Men who have sex with men in Kenya face stigma and discrimination in healthcare settings, which is a critical barrier to accessing HIV services. Healthcare worker bias is a documented driver of this inequity. This study evaluated the impact of a structured stigma-reduction training programme for healthcare workers on the perceived quality of HIV services for men who have sex with men at public health facilities in Mombasa, Kenya. A mixed-methods, pre-post intervention study was conducted. Healthcare workers from six facilities received multi-session training based on human rights and clinical competency principles. Data were collected via anonymous client exit interviews with men who have sex with men and in-depth interviews with a subset of trained healthcare workers. Quantitative data assessed changes in perceived respect, confidentiality, and willingness to return. Qualitative data explored healthcare worker experiences and attitude shifts. Quantitative data showed a significant improvement in clients' overall satisfaction, with those reporting feeling 'very respected' increasing from 32% to 58% post-intervention. Qualitative analysis revealed a key theme of increased healthcare worker self-awareness of unconscious bias and the adoption of more neutral, professional language during consultations. The stigma-reduction training led to measurable improvements in clients' experiences of HIV services. Addressing healthcare worker attitudes through targeted training is a feasible strategy to enhance service quality for this key population. Integrate sustained, mandatory stigma-reduction modules into continuous professional development for healthcare workers in public health systems. Programmes should combine rights-based education with practical clinical scenarios for managing diverse sexual health needs. HIV, stigma, healthcare workers, men who have sex with men, Kenya, service quality, training This study provides evidence for the effectiveness of a targeted training intervention in improving healthcare experiences for men who have sex with men in a Kenyan public health setting, informing policy on health worker education and stigma reduction.
Natalie James (Mon,) studied this question.