HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV: a cross-sectional analysis at enrollment into an observational cohort

Tiamiyu, Abdulwasiu Bolaji; Lawlor, John; Hu, Fengming; Kokogho, Afoke; Charurat, Manhattan; Ekeh, Charles Maduabuchi; Robb, Merlin L.; Adebajo, Sylvia; Eluwa, George I.; Ake, Julie A; Baral, Stefan; Nowak, Rebecca G.; Crowell, Trevor A

doi:10.1186/s12889-020-09315-y

Cited by 12 publications

(7 citation statements)

References 32 publications

(48 reference statements)

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“…Fourteen articles13 68–80 were partially intersectional stigma studies incorporating an intersectional approach to some elements of the analysis or presentation of their findings. We also identified 10 articles81–90 that studied multiple stigmas in a non-intersectional manner and 142 articles4 13 16–18 21 51 52 91–224 that studied one stigma in one population of SGM or studied one stigma in each of multiple populations (eg, SSSAB stigma only among MSM and transgender stigma only among TGW). A summary of each intersectional stigma study (n=21) appears in online supplemental file 2 and a summary of each non-intersectional stigma study (n=152) appears in online supplemental file 3.…”

Section: Resultsmentioning

confidence: 99%

Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Dada,

Abu-Ba’are,

Turner

et al. 2024

BMJ Open

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ObjectivesSexual and gender minority (SGM) populations in sub-Saharan Africa (SSA) are disproportionately impacted by HIV and often face multiple HIV-related stigmas. Addressing these stigmas could reduce SGM HIV vulnerability but little is known about how the stigmas operate and intersect. Intersectional stigma offers a lens for understanding the experiences of stigmatised populations and refers to the synergistic negative health effects of various systems of oppression on individuals with multiple stigmatised identities, behaviours or conditions. This review aims to (1) assess how often and in what ways an intersectional lens is applied in HIV-related stigma research on SGM populations in SSA and (2) understand how intersectional stigma impacts HIV risk in these populations.DesignScoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.Data sourcesPublic health and regional databases were searched in 2020 and 2022.Eligibility criteriaArticles in French and English on HIV-related stigma and HIV outcomes among men who have sex with men, women who have sex with women and/or transgender individuals in SSA.Data extraction and synthesisArticles were screened and extracted twice and categorised by use of an intersectional approach. Study designs and stigma types were described quantitatively and findings on intersectional stigma were thematically analysed.ResultsOf 173 articles on HIV-related stigma among SGM in SSA included in this review, 21 articles (12%) applied an intersectional lens. The most common intersectional stigmas investigated were HIV and same-sex attraction/behaviour stigma and HIV, same-sex attraction/behaviour and gender non-conformity stigma. Intersectional stigma drivers, facilitators and manifestations were identified across individual, interpersonal, institutional and societal socioecological levels. Intersectional stigma impacts HIV vulnerability by reducing HIV prevention and treatment service uptake, worsening mental health and increasing exposure to HIV risk factors.ConclusionIntersectional approaches are gaining traction in stigma research among SGM in SSA. Future research should prioritise quantitative and mixed methods investigations, diverse populations and intervention evaluation.

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Section: Resultsmentioning

confidence: 99%

Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Dada,

Abu-Ba’are,

Turner

et al. 2024

BMJ Open

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“…Of these, only the 87 studies containing qualitative data or behavioral quantitative data referring to recent sexual relationships of MSM with women were selected for the present synthesis [26–118]. Details of selected studies are presented in Supplementary File 2, http://links.lww.com/QAD/D49.…”

Section: Resultsmentioning

confidence: 99%

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Fiorentino,

Yanwou,

Gravier-Dumonceau Mazelier

et al. 2024

Aids

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In sub-Saharan Africa (SSA), MSM – a high HIV prevalence group – experience strong social stigma and pressure to have female partners. Accordingly, they could constitute a bridging group for HIV transmission to cisgender women. We developed a multilevel summary of MSM sexual behaviors and risk with women in various SSA regions. Following PRISMA guidelines, we conducted a mixed-method systematic review of data of sex with women in MSM in SSA. We performed meta-analyses on quantitative data (i.e. percent of recent sex and condomless sex with women) for each SSA region (when proportions reported in ≥4 studies). Pooled proportions were calculated using random-effects models. Qualitative data were analyzed using the three-step thematic synthesis methodology. The pooled proportion of MSM who had sex with women was 58% (33–83%) in East Africa (in the previous 3 months), and 27% (13–48%) in Southern Africa and 50% (95% CI 39–62%) in West Africa (in the previous 6 months); 23% (16–32%) of MSM in West Africa had condomless sex with a woman (during the most recent encounter). Approximately one quarter of MSM had recent multiple female partners. MSM reported having sex with women because of heteronormative pressure, erotic/romantic attraction, or financial needs leading to transactional sex. MSM may act as a bridging population to women in SSA, as they commonly practice sex with women and risky sexual behaviors with them. HIV programmes and community-based support for MSM should be adapted to this population to reduce this risk.

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“…Previous research has also identified HIV status disclosure as important in promoting treatment adherence, immune recovery, and viral suppression [34][35][36]. PWH who disclose to their family can have medications out in the home and available for taking, rather than having to hide and, therefore, potentially forget to take, the medications [37]. Additionally, some limited literature suggests that community or facilitybased treatment support may promote better outcomes, including retention in care and viral suppression [38], although more research in this area is needed.…”

Section: Discussionmentioning

confidence: 99%

Achieving the 3rd 95 in sub-saharan Africa: application of machine learning approaches to predict viral failure

Esber

Dear

King

et al. 2023

Aids

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Objective: Viral failure in people living with HIV (PLWH) may be influenced by multiple socio-behavioral, clinical, and context-specific factors, and supervised learning approaches may identify novel predictors. We compared the performance of two supervised learning algorithms to predict viral failure in four African countries. Design: Cohort study Methods: The African Cohort Study is an ongoing, longitudinal cohort enrolling PLWH at 12 sites in Uganda, Kenya, Tanzania, and Nigeria. Participants underwent physical examination, medical history-taking, medical record extraction, socio-behavioral interviews, and laboratory testing. In cross-sectional analyses of enrollment data, viral failure was defined as a viral load ≥1000 copies/mL among participants on antiretroviral therapy (ART) for at least six months. We compared the performance of lasso-type regularized regression and random forests by calculating area under the curve (AUC) and used each to identify factors associated with viral failure; 94 explanatory variables were considered. Results: Between January 2013 and December 2020, 2,941 PLWH were enrolled, 1,602 had been on ART for at least 6 months, and 1,571 participants with complete case data were included. At enrollment, 190 (12.0%) had viral failure. The lasso regression model was slightly superior to the random forest in its ability to identify PLWH with viral failure (AUC: 0.82 vs 0.75). Both models identified CD4 count, ART regimen, age, self-reported ART adherence and duration on ART as important factors associated with viral failure. Conclusion: These findings corroborate existing literature primarily based on hypothesis-testing statistical approaches and help to generate questions for future investigations that may impact viral failure.

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HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV: a cross-sectional analysis at enrollment into an observational cohort

Cited by 12 publications

References 32 publications

Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Achieving the 3rd 95 in sub-saharan Africa: application of machine learning approaches to predict viral failure

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