Abstract
ObjectiveTo explore the views and experiences of providing assistance and treatment of sexually transmitted infections to same-sex practicing male clients among service providers at pharmacies and drugstores in Dar es Salaam, Tanzania. Previous research suggests that sexually transmitted infections are an increasing concern for this population. Due to stigma and discrimination, men who have sex with men face limited access to treatment, which might contribute to increased self-medication. However, limited research has been conducted on the role of the pharmaceutical service provider with regards to this population in sub-Saharan Africa.MethodIn January 2016, 16 service providers at private pharmacies and drugstores with previous experience of providing services to this population were purposively selected for open-ended face-to-face interviews. The analysis was guided by the grounded theory approach.ResultsThe process that emerged was labelled “Stretching Boundaries for Pharmaceutical Responsibilities”. This reflected informants’ perceptions of themselves as being involved in a transition from having limited engagement in the care of same-sex practicing male clients to becoming regular service-providers to this group. Findings further revealed that the emotional commitment they developed for clients through this process led to a transgression of provider-client boundaries, which undermined objective decision-making when clients lacked prescription. Financial interests also emerged as an underlying motivation for providing incomplete or inaccurate drug dosages.ConclusionsFurther studies are required to better address incentives related to unregulated sale of drugs. Inter-professional networks between pharmacy and healthcare workers could support the development of targeted treatment for men who have sex with men and other key populations.
Highlights
Evidence suggests that sexually transmitted infections (STIs) constitute a growing problem for men who have sex with men (MSM) in Tanzania
Inter-professional networks between pharmacy and healthcare workers could support the development of targeted treatment for men who have sex with men and other key populations
This may be relevant to the findings of our study, as the experience of catering to MSM clients led to new approaches to service provision, which subsequently laid the foundation for becoming regular service providers to the MSM population
Summary
Evidence suggests that sexually transmitted infections (STIs) constitute a growing problem for men who have sex with men (MSM) in Tanzania. Another study conducted in Dar es Salaam found that prevalence of herpes simplex virus type 2 (HSV 2) was 40.9%, syphilis 0.11% and HBV 0.5% among the 753 MSM surveyed [2]. In our previous qualitative study from Dar es Salam, narratives revealed that participants’ experiences of discriminative actions by healthcare workers due to their sexual orientation and behaviours discouraged them from seeking healthcare services [4]. This is in line with the findings from a quantitative study in Dar es Salaam, which demonstrated that 14.8% of 200 surveyed MSM perceived stigma as an impediment to HIV services [5]
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