“I told myself, be bold and go and test”: Motivators and barriers to HIV testing among gays, bisexuals, and all other men who sex with men in Ghana – West Africa

Abstract

Limited evidence from Ghana and SSA shows that despite consistently a disproportionately high burden of HIV, GBMSM infrequently often delay testing until the point of illness. We therefore used qualitative interviews to collect insights of experiences, motivators, and barriers to HIV testing among GBMSM. Two community-based organizations used snowball and convenience sampling to recruit 10 MSM for IDIs and 8 to 12 for FGDs. We transcribed, coded, identified and analyzed the relationship and commonalities between the participants' responses. Under experiences with testing, 1) fear of HIV infection created a stressful HIV testing experience; and 2) friendly and supportive healthcare environment facilitated a positive experience in healthcare facilities. Motivators or facilitators of testing include: 1) the perception or belief that HIV testing is a HIV prevention strategy; 2) encouragement from friends and peers; 3) understanding risk associated with certain sexual behaviors such as transactional sex 4) education or information on HIV; 5) access to free testing and incentives; 6) early symptoms and provider recommendation. Barriers to HIV testing include: 1) negative community perceptions of HIV deter; 2) individual-level low risk perception or indifference about HIV infection; 3) location and cost; 4) inadequate testing availability; 5) Stigma at Healthcare facilities. The findings point to the need to address important issues around stigma, education, peer support and healthcare resources through interventions and research to improve HIV testing among GBMSM in the country.

“One pastor advised him to stop taking HIV medication”: Promoters and barriers to HIV care among gay, bisexual, and men who have sex with men living with HIV in Ghana

“…Stigma remains the most salient factor that hinders adherence to care among GBMSM [9]- [12], [28]. Our ndings show that stigma from HCF, as broadly reported elsewhere, and from family members and the community serve as barriers to the use of HIV services, including ART [9], [29]- [31]. Our participants reechoed sentiments from participants in the few available studies on HIV care among GBMSM in Ghana that point to the fear of being seen at the healthcare facility as a barrier to HIV care [12], [22], [32].…”

“…Also, recent studies in Ghana show that GBMSM prefer HIV testing from friendly providers and other GBMSM-led organizations to avoid stigma [10], [31]. Thus, interventions are urgently needed that address healthcare-level sexual and HIV stigma and promote a safe and friendly HIV care environment for GBMSM.…”

Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums: A clustered randomized control trial protocol.

“…In Ghana, the HIV epidemic continues to pose signi cant public health challenges, particularly among gay, bisexual, and other men who have sex with men (GBMSM) [1][2][3][4][5][6][7][8][9][10][11][12][13] . Contributing to less than 2% of Ghana's population, the HIV prevalence of this key population surpasses the national average by more than eightfold, emphasizing the need for targeted interventions to improve early detection, care linkage, and reduce community transmission [14][15][16] .…”