The immediate eff ect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria

Analysis of prospective data from the TRUST cohort

Sheree Schwartz, Rebecca G. Nowak, Ifeanyi Orazulike, Babajide Keshinro, Julie Ake, Sara Kennedy, Ogbonnaya Njoku, William A. Blattner, Manhattan E. Charurat, Stefan Baral

Research output: Contribution to journalArticle

Abstract

Background In January, 2014, the Same-Sex Marriage Prohibition Act was signed into law in Nigeria, further criminalising same-sex sexual relationships. We aimed to assess the immediate eff ect of this prohibition act on stigma, discrimination, and engagement in HIV prevention and treatment services in men who have sex with men (MSM) in Nigeria. Methods The TRUST cohort study uses respondent-driven sampling to assess the feasibility and eff ectiveness of engagement of MSM in HIV prevention and treatment services at a clinical site located with a community-based organisation trusted by the MSM community. TRUST is a prospective implementation research cohort of MSM (=16 years) in Abuja, Nigeria. We compared HIV clinical outcomes and stigma, including fear and avoidance of health care, across baseline and quarterly visits before and after implementation of the the Same-Sex Marriage Prohibition Act. Outcomes assessed were measures of stigma and discrimination, loss to follow-up, antiretroviral therapy status, and viral load. We compared outcomes before and after the legislation with χ2 statistics, and estimated incident stigma-related events and loss to follow-up with Poisson regression. Findings Between March 19, 2013, and Aug 7, 2014, 707 MSM participated in baseline study procedures, contributing to 756 before legislation (prelaw) and 420 after legislation (postlaw) visits. Reported history of fear of seeking health care was signifi cantly higher in postlaw visits than in prelaw visits (n=161 [38%] vs n=187 [25%]; p

Original languageEnglish (US)
Pages (from-to)e299-e306
JournalThe Lancet HIV
Volume2
Issue number7
DOIs
StatePublished - Jul 1 2015

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Nigeria
Marriage
Legislation
HIV
Fear
Delivery of Health Care
Viral Load
Cohort Studies
Therapeutics
Organizations
Research

ASJC Scopus subject areas

  • Infectious Diseases
  • Epidemiology
  • Immunology
  • Virology

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The immediate eff ect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria : Analysis of prospective data from the TRUST cohort. / Schwartz, Sheree; Nowak, Rebecca G.; Orazulike, Ifeanyi; Keshinro, Babajide; Ake, Julie; Kennedy, Sara; Njoku, Ogbonnaya; Blattner, William A.; Charurat, Manhattan E.; Baral, Stefan.

In: The Lancet HIV, Vol. 2, No. 7, 01.07.2015, p. e299-e306.

Research output: Contribution to journalArticle

Schwartz, Sheree ; Nowak, Rebecca G. ; Orazulike, Ifeanyi ; Keshinro, Babajide ; Ake, Julie ; Kennedy, Sara ; Njoku, Ogbonnaya ; Blattner, William A. ; Charurat, Manhattan E. ; Baral, Stefan. / The immediate eff ect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria : Analysis of prospective data from the TRUST cohort. In: The Lancet HIV. 2015 ; Vol. 2, No. 7. pp. e299-e306.
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