The Synergistic Impact of Sexual Stigma and Psychosocial Well-Being on HIV Testing: A Mixed-Methods Study Among Nigerian Men who have Sex with Men
The Synergistic Impact of Sexual Stigma and Psychosocial Well-Being on HIV Testing: A Mixed-Methods Study Among Nigerian Men who have Sex with Men
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DOI：
10.1007/s10461-018-2191-5
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发表时间：
2018-12-01
影响因子：
4.4
通讯作者：
Nowak, Rebecca G.
中科院分区：
文献类型：
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作者：
Rodriguez-Hart, Cristina;Bradley, Cory;Nowak, Rebecca G.
尽管性污名与男男性行为者（MSM）中艾滋病毒检测的减少有关，但这种关联的机制尚不清楚。我们使用解释性顺序混合方法分析了2013年3月/2016年2月/尼日利亚一项前瞻性队列研究中的25个定性访谈和1480个定量访谈，评估了社会心理健康在性耻辱和艾滋病毒检测之间的作用。利用结构方程模型，我们发现性耻感与艾滋病毒检测中的自杀意念之间存在协同负相关。从质量上讲，先前的耻辱经历往往产生心理困扰和不安全感，从而降低了在一般卫生设施寻求服务的意愿。男男性行为者报告说，在对男男性行为者友好的研究诊所感到安全，但仍然描述了对社会心理支持服务的需求。解决尼日利亚男男性行为者的耻辱感和未满足的心理健康需求，有可能提高艾滋病毒检测的接受程度。
Although sexual stigma has been linked to decreased HIV testing among men who have sex with men (MSM), mechanisms for this association are unclear. We evaluated the role of psychosocial well-being in connecting sexual stigma and HIV testing using an explanatory sequential mixed methods analysis of 25 qualitative and 1480 quantitative interviews with MSM enrolled in a prospective cohort study in Nigeria from March/2013-February/2016. Utilizing structural equation modeling, we found a synergistic negative association between sexual stigma and suicidal ideation on HIV testing. Qualitatively, prior stigma experiences often generated psychological distress and perceptions of feeling unsafe, which decreased willingness to seek services at general health facilities. MSM reported feeling safe at the MSM-friendly study clinic but still described a need for psychosocial support services. Addressing stigma and unmet mental health needs among Nigerian MSM has the potential to improve HIV testing uptake.