Assessing the association of stigma and HIV service and prevention uptake among men who have sex with men and transgender women in South Africa.

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Title: Assessing the association of stigma and HIV service and prevention uptake among men who have sex with men and transgender women in South Africa.
Authors: Brown, Carolyn A., Siegler, Aaron J., Zahn, Ryan J., Valencia, Rachel K., Sanchez, Travis, Kramer, Michael R., Phaswana-Mafuya, Nancy Refilwe, Stephenson, Rob, Bekker, Linda-Gail, Baral, Stefan D., Sullivan, Patrick S.
Source: AIDS Care. Oct2023, Vol. 35 Issue 10, p1497-1507. 11p. 4 Charts, 1 Graph.
Subjects: HIV infection epidemiology, HIV prevention, Statistics, Health services accessibility, Trans women, Human sexuality, Social stigma, Medical care, Surveys, Descriptive statistics, Research funding, Sexual orientation identity, Sex customs, Scale analysis (Psychology), Men who have sex with men, Data analysis software, Health equity, Logistic regression analysis, Psychology of HIV-positive persons, Gay people, Longitudinal method
Geographic Terms: South Africa
Abstract: HIV prevention for gay, bisexual, and other men who have sex with men (GBMSM) and transgender women (TGW) is critical to reducing health disparities and population HIV prevalence. To understand if different types of stigma impact engagement with HIV prevention services, we assessed associations between stigmas and use of HIV prevention services offered through an HIV prevention intervention. This analysis included 201 GBMSM and TGW enrolled in a prospective cohort offering a package of HIV prevention interventions. Participants completed a baseline survey that included four domains of sexual identity/behavior stigma, HIV-related stigma, and healthcare stigma. Impact of stigma on PrEP uptake and the number of drop-in visits was assessed. No domain of stigma was associated with PrEP uptake. In bivariate analysis, increased enacted sexual identity stigma increased number of drop-in visits. In a logistic regression analysis constrained to sexual identity stigma, enacted stigma was associated with increased drop-in visits (aIRR = 1.30, [95% CI: 1.02, 1.65]). Participants reporting higher enacted stigma were modestly more likely to attend additional services and have contact with the study clinics and staff. GBMSM and TGW with higher levels of enacted stigma may seek out sensitized care after negative experiences in their communities or other healthcare settings. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:HIV prevention for gay, bisexual, and other men who have sex with men (GBMSM) and transgender women (TGW) is critical to reducing health disparities and population HIV prevalence. To understand if different types of stigma impact engagement with HIV prevention services, we assessed associations between stigmas and use of HIV prevention services offered through an HIV prevention intervention. This analysis included 201 GBMSM and TGW enrolled in a prospective cohort offering a package of HIV prevention interventions. Participants completed a baseline survey that included four domains of sexual identity/behavior stigma, HIV-related stigma, and healthcare stigma. Impact of stigma on PrEP uptake and the number of drop-in visits was assessed. No domain of stigma was associated with PrEP uptake. In bivariate analysis, increased enacted sexual identity stigma increased number of drop-in visits. In a logistic regression analysis constrained to sexual identity stigma, enacted stigma was associated with increased drop-in visits (aIRR = 1.30, [95% CI: 1.02, 1.65]). Participants reporting higher enacted stigma were modestly more likely to attend additional services and have contact with the study clinics and staff. GBMSM and TGW with higher levels of enacted stigma may seek out sensitized care after negative experiences in their communities or other healthcare settings. [ABSTRACT FROM AUTHOR]
ISSN:09540121
DOI:10.1080/09540121.2023.2175770