TY - JOUR
T1 - Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso
AU - Kim, Hae Young
AU - Grosso, Ashley
AU - Ky-Zerbo, Odette
AU - Lougue, Marcel
AU - Stahlman, Shauna
AU - Samadoulougou, Cesaire
AU - Ouedraogo, Gautier
AU - Kouanda, Seni
AU - Liestman, Benjamin
AU - Baral, Stefan
N1 - Funding Information:
The USAID and Project SEARCH, Task Order No. 2, is funded by the US Agency for International Development under Contract No. GHH-I-00-0700,032-00, beginning September 30, 2008, and supported by the President's Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project is led by the Johns Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). This publication was also made possible with help from the Johns Hopkins University Center for AIDS Research, an NIH-funded program (P30AI094189), which is supported by the following NIH cofunding and participating institutes and centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
KW - Female sex workers
KW - HIV/AIDS
KW - Health care utilization
KW - Men who have sex with men
KW - Stigma
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U2 - 10.1016/j.annepidem.2017.11.009
DO - 10.1016/j.annepidem.2017.11.009
M3 - Article
C2 - 29425532
AN - SCOPUS:85044666575
SN - 1047-2797
VL - 28
SP - 13
EP - 19
JO - Annals of epidemiology
JF - Annals of epidemiology
IS - 1
ER -