In a study of MSM in Nairobi, health care providers did not ask about Kisumu hookup behavior Kisumu hookup thus did not offer prevention information Geibel et al.

This contributes to both a lack of appropriate health education and promotion for MSM Kisumu hookup lack of quality health care Kisumu hookup. In efforts to understand the African HIV epidemic over the past two decades, the role of same-sex behavior has been, for the most part, left out.

However, there has been a recent Kisumu hookup in attention and study Kenya Ministry of Health, The vast majority of MSM Kisumu hookup for our study reported they would be willing to be contacted to participate in future HIV research studies and that use of fingerprinting for identification purposes would be acceptable in Kisumu, though some thought there would be reservations. Including MSM in innovative HIV prevention research is needed due to Kisumu hookup many factors that influence effectiveness Kisumu hookup current prevention programs e.

Onyango-Ouma and colleagues Onyango-Ouma et al. One important finding from the qualitative data in our study was that MSM who reported they tested negative for HIV said that the result Kisumu hookup them more careful in protecting themselves so that they remained HIV-negative in the future.

Risk reduction counseling offered as part of clinical trial participation has been associated with reduced HIV risk behavior and low HIV incidence in Kenya Kaul et al. Several limitations should be considered in the interpretation of our results. First, there may have been response bias in that some men may have posed as MSM to be part of a study and thus reimbursed for their time and transport, or modified their responses due to social desirability bias.

However, we guarded Kisumu hookup the first possibility by requiring that two known MSM verify the sexual orientation of the potential participant and by using the contact strategies Kisumu hookup by the Kisumu hookup MSM.

We guarded against the second Kisumu hookup by using strategies suggested by MSM so that they had a level of comfort that our goal was to Kisumu hookup more about them while keeping their identity confidential.

Second, because specific strategies suggested by the 15 MSM interviewed were used to contact the MSM for survey administration, the survey sample was not probabilistic and the survey respondents cannot be presumed to be representative of the MSM in Kisumu.

Third, our sample size was small, so we were Kisumu hookup to bivariate analyses.

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The sample size may also have been too small to detect differences when they, in fact, existed. Results might Kisumu hookup different with a larger sample of MSM. Fourth, we did not have a non-MSM group to compare discomfort seeking health services. Fifth, we did not collect systematic information Kisumu hookup the HIV status of participants.

However, it could also be because the respondent had no need to seek services at a public hospital. Seventh, the oldest survey participant was 34 years of age, so we Kisumu hookup not have an MSM sample covering the full adult age distribution. Future studies should give Kisumu hookup effort to recruiting older MSM. Finally, important factors associated with discomfort in seeking health services at a Kisumu hookup hospital may not have been included in our Kisumu hookup. The strength of this study is that it offers one of the first insights into the attitudes related to Kisumu hookup services and HIV research study participation among MSM in Kisumu, Kenya.

Our study found that a large percentage of MSM in Kisumu Kenya had some discomfort when Kisumu hookup health services at a public hospital; a feeling of being stared at was the only factor associated with this group. Similarly, the main barrier to participating in HIV research was having personal information made available to others in the Kisumu hookup. Until the discriminatory laws change, as suggested by Lane and colleagues Lane et al.

There was some evidence in our qualitative data Kisumu hookup such a network was available to some MSM in Kisumu. Given that MSM in Kenya are being recognized as a key group in the HIV epidemic in Kenya, Kisumu hookup to provide for safe and confidential facilities to offer health services and health education and promotion to MSM in Kisumu hookup parts of Kenya is required.

We thank all study participants. John Vulule, for their support. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of Kisumu hookup Centers for Disease Control and Prevention.

National Kisumu hookup for Biotechnology InformationU. Author manuscript; available in PMC Aug Author information Copyright and License information Disclaimer.

Address correspondence to Deborah A. See other articles in PMC that cite the published article. Procedure Phase 1 Individual interviews A purposive snowball sampling approach Patton, was used to identify 15 MSM for individual interviews.

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