Research article: Assessment of Stigma, Vulnerability to Violence and Coping Mechanisms among HIV Positive Men Who Have Sex with Men in Akwa-Ibom State, Nigeria
Paul Umoh, Olaniyi Felix Sanni, Godwin Emmanuel, Ochonye Bartholomew Boniface, Paul Amechi, Roger Abang, Abiye Kalaiwo, Olugbemi Motilewa
Abstract
Purpose: HIV-positive men who have sex with men (MSM) are significant contributors to HIV transmission globally. This study aimed to assess the level and type of stigma and violence among MSM attending Heartland Alliance LTD/GTE (HALG) one-stop-shop (OSS) and their coping mechanisms.
Method: Using a mixed method, this was a descriptive cross-sectional study of MSM receiving care in Heartland Alliance OSS in Akwa Ibom State. A total of 443 MSM were recruited across four OSS. Quantitative data were collected using a pretested structured questionnaire and an adopted stigma scale. Four focus group discussions (FGDs) comprised 8- 10 MSM purposively selected per section. A three-item guide was developed for stigma, violence, and coping mechanisms. IBM-SPSS version 27 was used for data analysis; stigma was scored using a Likert scale. Transcripts from FGDs were analyzed using content analysis and presented in themes.
Results: The study comprised 443 respondents. About 50% have disclosed their HIV status, 48% reported alcohol consumption, 31% reported substance use, and 95.9% said they used condoms consistently. Perceived stigma was seen in 60%, internal stigma in 41.5%, and 48.2% experienced high stigma. Predictors of stigma were the use of substance odds ratio (OR): 5.37(2.49-11.55) compared to non-use, being a civil servant OR:5.87(1.68-20.57) and being a professional OR:8.73 (2.36-32.33). The predictors of rape were being married OR:1.95(1.04-3.64) and substance use OR:2.03(1.18-3.63). Use of alcohol OR:2.25(1.22-4.19) and civil servant OR:3.33(1.10-10.12) were the independent predictors. A good number of the MSM use avoidant coping mechanisms for both stigma and violence; they try not to disclose their status and sexual orientation, and in a few cases, they have combated violence with violence.
Conclusion: There is a need to expand integrated services for MSM, including mental health assessment, psychological support, and counselling for those suffering from stigma and all forms of violence.
Keywords: HIV Stigma, Violence Vulnerability, Coping Mechanisms, MSM
Int. J. Bio. Lab. Sci 2024(13)2:91-107 【PDF】