Associations of gender identity with sexual behaviours, social stigma and sexually transmitted infections among adults who have sex with men in Abuja and Lagos, Nigeria.
Africa South of the Sahara
chlamydia
gonorrhoea
sexual and gender minorities
social stigma
transgender persons
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
16
02
2022
accepted:
23
06
2022
entrez:
7
7
2022
pubmed:
8
7
2022
medline:
9
7
2022
Statut:
ppublish
Résumé
Sexual and gender minority populations are disproportionately affected by the global syndemic of HIV and other sexually transmitted infections (STIs). We hypothesized that transgender women (TGW) and non-binary individuals in Nigeria have more STIs than cis-gender men who have sex with men (cis-MSM), and that experiences of stigma and sexual practices differ between these three groups. From 2013 to 2020, TRUST/RV368 enrolled adults assigned male sex at birth who reported anal sex with men in Abuja and Lagos, Nigeria. Participants were tested for STIs and completed questionnaires about sexual behaviours and social stigma every 3 months. Participants were categorized as cis-MSM, TGW or non-binary/other based on self-reported gender identity. Gender group comparisons were made of HIV, gonorrhoea and chlamydia prevalence and incidence; stigma indicators; and condom use during anal sex. Among 2795 participants, there were 2260 (80.8%) cis-MSM, 284 (10.2%) TGW and 251 (9.0%) non-binary/other individuals with median age of 23 years (interquartile range 20-27). HIV prevalence among cis-MSM, TGW and non-binary/other participants was 40.8%, 51.5% and 47.6%, respectively (p = 0.002). HIV incidence was 8.7 cases per 100 person-years (PY) (95% confidence interval [CI] 6.9-10.8), 13.1 cases/100 PY (95% CI 6.5-23.4) and 17.6 cases/100 PY (95% CI 9.8-29.0, p = 0.025), respectively. Anorectal gonorrhoea incidence was lower in cis-MSM than TGW (22.2 [95% CI 19.6-25.0] vs. 35.9 [95% CI 27.3-46.3]). TGW were more likely than cis-MSM to report being affected by stigma, including assault (47.2% vs. 32.3%), fear of walking around (32.4% vs. 19.2%) and healthcare avoidance (25.0% vs. 19.1%; all p < 0.05). TGW were more likely to report always using condoms than non-binary/other individuals (35.3% vs. 26.2%, p = 0.041) during receptive anal sex. Sexual and gender minorities in Nigeria have heterogeneous sexual behaviours and experiences of social stigma that may influence the vulnerability to HIV and other STIs. There is a need for tailored interventions that acknowledge and are informed by gender. Further research is needed, particularly among understudied non-binary individuals, to better understand disparities and inform tailored interventions to improve outcomes among these communities.
Identifiants
pubmed: 35794838
doi: 10.1002/jia2.25956
pmc: PMC9259961
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25956Subventions
Organisme : NIAID NIH HHS
ID : R01 AI120913
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH099001
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH110358
Pays : United States
Organisme : FIC NIH HHS
ID : D43TW010051
Pays : United States
Informations de copyright
© 2022 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
Références
Am J Public Health. 2013 May;103(5):943-51
pubmed: 23488522
AIDS. 2017 Nov 13;31(17):2415-2420
pubmed: 28926403
Sex Transm Dis. 2019 Feb;46(2):112-117
pubmed: 30278030
Soc Sci Med. 2015 Dec;147:222-31
pubmed: 26599625
Glob Public Health. 2016 Aug-Sep;11(7-8):835-48
pubmed: 26785751
Medicine (Baltimore). 2015 Oct;94(41):e1830
pubmed: 26469928
Int J STD AIDS. 2018 Jun;29(7):665-672
pubmed: 29350112
BMC Public Health. 2021 Jun 7;21(1):1090
pubmed: 34098916
Clin Infect Dis. 2020 Mar 3;70(6):1247-1253
pubmed: 31504345
Lancet. 2012 Jul 28;380(9839):367-77
pubmed: 22819660
Am J Public Health. 2014 Nov;104(11):2199-206
pubmed: 25211716
BMC Infect Dis. 2020 Dec 7;20(1):932
pubmed: 33287723
Ann Epidemiol. 2019 May;33:79-83.e1
pubmed: 30955993
Lancet HIV. 2015 Jul;2(7):e299-306
pubmed: 26125047
Cochrane Database Syst Rev. 2002;(1):CD003255
pubmed: 11869658
Sex Health. 2019 Sep;16(5):401-411
pubmed: 31505159
AIDS. 2013 Jan 28;27(3):437-46
pubmed: 23079811
Arch Sex Behav. 2021 May;50(4):1665-1676
pubmed: 32193812
J Int AIDS Soc. 2021 Jan;24(1):e25661
pubmed: 33496381
Arch Sex Behav. 2014 Nov;43(8):1503-14
pubmed: 25030120
Bull World Health Organ. 2019 Aug 01;97(8):548-562P
pubmed: 31384073
EClinicalMedicine. 2021 Jul 17;38:101033
pubmed: 34505031
Am J Epidemiol. 2020 Jul 1;189(7):690-697
pubmed: 31942619
Glob Public Health. 2016 Aug-Sep;11(7-8):849-65
pubmed: 27173599
J Int AIDS Soc. 2020 Oct;23 Suppl 6:e25599
pubmed: 33000907
N Engl J Med. 2010 Dec 30;363(27):2587-99
pubmed: 21091279
Infect Dis Obstet Gynecol. 2016;2016:5758387
pubmed: 27366021
Ann Epidemiol. 2019 Mar;31:11-19.e3
pubmed: 30642695
Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):172-9
pubmed: 26825472
Cult Health Sex. 2007 Mar-Apr;9(2):153-68
pubmed: 17364723
Sex Transm Infect. 2017 Aug;93(5):307-308
pubmed: 28389442
Lancet HIV. 2017 Sep;4(9):e402-e410
pubmed: 28747274
Soc Sci Med. 1997 May;44(9):1303-12
pubmed: 9141163
J Acquir Immune Defic Syndr. 2015 Mar 1;68(3):337-44
pubmed: 25469526
PLoS Med. 2014 Jun 24;11(6):e1001658
pubmed: 24959671
Transgend Health. 2018 Dec 18;3(1):201-209
pubmed: 30581993
BMC Int Health Hum Rights. 2017 May 30;17(1):16
pubmed: 28558693
PLoS Med. 2017 Nov 7;14(11):e1002422
pubmed: 29112689
Lancet. 2016 Jul 23;388(10042):412-436
pubmed: 27323919
Sex Transm Dis. 2020 Mar;47(3):202-206
pubmed: 31880740
Issues Ment Health Nurs. 2022 Feb;43(2):111-118
pubmed: 34469283
J Int AIDS Soc. 2017 Apr 20;20(1):21489
pubmed: 28453241
AIDS Care. 2020 Mar;32(3):310-315
pubmed: 31530004
AIDS Behav. 2017 Sep;21(9):2774-2783
pubmed: 28035497
AIDS Behav. 2018 May;22(5):1662-1670
pubmed: 29168069
Afr J Prim Health Care Fam Med. 2019 Jul 10;11(1):e1-e9
pubmed: 31296016
Transgend Health. 2020 Jun 08;5(2):90-103
pubmed: 32656353
J Int AIDS Soc. 2016 Dec 07;19(1):21270
pubmed: 27931519
Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):168-71
pubmed: 26910276
J Int AIDS Soc. 2020 Oct;23 Suppl 6:e25596
pubmed: 33000908
J Soc Issues. 2017 Sep;73(3):586-617
pubmed: 29170566
BMC Med. 2019 Feb 15;17(1):7
pubmed: 30764816
Sex Transm Infect. 2018 Dec;94(8):578-581
pubmed: 29378902
J Int AIDS Soc. 2019 Jun;22(6):e25323
pubmed: 31194291
BMC Public Health. 2018 Jul 27;18(1):919
pubmed: 30049270
Sex Health. 2017 Oct;14(5):456-468
pubmed: 29216970
BMC Public Health. 2020 Aug 26;20(1):1282
pubmed: 32842997
AIDS Behav. 2011 Apr;15(3):663-73
pubmed: 20811771
J Int AIDS Soc. 2020 Oct;23 Suppl 6:e25592
pubmed: 33000914
Lancet Infect Dis. 2013 Mar;13(3):214-22
pubmed: 23260128
AIDS. 2013 Nov 13;27(17):2665-78
pubmed: 23842129
Soc Sci Med. 2013 May;84:22-9
pubmed: 23517700
Am J Public Health. 2019 Jan;109(1):e1-e8
pubmed: 30496000
J Acquir Immune Defic Syndr. 2015 Mar 1;68 Suppl 2:S107-13
pubmed: 25723974
Lancet HIV. 2015 Dec;2(12):e512-9
pubmed: 26614965
Lancet Infect Dis. 2018 Mar;18(3):308-317
pubmed: 29229440