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

TRUST/RV368 Study Group

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3905-3915
Number of pages11
JournalAIDS and behavior
Volume22
Issue number12
DOIs
StatePublished - Jan 1 2018

Funding

Funding This work was supported by a cooperative agreement (W81XWH-11-2-0174) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the U.S. Department of Defense (DoD). This study is also supported by funds from the US National Institutes of Health under Award No. R01MH099001 and R01AI120913 and training grant T32 A1050056-12, the US Military HIV Research Program (Grant No. W81XWH-07-2-0067), Fogarty AITRP (D43TW01041), and the President’s Emergency Plan for AIDS Relief through cooperative agreement U2G IPS000651 from the HHS/ Centers for Disease Control and Prevention (CDC), Global AIDS Program with IHVN.

Keywords

  • Hiv testing
  • Latent class analysis
  • Men who have sex with men
  • Mental health
  • Stigma
  • Suicidal ideation

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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