The Synergistic Impact of Sexual Stigma and Psychosocial Well-Being on HIV Testing: A Mixed-Methods Study Among Nigerian Men who have Sex with Men.

Journal: AIDS and behavior

Volume: 22

Issue: 12

Year of Publication: 2019

Affiliated Institutions:  Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. crodriguezhart@health.nyc.gov. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. International Center on Advocacy and Rights to Health, Abuja, Nigeria. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. School of Public Health, University of Maryland, College Park, MD, USA. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.

Abstract summary 

Although sexual stigma has been linked to decreased HIV testing among men who have sex with men (MSM), mechanisms for this association are unclear. We evaluated the role of psychosocial well-being in connecting sexual stigma and HIV testing using an explanatory sequential mixed methods analysis of 25 qualitative and 1480 quantitative interviews with MSM enrolled in a prospective cohort study in Nigeria from March/2013-February/2016. Utilizing structural equation modeling, we found a synergistic negative association between sexual stigma and suicidal ideation on HIV testing. Qualitatively, prior stigma experiences often generated psychological distress and perceptions of feeling unsafe, which decreased willingness to seek services at general health facilities. MSM reported feeling safe at the MSM-friendly study clinic but still described a need for psychosocial support services. Addressing stigma and unmet mental health needs among Nigerian MSM has the potential to improve HIV testing uptake.

Authors & Co-authors:  Rodriguez-Hart Cristina C Bradley Cory C German Danielle D Musci Rashelle R Orazulike Ifeanyi I Baral Stefan S Liu Hongjie H Crowell Trevor A TA Charurat Man M Nowak Rebecca G RG

Study Outcome 

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Statistics
Citations :  Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20:1447–50.
Authors :  11
Identifiers
Doi : 10.1007/s10461-018-2191-5
SSN : 1573-3254
Study Population
Men
Mesh Terms
Adult
Other Terms
HIV testing;Latent class analysis;Men who have sex with men;Mental health;Stigma;Suicidal ideation
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Quantitative,Qualitative,Mixed Methods
Country of Study
Niger
Publication Country
United States