Exploring factors that affect uptake of water-based lubricants and male condoms among men who have sex with men in Salima District, Malawi
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Date
2022-03-01
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Abstract
Men who have sex with men (MSM) are at high risk of contracting HIV due to several factors, both biological and social. They form an underserved population in terms of getting support for both HIV prevention and treatment due to so many factors that make them vulnerable. Key to HIV prevention among MSM is the correct and consistent use of water-based lubricants and condoms. However, studies have shown MSM are still underserved and lack access to prevention commodities. As such, there is low uptake of lubricants and condoms among the population due to several factors that need contextualization for them to be addressed.
The goal of this study was therefore, to explore factors that influence uptake of condoms and lubricants among MSM. Specially, the study aimed at classifying the identified factors into either facilitators or barrier of uptake.
A phenomenological qualitative study was implemented to inquire the living experiences of MSM in relation to access and use of condoms and lubricants. Data was collected focus group discussions and in-depth interviews. Participants were sampled through snowballing and purposive sampling.
The study found three main factors affecting uptake of condoms and lubricants; availability, accessibility, knowledge and perceptions on condom and lubricant use. These are largely influence by a contingent of other underlying factors that are categorized into five domains: structural, physical, cultural, socioeconomic, and legal. All these taken from a different angle can be either facilitators or barriers of uptake. Notable underlying factors affecting uptake of these commodities among MSM included poverty, relationship between MSM and health service providers, distance to selling or access points of the commodities, stigma and discrimination, cultural, traditional, and religious beliefs among others.
The study concurred with other studies that the main factors are availability, accessibility, and knowledge on importance of using the commodities and appropriate use, which are affected by various underlying factors. Lubricants are not available in the mainstream health system and there is need to consider starting stocking at different levels to enhance and localize accessibility and use.