The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States.
The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States.
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DOI：
10.2196/publichealth.5824
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发表时间：
2016-07-26
影响因子：
8.5
通讯作者：
Baral, Stefan David
中科院分区：
文献类型：
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作者：
Stahlman, Shauna;Sanchez, Travis Howard;Baral, Stefan David
背景技术背景：作为人类免疫缺陷病毒（艾滋病毒）综合预防和治疗方案的一部分，人们越来越关注减少男同性恋者和其他男男性行为者（MSM）性行为相关耻辱的必要性。然而，大多数专注于测量和减轻耻辱感的研究都是在高收入环境中进行的，由于缺乏跨环境的一致性指标，因此对这些研究结果的可转移性的描述能力提出了挑战。这些分析的目的是描述美国性行为耻辱的流行程度，并使用一致的指标比较南部和西部非洲以及美国MSM之间性行为耻辱的流行率。在2013年至2016年从7个撒哈拉以南非洲国家的多项研究中招募的4285名男男性行为者和2015年美国男性互联网调查中招募的2590名男男性行为者进行了面对面访谈，AMIS），一项基于网络的匿名行为调查。我们将研究样本限制在过去12个月内至少与男性发生过一次肛交的男性以及18岁及以上的男性。未经调整和调整的患病率被用来比较患病率的耻辱groups.RESULTS：在美国，患病率的性行为耻辱没有显着不同的种族/民族或地理区域，除了在少数情况下。害怕寻求医疗保健，逃避医疗保健，感觉警察拒绝保护，被勒索和被强奸在美国农村比城市更常见（P
BACKGROUND: There has been increased attention for the need to reduce stigma related to sexual behaviors among gay men and other men who have sex with men (MSM) as part of comprehensive human immunodeficiency virus (HIV) prevention and treatment programming. However, most studies focused on measuring and mitigating stigma have been in high-income settings, challenging the ability to characterize the transferability of these findings because of lack of consistent metrics across settings.OBJECTIVE: The objective of these analyses is to describe the prevalence of sexual behavior stigma in the United States, and to compare the prevalence of sexual behavior stigma between MSM in Southern and Western Africa and in the United States using consistent metrics.METHODS: The same 13 sexual behavior stigma items were administered in face-to-face interviews to 4285 MSM recruited in multiple studies from 2013 to 2016 from 7 Sub-Saharan African countries and to 2590 MSM from the 2015 American Men's Internet Survey (AMIS), an anonymous Web-based behavioral survey. We limited the study sample to men who reported anal sex with a man at least once in the past 12 months and men who were aged 18 years and older. Unadjusted and adjusted prevalence ratios were used to compare the prevalence of stigma between groups.RESULTS: Within the United States, prevalence of sexual behavior stigma did not vary substantially by race/ethnicity or geographic region except in a few instances. Feeling afraid to seek health care, avoiding health care, feeling like police refused to protect, being blackmailed, and being raped were more commonly reported in rural versus urban settings in the United States (P