TY - JOUR
T1 - HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV
T2 - A cross-sectional analysis at enrollment into an observational cohort
AU - Tiamiyu, Abdulwasiu B.
AU - Lawlor, John
AU - Hu, Fengming
AU - Kokogho, Afoke
AU - Charurat, Manhattan E.
AU - Ekeh, Charles
AU - Robb, Merlin L.
AU - Adebajo, Sylvia
AU - Eluwa, George
AU - Ake, Julie A.
AU - Baral, Stefan D.
AU - Nowak, Rebecca G.
AU - Crowell, Trevor A.
AU - Adebajo, Sylvia
AU - Crowell, Trevor
AU - Gaydos, Charlotte
AU - Kokogho, Afoke
AU - Malia, Jennifer
AU - Makanjuola, Olumide
AU - Michael, Nelson
AU - Ndembi, Nicaise
AU - Nowak, Rebecca
AU - Olawore, Oluwasolape
AU - Parker, Zahra
AU - Peel, Sheila
AU - Ramadhani, Habib
AU - Robb, Merlin
AU - Rodriguez-Hart, Cristina
AU - Sanders-Buell, Eric
AU - Shoyemi, Elizabeth
AU - Tovanabutra, Sodsai
AU - Vasan, Sandhya
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/8/26
Y1 - 2020/8/26
N2 - Background: Men who have sex with men (MSM) and transgender women (TGW) are disproportionately impacted by HIV and may face barriers to HIV status disclosure with negative ramifications for HIV prevention and care. We evaluated HIV status disclosure to sexual partners, HIV treatment outcomes, and stigma patterns of MSM and TGW in Abuja and Lagos, Nigeria. Methods: Previously-diagnosed MSM and TGW living with HIV who enrolled in the TRUST/RV368 cohort from March 2013 to August 2018 were asked, "Have you told your (male/female) sexual partners (MSP/FSP) that you are living with HIV?"In separate analyses, robust Poisson regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (95% CIs) for characteristics associated with HIV status disclosure to MSP and FSP. Self-reported stigma indicators were compared between groups. Results: Of 493 participants living with HIV, 153 (31.0%) had disclosed their HIV status to some or all MSP since being diagnosed. Among 222 with FSP, 34 (15.3%) had disclosed to some or all FSP. Factors independently associated with disclosure to MSP included living in Lagos (RR 1.58 [95% CI 1.14-2.20]) and having viral load < 50 copies/mL (RR 1.67 [95% CI 1.24-2.25]). Disclosure to FSP was more common among participants who were working in entertainment industries (RR 6.25 [95% CI 1.06-36.84]) or as drivers/laborers (RR 6.66 [95% CI 1.10-40.36], as compared to unemployed) and also among those married/cohabiting (RR 3.95 [95% CI 1.97-7.91], as compared to single) and prescribed ART (RR 2.27 [95% CI 1.07-4.83]). No differences in self-reported stigma indicators were observed by disclosure status to MSP but disclosure to FSP was associated with a lower likelihood of ever having been assaulted (26.5% versus 45.2%, p = 0.042). Conclusions: HIV status disclosure to sexual partners was uncommon among Nigerian MSM and TGW living with HIV but was associated with improved HIV care outcomes. Disclosure was not associated with substantially increased experiences of stigma. Strategies to encourage HIV status disclosure may improve HIV management outcomes in these highly-marginalized populations with a high burden of HIV infection.
AB - Background: Men who have sex with men (MSM) and transgender women (TGW) are disproportionately impacted by HIV and may face barriers to HIV status disclosure with negative ramifications for HIV prevention and care. We evaluated HIV status disclosure to sexual partners, HIV treatment outcomes, and stigma patterns of MSM and TGW in Abuja and Lagos, Nigeria. Methods: Previously-diagnosed MSM and TGW living with HIV who enrolled in the TRUST/RV368 cohort from March 2013 to August 2018 were asked, "Have you told your (male/female) sexual partners (MSP/FSP) that you are living with HIV?"In separate analyses, robust Poisson regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (95% CIs) for characteristics associated with HIV status disclosure to MSP and FSP. Self-reported stigma indicators were compared between groups. Results: Of 493 participants living with HIV, 153 (31.0%) had disclosed their HIV status to some or all MSP since being diagnosed. Among 222 with FSP, 34 (15.3%) had disclosed to some or all FSP. Factors independently associated with disclosure to MSP included living in Lagos (RR 1.58 [95% CI 1.14-2.20]) and having viral load < 50 copies/mL (RR 1.67 [95% CI 1.24-2.25]). Disclosure to FSP was more common among participants who were working in entertainment industries (RR 6.25 [95% CI 1.06-36.84]) or as drivers/laborers (RR 6.66 [95% CI 1.10-40.36], as compared to unemployed) and also among those married/cohabiting (RR 3.95 [95% CI 1.97-7.91], as compared to single) and prescribed ART (RR 2.27 [95% CI 1.07-4.83]). No differences in self-reported stigma indicators were observed by disclosure status to MSP but disclosure to FSP was associated with a lower likelihood of ever having been assaulted (26.5% versus 45.2%, p = 0.042). Conclusions: HIV status disclosure to sexual partners was uncommon among Nigerian MSM and TGW living with HIV but was associated with improved HIV care outcomes. Disclosure was not associated with substantially increased experiences of stigma. Strategies to encourage HIV status disclosure may improve HIV management outcomes in these highly-marginalized populations with a high burden of HIV infection.
KW - Disclosure
KW - HIV
KW - HIV management outcomes
KW - Nigeria
KW - Sexual and gender minorities
KW - Social stigma
UR - http://www.scopus.com/inward/record.url?scp=85089932719&partnerID=8YFLogxK
U2 - 10.1186/s12889-020-09315-y
DO - 10.1186/s12889-020-09315-y
M3 - Article
C2 - 32842997
AN - SCOPUS:85089932719
SN - 1471-2458
VL - 20
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 1282
ER -