AI Article Synopsis
- - The study investigates the effects of stigma on healthcare access and HIV prevalence among men who sell sex (MSS) in Nigeria, emphasizing the unique challenges they face compared to other men who have sex with men (MSM).
- - Using respondent-driven sampling, researchers found that out of 1552 participants, 735 identified as MSS, who were generally younger and reported higher levels of stigma and healthcare avoidance.
- - Despite the higher stigma, HIV prevalence among MSS was not significantly different from other MSM, suggesting that tailored interventions are necessary to improve healthcare access and HIV prevention for this group.
Article Abstract
Introduction: Among men who have sex with men (MSM), men who sell sex (MSS) may be subject to increased sexual behaviour-related stigma that affects uptake of healthcare and risk of sexually transmitted infections (STIs). The objectives of this study were to characterize stigma, access to care, and prevalence of HIV among MSS in Nigeria.
Methods: Respondent-driven sampling was used to recruit MSM in Abuja and Lagos into the ongoing TRUST/RV368 study, which provides HIV testing and treatment. Detailed behavioural data were collected by trained interviewers. MSS were identified by self-report of receiving goods or money in exchange for sex with men. Poisson regression with robust error variance was used to explore the impact of sex-selling on the risk of HIV.
Results: From 12 initial seed participants, 1552 men were recruited from March 2013-March 2016. Of these, 735 (47.4%) reported sex-selling. Compared to other MSM, MSS were younger (median 22 vs. 24 years, p < 0.001) and more likely to identify as gay/homosexual (42.4% vs. 31.5%, p < 0.001). MSS were more likely to report perceived and experienced stigmas such as healthcare avoidance (27.6% vs. 21.5%, p = 0.005) and verbal harassment (39.2% vs. 26.8%, p < 0.001). Total HIV prevalence was 53.4%. After controlling for other factors, HIV prevalence among MSS was similar to that observed among other MSM (relative risk 0.94 [95% confidence interval 0.84-1.05]).
Conclusion: These data highlight increased sexual behaviour-related stigma affecting MSS, as compared with other MSM, that limits uptake of healthcare services. The distinct characteristics and risks among MSS suggest the need for specific interventions to optimize linkage to HIV prevention and treatment services in Nigeria.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515015 | PMC |
| http://dx.doi.org/10.7448/IAS.20.01.21489 | DOI Listing |
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