Stigma, Social Cohesion, and HIV Risk Among Sexual and Gender Minorities in Two Cities in Zimbabwe

Abstract

Though stigma is a recognized contributor to the disproportionate HIV burden among sexual and gender minorities (SGM) in sub-Saharan Africa, data describing this association among Zimbabwean SGM are limited. We examined relationships between SGM stigma and HIV and the potential for social cohesion to moderate the association among Zimbabwean men who have sex with men, transgender women, and genderqueer individuals. Consenting participants (n = 1511) recruited through respondent-driven sampling for a biobehavioral survey in Harare and Bulawayo completed structured interviews and received HIV testing. Reported SGM stigma was common (68.9% in Harare and 65.3% in Bulawayo) and associated with HIV infection in Harare (adjusted prevalence ratio [aPR] = 1.82, 95% confidence interval [CI] = 1.27–2.62) and Bulawayo (aPR = 1.51, 95% CI = 1.15–2.00) in relative risk regression. Social cohesion did not moderate these relationships. Findings demonstrate stigma’s association with HIV vulnerability among Zimbabwean SGM, highlighting the need for stigma-mitigation to reduce HIV transmission in this population.

Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe

“…This is reflected in the results which show that those in the community-led arm had over double (OR 2.08 95% CI 1.03–4.19) the odds of HIV self-testing compared to community-based arm in high social cohesion communities. This is aligned with previous research that has found higher social cohesion to increase HIV testing [ 10 , 23 ]. Literature has suggested that increased cohesion promotes trust and community empowerment which results in behaviour change.…”

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

“…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.…”

Saúde e vulnerabilidade da população LGBT+: Uma revisão integrativa

“…Em outro momento, Miller et al (2022) comenta sobre o estigma, coesão social e risco de desenvolvimento de IST entre as minorias e, assim como já evidenciado no quadro sinóptico sendo um fator de risco, os autores salientam a importância do conhecimento dos profissionais, abastecidos de informações baseadas em evidência científica, repassadas de forma clara, ética e profissional mas além de tudo, com um olhar futurista para que o indicador de vulnerabilidade dessa população diminua a cada dia.…”