Hidden healthcare populations: using intersectionality to theorise the experiences of LGBT+ people in Nigeria, Africa

Sekoni, Adekemi; Jolly, Kate; Gale, Nicola

doi:10.1080/17441692.2020.1849351

Cited by 20 publications

(20 citation statements)

References 43 publications

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“…Homosexual and bisexual relationships are not always openly disclosed in the Nigerian context because the country criminalises same-sex sexual activity and many are against it due to various cultural and religious reasons. 10 Consequently, we do not know if some of our participants denied homosexual orientation for fear of stigma and discrimination. It is however noteworthy that our results suggest that the potential of spread of HMPX via sexual contact is not exclusive of the current outbreak outside endemic countries in Africa and may not necessarily be restricted to gay and bisexual men alone as being reported outside Africa.…”

Section: Discussionmentioning

confidence: 90%

Sexual history of human monkeypox patients seen at a tertiary hospital in Bayelsa, Nigeria.

Ogoina

Yinka-Ogunleye

2022

Int J STD AIDS

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Background: Human monkeypox (HMPX) is currently spreading outside endemic countries in Africa and the majority of those affected are gay and bisexual men within interconnected sexual networks. We investigated the sexual history of HMPX cases seen at a tertiary hospital in Bayelsa State during the 2017–2018 outbreak in Nigeria. Method: A cross-sectional study was conducted between 20 October 2017 and 2 January 2019 among adult confirmed/probable HMPX cases. A questionnaire was used to collect data on the sexual history of participants, including sexual contact in relation to the first symptom, and high-risk behaviours (HRB) such as a history of condomless casual sex, multiple sexual partners, and transactional sex. Results: Of 21 patients, 16 (76.2%) gave consent to participate in the study: age range of 22–43 years, 75% males, three (18.8%) HIV-1 positive, and 13 (81.2%) with genital ulcers. Nine (56.2%) of participants reported HRB, and all were male heterosexuals. Eight of the 16 participants (50%) reported having sex within a month before their first symptom, and five (62.5%) of this number reported HRB. There were two cases of sex with a partner with a non-genital rash, and a spouse who developed a vulval ulcer four days after sex with her husband. Conclusion: Our results support the role of sexual contact in the transmission of monkeypox among some confirmed cases from Nigeria. However, future elaborate studies are required to confirm if sexual behaviour and sexual transmission are associated with HMPX in Nigeria.

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Section: Discussionmentioning

confidence: 90%

Sexual history of human monkeypox patients seen at a tertiary hospital in Bayelsa, Nigeria.

Ogoina

Yinka-Ogunleye

2022

Int J STD AIDS

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“…Over 40% of transgender individuals reported violations of their rights in this study. Though we did not distinguish between perceived and/or enacted human rights violations, Sekoni et al [ 28 ] provided evidence to indicate that transgender individuals do experience enacted rights violations that needs to be addressed. The needs of minority groups, including those of transgender individuals, need to be amplified to eliminate the risk of being left behind.…”

Section: Discussionmentioning

confidence: 74%

“…Attention also needs to be paid to transgender individuals, who consistently reported higher likelihood of experiencing rights violations compared to men in this study. There is a small body of evidence about transgenderism in Nigeria [ 54 – 56 ] that suggest a high prevalence of HIV [ 54 ], sexually transmitted infections [ 57 ] as well as stigma and human rights violations, which hinders service utilization [ 28 , 57 ]. This study provides the first quantitative report on the perspectives of transgender individuals on the violation of their rights to autonomy within the health care sector in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

“…There are no reliable estimates of transgender individuals in the country [25]. These populations who are often at high risk for HIV infection -singles (who are often adolescents and young persons, sexual (gay, bisexual, queer) and gender minority (transgender) individuals [26] -are often stigmatised by the society in Nigeria [27][28][29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

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Whose rights are being violated when receiving HIV and sexual and reproductive health services in Nigeria?

Foláyan

Stevens-Murphy²,

Nwakamma³

et al. 2022

BMC Health Serv Res

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Background In Nigeria, vulnerability status may increase the risk for the violation of human rights while receiving health care. The present study determined the proportion and profile of people who reported rights violation while accessing HIV and sexual and reproductive health (SRH) services. Methods This was a cross sectional study with data collected between February and March 2021. The dependent variables were patients’ rights to autonomy: right to privacy and confidentiality of medical records; right to be treated with respect, regardless of gender, race, religion, ethnicity, allegations of crime, disability or economic circumstances; right to decline or consent to participation in medical research, experimental procedures or clinical trials; right to quality care in accordance to prevailing standards; and right to complain and express dissatisfaction regarding services received. The independent variables were sexual identity (heterosexual/straight, gay, lesbian, bisexual, queer), HIV status (positive, negative, do not know), living with disability (yes/no), and access point to HIV services (public or donor funded/private). Five multivariate regression models were developed to determine associations between the dependent and independent variable after adjusting for age, education level (no formal education, primary, secondary, tertiary), sex (male, female, intersex), marital status (single, married, separated/divorced, cohabiting) and gender identity (male, female, transgender). Results Complete data from 2119 study participants were analysed. Transgender individuals had significantly higher odds of experiencing violation of their rights to privacy and confidentiality of medical records (AOR:1.70), right to be treated with respect (AOR:1.71), right to complain and express dissatisfaction regarding services received (AOR:1.57) and right to decline consent to participate in medical research, experimental research, experimental procedures or clinical trials (AOR:1.81) compared to individuals who were males. Conclusion A high proportion of recipients of HIV and SRH services in Nigeria reported rights violations. Transgender individuals appear to have higher risk and those in spousal relationships have lower risk for rights violations. Studies are needed to learn how to improve rights-based HIV and SRH service delivery in Nigeria especially for transgender individuals.

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“…Low levels of HIV risk perception, deficiencies in HIV knowledge, and engaging in high-risk sexual behaviors among TGW are well-documented in non-African populations [18]. Unfortunately, the transgender population in Africa is a hidden and understudied population [19]. Most transgender data is historically not collected separately; instead, it is lumped together with MSM data, which is misleading [19].…”

Section: Introductionmentioning

confidence: 99%

HIV risk perception and sexual behavior among HIV-uninfected men and transgender women who have sex with men in sub-Saharan Africa: Findings from the HPTN 075 qualitative sub-study

Chimwaza

Dadabhai

Nyondo-Mipando

et al. 2022

PLOS Glob Public Health

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There remains a limited understanding of how men who have sex with men (MSM) and transgender women (TGW) in sub-Saharan Africa (SSA) perceive their risk for HIV and how risk influences behavior during sexual interactions. We performed thematic analysis on in-depth interviews from the qualitative sub-study of HPTN 075 in Kenya, Malawi, and South Africa. Using the Integrated Behavioral Model (IBM) constructs, we found that most MSM and TGW perceived themselves to be at risk for HIV, leading them to regularly engage in safer sexual behaviors. Notably, even though these MSM and TGW perceived themselves to be at risk for HIV, some of them reported engaging in transactional sex, sex under the influence of alcohol, and intentional non-use of condoms. This indicates that HIV risk perception was not always associated with safer sexual behaviors or a reduction in risk behaviors. Attitudes (negative attitudes toward condom use), perceived norms (social pressures), and environment constraints (contextual barriers) were related to MSM and TGW not engaging in safe sexual behavior. Hearing the perspectives of MSM and TGW on their sexual behavior continues to be important for the development and implementation of effective prevention policies and interventions. Eliminating structural barriers such as stigma, discrimination, and criminalization of same-sex sexuality is a crucial prerequisite for the success of interventions to promote sexual health among MSM and TGW in SSA.

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Hidden healthcare populations: using intersectionality to theorise the experiences of LGBT+ people in Nigeria, Africa

Cited by 20 publications

References 43 publications

Sexual history of human monkeypox patients seen at a tertiary hospital in Bayelsa, Nigeria.

Sexual history of human monkeypox patients seen at a tertiary hospital in Bayelsa, Nigeria.

Whose rights are being violated when receiving HIV and sexual and reproductive health services in Nigeria?

HIV risk perception and sexual behavior among HIV-uninfected men and transgender women who have sex with men in sub-Saharan Africa: Findings from the HPTN 075 qualitative sub-study

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