Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria.
Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria.
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DOI：
10.1007/s10508-020-01644-8
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发表时间：
2021-05
影响因子：
3.8
通讯作者：
TRUST/RV368 Study Group
中科院分区：
文献类型：
--
作者：
Kokogho A;Amusu S;Baral SD;Charurat ME;Adebajo S;Makanjuola O;Tonwe V;Storme C;Michael NL;Robb ML;Ake JA;Nowak RG;Crowell TA;TRUST/RV368 Study Group
男男性行为者（MSM）和跨性别女性（TGW）披露同性性行为可能有助于适当的医疗保健参与，包括艾滋病毒和其他性传播感染（STI）的风险评估，以及与合作伙伴协商使用避孕套。然而，披露也可能产生耻辱感。在这些横断面分析中，MSM和TGW根据在入组阿布贾和尼日利亚拉各斯的TRUST/RV 368综合艾滋病毒和性传播感染护理计划研究时向家庭成员和医疗保健提供者（HCP）披露的自我报告进行分类。多变量泊松回归模型与稳健的误差方差被用来估计相对风险的披露与95%的置信区间。皮尔森卡方检验被用来比较避孕套的使用和耻辱的披露状态指标。在回答有关披露的基线问题的2557名参与者中，384名（15.0%）曾向家庭成员披露，733名（28.7%）曾向HCP披露，其中192名（7.5%）曾向双方披露。高等教育，流行的艾滋病毒感染，并在拉各斯居住的每一个与披露给家人和HCP的可能性增加。老年参与者更有可能向HCP而不是家人透露。与未披露的参与者相比，向家人或HCP披露的参与者更有可能报告在肛交期间使用避孕套以及感知和经历的耻辱，包括医疗回避，勒索，攻击和性暴力。在安全空间内改进披露做法可能会加强男男性行为者和女同性恋者在医疗保健和艾滋病毒预防服务中的参与。本文的在线版本（10.1007/s10508-020-01644-8）包含补充材料，可供授权用户使用。
Disclosure of same-sex sexual practices by men who have sex with men (MSM) and transgender women (TGW) may facilitate appropriate healthcare engagement, including risk assessment for HIV and other sexually transmitted infections (STIs), and negotiation of condom use with partners. However, disclosure may also generate stigma. In these cross-sectional analyses, MSM and TGW were categorized based on self-report of disclosure to family members and healthcare providers (HCP) at enrollment into the TRUST/RV368 study of comprehensive HIV and STI care programs in Abuja and Lagos, Nigeria. Multivariable Poisson regression models with robust error variance were used to estimate relative risk of disclosure with 95% confidence intervals. Pearson’s chi-squared test was used to compare condom use and stigma indicators by disclosure status. Of 2557 participants who answered baseline questions about disclosure, 384 (15.0%) had ever disclosed to a family member and 733 (28.7%) to HCP, including 192 (7.5%) who disclosed to both. Higher education, prevalent HIV infections, and residence in Lagos were each associated with increased likelihood of disclosure to family and HCP. Older participants were more likely to disclose to HCP but not family. Participants who made a disclosure to family or HCP were more likely to report condom use during anal sex as well as perceived and experienced stigma that included healthcare avoidance, blackmail, assault, and sexual violence as compared to participants who had not disclosed. Improved disclosure practices within safe spaces may enhance engagement of MSM and TGW in healthcare and HIV prevention services. The online version of this article (10.1007/s10508-020-01644-8) contains supplementary material, which is available to authorized users.
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影响因子：
15.8
作者：
Beyrer C
通讯作者：
Beyrer C
影响因子：
22.4
作者：
Chaudoir, Stephenie R.;Fisher, Jeffrey D.
通讯作者：
Fisher, Jeffrey D.
影响因子：
168.9
作者：
Beyrer, Chris;Baral, Stefan D.;van Griensven, Frits;Goodreau, Steven M.;Chariyalertsak, Suwat;Wirtz, Andrea L.;Brookmeyer, Ron
通讯作者：
Brookmeyer, Ron
DOI：
10.1097/qai.0000000000000439
发表时间：
2015-03-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Charurat ME;Emmanuel B;Akolo C;Keshinro B;Nowak RG;Kennedy S;Orazulike I;Ake J;Njoku O;Baral S;Blattner W;TRUST Study Group
通讯作者：
TRUST Study Group
影响因子：
3.7
作者：
Ibiloye, Olujuwon;Decroo, Tom;Agada, Peter
通讯作者：
Agada, Peter