Stigma and health care among the Men with the experience Sex with men in Dhaka city

Abstract

Health care is one of the basic needs of the human being. Right to health care is recognized globally by the declaration of various international agreements .The right to health is the economic, social and cultural right to a universal minimum standard of health to which all individuals are entitled. The concept of a right to health has been enumerated in international agreements which include the Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of Persons with Disabilities. An alternative way to conceptualize one facet of the right to health is a “human right to health care.” So Men having sex with men (MSM) also deserve the right to health. But stigma plays a significant role as barrier of getting health care services. Bangladesh is a religiously rigid country, so MSM behavior in this country is publicly prohibited religiously, socially and culturally. That‟s why health care services are a crucial issue for the Men having sex with men (MSM). Here health care for the MSM is related to stigma. There are so many studies or research work internationally and nationally on HIV/AIDS related health care services and MSM. But stigma related health care service is ignored in these studies. The researcher could not found any study on this topic, that‟s why the researcher intended to make Stigma and Health care of the Men having sex with men (MSM) as the pivotal area for research. Therefore, the overall aim of this thesis was to explore the lived experiences of MSM with health care, in particular the intersection of health care related stigma with social, behavioral, and health outcomes in Dhaka city. For this thesis, data were collected via semi structured, face-to-face interviews with 73 MSM and case study on 8 MSM living in Dhaka city. Using a descriptive narrative approach, the researcher sought to address the influence of health care related stigma in the lives of these men. Results indicated that MSM participating in this study accessed health services through various agencies. MSM also experienced stigma in multiple and overlapping ways; MSM described stigmatizing experiences stemming from religious sources, communities, family and friends, and from the medical establishment. Moreover, it was revealed that homophobia and HIV-related stigma were related; participants did not differentiate between the two. Homophobia and HIV related stigma were specifically contextualized in relation to urbanity and religiosity. The results within this dissertation are intended to inform health professionals in the planning and implementation of interventions and treatments for this hidden population in Dhaka city. This exploratory thesis provides insight and contextual information for a highly stigmatized population. Lastly, this project provided urban MSM with a voice.