@article{5d78311268ff49209a893d4e2bb94483,
title = "Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria",
abstract = "Disclosure of same-sex sexual practices by men who have sex with men (MSM) and transgender women (TGW) may facilitate appropriate healthcare engagement, including risk assessment for HIV and other sexually transmitted infections (STIs), and negotiation of condom use with partners. However, disclosure may also generate stigma. In these cross-sectional analyses, MSM and TGW were categorized based on self-report of disclosure to family members and healthcare providers (HCP) at enrollment into the TRUST/RV368 study of comprehensive HIV and STI care programs in Abuja and Lagos, Nigeria. Multivariable Poisson regression models with robust error variance were used to estimate relative risk of disclosure with 95% confidence intervals. Pearson{\textquoteright}s chi-squared test was used to compare condom use and stigma indicators by disclosure status. Of 2557 participants who answered baseline questions about disclosure, 384 (15.0%) had ever disclosed to a family member and 733 (28.7%) to HCP, including 192 (7.5%) who disclosed to both. Higher education, prevalent HIV infections, and residence in Lagos were each associated with increased likelihood of disclosure to family and HCP. Older participants were more likely to disclose to HCP but not family. Participants who made a disclosure to family or HCP were more likely to report condom use during anal sex as well as perceived and experienced stigma that included healthcare avoidance, blackmail, assault, and sexual violence as compared to participants who had not disclosed. Improved disclosure practices within safe spaces may enhance engagement of MSM and TGW in healthcare and HIV prevention services.",
keywords = "AIDS, Gender and sexual minorities, Nigeria, Sexual orientation, Stigma, Transgender",
author = "{For the TRUST/RV368 Study Group} and Afoke Kokogho and Senate Amusu and Baral, {Stefan D.} and Charurat, {Manhattan E.} and Sylvia Adebajo and Olumide Makanjuola and Veronica Tonwe and Casey Storme and Michael, {Nelson L.} and Robb, {Merlin L.} and Ake, {Julie A.} and Nowak, {Rebecca G.} and Crowell, {Trevor A.}",
note = "Funding Information: The study team would like to thank the study participants for their valuable contributions to this research. The TRUST/RV368 Study Group includes Principal Investigators: Manhattan Charurat (University of Maryland, Baltimore, MD, USA), Julie Ake (Walter Reed Army Institute of Research, Silver Spring, MD, USA); Co-Investigators: Sylvia Adebajo, Stefan Baral, Erik Billings, Trevor Crowell, George Eluwa, Abiola Fasina, Charlotte Gaydos, Sosthenes Ketende, Afoke Kokogho, Hongjie Liu, Jennifer Malia, Olumide Makanjuola, Nelson Michael, Nicaise Ndembi, Jean Njab, Rebecca Nowak, Oluwasolape Olawore, Zahra Parker, Sheila Peel, Habib Ramadhani, Merlin Robb, Cristina Rodriguez-Hart, Eric Sanders-Buell, Sodsai Tovanabutra; Eric Volz; Institutions: Institute of Human Virology at the University of Maryland School of Medicine, University of Maryland School of Public Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University School of Medicine, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Henry M. Jackson Foundation for the Advancement of Military Medicine, Henry M. Jackson Foundation Medical Research International, Institute of Human Virology Nigeria, International Centre for Advocacy for the Right to Health, The Initiative for Equal Rights, Population Council (Pop Council) Nigeria, Imperial College London. This work was presented, in part, at the INTEREST Workshop in Lilongwe, Malawi, May 16?19, 2017. Funding Information: This work was supported by a cooperative agreement between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the U.S. Department of Defense [W81XWH-11-2-0174]; the National Institutes of Health [R01 MH099001, R01 AI120913, R01 MH110358]; Fogarty Epidemiology Research Training for Public Health Impact in Nigeria program [D43TW010051]; and the President{\textquoteright}s Emergency Plan for AIDS Relief through a cooperative agreement between the Department of Health and Human Services/Centers for Disease Control and Prevention, Global AIDS Program, and the Institute for Human Virology Nigeria [NU2GGH002099]. Acknowledgements Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2021",
month = may,
doi = "10.1007/s10508-020-01644-8",
language = "English (US)",
volume = "50",
pages = "1665--1676",
journal = "Archives of Sexual Behavior",
issn = "0004-0002",
publisher = "Springer New York",
number = "4",
}