Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso

Hae Young Kim, Ashley Grosso, Odette Ky-Zerbo, Marcel Lougue, Shauna Stahlman, Cesaire Samadoulougou, Gautier Ouedraogo, Seni Kouanda, Benjamin Liestman, Stefan Baral

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study is to examine the prevalence and correlates of perceived health care stigma among female sex workers (FSWs) and men who have sex with men (MSM), including other stigma types, suicidal ideation, and participation in social activities. Methods: FSWs (N = 350) and MSM (N = 330) aged ≥18 were recruited in Bobo-Dioulasso, Burkina Faso. Perceived health care stigma was defined as either ever being afraid of or avoiding health care services because someone might find out the participant has sex with men (for MSM) or sells sex (for FSW). Correlates of perceived health care stigma were examined using multivariable logistic regression. Results: The prevalence of perceived health care stigma was 14.9% (52/350) and 24.5% (81/330) in FSWs and MSM, respectively. Among FSWs, experienced or social stigma, including verbal harassment (adjusted odds ratio [aOR] = 3.59, 95% confidence interval [CI] 1.48–8.71), feeling rejected by friends (aOR = 2.30, 95% CI 1.14–4.64), and feeling police refused to protect them (aOR = 2.58, 95% CI 1.27–5.25), was associated with perceived health care stigma. Among MSM, experiencing verbal harassment (aOR = 1.95, 95% CI 1.09–3.50) and feeling scared to walk in public (aOR = 2.93, 95% CI 1.47–5.86) were associated with perceived health care stigma. Conclusions: In these key populations, perceived health care stigma was prevalent and associated with experienced and social stigmas. To increase coverage of effective HIV services, interventions should incorporate approaches to comprehensively mitigate stigma.

Original languageEnglish (US)
Pages (from-to)13-19
Number of pages7
JournalAnnals of epidemiology
Volume28
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • Female sex workers
  • HIV/AIDS
  • Health care utilization
  • Men who have sex with men
  • Stigma

ASJC Scopus subject areas

  • Epidemiology

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    Kim, H. Y., Grosso, A., Ky-Zerbo, O., Lougue, M., Stahlman, S., Samadoulougou, C., Ouedraogo, G., Kouanda, S., Liestman, B., & Baral, S. (2018). Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso. Annals of epidemiology, 28(1), 13-19. https://doi.org/10.1016/j.annepidem.2017.11.009