Background
Client receiving services at Clinica de Familia La Romana with health providers Riqui Rosario and Dr. Wendy Galvez. Photo: Carol Brito
Clínica de Familia (Family Clinic) began its Comprehensive Health Program for Men in May 2014. “As a community health clinic providing services to vulnerable populations in the eastern Dominican Republic, we realized that there was a large unmet need for men´s health services,” says Clínica de Familia Executive Director Mina Halpern. “This was particularly evident among both the participants of a male circumcision study conducted at the Clinic, as well as by the very limited numbers of men from key populations seeking services at our Clinic.”
In just five months, the Clinic has recruited more than 100 men ranging in age from 16 to 61, including men who are clients of sex workers and men who have sex with men, thanks to an effective collaboration with Grupo Este Amor. “We have defied the conventional wisdom here in La Romana,” Mina Halpern went on to say. “Everyone said that a health program for men would be a failure, because men only go to the doctor when they are very sick. We have shown that with education and
outreach, men will come to the clinic for check-ups.”
The Program
Medical consultations take place two afternoons per week, including during the clinic’s extended hours, in order to provide greater accessibility of this service to men working during regular business hours. During the medical consultations, an extensive medical history is taken and a physical exam is conducted. Any participants exhibiting any symptoms of a sexually transmitted infection (STI) are tested and treated. Regardless of symptoms, all participants receive syphilis and HIV counseling and testing every three months, as a routine part of the program’s services.
In addition, program participants have access to the clinic’s psycho-social support services, including counseling with a professional psychologist, adherence counseling (for those who are diagnosed with HIV and start antiretroviral therapy), social work services, and health promoters. The clinic staff also provides individualized education on risk reduction and STIs, and participants are provided with educational materials, condoms, and lubricant at the end of their visit. Any men who are diagnosed with HIV are immediately enrolled in the Clinic’s HIV program.
The Clinic conducts periodic client satisfaction interviews with program participants, in order to understand their experiences in the program, better meet their needs, and improve the quality of the service. Acceptability of the intervention by the male clients has been very high. The program creates an open dialogue between providers and clients that helps the Clinic staff respond to the specific needs of the individual.
As a result, the program´s clients have helped promote the program with their friends, motivating other participants. José, one of the very first clients of the program, was so satisfied with the services he received that he has brought in five of his closest friends, to make sure that they receive care as well.
“I was treated with respect by the doctor and other staff at the Clinic, and the counselor helped talk me through my fears about getting an HIV test,” says José. “When I received my results, we talked about what I needed to do to stay HIV-negative. I wanted to make sure my friends got the same information.”
The Clinic has created promotional materials, including posters, fliers, and coupons, and has also produced a radio advertisement about the importance of getting medical check-ups, which is played by DJs at brothels, gyms, barber shops, and other places where men hang out, in order to motivate men to come to the clinic.
These initiatives, in addition to work of both Clinic and Este Amor health promoters, have brought men into the clinic that have not been to a doctor since their visits to the pediatrician as children. Without a doubt, Clínica de Familia’s Comprehensive Health Program for Men is helping to ensure that the men who are highest risk for acquiring HIV and other STIs have access to unique, high quality, male-friendly health services in the eastern Dominican Republic.
