Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria
2020/03/19 by Afoke Kokogho, Senate Amusu, Stefan Baral +14 · 18 citations
Psychology · Medicine · Social Sciences · #LGBTQ Health, Identity, and Policy #HIV/AIDS Research and Interventions #African Sexualities and LGBTQ+ Issues
paper · pdf · doi:10.1007/s10508-020-01644-8
Abstract
Disclosure of same-sex sexual practices by men who have sex with men (MSM) and transgender women (TGW) may facilitate appropriate healthcare engagement, including risk assessment for HIV and other sexually transmitted infections (STIs), and negotiation of condom use with partners. However, disclosure may also generate stigma. In these cross-sectional analyses, MSM and TGW were categorized based on self-report of disclosure to family members and healthcare providers (HCP) at enrollment into the TRUST/RV368 study of comprehensive HIV and STI care programs in Abuja and Lagos, Nigeria. Multivariable Poisson regression models with robust error variance were used to estimate relative risk of disclosure with 95% confidence intervals. Pearson's chi-squared test was used to compare condom use and stigma indicators by disclosure status. Of 2557 participants who answered baseline questions about disclosure, 384 (15.0%) had ever disclosed to a family member and 733 (28.7%) to HCP, including 192 (7.5%) who disclosed to both. Higher education, prevalent HIV infections, and residence in Lagos were each associated with increased likelihood of disclosure to family and HCP. Older participants were more likely to disclose to HCP but not family. Participants who made a disclosure to family or HCP were more likely to report condom use during anal sex as well as perceived and experienced stigma that included healthcare avoidance, blackmail, assault, and sexual violence as compared to participants who had not disclosed. Improved disclosure practices within safe spaces may enhance engagement of MSM and TGW in healthcare and HIV prevention services.
Citations
Cited by
- HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV: a cross-sectional analysis at enrollment into an observational cohort. [europepmc]
- From general to specific: moving past the general population in the HIV response across sub-Saharan Africa. [europepmc]
- Retention of a cohort of men who have sex with men and transgender women at risk for and living with HIV in Abuja and Lagos, Nigeria: a longitudinal analysis. [europepmc]
- The Role of Contextual Factors in the Health Care Utilization of Aging LGBT Adults. [europepmc]
- Associations between punitive policies and legal barriers to consensual same-sex sexual acts and HIV among gay men and other men who have sex with men in sub-Saharan Africa: a multicountry, respondent-driven sampling survey. [europepmc]
- Correlates of self-reported and biomarker based adherence to daily oral HIV pre-exposure prophylaxis among a cohort of predominantly men who have sex with men in Nigeria. [europepmc]
- "What if I get sick, where shall I go?": a qualitative investigation of healthcare engagement among young gay and bisexual men in Nairobi, Kenya. [europepmc]
- Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa. [europepmc]
- Community stigma, victimization, and coping strategies among gay, bisexual, and other cis-gender men who have sex with men in slum communities in Ghana. BSGH-003. [europepmc]
- Healthcare access and barriers to utilization among transgender and gender diverse people in Africa: a systematic review. [europepmc]
- Measuring sexual behavior stigma among cisgender men who have sex with men: an assessment of cross-country measurement invariance. [europepmc]
- Impact of Age of Sexual Debut on HIV Care Engagement Among Sexual and Gender Minorities in Nigeria. [europepmc]
- Othering and Marginalizing the "Queer" in Rwanda: Findings from Public Perceptions and Lived Experiences of LGBT People. [europepmc]
- Strengthening anal cancer prevention in Abuja, Nigeria: Identifying barriers and potential strategies to improve training. [europepmc]
- Oral human papillomavirus and HIV: A cross-sectional study among men with same-sex sexual contact in Nigeria. [europepmc]
- A qualitative study of the ecology of stigma experiences - An application of the ecological model to stigma experiences of trans-women from Ghana. BSGH019. [europepmc]
- “What if I get sick, where shall I go?”: a qualitative investigation of healthcare engagement among young gay, bisexual and other men who have sex with men in Nairobi, Kenya [europepmc]
- “We must help them despite who they are…”: Healthcare providers’ attitudes and perspectives on care for tertiary student men who have sex with men in Nairobi, Kenya [europepmc]
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