Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania


  •   Happiness P. Saronga

  •   Jackline V. Mbishi

  •   Saidah S. Bakar

  •   Switbert R. Kamazima


Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services.

Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis.

Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities.

Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

Keywords: Health care utilization, Sexuality, Sexually transmitted infections, Tanzania, Women’s health, Women who have sex with women


Koh AS, Gómez CA, Shade S, Rowley E: Sexual risk factors among self-identified lesbians, bisexual women, and heterosexual women accessing primary care settings. Sex Transm Dis 2005, 32:563–569.

Fethers K, Marks C, Mindel C, Estcourt CS: Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Inf 76345–349, 76:345–349.

Marazzo JM, Gorgos LM: Emerging sexual health issues among women who have sex with women. Curr Infect Dis Rep 2012, 14:204–211.

Bailey J V., Farquhar C, Owen C, Mangtani P: Sexually transmitted infections in women who have sex with women. Sex Transm Infect 2004, 80:244–246.

Gorgos LM, Marrazzo JM: Sexually transmitted infections among women who have sex with women. Clin Infect Dis 2011, 53(SUPPL. 3).

Hughes C, Evans A: Health needs of women who have sex with women. Bmj 2004, 328:464.

Delany-Moretlwe S, Cowan FM, Busza J, Bolton-Moore C, Kelley K, Fairlie L: Providing comprehensive health services for young key populations: Needs, barriers and gaps. J Int AIDS Soc 2015, 18:29–40.

Human Rights Watch: “Treat Us Like Human Beings” Discrimination against Sex Workers, Sexual and Gender Minorities, and People Who Use Drugs in Tanzania. 2013.

Magesa DJ, Leshabari M: Perceived barriers to access available health services among men who have sex with men in Dar es Salaam, Tanzania. Tanzan J Health Res 2017, 19:1–8.

Robert K, Maryline M, Jordan K, Lina D, Helgar M, Annrita I, Wanjiru M, Lilian O: Factors influencing access of HIV and sexual and reproductive health services among adolescent key populations in Kenya. Int J Public Health 2020, 65:425–432.

Ssekamatte T, Isunju JB, Naume M, Buregyeya E, Mugambe RK, Wanyenze RK, Bukenya JN: Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda. BMC Infect Dis 2020, 20:1–15.

NACP: Comprehensive Package of HIV Interventions for Key Population. 2014(September).


How to Cite
Saronga, H. P., Mbishi, J. V., Bakar, S. S., & Kamazima, S. R. (2021). Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania. European Journal of Clinical Medicine, 2(3), 142–145. https://doi.org/10.24018/clinicmed.2021.2.3.82