Awareness and Willingness to use Condoms and Preexposure Prophylaxis among Gay, Bisexual, and Other Cisgendered Men who Have sex with men in Slum Communities in Ghana. BSGH-004

Abstract

Introduction: Research has begun to examine human immunodeficiency virus (HIV) prevention strategies within the Ghanaian context. Still, little is known about specific populations such as gay, bisexual, and other cisgender men who have sex with men (GBMSM) living in slum communities. We studied HIV prevention strategies such as condoms and preexposure prophylaxis (PrEP) in slum communities and the awareness and willingness to use these choices among GBMSM. This qualitative study examines HIV prevention strategies, specifically examining PrEP and condom use behaviors among GBMSM in Ghana. Methods: We conducted in-depth face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi cities in Ghana. Data were analyzed through a summative content analysis with multiple reviewers to develop codes. Data were collected from participants in January 2022. Results: We found the fear and perceived risk of infection were motivators for consistent condom use, especially during anal sex. GBMSM living with HIV receiving antiretroviral therapy were more inclined to use condoms. We found motivations for using PrEP were influenced by the type of sexual activity and a history of negative HIV status. Also, the barriers to PrEP for GBMSM included limited access to healthcare facilities and the distance to these facilities. Conclusions: To improve condom and PrEP access and uptake, we recommend addressing structural barriers by increasing the number of health facilities and implementing targeted interventions to address the lack of information on HIV awareness and prevention. Involving peer educators may also effectively promote HIV prevention strategies, especially in communities with limited access to healthcare such as slums. Overcoming these access constraints could significantly enhance awareness and prevention of HIV, leading to improved health outcomes for GBMSM living in slum communities.

“I’m scared of the nurses telling other people I am a transwoman”: Disclosure and nondisclosure of gender identity among trans women in Ghana’s urban slums– BSGH010

“…Drivers and Facilitators of stigma for trans women could show in traditional gender norms, lack of education, religious and cultural beliefs, lack of support systems from family, friends and community, and discriminatory laws and policies among others (55). For trans women in Ghana, the social and gender norms, the legal legislation, and cultural norms in the country exacerbate the negative experiences they face by identifying as separate from the dominant heterosexual beliefs in Ghana (35)(36)(37)41). Together, drivers and facilitators determine how stigma markers are applied, which may lead to stigmatizing experiences for trans women, consequentially encouraging the concealment of gender identity (5,57), social exclusion (58, 59), discrimination (5,7,10), and gossip at healthcare facilities (60).…”

“…Currently, Ghana's legislative environment has been unfavorable to LGBTQI + individuals (35)(36)(37)(38)(39)(40)(41). Laws, such as the "unnatural carnal knowledge" provision in the Ghanaian Criminal Code Amendment Act of 2003, criminalizes same-sex conduct (36,42,43).…”

“…This study focuses on urban slum communities, recognizing unique challenges in these areas due to limited infrastructure, inadequate healthcare facilities, substandard housing, and limited transportation and educational resources (50-54). Living in such contexts increases the likelihood of adverse health outcomes, particularly for LGBTQ + individuals, who face additional barriers to accessing healthcare (32,(35)(36)(37)41). For trans women in these communities, there's an elevated risk of encountering unsupportive attitudes from healthcare professionals, exacerbating existing challenges (32,(35)(36)(37)41).…”

“…Living in such contexts increases the likelihood of adverse health outcomes, particularly for LGBTQ + individuals, who face additional barriers to accessing healthcare (32,(35)(36)(37)41). For trans women in these communities, there's an elevated risk of encountering unsupportive attitudes from healthcare professionals, exacerbating existing challenges (32,(35)(36)(37)41).…”

Adolescent HIV Prevent and Care Framework: A Global Scoping Review Protocol-BSGH 006

“…HIV stigma and sex stigma in some communities deter adolescents from accessing HIV care 29,30 . Additionally, the side effects of HIV medications can affect adherence as they can affect adolescents' ability and willingness to consistently take their prescribed Antiretrovirals [31][32][33] . Determining appropriate antiretroviral (ART) dosages for sustained suppression in adolescents is challenging [34][35][36] .…”