Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Dada, Debbie; Abu-Ba’are, Gamji R; Turner, DeAnne; Mashoud, Ibrahim Wunpini; Owusu-Dampare, Francis; Apreku, Amos; Ni, Zhao; Djiadeu, Pascal; Aidoo-Frimpong, Gloria; Zigah, Edem Yaw; Nyhan, Kate; Nyblade, Laura; Nelson, LaRon E

doi:10.1136/bmjopen-2023-078794

Cited by 6 publications

(3 citation statements)

References 224 publications

(554 reference statements)

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“…Research assistants (EYZ, OWS) engaged in data collection had prior and extensive research training from working with these populations in the past. We also utilized the expertise of these researchers in our past studies, with similar populations, hence, the familiarity and experience engaging our participants [23,24,[40][41][42][43][44]. The research assistants also read the consent forms out loud and provided extra explanations to ensure everything was understood.…”

Section: Data Collection Proceduresmentioning

confidence: 99%

Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums—BSGH-005

Abu-Ba’are,

Shamrock,

Zigah

et al. 2024

PLoS ONE

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Despite significant progress in Ghana’s HIV response, disparities in HIV prevalence persist among different populations. Gays, bisexuals, and other men who have sex with men (GBMSM) in the country remain vulnerable to HIV infection due to high levels of stigma and discrimination, limited access to healthcare services, and low HIV knowledge levels. While limited studies focus on HIV prevention and care in the Ghanaian GBMSM context, we did not find studies on GBMSM in slums. We, therefore, explored stigma and motivations of HIV testing among GBMSM in slums. In collaboration with our community partners, we recruited and conducted face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi, Ghana. Our multiple-reviewer summative content analysis identified the following: under HIV stigma, we identified two categories, avoidance of GBMSM living with HIV and fear of testing positive for HIV. Under motivations for HIV testing, we identified three categories; HIV vulnerability, knowing one’s HIV status, and positive messaging about HIV. Our findings provide valuable insights into stigma and motivations for HIV testing among GBMSM in Ghanaian slums. They also highlight the importance of targeted HIV education interventions to empower GBMSM to take responsibility for their sexual health and address the unique challenges they face accessing HIV testing services.

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Section: Data Collection Proceduresmentioning

confidence: 99%

Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums—BSGH-005

Abu-Ba’are,

Shamrock,

Zigah

et al. 2024

PLoS ONE

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“…Additionally, legal structures in several sub-Saharan African countries, including Ghana, criminalize same-sex relationships and behaviors, contributing to the reinforcement of stigma against transgender individuals [22][23][24][25] . In Ghana, a recently passed anti-LGBT bill by parliament is pending presidential assent to become law, with signi cant international and domestic pressure urging the president to reject this discriminatory legislation 26 .…”

Section: Introductionmentioning

confidence: 99%

A qualitative description of HIV testing and healthcare experiences among trans women in Ghanaian urban slums BSGH-011

Dakpui,

Shamrock,

Aidoo-Frimpong

et al. 2024

Preprint

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Background Achieving the UNAIDS 90–90–90 targets hinges on identifying and engaging individuals with HIV in care, requiring 90% of those infected to be diagnosed, initiated on ART, and achieving viral suppression. Despite this imperative, HIV testing services as well as research in Ghana often overlook the unique experiences of transgender women in urban slums, impacting their engagement with care. Using the gender affirmative model lens, this study reports the HIV testing experiences of trans women in Ghanaian slums, highlighting how the healthcare environment, counseling, and healthcare provider attitudes shape these experiences. Methods A qualitative descriptive interview design was employed, involving 20 trans women aged 18 to 31 years living in urban slums in the Greater Accra Metropolitan Area of Ghana. Participants were recruited using purposive and snowball sampling techniques. Data were collected through face-to-face interviews, transcribed verbatim, and analyzed using NVivo. Results were presented in categories and subcategories. Results Two main categories emerged from our data analysis: 1) Positive Experiences with HIV Testing, and 2) Negative Experiences with HIV Testing. Positive experiences with HIV testing among trans women in Ghanaian slums included a welcoming environment at healthcare facilities, supportive counseling, and relatability with HIV-positive nurses. Negative experiences were characterized by fear and anxiety during testing, often intensified by healthcare worker attitudes, including unwelcoming behaviors and judgmental body language, especially in facilities that are not key population friendly. These categories provided a framework for understanding the varied experiences of trans women in Ghanaian slums regarding HIV testing. Conclusion The study emphasizes the urgent need for healthcare facilities in Ghanaian slums to address discriminatory practices and attitudes towards trans women, fostering a welcoming and affirming environment. Adopting a multifaceted approach integrating the gender-affirmative model's principles is crucial to enhancing HIV testing experiences and achieving improved health outcomes for trans women. Policymakers and healthcare providers must prioritize comprehensive training, inclusive healthcare environments, and culturally competent care to mitigate health disparities among this population.

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“…Some other reviews focus on concrete methods and methodology, such as intersectionality in quantitative research [ 11 ], or highlight a concrete approach such as community-based participatory research as a well-suited method for intersectional perspectives [ 58 ]. Moreover, different reviews highlight that intersectionality should be incorporated in the whole research process, from conceptualization and development of research questions, researched population/sample, to analysis, and to the way results are reported [ 29 , 74 , 102 ].…”

Section: Introductionmentioning

confidence: 99%

The concept of intersectionality in bioethics: a systematic review

Brünig,

Kahrass,

Salloch

2024

BMC Med Ethics

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Background Intersectionality is a concept that originated in Black feminist movements in the US-American context of the 1970s and 1980s, particularly in the work of feminist scholar and lawyer Kimberlé W. Crenshaw. Intersectional approaches aim to highlight the interconnectedness of gender and sexuality with other social categories, such as race, class, age, and ability to look at how individuals are discriminated against and privileged in institutions and societal power structures. Intersectionality is a “traveling concept”, which also made its way into bioethical research. Methods We conducted a systematic review to answer the question of where and how the concept of intersectionality is applied in bioethical research. The PubMed and Web of Science databases were systematically searched and 192 articles addressing bioethical topics and intersectionality were finally included. Results The qualitative analysis resulted in a category system with five main categories: (1) application purpose and function, (2) social dimensions, (3) levels, (4) health-care disciplines and academic fields, and (5) challenges, limitations, and critique. The variety of academic fields and health-care disciplines working with the concept ranges from psychology, through gynaecology to palliative care and deaf studies. Important functions that the concept of intersectionality fulfils in bioethical research are making inequities visible, creating better health data collections and embracing self-reflection. Intersectionality is also a critical praxis and fits neatly into the overarching goal of bioethics to work toward social justice in health care. Intersectionality aims at making research results relevant for respective communities and patients, and informs the development of policies. Conclusions This systematic review is, to the best of our knowledge, the first one to provide a full overview of the reference to intersectionality in bioethical scholarship. It creates a basis for future research that applies intersectionality as a theoretical and methodical tool for analysing bioethical questions.

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Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa

Cited by 6 publications

References 224 publications

Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums—BSGH-005

Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums—BSGH-005

A qualitative description of HIV testing and healthcare experiences among trans women in Ghanaian urban slums BSGH-011

The concept of intersectionality in bioethics: a systematic review

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