Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, E7146, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
AIDS Behav. 2011 Aug;15(6):1088-97. doi: 10.1007/s10461-010-9861-2.
Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM.
在撒哈拉以南非洲的大部分地区，同性性行为受到歧视。本研究在马拉维、纳米比亚和博茨瓦纳评估了男男性行为者（MSM）中歧视、获得和使用医疗保健服务之间的横断面关系以及艾滋病毒知识。调查和艾滋病毒筛查用于探索这些变量以及艾滋病毒的流行情况。总体而言，19%的男性筛查出艾滋病毒感染呈阳性。93%的人知道艾滋病毒通过与男性进行肛交传播，但只有 67%的人曾获得过如何预防这种传播的信息。很少有人（17%）报告过曾向卫生专业人员透露过同性性行为，19%的人曾因性取向而害怕寻求医疗保健。男性报告曾被拒绝医疗服务（5%），21%的人曾因性取向而受到勒索。在经历歧视和害怕寻求医疗保健服务之间观察到强烈的关联。描述耻辱感与寻求医疗保健服务的行为和态度之间的关系，可以为非洲 MSM 的艾滋病毒干预措施的制定和实施提供信息。
