Associations between resilience, self-esteem, HIV status, and sexual identity among residents in Nigeria

Abstract

BackgroundResilience and self-esteem are personal attributes that may moderate the complex psychosocial outcomes associated with HIV infection. The aim of this study was to determine the associations between resilience, self-esteem, HIV status and sexual identity of adolescents and adults in Nigeria. MethodsThis was a sub-study of a large country wide cross-sectional study that recruited a participants 13 years and above between September and October 2020 using an online survey. Data on sociodemographic characteristics (age, sex at birth, educational status, marital and employment status); sexual identity (heterosexual, lesbian, gay bisexual); HIV status (positive, negative, unknown); self-esteem and resilience were extracted. Two multiple linear regression models were built to determine associations between dependent variables (resilience and self-esteem) and independent variables (HIV status and sexual identity). The sociodemographic characteristics were adjusted as confounders in the analyses. ResultsThere were 2772 complete responses of which 170 participants (6.1%) reported being HIV positive and 1271 (45.9%) identified as sexual minority individuals. Respondents who were sexual minority individuals had significantly lower resilience (B: -3.61, p < 0.001) and lower self-esteem (B: -1.22, p < 0.001) when compared with the heterosexual group Also, respondents who self-identified as HIV positive had significantly lower resilience (B: -2.65, p < 0.001) and lower self-esteem (B: -0.92, p < 0.001). In addition, having an unknown HIV status was associated with significantly lower resilience (B: -2.35, p < 0.001) and lower self-esteem (B: -0.86, p < 0.001). ConclusionResilience and self-esteem appear to be lower among adolescents and adults in Nigeria who are sexual minority individuals, HIV positive or who do not know their HIV status. These populations need to be identified and their resilience self-esteem built to improve their wellbeing.