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

AIDS and Behavior volume 15, pages 1088–1097 (2011)Cite this article

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.

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Acknowledgment

The study was supported, in part, by a grant from the Sexual Health and Rights Program, SHARP, of the Open Society Institute, New York, NY.

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Authors and Affiliations

  1. Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, E7146, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Heather Fay, Stefan D. Baral, Andrea Wirtz & Chris Beyrer

  2. Center for the Development of People, Blantyre, Malawi

    Gift Trapence

  3. Botswana Network on Ethics, Law, and HIV/AIDS, Gaborone, Botswana

    Felistus Motimedi

  4. Department of Community Health, University of Malawi, College of Medicine, Blantyre, Malawi

    Eric Umar

  5. University of Namibia, Windhoek, Namibia

    Scholastika Iipinge

  6. The Rainbow Project, Windhoek, Namibia

    Friedel Dausab

Authors
  1. Heather Fay
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  2. Stefan D. Baral
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  3. Gift Trapence
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  4. Felistus Motimedi
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  5. Eric Umar
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  6. Scholastika Iipinge
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  7. Friedel Dausab
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  8. Andrea Wirtz
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  9. Chris Beyrer
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Correspondence to Chris Beyrer.

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Fay, H., Baral, S.D., Trapence, G. et al. Stigma, Health Care Access, and HIV Knowledge Among Men Who Have Sex With Men in Malawi, Namibia, and Botswana. AIDS Behav 15, 1088–1097 (2011). https://doi.org/10.1007/s10461-010-9861-2

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  • DOI: https://doi.org/10.1007/s10461-010-9861-2

Keywords

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