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

被引：35

作者：

Rodriguez-Hart, Cristina ^{[1
,2
]}

Bradley, Cory ^{[2
]}

German, Danielle ^{[2
]}

Musci, Rashelle ^{[3
]}

Orazulike, Ifeanyi ^{[4
]}

Baral, Stefan ^{[5
]}

Liu, Hongjie ^{[6
]}

Crowell, Trevor A. ^{[7
,8
]}

Charurat, Man ^{[1
]}

Nowak, Rebecca G. ^{[1
]}

机构：

[1] Univ Maryland, Sch Med, Inst Human Virol, Baltimore, MD 21201 USA

[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Behav & Soc, Baltimore, MD 21205 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA

[4] Int Ctr Advocacy & Rights Hlth, Abuja, Nigeria

[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[6] Univ Maryland, Sch Publ Hlth, College Pk, MD 20742 USA

[7] Walter Reed Army Inst Res, US Mil HIV Res Program, Silver Spring, MD USA

[8] Henry M Jackson Fdn Adv Mil Med, Bethesda, MD USA

来源：

AIDS AND BEHAVIOR | 2018年 / 22卷 / 12期

基金：

美国国家卫生研究院;

关键词：

Men who have sex with men; Stigma; Latent class analysis; HIV testing; Suicidal ideation; Mental health; COGNITIVE-BEHAVIORAL THERAPY; HEALTH; MSM; INTERVENTIONS; GAY; POPULATIONS; PREVENTION; DEPRESSION; PREJUDICE; KNOWLEDGE;

D O I：

10.1007/s10461-018-2191-5

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

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.

引用

页码：3905 / 3915

页数：11

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