Original Paper

AIDS and Behavior

, Volume 15, Issue 6, pp 1088-1097

Stigma, Health Care Access, and HIV Knowledge Among Men Who Have Sex With Men in Malawi, Namibia, and Botswana

  • Heather FayAffiliated withDepartment of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health
  • , Stefan D. BaralAffiliated withDepartment of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health
  • , Gift TrapenceAffiliated withCenter for the Development of People
  • , Felistus MotimediAffiliated withBotswana Network on Ethics, Law, and HIV/AIDS
  • , Eric UmarAffiliated withDepartment of Community Health, University of Malawi, College of Medicine
  • , Scholastika IipingeAffiliated withUniversity of Namibia
  • , Friedel DausabAffiliated withThe Rainbow Project
  • , Andrea WirtzAffiliated withDepartment of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health
  • , Chris BeyrerAffiliated withDepartment of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health Email author 

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Abstract

Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM.

Keywords

Stigma Discrimination HIV/AIDS Men who have sex with men (MSM) Namibia Botswana Malawi