THAE0403 | HEALTHCARE PREFERENCES AND BARRIERS AMONG SEXUAL AND GENDER MINORITY PERSONS IN KAYUNGA AND MUKONO DISTRICTS, UGANDA

Isaac Gulemye, Linia Kansiime | Anchoring Communities Uganda, Mukono, Uganda

Sexual and gender minority (SGM) individuals in Uganda face numerous challenges in accessing healthcare services. Understanding their preferences between public and private health facilities is crucial for improving healthcare delivery in the Kayunga and Mukono districts. A cross-sectional study was conducted between November and December 2024 in the Kayunga and Mukono districts of Uganda. A sample of 186 SGM individuals (94 female-identifying, 92 male-identifying) was recruited using a snowballing approach. Data on healthcare preferences and reasons for these preferences were collected. Statistical analysis was performed using SPSS version 26 to determine associations. The majority of participants preferred private clinics (n=124, 66.7%) over public health facilities despite the potentially higher costs. Reasons for this preference included proximity (χ²(1)=105.12, p<0.001), perceived better quality of care (χ²(1)=145.35, p<0.001), and reliability (χ²(1)=121.78, p<0.001). However, a significant proportion (n=159, 85.5%) reported that essential services such as Pre-Exposure Prophylaxis (PrEP) were not available at private clinics. Furthermore, SGM persons were significantly less likely to seek services at faith-based Private Not-For-Profit (PNFP) health facilities (χ²(1)=118.46, p<0.001), and among those who would consider PNFP facilities (n=17), a large majority (n=15, 90.3%) indicated they would not disclose their SGM status (χ²(1)=10.59, p=0.001). Despite the higher cost and limited availability of specific services like PrEP, SGM individuals in Kayunga and Mukono districts predominantly prefer private clinics due to perceived advantages in proximity, quality, and reliability. The significant reluctance to utilize and disclose their status at PNFP facilities highlights a critical barrier. We recommend strengthening the capacity of private clinics to offer comprehensive services, including PrEP, and implementing sensitization programs within PNFP facilities to foster a more inclusive and accepting environment for SGM individuals, thereby improving.