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A novel urban clinical service targeting men who have sex with men (MSM) - an initial audit of patterns of utilisation and disease burden
K.B. Rebe1,2, G. De Swardt1, H. Struthers3, J. McIntyre3, Health4Men
1Perinatal HIV Research Unit, Health4Men, Cape Town, South Africa, 2GF Jooste Hospital, Infectious Diseases Unit, Cape Town, South Africa, 3Perinatal HIV Research Unit, Johannesburg, South Africa
Background: MSM are at high risk for HIV transmission and are prioritised in the South African National Strategic AIDS Plan. Despite this, little is known regarding their burden of disease and health requirements. Health4Men is a novel clinical service in Cape Town's “gay village”, initiated by the Western Cape Department of Health in partnership with the PHRU which aims to address the health care needs of MSM in urban and peri-urban Cape Town.
Methods: We retrospectively reviewed clinic data for all male clients attending the service between inception in August 2008 and February 2009 We report on: patient demographic data, service utilisation and disease burden, specifically relating to sexual health, HIV and psychological problems.
Results: 186 patients attended the service during the review period. Their average age was 36 yrs (20-65yrs). 147 (78.6%) clients were white, 24 (12.9%) coloured and 15 (8.1%) black. 116 (62.4%) did not have private medical insurance. 82 (44.1%) attending the clinic were HIV-positive. 73 (39.2%) were positive at entry while a further 9/81 (11.1%) tested positive at the clinic. 46 (56.1%) of HIV positive patients are on anti-retroviral therapy. Those patients not on treatment still have a preserved CD4 count. 34 (18.3%) patients attending the service had an STI with syphilis and non-specific urethritis being equally common (11 each) and HPV infection next (6). 59 (31.7%) patients required counselling with couples counselling (11 patients), depression (10 patients) and substance abuse counselling (4 patients) being common reasons for attending
Conclusions: This audit furthers our knowledge of the disease burden and health service utilisation of MSM in central Cape Town, and will help guide future development of our own service, and assist in national planning to meet the unique needs of South African MSM
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