Increase of office visits registered and STI cases detected after the inclusion of member from the MSM community: a new outpatient clinic model to provide MSM-tailored health services
1Universidad Peruana Cayetano Heredia, Unidad de Salud, Sexualidad y Desarrollo Humano, Lima, Peru, 2Centro de Salud 'Alberto Barton', Callao, Peru
Background: Stigma and discrimination faced by gay men, transvestite, bisexual and other groups of men who have sex with men (MSM) in health facilities are a barrier for access to comprehensive care. Such barriers arise mostly from unfriendly health care systems, uncommitted health care providers and reluctance of non-health staff to guide old and new potential clients of the ongoing system. The inclusion of Peer Educators from the MSM Community into the labor force and working system of a Referral STI Center might shorten these barriers.
Methods: Observational retrospective time-series ecological study. Comparison of the number of office visits by MSM as well as the number of STI cases diagnosed annually during 2008-2009 at Alberto-Barton Health Center in Callao, Peru.
Results: 3 Peers members from MSM community were included into the clinic model by mid-2009. Functions covered by them included: nursing, pharmacy, bio-safety and medical records archiving. Recorded comparisons and absolute increases for 2008 vs. 2009 included: Office visits (1201 vs. 1495, 20% absolute increase), syphilis (36 cases vs. 58, 38%), genital ulcer (69 vs. 101, 31%), and HIV (71 vs. 108, 35%). Overall, STI prevalence increased from 3%, 6% and 6% in 2008, to 4%, 7% and 7% in 2009 for each STI respectively.
Conclusions: Findings suggest integration of Peer-MSMs into the care providing system contributed to boost coverage and STI detection in MSM populations served by this new model clinic. This model might prove useful not only for detection and treatment of new STI cases but also for offering complimentary services beyond sexual health, such as counseling, general medical and dental care or even legal support. New opportunities for care, prevention and community strengthen should also be considered. Future further and more robust evaluations over extended periods of time are still needed but these preliminary findings are encouraging.
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