Abstract
BackgroundThere have been several barriers in effectively engaging men who have sex with men for STI/HIV prevention and treatment programming in Nigeria including social stigma, policies, and laws criminalizing same-sex practices. The objective of this study was to describe the human rights context for MSM in Abuja and characterize factors associated with having had a genital ulcer disease in the previous 12 months, a health outcome associated with increased risk of HIV acquisition and transmission.MethodsA convenience sample of 297 men reporting ever having had anal intercourse with another man participated in the study in 2008. A structured survey instrument including sexual risk behaviour for STI/HIV, disclosure of sexual orientation, perceived and enacted human rights violations were performed. Descriptive and inferential data analyses were conducted using Stata11 software.Results36% reported having been discriminated due to sexual orientation and 17% reported being afraid to walk the streets of their community. Enacted rights violations included 41% having been blackmailed, 36% been beaten, 13% been denied housing, and 11% been jailed due to sexual orientation. Having been blackmailed due to sexual orientation (aOR 3.40, 95%CI: 1.35–8.56) was significantly associated with reporting having had a genital ulcer in the last 12 months. Having been beaten due to sexual orientation (aOR 2.36, 95%CI:0.96–5.82) was moderately significantly associated with reporting having had a genital ulcer in the last 12 months.ConclusionsHigh levels of experienced stigma, discrimination and human rights violations among MSM in Abuja was reported, constituting structural risks that are linked to sexual risk behaviour for STI/HIV. Given data on the high prevalence and incidence of HIV among MSM in Abuja, these findings reinforce the need for structural interventions to mediate access to STI/HIV prevention and treatment services.
Highlights
There have been several barriers in effectively engaging men who have sex with men for sexually transmitted infections (STI)/HIV prevention and treatment programming in Nigeria including social stigma, policies, and laws criminalizing same-sex practices
The 2014 Integrated Biological and Behavioural Surveillance Study (IBBSS) among men who have sex with men (MSM) estimated HIV prevalence to be 22.9%, an increase compared to the IBBSS 2010 that reported a HIV prevalence of 17.2% [10, 11]
Socio-demographic characteristics of the study population Table 1 describes the characteristics of the 297 MSM who participated in the study
Summary
There have been several barriers in effectively engaging men who have sex with men for STI/HIV prevention and treatment programming in Nigeria including social stigma, policies, and laws criminalizing same-sex practices. Strömdahl et al BMC International Health and Human Rights (2019) 19:7 reported increases in the arrests of gay men and other MSM in Nigeria [7]. The 2014 Integrated Biological and Behavioural Surveillance Study (IBBSS) among MSM estimated HIV prevalence to be 22.9%, an increase compared to the IBBSS 2010 that reported a HIV prevalence of 17.2% [10, 11]. These estimates are about five times higher than the HIV prevalence in the general population [12, 13]
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