Coming Out of the Nkuta: Disclosure of Sexual Orientation Associated with Reduced Risk Behavior Among MSM in Cameroon

Mao

Journal of the International AIDS Society

et al. 2017

Background: Many men who have sex with men (MSM) in China are “in the closet.” The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods: A nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results: A total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25–2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50–4.51 for HIV, and aOR = 4.92, 95% CI: 3.47–6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93–2.72). Conclusion: Over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

Section: Discussioncontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Disclosure of sexual orientation to health professionals in China: results from an online cross‐sectional study

Mao

Journal of the International AIDS Society

et al. 2017

“…After disclosing to families or friends, MSM could receive more emotional or tangible support, increased self-esteem and decreased depression or anxiety [ 10 ]. After disclosing to sexual partners, MSM tend to have safer sex [ 11 , 12 ] which may reduce HIV transmission. In addition, disclosure to health providers is related to adherence to health-care and service[ 13 , 14 ], thus controlling disease progression.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with disclosing men who have sex with men (MSM) sexual behaviors and HIV-positive status: A study based on a social network analysis in Nanjing, China

2018

ObjectiveWe explored the factors associated with disclosure of men who have with sex with men (MSM) behaviors and HIV-positive status among HIV-positive MSM in Nanjing, China.MethodsSocial network analysis and epidemiological methods were combined in this pilot study. Information about participants’ (egos’) characteristics and behaviors and their social network members (alters) were collected through interview-administered questionnaires. General estimating equation logistic regression analysis was applied in both univariate and multivariate analysis.ResultsEighty-seven HIV-positive MSM participated. Their mean age was 35.9 ±13.81years. They were more likely to disclose their MSM behavior to their friends [adjust Odds Ratio (AOR) = 6.43, 95% confidence interval (CI):3.08–13.42] or to the social network members who were not heterosexual [AOR = 4.40, 95%CI: 2.17–8.91]. Being participants’ friends [AOR = 5.16, 95%CI: 2.03–13.10] or family members [AOR = 6.22, 95%CI: 2.52–15.33] was significantly associated with HIV-positive status disclosure.ConclusionHIV-positive MSM tended to disclose their MSM behaviors and HIV positive status to close friends, family members or other individuals who were HIV-positive, engaging in MSM behavior, or both. Consequently, it will be an effective way to implement HIV prevention and intervention strategies in both MSM population and their trusted social networks.

“…The disclosure rates of about 15% and 29% to a family member and a HCP, respectively, among MSM and TGW in this study were substantially lower than the rates of about 75% and 56%, respectively, which have been reported from South Africa, where MSMfriendly legislation exists (Daniels et al, 2018). In contrast, research from countries with laws that criminalize same-sex sexual practices among men generally shows much lower rates of disclosure, including disclosure to a family member by 46% of MSM and TGW in Cameroon, to HCP by 31% of MSM and TGW in Swaziland, and disclosure to a HCP by only 17% of MSM and TGW participants in a large crosssectional study in Malawi, Namibia, and Botswana (Brown et al, 2016;Fay et al, 2011;Henry et al, 2012). In addition to criminalization, cultural and societal factors may also contribute to disclosure practices and should be considered when designing affirmative and targeted population-based HIV and STI prevention intervention.…”

Section: Discussionmentioning

confidence: 99%

Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria

et al. 2020

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.