Adekemi O. Sekoni

Experiences of social oppression among men who have sex with men in a cosmopolitan city in Nigeria

Background In several African countries, men who have sex with men (MSM) are becoming visible, as a result of which they are now victims of human rights violations. This has a negative effect on their ability to access services targeted at human immunodeficiency virus (HIV) prevention and care. The main objective of this study was to document the experiences of social oppression among MSM in Lagos State, Nigeria. Methods Simple random sampling was used to select three of the seven local government areas in Lagos State that had community centers. Snowball sampling was used to recruit 291 participants. The survey instrument was a pretested questionnaire. The results were presented as means and percentages. Univariate, bivariate, and multivariate analysis was carried out at P<0.05. Results The mean age of the participants was 25.3±4.6 years, and the majority (66.0%) were currently single and not in a steady relationship. Half of the men self-identified as gay and about 48% as bisexual. Alcohol use occurred in 56.7% of the respondents, about a quarter (25.8%) smoked cigarettes, and 11.0% reported using hard drugs. The commonest acts of human rights violation and or violence reported were aggression 35.7%, alienation 29.9%, verbal abuse 19.2%, physical abuse 17.9%, rape by a man 16.8%, and psychological abuse 20.3%. The predictors of human rights violation were level of education (adjusted odds ratio 2.6, P=0.019), marital status (adjusted odds ratio 2.3, P=0.005), and sexual orientation (adjusted odds ratio 1.9, P=0.017). For physical and sexual abuse, MSM who consumed alcohol and were homosexual/transgender were at risk. Conclusion This study showed that a high proportion of MSM had experienced various forms of human rights violation and abuse as a result of their sexual orientation/identity. There is a need to document and quantify these happenings, which can serve as an advocacy tool for reform.

Trained Community Volunteers Improve Tuberculosis Knowledge and Attitudes Among Adults in a Periurban Community in Southwest Nigeria

Nigeria has the worlds 10th largest tuberculosis (TB) burden. Targeted community-based interventions can potentially help reduce TB incidence. We designed an intervention in a periurban community where 10 community volunteers were trained to provide community TB education and also detect and refer TB suspects to a nearby clinic. To determine the effect of the intervention on knowledge, attitude, and preventive practices of TB, we compared results from a pre-intervention survey with those of a post-intervention survey. Pre-intervention, respondents had a mean knowledge score of 10.6 ± 7.0 of a possible 34, a mean attitude score of 5.8 ± 3.3 of a possible 10, and a mean practice score of 5.3 ± 1.4 of a possible 7. The intervention significantly increased the mean knowledge score to 16 ± 5.4 (P < 0.001) and mean attitude score to 7.0 ± 1.8 (P < 0.001); however, there was no statistically significant difference in the mean practice score. Eight TB suspects were referred to the clinic, and one suspect was subsequently diagnosed with TB. The use of trained community volunteers to share information on TB improved the overall knowledge and attitudes of respondents. Continued empowerment of the community should be encouraged to promote TB prevention and care.

Uptake of HIV self-testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

HIV self‐testing (HIVST) offers an alternative to facility‐based HIV testing services, particularly for populations such as men who have sex with men (MSM) who may fear accessing testing due to stigma, discrimination and criminalization. Innovative HIV testing approaches are needed to meet the goal of 90% of people living with HIV being diagnosed. This study piloted an intervention to distribute oral HIVST kits to MSM through key opinion leaders (KOLs) in Lagos, Nigeria and assessed the feasibility, acceptability, uptake of HIVST and linkage to HIV treatment.

Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

Abstract Background People living with HIV and AIDS (PLWHA) experience some form of stigma which could lead to poor medication adherence. Objectives This study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy. Method A cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD) with seven participants at the clinic using an interview guide with open-ended questions. Results Overall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs) in unlabelled pill boxes. Conclusion This study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.