Young Africans’ representations of the origins of same-sex attraction and implications for sexual and mental health

Winskell, Kate; Sabben, Gaëlle; Pruitt, Kaitlyn L.; Allen, Kristi; Findlay, Trinity; Stephenson, Rob

doi:10.1080/13691058.2016.1225820

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…Health inequalities extend to conditions of socioeconomic disadvantage and social isolation, and are directly linked to poorer health (Braveman et al, 2011; Commission on the Social Determinants of Health, 2008). The lack of laws penalizing same-sex sexual behavior or criminalizing LBW identities is insufficient to counter persistent cultural stigmatization (Winskell et al, 2017). Proactive laws protecting LBW from hate crimes and discrimination are needed to signal systemic governmental support for LBW and other sexual minority and gender diverse people.…”

Section: Discussionmentioning

confidence: 99%

Trauma, mental health, and health care experiences of lesbian and bisexual women in Rwanda.

Hughes¹,

Riggle²,

Moreland³

et al. 2023

Psychology of Sexual Orientation and Gender Diversity

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Lesbian and bisexual women (LBW), regardless of where they live in the world, are at increased risk for traumatic experiences and negative mental health sequelae. LBW in Rwanda are an underresearched, at-risk population group that likely experiences substantial trauma associated with their sexual identity (and in some cases their nontraditional gender presentation). We interviewed 20 Rwandan LBW about their stressful and traumatic experiences, perceptions of their mental health, and their experiences with health care providers. Thematic analyses revealed multiple traumatic and stress ful experiences related to harassment, violence, and abuse, including rape and other forms of sexual violence; marriage to a male partner (forced or chosen); rejection or abandonment by family and friends; and being forced to break up or end a relationship with a female partner. Participants reported feelings of stress, sadness, hopelessness, and depression; suicidal thoughts; and social isolation. While a few participants reported positive experiences with health care providers, many reported concealing their sexual identity from health care providers or experiencing discrimination-factors that limited receipt of needed care. These results suggest a need for expanded systemic support for lesbian and bisexual women, and the broader sexual and gender minority community in Rwanda. Cultural acceptance and legal protections, as well as enhanced training opportunities for health providers is recommended. Public Significance StatementFindings from this study, based on interviews with 20 women in Rwanda who identified as lesbian or bisexual, suggest that traumatic experiences are common and have substantial impact on health and well-being. Although health care was reported to be generally available, these women felt the need to conceal their sexual identity to avoid discrimination in health care settings, which limits opportunities to receive needed care. Cultural acceptance, legal protections, and professional training are needed to better serve this population (and the broader sexual and gender minority community) and support their health and well-being.

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Section: Discussionmentioning

confidence: 99%

Trauma, mental health, and health care experiences of lesbian and bisexual women in Rwanda.

Hughes¹,

Riggle²,

Moreland³

et al. 2023

Psychology of Sexual Orientation and Gender Diversity

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“…To date, the few studies on the mental health of sexual minority individuals in Africa have been conducted largely among adults, with a focus on men who have sex with men48–53. A paucity of African studies have focused on adolescent sexual minority individuals 54–56…”

Section: Discussionmentioning

confidence: 99%

“…A paucity of African studies have focused on adolescent sexual minority individuals. [54][55][56] In our cohort of adolescents living in Nigeria, approximately one-third identified as sexual minority individuals. While this estimate may be exaggerated from participant sampling and the self-report method, there are no data available on the proportion of sexual minority individuals in Nigeria that may otherwise help with the weighting of these data.…”

Section: Bmj Global Healthmentioning

confidence: 96%

Associations between mental health and HIV status among sexual minority and heterosexual adolescents in Nigeria

et al. 2022

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BackgroundWe aimed to determine associations between the mental health status of adolescents by self-reported sexual identity; and to determine associations between the mental health status of sexual minority adolescents living with and without HIV.MethodsThis cross-sectional study collected data from Nigerians aged 13–19 years old using an online survey. We collected information on dependent (sexual identity) and independent (presence of depressive symptoms, generalised anxiety disorder, suicidal attempt/ideation, HIV status) study variables. A multivariate regression model determined associations between the dependent and independent variables. A second multivariate regression model was developed to establish associations between HIV status among sexual minority individuals and the dependent variables. All models were adjusted for age, sex assigned at birth and education level.ResultsAmong 1247 respondents living in Nigeria, 497 (39.9%) identified as sexual minority individuals. Compared with their heterosexual peers, sexual minority adolescents had significantly higher odds of reporting depressive symptoms (adjusted OR (AOR): 5.54; 95% CI: 4.10 to 7.47; p<0.001), high general anxiety (AOR: 3.56; 95% CI: 2.64 to 4.79; p<0.001) and history of suicidal attempt/ideation (AOR: 2.95; 95% CI: 2.20 to 3.94; p<0.001). Sexual minority adolescents living with HIV had significantly higher odds of high general anxiety (AOR: 2.42; 95% CI: 1.21 to 4.84; p=0.013), while those with unknown HIV status had significantly higher odds of depressive symptoms (AOR: 3.82, 95% CI: 2.78 to 5.27; p<0.001), high general anxiety (AOR: 3.09; 95% CI: 2.29 to 4.17; p<0.001) and suicidal attempt/ideation (AOR: 1.65; 95% CI: 1.22 to 2.24; p=0.001).ConclusionSexual minority adolescents reported poorer mental health status than heterosexual adolescents. Although there was no significant difference in the mental health status of sexual minority adolescents living and not living with HIV, sexual minority adolescents with unknown HIV status reported worse mental health than their HIV-negative peers. Sexual minority adolescents in Nigeria need comprehensive rights-based care that improves access to mental health services, and those with unknown HIV status may need both HIV and mental health screening and care.

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“…In contrast to experts, lay participants also viewed contagion and heredity to work jointly in the development of podoconiosis. While podoconiosis is a disease where apparent wound oozing might logically raise these concerns, contagion beliefs about other conditions such as epilepsy and same-sex attraction also are well documented in LMICs (Herrmann et al 2016; Winskell et al 2016). Findings suggest that contagion beliefs are difficult to override and may not be responsive to standard health education strategies (Curtis 2011).…”

Section: Discussionmentioning

confidence: 99%

“…However, experts noted this to be inherited, whereas lay participants viewed weakened immunity as a susceptibility factor that was not inherited but a result of harsh living conditions. Recently, there have been efforts to engage individuals who have understandings that align with expert knowledge standards in story-writing competitions (Winskell et al 2016). These stories are then used to augment health education interventions by contextualizing and contrasting with widely accepted lay perceptions.…”

Section: Discussionmentioning

confidence: 99%

Applying mental model methods to characterize understanding of gene-environment influences: the case of podoconiosis in Ethiopia

Allen

McBride

Engdawork

et al. 2017

Critical Public Health

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The rapid pace of genomic discovery has raised public expectation and concerns about the utility of new discoveries and their potential to exacerbate health disparities. Improving literacy concerning gene and environmental (GxE) contributors to disease is needed to avoid commonly observed deterministic misconceptions about genomics. Mental models approaches that incorporate community engagement processes could be used to inform GxE literacy-building interventions. We used a mental models approach to describe and systematically compare expert and lay understanding of GxE interactions, using the example of podoconiosis, a non-infectious lymphedema endemic in highland Ethiopia. Methods included: (1) specifying elicitation questions for a literature review, (2) eliciting an expert model, (3) eliciting a lay model, and (4) comparing the two models. We used a coding scheme to identify lay participants’ knowledge gaps, misunderstandings and extra knowledge relative to the expert standard. Results indicated that lay participants’ viewed poverty as an important susceptibility factor and considered heredity and contagion to have a joint causal influence. Experts did not endorse either of these viewpoints. Conventional expert-based interventions aimed to correct misconceptions about behaviors important for prevention may be stymied by lay views that social environmental factors have more important influences on health outcomes. GxE literacy interventions that consider multiple levels of influence including social determinants of health and personal resilience to augment health education strategies are needed in diverse settings. Novel communication approaches will be needed to help target audiences disentangle long-held conceptions of heredity and contagion.

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Young Africans’ representations of the origins of same-sex attraction and implications for sexual and mental health

Cited by 9 publications

References 19 publications

Trauma, mental health, and health care experiences of lesbian and bisexual women in Rwanda.

Trauma, mental health, and health care experiences of lesbian and bisexual women in Rwanda.

Associations between mental health and HIV status among sexual minority and heterosexual adolescents in Nigeria

Applying mental model methods to characterize understanding of gene-environment influences: the case of podoconiosis in Ethiopia

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