Blueprint for the provision of comprehensive care to gay men and other men who have sex with men (MSM) in Latin America and the Caribbean

This publication, published by the Pan American Health Organisation (PAHO), is a guide for clinicians and health administrators in Latin America and the Caribbean (LAC) Region countries, in both the formal health sector as well as within specialised men who have sex with men (MSM) health clinics. It is intended to strengthen the ability of health care providers to address the distinct health needs of gay men and other MSM within the context of health promotion and health care delivery.

The authors argue that, in part due to ignorance, stigma, and homophobia, health services, including primary health care, typically have not been adequately responsive to the health needs of gay men and other MSM in the LAC Region. Specifically, the formal health sector, including Ministries of Health and Social Security Administrations, often lack personnel with expertise in the diverse health needs of gay men and other MSM populations. Conversely, health centers designed to serve diverse MSM often lack resources to provide the full array of needed services and may benefit from strengthening their core health services.

In light of the above realities, the authors contend that a more practical and in turn effective approach may be to expand coverage for young and adult men at large, and in the context of comprehensive male health care services. These services could incorporate strategic orientations, actions, and interventions that are essential for MSM. This requires careful service design to ensure that:

• providers are aware that the user of the service may require some specific attention because of his sexual activities, orientation, and/or identity.
• providers are familiar with a set of corealgorithms for the management of the most common health (including mental) care concerns and needs of MSM.
• users of male health care services perceive and recognise these spaces as safe, supportive, and inclusive.
• user needs are met through comprehensive approaches that include educational interventions, laboratory examinations, and referral to other appropriate services.
• services are open to the diversity that existswithin the male population.