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The implementation and operation of sexual health services for men who have sex with men in Cape Town
G. Jobson1, K. Rebe1,2, G. De Swardt1, J. Leahy1, H. Struthers1, J. Mcintyre1
1Wits Health Consortium, Perinatal HIV Research Unit, Johannesburg, South Africa, 2G F Jooste Hospital, Infectious Diseases Unit, Cape Town, South Africa
Background: HIV services in South Africa have been primarily targeted at the heterosexual population. This is understandable in light of the scale of the epidemic in this population, and the fact that heterosexual intercourse is the primary mode of HIV transmission in the country. This focus, however, neglects populations that may be at very high risk of HIV infection. Men who have sex with men (MSM) are one such population.
This paper documents the initiation and operation of a health service targeting MSM in Cape Town, with a view to understanding the particular dynamics and processes that have contributed to its success thus far.
Methods: This is a process paper describing the initiation, implementation, and management of a dedicated sexual health service targeting MSM in Cape Town. It is based on focused discussions with the various people involved in implementing the service, and available documentation of this process.
Results: The service has been operating for six months and has provided support to over 200 patients. There are important lessons arising from this project.
These include:
1. Services should be sited in areas where they are visible and accessible to the target population.
2. Hiring staff who are familiar with the local context and its particular social dynamics may increase the likelihood of the project's success.
3. Creating an environment where men feel comfortable is of key importance.
4. The local MSM community is extremely diverse and prevention and health care messaging need to be appropriate to specific communities.
Conclusions: Given the necessity of implementing health services targeting populations that are at increased risk of HIV infection, the successful operation of this service provides important lessons and insights that may be useful in the initiation of similar projects in other areas.
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