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. 2021 Dec 3;21(1):2206.
doi: 10.1186/s12889-021-12151-3.

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

John Mark Wiginton  1 , Sarah M Murray  2 , Ohemaa Poku  2 , Jura Augustinavicius  2 , Kevon-Mark Phillip Jackman  2 , Jeremy Kane  3 , Serge C Billong  4 , Daouda Diouf  5 , Ibrahima Ba  5 , Tampose Mothopeng  6 , Iliassou Mfochive Njindam  7   8 , Gnilane Turpin  7   8 , Ubald Tamoufe  8 , Bhekie Sithole  9 , Maria Zlotorzynska  10 , Travis H Sanchez  10 , Stefan D Baral  7
Affiliations

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

John Mark Wiginton et al. BMC Public Health. .

Erratum in

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.

Keywords: Disclosure; Healthcare stigma; Men who have sex with men; Sub-Saharan Africa.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Disclosure of same-sex practices among MSM in SSA (by country), 2014–2016 (N = 3040). MSM, men who have sex with men; SSA, sub-Saharan Africa; HCW, healthcare worker
See this image and copyright information in PMC

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