Providing competent, comprehensive and inclusive sexual health services for men who have sex with men in low- and middle-income countries: a scoping review
Cedric H. Bien-Gund A B , Peipei Zhao C , Bolin Cao D , Weiming Tang A E F , Jason J. Ong G , Stefan D. Baral H , José A. Bauermeister I , Li-Gang Yang J , Zhenzhou Luo C and Joseph D. Tucker A E G K L
+ Author Affiliations
- Author Affiliations
A University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou 510095, China.
B Division of Infectious Diseases, Department of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
C Shenzhen Nanshan Center for Chronic Disease Control, No. 8 Longyuan Road, Shenzhen 510855, China.
D School of Media and Communication, Shenzhen University, 3688 Nanhai Avenue, Shenzhen 518060, China.
E Social Entrepreneurship to Spur Health, No. 2 Lujing Road, Guangzhou 510095, China.
F School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC 27516, USA.
G Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
H Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
I Department of Family and Community Health, School of Nursing, 418 Curie Boulevard, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Guangdong Provincial STD Control Center, No. 2 Lujing Road, Guangzhou 510095, China.
K Institute of Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Road, Chapel Hill, NC 27599, USA.
L Corresponding author. Email: jdtucker@med.unc.edu
Sexual Health 16(4) 320-331 https://doi.org/10.1071/SH18191
Submitted: 6 October 2018 Accepted: 7 March 2019 Published: 19 June 2019
Abstract
Although men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmissible infections, sexual health services for MSM in low- and middle-income countries (LMIC) remain under-resourced and are poorly understood. A scoping review of literature on MSM sexual health in LMIC was conducted in order to identify key clinical services and gaps in knowledge. Three databases were searched, in addition to hand-reviewing key journals and bulletins, to identify literature with a focus on MSM sexual health. Key services related to providing care to MSM in LMIC that emerged from our review are described. These services include creation of safe and confidential clinic environments, HIV testing services, behavioural interventions, HIV pre-exposure prophylaxis (PrEP), rapid antiretroviral therapy (ART) initiation and STI services. Compared with high-income settings, major differences in LMIC include lack of diagnostic technology, unfavourable legal environments and lack of funding for MSM health. Innovative approaches to healthcare delivery, such as harnessing mobile technology, self-testing and crowdsourcing interventions, can improve health services among MSM in LMIC. There are gaps in the evidence about how best to provide sexual health services for MSM in LMIC settings. Implementation research and scale-up of existing biomedical and behavioural interventions, such as HIV/STI testing services, PrEP and early antiretroviral initiation are urgently needed in LMIC.
Additional keywords: guidelines, HIV care continuum, HIV testing, sexually transmissible infections.
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