Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries

Abstract Background For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma. Methods We performed mixed-effec...

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Autores principales:	John Mark Wiginton, Sarah M. Murray, Ohemaa Poku, Jura Augustinavicius, Kevon-Mark Phillip Jackman, Jeremy Kane, Serge C. Billong, Daouda Diouf, Ibrahima Ba, Tampose Mothopeng, Iliassou Mfochive Njindam, Gnilane Turpin, Ubald Tamoufe, Bhekie Sithole, Maria Zlotorzynska, Travis H. Sanchez, Stefan D. Baral
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Disclosure Healthcare stigma Men who have sex with men Sub-Saharan Africa Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/e1053613b59242a3b5e8339fb02658cb
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spelling	oai:doaj.org-article:e1053613b59242a3b5e8339fb02658cb2021-12-05T12:09:33ZDisclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries10.1186/s12889-021-12151-31471-2458https://doaj.org/article/e1053613b59242a3b5e8339fb02658cb2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12151-3https://doaj.org/toc/1471-2458Abstract Background For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma. Methods We performed mixed-effects regressions on pooled data from MSM in Cameroon, Senegal, Côte d’Ivoire, Lesotho, and eSwatini to assess associations between disclosure and sexual behavior stigma in healthcare contexts; we used logistic regressions to analyze country-specific data. Results Compared to participants who had not disclosed to either family or HCWs, those who had disclosed only to family were more likely to have been gossiped about by HCWs (aOR = 1.70, CI = 1.18, 2.45); the association between having disclosed to family and having felt mistreated in a health center approached, but did not achieve, statistical significance (aOR = 1.56, CI = 0.94, 2.59). Those who had disclosed only to HCWs were more likely to have feared to seek health services (aOR = 1.60, CI = 1.14, 2.25), avoided health services (aOR = 1.74, CI = 1.22, 2.50), and felt mistreated in a health center (aOR = 2.62, CI = 1.43, 4.81). Those who had disclosed to both were more likely to have feared to seek health services (aOR = 1.71, CI = 1.16, 2.52), avoided health services (aOR = 1.59, CI = 1.04, 2.42), been gossiped about by HCWs (aOR = 3.78, CI = 2.38, 5.99), and felt mistreated in a health center (aOR = 3.39, CI = 1.86, 6.20). Country-specific analyses suggested that data from Cameroon drove several of these associations. Conclusions Research to determine the factors driving disclosure’s differential effect on healthcare stigma across contexts is needed. Ultimately, supportive environments enabling safe disclosure is critical to understanding HIV-acquisition risks and informing differentiated HIV-prevention, treatment, and testing services for MSM across SSA.John Mark WigintonSarah M. MurrayOhemaa PokuJura AugustinaviciusKevon-Mark Phillip JackmanJeremy KaneSerge C. BillongDaouda DioufIbrahima BaTampose MothopengIliassou Mfochive NjindamGnilane TurpinUbald TamoufeBhekie SitholeMaria ZlotorzynskaTravis H. SanchezStefan D. BaralBMCarticleDisclosureHealthcare stigmaMen who have sex with menSub-Saharan AfricaPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Disclosure Healthcare stigma Men who have sex with men Sub-Saharan Africa Public aspects of medicine RA1-1270
spellingShingle	Disclosure Healthcare stigma Men who have sex with men Sub-Saharan Africa Public aspects of medicine RA1-1270 John Mark Wiginton Sarah M. Murray Ohemaa Poku Jura Augustinavicius Kevon-Mark Phillip Jackman Jeremy Kane Serge C. Billong Daouda Diouf Ibrahima Ba Tampose Mothopeng Iliassou Mfochive Njindam Gnilane Turpin Ubald Tamoufe Bhekie Sithole Maria Zlotorzynska Travis H. Sanchez Stefan D. Baral Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
description	Abstract Background For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma. Methods We performed mixed-effects regressions on pooled data from MSM in Cameroon, Senegal, Côte d’Ivoire, Lesotho, and eSwatini to assess associations between disclosure and sexual behavior stigma in healthcare contexts; we used logistic regressions to analyze country-specific data. Results Compared to participants who had not disclosed to either family or HCWs, those who had disclosed only to family were more likely to have been gossiped about by HCWs (aOR = 1.70, CI = 1.18, 2.45); the association between having disclosed to family and having felt mistreated in a health center approached, but did not achieve, statistical significance (aOR = 1.56, CI = 0.94, 2.59). Those who had disclosed only to HCWs were more likely to have feared to seek health services (aOR = 1.60, CI = 1.14, 2.25), avoided health services (aOR = 1.74, CI = 1.22, 2.50), and felt mistreated in a health center (aOR = 2.62, CI = 1.43, 4.81). Those who had disclosed to both were more likely to have feared to seek health services (aOR = 1.71, CI = 1.16, 2.52), avoided health services (aOR = 1.59, CI = 1.04, 2.42), been gossiped about by HCWs (aOR = 3.78, CI = 2.38, 5.99), and felt mistreated in a health center (aOR = 3.39, CI = 1.86, 6.20). Country-specific analyses suggested that data from Cameroon drove several of these associations. Conclusions Research to determine the factors driving disclosure’s differential effect on healthcare stigma across contexts is needed. Ultimately, supportive environments enabling safe disclosure is critical to understanding HIV-acquisition risks and informing differentiated HIV-prevention, treatment, and testing services for MSM across SSA.
format	article
author	John Mark Wiginton Sarah M. Murray Ohemaa Poku Jura Augustinavicius Kevon-Mark Phillip Jackman Jeremy Kane Serge C. Billong Daouda Diouf Ibrahima Ba Tampose Mothopeng Iliassou Mfochive Njindam Gnilane Turpin Ubald Tamoufe Bhekie Sithole Maria Zlotorzynska Travis H. Sanchez Stefan D. Baral
author_facet	John Mark Wiginton Sarah M. Murray Ohemaa Poku Jura Augustinavicius Kevon-Mark Phillip Jackman Jeremy Kane Serge C. Billong Daouda Diouf Ibrahima Ba Tampose Mothopeng Iliassou Mfochive Njindam Gnilane Turpin Ubald Tamoufe Bhekie Sithole Maria Zlotorzynska Travis H. Sanchez Stefan D. Baral
author_sort	John Mark Wiginton
title	Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
title_short	Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
title_full	Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
title_fullStr	Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
title_full_unstemmed	Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
title_sort	disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-saharan african countries
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e1053613b59242a3b5e8339fb02658cb
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Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries

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