The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa (original) (raw)
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Background: Research suggests that men who have sex with men (MSM) often engage in high-risk sex and use illicit substances. Objective: To increase understanding of HIV knowledge and vulnerability among adolescent and young adult MSM, with a focus on alcohol and drug use and transactional sex. Methods: We conducted in-depth interviews and Focus Group Discussions (FGDs) with adolescent (aged 15-17 years) and young adult (aged 18-29 years) MSM in Kumasi, Ghana. MSM who reported recent alcohol and/or substance use or engagement in transactional sex were eligible. Questions covered HIV-related knowledge, experiences with substance-use and transactional sex, and attitudes regarding sexual risk-taking and HIV-related services. Data were analyzed thematically using NVivo 10.0 software. Results: Ninety-nine MSM participated in 44 interviews and 8 FGDs. Most were attending or had completed secondary school. HIV knowledge was high, but with major gaps. Most consumed alcohol; one-fourth used drugs. Alcohol and substances were consumed to enhance pleasure during sex with another man. Transactional sex was common and positively viewed. Half of the participants used Conclusion: As Ghana strives to achieve the UNAIDS's 90-90-90 global targets (90% of people living with HIV know their status, 90% who know their status are on sustained treatment, and 90% of those on treatment are virally suppressed), we recommend enhancing MSM-targeted prevention programs, improving care options, and increasing use of critical clinical HIV-services by ensuring that MSM receive unbiased, confidential care.
The open AIDS journal, 2018
Research suggests that men who have sex with men (MSM) often engage in high-risk sex and use illicit substances. To increase understanding of HIV knowledge and vulnerability among adolescent and young adult MSM, with a focus on alcohol and drug use and transactional sex. We conducted in-depth interviews and Focus Group Discussions (FGDs) with adolescent (aged 15-17 years) and young adult (aged 18-29 years) MSM in Kumasi, Ghana. MSM who reported recent alcohol and/or substance use or engagement in transactional sex were eligible. Questions covered HIV-related knowledge, experiences with substance-use and transactional sex, and attitudes regarding sexual risk-taking and HIV-related services. Data were analyzed thematically using NVivo 10.0 software. Ninety-nine MSM participated in 44 interviews and 8 FGDs. Most were attending or had completed secondary school. HIV knowledge was high, but with major gaps. Most consumed alcohol; one-fourth used drugs. Alcohol and substances were consume...
Stigma, sexual risk and desire for HIV tests in Ghana
Sexual Health, 2011
Background: Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. This study examined the effect of stigma on desire for HIV testing, while controlling for socio-demographic and other influences. Method: The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma while controlling for selected socio-demographic, socio-cognitive and socio-behavioural covariates. Results: The study revealed significant associations between several socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (adjusted odds ratio (AOR) = 0.41; 95% confidence interval (CI) = 0.24-0.72) and female (AOR = 0.62; 95% CI = 0.41-0.93) respondents in the wealthiest households, and those who know someone infected with HIV (AOR = 0.65; 95% CI = 0.43-1.00) have lower odds of desiring an HIV test. The study showed a significant but negative interaction between risky sexual behaviours and community stigma (AOR = 0.44; 95% CI = 0.19-0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females who live in communities with high levels of stigma. Conclusion: Since community-level education and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government's ongoing anti-stigma campaigns and other HIV prevention programs recognise the role of community stigma in influencing HIV testing decisions, especially in the context of risky sexual behaviours.
AIDS Care, 2020
LGBTQ populations experience human rights abuses worldwide; data need to document the health impact of these experiences in Africa. In Ghana, we measured events of sexuality-based stigma, discrimination, and violence among men who have sex with men (MSM) and the impact on HIV testing behavior. Data are from respondent-driven sampling surveillance surveys in Accra/Tema, Kumasi, Cape Coast/Takoradi, and Koforidua. Discrimination was common among MSM: 6.2% −30.6% were refused services, 29.0%−48.9% experienced verbal/symbolic violence, 2.8%−12.8% experienced physical violence, 12.3%−30.0% experienced sexual violence due to their sexuality in the preceding year. MSM who experienced sexual violence in their first male sexual encounter were less likely to ever test for HIV in Accra/Tema and Cape Coast/Takoradi. Further studies are needed to examine the impact of stigma and violence on MSM's HIV health-seeking behavior in Ghana. Structural interventions are needed to mitigate the consequences of stigma and discrimination on MSM health and well-being.
Drivers of young people's attitudes towards HIV/AIDS stigma and discrimination: evidence from Ghana
African journal of reproductive health, 2013
Using data from the 2008 Ghana Demographic and Health Survey, this paper examines the drivers of young people's attitudes towards HIV/AIDS stigma and discrimination in Ghana. Descriptive statistics and binary logistic regression were used to examine these drivers. The odds of low stigma and discrimination attitudes increased with higher education: thus, males [OR = 11.04; 95% CI = 4.59-26.54] and females [OR = 5.12; 95% CI = 2.41-11.28] with higher education were significantly more likely to express positive attitudes towards people living HIV. Controlling for beliefs, myths and knowledge about causes of HIV, the influence of education on HIV-related stigma among males and females reduces considerably but the odds remain statistically significant. Beliefs, myths and knowledge of HIV causes/prevention had varying significant effects on stigma. Ethnic, regional and religious differences also emerged in the results. The findings suggest that people with better and accurate knowledg...
Knowledge, Attitudes, and Behaviours of Adults (15-49 Years) towards HIV/AIDS in Ghana
Texila International Journal of Academic Research, 2021
The adult population (15-49 years) are the most productive and yet the most vulnerable to HIV infections in Ghana. A phenomenon that threatens the socioeconomic growth of the country and the survival of its people. Poor knowledge, ill-informed attitudes, and risky lifestyles are the key factors that hinder the prevention of HIV spread among adults. The study's aim was to explore knowledge, attitudes, and risky behaviours among adults which hinder the prevention of HIV/AIDS in Ghana. A case-control study of 362 adults was conducted in the Ahafo and Northern regions of Ghana in 2020. Descriptive and inferential statistics were significant at 1% and 5%. Results indicated that the majority of adults in Ghana are sexually active with limited education but high knowledge of HIV/AIDS. The study revealed significant levels of association between HIV infections and age, sex, marital status, sex with multiple partners, use of the condom, sex for money, sexually transmitted infections, alcohol or drug abuse, personal income, access to places where sex is traded, and migration. The study concludes that both cases and controls generally had good knowledge regarding HIV/AIDS but show poor attitudes towards PLHIV and also engaged in risky behaviours that might predispose others to HIV infections. Findings also highlight the need for culturally adaptive and age-specific HIV education for adults across all regions. Identified misconceptions on HIV/AIDS, poor attitudes of adults towards PLHIV, and risky behaviours of adults regarding HIV/AIDS need specific and targeted education towards behavioural change.
AIDS and Behavior, 2010
Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM.
HIV and AIDS Review, 2021
An estimated 11.8 million youths in sub-Saharan Africa are living with HIV and AIDS, and more than one-half of those newly infected with HIV today are between 18 and 24 years. This study reviewed research assessing the impact of stigma on HIV treatment seeking behavior among youths in sub-Saharan Africa. The review highlighted particular stigma issues that young people face. Also, it analyzed the causes and consequences of stigma, and identified skills to cope with stigma and to build modalities for a change of behavior. The review include original articles published between 1988 and 2019 on HIV and AIDS stigma, which were found on various internet sites. The review determined that in developing countries, social and economic factors have an impact on HIV infection, including mainly older grandparents and their role as caregivers of orphaned children as a result of parental HIV infection. Therefore, there is a need to incorporate culturally sensitive modalities that assure target populations' ability to respond to local understandings of key issues associated with HIV and AIDS stigmatization. Stigma among the youth remains a barrier to all essential components, which constitute a good prevention program, and much detailed research on stigma reduction is required to improve components of a good prevention program. Health education campaigns should integrate a change from fear to care for people living with HIV/AIDS, especially among healthcare personnel. More prevention activities should be situated in rural and remote areas of each country than in urban locations, as currently in Nigeria. Since most of the population resides in rural areas, it is most appropriate to concentrate these programs in such locations.
PloS one, 2014
Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d'Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011-2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 1...
African Population Studies, 2014
The study examined the association between HIV test uptake and socioeconomic characteristics of individuals, including HIV-related stigma behaviours. The study also investigated the socioeconomic determinants of HIV-related stigma in Ghana. Cross tabulations and logistic regression techniques were applied to data from the 2008 Ghana Demographic and Health Survey. The results showed significantly low HIV test uptake and some level of HIV-related stigma prevalence in Ghana. Higher wealth status, educational attainment and HIV-related stigma were significant determinants of HIV test uptake. Aside wealth status and education, rural place of residence and religious affiliation were positive and significant determinants of HIV-related stigma. The findings call for comprehensive HIV education including treatment, prevention and care. Legislations to discourage stigma and improve HIV-testing will be critical policy steps in the right direction.