Abstract

ObjectivesTo explore the attitudes that medical students in Haiti harbour toward Men who have Sex with Men living with HIV in order to better understand how stigma and other factors may impair healthcare, and to explore suggestions of opportunities in line with the values of social accountability. MethodsThis study employed a qualitative design by using a grounded theory approach regarding the context of Haiti. We used purposive sampling to select the 22 research participants. In-depth interviews were conducted, audio-recorded, transcribed and analyzed using an inductive content analysis approach. ResultsAlthough stigmatizing attitudes emerged through the findings, medical students expressed willingness to provide Men who have Sex with Men with adequate health services in relation to HIV care. Their expressions were based on the Men who have Sex with Men's comprehensive right to receive equitable care, the moral responsibility of healthcare professionals, their perception of health disparities and the HIV global risk reduction. Participants pointed out that the medical education curriculum did not consider sexual health and specificities of sexual minorities and suggested a more inclusive and socially accountable training based on equity and quality. ConclusionsThe students expressed favourable attitudes regarding health services to Men who have Sex with Men even though some layered stigmatizing attitudes emerged through the discussions. They all lacked skills on how to handle health specificities of sexual minorities. These findings recommend a revision of the medical education curriculum in regard to social accountability principles.

Highlights

  • Advances in scientific understanding of HIV prevention and treatment by the global health community, government and civil society organizations have made it possible to control the epidemic.[1]

  • We sought to assess the attitude of medical students towards Men who have Sex with Men (MSM) living with HIV based on an inductive approach, which provided the framework for data analysis.[26,27]

  • Data was collected through in-depth interviews from the 22 participants selected. We explored their personal views on people living with HIV (PLHIV) in general, their attitudes regarding MSM living with HIV, their willingness to provide care for them, their experiences with MSM in the clinical settings, and suggestions towards provision of sexual healthcare targeting and appropriate for MSM

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Summary

Introduction

Advances in scientific understanding of HIV prevention and treatment by the global health community, government and civil society organizations have made it possible to control the epidemic.[1] To achieve the goal of ending HIV by 2030, targets have been set by the United Nations for HIV diagnosis and care continuum. In Haiti, a country of the Caribbean, which is the most affected region after Africa, prevention and treatment strategies implemented in collaboration with international organizations and donors have contributed to reducing the national HIV prevalence from 6.2% in 1993 to 2% in 2018. According to a survey conducted and published by the United Nations, the HIV prevalence among MSM was 18.2% in 2017, making them the most underserved population in terms of HIV prevention and care.[4,5,6]

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