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Table 1 Examples of goals, successes and challenges in engaging with MSM communities

From: Public/community engagement in health research with men who have sex with men in sub-Saharan Africa: challenges and opportunities

Examples of goals of engagement Suggestions based on field experience Examples of issues and challenges
Research
• Better designed and implemented studies (questions, ways of working, benefits, CE) • Include diverse representatives of key populations in a range of interactions in designing studies, how they are implemented and feedback
• Community representative groups such as CABs/Gs may be considered as a key channel of engagement
• Ensure all research team members and CE partners understand the research and CE goals, limits and messages
• If/how to engage those who choose not to be identified? Risk failing to engage with those who do not feel represented by self-proclaimed ‘representatives’
• Potential to breach confidentiality and exacerbating risk in interactions with representatives
• Should CAB/Gs include non-MSM representatives? If not, should separate CAB/Gs be established to engage with other community members? (Table 2)
Public health
• Improved health and well-being for MSM • Improved health and well-being for general communities As above and
• Provide evidence to support MSM-friendly policy change
• Providing MSM-specific access to healthcare with MSM friendly staff
• Where possible, provide services to a wider range of community members than currently access services, and do not make access to such services dependent on research participation
• Lobby (through networks) for health policy change to support improved health and well-being for MSM as important part of general community
• Link with LGBT organisations to refer to services beyond medical research and care
As above and
• Key messages about health research involving MSM not carefully worded and understood by all research team members can be stigmatising for MSM
• Activities can contribute to MSM discrimination by targeting MSM communities as specific beneficiaries of interventions that many others would appreciate; such activities also separate and make more visible MSM from other community members
• Activities may be interpreted as promotion of homosexuality, exacerbating MSM discrimination
Human rights/social justice
• Advocating for legal changes
• Empowerment of MSM individuals and communities
As above and
• Lobby for specific health and social rights of MSM
• Hire LGBT staff
• Provide training about LGBT issues to all staff and healthcare providers
As above and
• Failure to act may result in tokenistic research agendas and contribute to structural violence
• May need to operate covertly to ensure safety of participants and operations
  1. CAB/G, Community advisory boards/groups; CE, Community engagement; GMT, Gay-Other MSM-Transgender; LGBT, Lesbian, gay, bisexual, and transgender; MSM, Men who have sex with men.