Experiences of care-seeking behaviour for sexually transmitted infections among gay and bisexual men: A phenomenological study
), Cecilia A. Yeboah Snr(2), Bismark Nantomah(3), Emmanuel Manu(4), Mawuli K. Kushitor(5),
(1) Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba
(2) Kwatire Government Hospital, Sunyani West Municipal Health Directorate, Odumase – Bono Region
(3) Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale
(4) Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho
(5) Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho
Corresponding Author
Abstract
Gay and bisexual men (GBM) are stigmatized in the Ghanaian society and that negatively affect their care-seeking behaviour. We sought to understand the experiences of care-seeking behaviour (CSB) for STIs among gay and bisexual men in Sunyani, capital of Bono Region, Ghana. A respondent-driven sampling was used to collect data from 17 gay and bisexual men in Sunyani based on phenomenological qualitative approach. The data were thematically analysed using the Atlas.ti software. Results were presented under various themes with appropriate accompanying excerpts. Two broad themes emerged from the data - personal and health system experiences of treating STIs. Personal experiences such as economic conditions, knowledge on STI, marital experiences and bisexual’s partner awareness of sexual orientation had influences on CSB. Experience with cost of treatment, stigmatisation by health care workers (HCW) and perceived quality healthcare were the health system factors found to influence CSB. To help improve STIs care-seeking behaviour, government need to encourage and economically empower GBM, while at the same time, improving their knowledge on STI prevention and control. The National Health Authority should intensify and monitor the implementation of the national health insurance at the private healthcare sectors without favour and discrimination for gay and bisexual men.
References
Kushwaha S, Lalani Y, Maina G, Ogunbajo A, Wilton L, Agyarko-Poku T, Adu-Sarkodie Y, Boakye F, Zhang N and Nelson LE. “But the moment they find out that you are MSM…”: A qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana’s health care system. BMC Public Health. 2017;17:770-178.
UNAIDS. Miles to go. Global AIDS update 2018.
Assi R, Hashim PW, Reddy VB, Einarsdottir H and Longo WE. Sexually transmitted infections of the anus and rectum. World J Gastroenterol. 2014 Nov 7;20(14):15262-8.
Wirtz AL, Kamba D, Jumbe V, Trapence G, Gubin R, Umar E, Strömdahl SK, Beyrer C and Baral SD. A qualitative assessment of health seeking practices among and provision practices for men who have sex with men in Malawi. BMC international health and human rights. 2014 Dec;14(1):1-1.
Act 29 of Ghana. Criminal offences Act, 1960.
Sabin L and Ashigbie P, Hollenbeck‐Pringle D, Agyarko‐Poku T, Akuoko K, Baffuor Opoku K, Adu-Sarkodie Y, Beard J, Bachman DeSilva M, Green K, Wambugu S and Ahmed ARY. Attitudes and behaviors among older MSM in Ghana. The Open AIDS Journal. 2018 Aug;12:69-80.
Ghana AIDS Commission. Ghana HIV/AIDS Strategic Framework, 2001-2005. Ghana AIDS Commission; 2001.
Epp J. Achieving health for all: A framework for health promotion. Health Promotion International. 1986 Jan;1(4):419-28.
Walsh JA and Warren KS. Selective primary health care: an interim strategy for disease control in developing countries. Social Science & Medicine. Part C: Medical Economics. 1980 Jun;14(2):145-163.
Laar A and DeBruin D. Key populations and human rights in the context of HIV services rendition in Ghana. BMC International Health and Human Rights. 2017 Dec;17(1):1-10.
Ghana Country Coordination Mechanism. Assessing the scope and effectiveness of key population interventions in the response to the HIV and AIDS Epidemic in Ghana [cited 2017]. Available online at https:// https://www.ccmghana.net/images/Funding_ Request_Development/Matching_Funds/Ghana-KP-Assessment-final7thNov2017.pdf
Dutta A, Paxton A and Kallarakal A. The costs and impacts of investing in the HIV Response in Ghana. Washington, DC: Futures Group, Health Policy Project.
Moore AR, Driver N, Owusu A and Amey F. Sexual identity and risk behaviour among men who have sex with men (MSM) in Accra, Ghana and Lomẻ, Togo. Cogent Medicine. 2017 Jan;4(1):1333696.
Arnold EA, Rebchook GM and Kegeles SM. ‘Triply cursed’: Racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men. Culture, Health & Sexuality. 2014 Jul;16(6):710-722.
My JoyOnline. Choggu Chief fines 4 suspected to be gay. Available at https://www. myjoyonline.com/choggu-chief-fines-4-suspected-to-be-gay/. (Accessed on 3rd January, 2022). 2021.
Sallar AM and Somda DAK. Homosexuality and HIV in Africa: An essay on using entertainment education as a vehicle for stigma reduction. Sexuality & culture, 2011 Feb;15 (3):279-309
Chinadaily.com.cn. 3 gays arrested in Ghana. Available at http://www.chinadaily. com.cn/world/2011-11/05/content_140432 72.htm (Accessed on 2nd January, 2022). 2011
Budhathoki SS, Pokharel PK, Good S, Limbu S, Bhattachan M and Osborne RH. The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review. BMC Health Services Research. 2017 Dec;17(1):237.
Ngo AD, Ratliff EA, McCurdy SA, Ross MW, Markham C and Pham HT. Health-seeking behaviour for sexually transmitted infections and HIV testing among female sex workers in Vietnam. AIDS Care. 2007 Aug;19(7):878-87.
O’Brien BC, Harris IB, Beckman TJ, Reed DA and Cook DA. Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine. 2014 Sep;89(9):1245-1251.
Rosenstock I. Historical Origins of the Health Belief Model. Health Education Behaviour. 1974 Aug;2(4):328–335.
Ghana Statistical Service. Population by regions: Bono. Available online at https://statsghana.gov.gh/regionalpopulation.php?population=MTMxOTU3MTAxOC44MjU=&&Bono®id=2 (Accessed on 10th July 2020). 2020.
Anarfi JK, Awusabo-Asare K and Nsowah-Nuamah NNN. Push and pull factors of international migration: Country report, Ghana, Brussels, European Commission. 1999.
Yendaw E. A study of the underlying determinants of return migration of international return migrants to the Berekum Municipality, Ghana. International Journal of Sociology and Anthropology. 2013 Sept;5(8):297-310.
Kerr C, Nixon A and Wild D. Assessing and demonstrating data saturation in qualitative inquiry supporting patient-reported outcomes research. Expert review of pharmacoeconomics & outcomes research. 2010 Jun;10(3):269-281.
Benoot C, Hannes K and Bilsen J. The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory. BMC medical research methodology. 2016 Dec;16(1):21.
Miles MB and Huberman AM. Qualitative data analysis: An expanded sourcebook (2nd Ed.). USA: Sage Publications Inc. 1994.
Marshall C and Rossman GB. Designing qualitative research. USA: Sage publications. 2014.
Doody O and Doody CM. Conducting a pilot study: Case study of a novice researcher. British Journal of Nursing. 2015 Nov;24(21):1074-1078.
Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qualitative Research. 2001 Jan;1(3):385-405.
Fereday J and Muir-Cochrane E. Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods. 2006 Mar;5(1):80-92.
Khandkar SH. Open coding. University of Calgary. 2009 Oct;23:2009.
Cassol H, Pétré B, Degrange S, Martial C, Charland-Verville V, Lallier F, Bragard I, Guillaume M and Laureys S. Qualitative thematic analysis of the phenomenology of near-death experiences. PloS ONE. 2018 Feb;13(2):e0193001.
Syed M and Nelson SC. Guidelines for establishing reliability when coding narrative data. Emerging Adulthood. 2015 Dec;3(6):375-387.
Abubakari GM, Nelson LE, Ogunbajo A, Boakye F, Appiah P, Odhiambo A, Sa T, Zhang N, Ngozi I, Scott A, Maina G, Manu A and Torpey K. Implementation and evaluation of a culturally grounded group-based HIV prevention programme for men who have sex with men in Ghana. Glob Public Health. 2021
Ghana Aids Commission. (2017). National and sub-national HIV and AIDS estimates and projections. Available at on https://www.ghanaids.gov.gh/mcadmin/Uploads/ 20172022_national_and_sub%20national_Estimates_Report(1).pdf. (Accessed 23rd July, 2021). 2017.
Creswell JW and Poth CN. Qualitative inquiry and research design choosing among five approaches (4th Ed.). US: SAGE Publications, Inc., Thousand Oaks. 2018.
Burns N, Grove S and Gray J. The practice of nursing research. Appraisal, synthesis, and generation of evidence (7th Ed.). St Louis: Saunders Elsevier. 2012.
Azhar N and Doss JG. Health-seeking behaviour and delayed presentation of oral cancer patients in a developing country: A qualitative study based on the self-regulatory model. Asian Pacific Journal of Cancer Prevention: APJCP. 2018;19(10):2935.
Musinguzi G, Anthierens S, Nuwaha F, Van Geertruyden JP, Wanyenze RK and Bastiaens H. Factors influencing compliance and health seeking behaviour for hypertension in Mukono and Buikwe in Uganda: A qualitative study. International Journal of Hypertension. 2018 Apr;2018.
Ali M and De Muynck A. Illness incidence and health seeking behaviour among street children in Rawalpindi and Islamabad, Pakistan–a qualitative study. Child: Care, Health and development. 2005 Sep;31(5):525-532.
Letsyo E, Jerz G, Winterhalter P and Beuerle T. Toxic pyrrolizidine alkaloids in herbal medicines commonly used in Ghana. Journal of ethnopharmacology. 2017 Apr;202:154-161.
Thompson AE, Anisimowicz Y, Miedema B, Hogg W, Wodchis WP and Aubrey-Bassler K. The influence of gender and other patient characteristics on health care-seeking behaviour: A QUALICOPC study. BMC Family Practice. 2016 Dec;17(1):38.
Backman AS, Blomqvist P, Lagerlund M, Carlsson–holm E and Adami J. Characteristics of non-urgent patients: Cross-sectional study of emergency department and primary care patients. Scandinavian Journal of Primary Health Care. 2008 Jan;26(3):181-187.
Sallar AM and Somda DA. Homosexuality and HIV in Africa: An essay on using entertainment education as a vehicle for stigma reduction. Sexuality & culture. 2011 Sep;15(3):279-309.
Otchere YO. Masculine Gender Role Conflict and its Psycho-Social Correlates: A Study among Homosexual Men in Ghana. Doctoral dissertation, University of Ghana. 2014.
Antwi S and Zhao X. A logistic regression model for Ghana National Health Insurance claims. International Journal of Business and Social Research (IJBSR). 2012 Dec;2(7):139-47.
Fenny AP, Asante FA, Enemark U and Hansen KS. Treatment-seeking behaviour and social health Insurance in Africa: The case of Ghana under the National Health Insurance Scheme. Global Journal of Health Science. 2015 Jan;7(1):296.
Koester KA, Collins SP, Fuller SM, Galindo GR, Gibson S and Steward WT. Sexual healthcare preferences among gay and bisexual men: a qualitative study in San Francisco, California. PLoS ONE. 2013 Aug;8(8):e71546.
Musoke D, Boynton P, Butler C and Musoke MB. Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda. African Health Sciences. 2014;14(4):1046-1055.
Afolabi MO, Daropale VO, Irinoye AI and Adegoke AA. Health-seeking behaviour and student perception of
health care services in a university community in Nigeria. Health. 2013;5:817-824.
Mahmood SS, Iqbal M and Hanifi SM. Health-seeking behaviour. Health for the Rural Masses. 2009;67.
Barrientos J, Silva J, Catalan S, Gómez F and Longueira J. Discrimination and victimization: Parade for lesbian, gay, bisexual, and transgender (LGBT) pride, in Chile. Journal of homosexuality. 2010 Jun;57(6):760-775.
Rispel LC, Metcalf CA, Cloete A, Moorman J and Reddy V. You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities. Journal of Public Health Policy. 2011 Jun;32(1):S137-151.
Albuquerque GA, de Lima Garcia C, da Silva Quirino G, Alves MJH, Belém JM, dos Santos Figueiredo FW, da Silva Paiva L, do Nascimento VB, da Silva Maciel E, Valenti VE, de Abreu LC and Adami F. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC International Health and Human Rights. 2016 Dec;16(1):2.
Müller A. Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa. BMC international health and human rights. 2017 Dec;17(1):16.
Bamfo BA and Dogbe CS. Factors influencing the choice of private and public hospitals: Empirical evidence from Ghana. International Journal of Pharmaceutical and Healthcare Marketing. 2017 Apr;0054.
Article Metrics
Abstract View
: 930 times
Download : 358 times
Refbacks
- There are currently no refbacks.
