“We feel like a nuisance and a disturbance, so we don’t want to make any noise.” The Patient Charter exists, but we don’t know the document. We don’t know what our rights are. We don’t question.” “When I got PREP at PSI, she never explained to me what the side effects would be. And how do you hold someone accountable when you don’t know what to hold them accountable for?” “It was also like that for me at PSI. When I went for PREP, they asked me to write down my partners name and details, and my next of kin. I didn’t want to do that – I’m not out – but I wanted PREP, and I didn’t ask why they wanted those details.” It is evident, however, that the management of health facilities desire better engagement, more closely connected, more frequently. This represents an important opportunity to systematise and institutionalise accountability that facilitates clearer communication, better relationship and improved shared ownership of the system for health. “We would like to work more with the gays, the lesbians, the trans people but we are not seeing as many as we would hope here at PSI. We would like to go there to them sometimes to offer testing and other services. Possibly they don’t know they can come here for a stigmafree service.” “More engagement would help. We want to engage with them more on a personal level and on a managerial level. We could even arrange a half day or a whole day workshop, so we become more aware of their needs.” “We want to know them. We want to engage them. And right now our engagement is not enough.” “We need their feedback. If we are not doing enough, we need to hear it.” PERCEPTIONS, PERSPECTIVES Access to facility-based health services for LGBT people in Harare & Bulawayo, Zimbabwe: A Situational Analysis 40