1 Department of Community Health and Primary Care, College of Medicine, University of Lagos , Lagos, Nigeria .
2 Department of Epidemiology & Biostatistics, University of Birmingham , Birmingham, United Kingdom .
LGBT Health. 2016 Aug;3(4):300-7. doi: 10.1089/lgbt.2015.0061. Epub 2016 Apr 19.
After signing of the Same-Sex Marriage (Prohibition) Act 2013 in Nigeria, media reports portray widespread societal intolerance toward the lesbian, gay, and bisexual population. This study was conducted to assess the attitudes of university undergraduates in Lagos state, Nigeria, toward provision of healthcare services for men who have sex with men (MSM), because the 2014 same-sex marriage prohibition law stipulates a jail sentence for organizations providing services to MSM.
A cross-sectional descriptive study was conducted by using self-administered questionnaires to collect information, including homophobic attitudes and views on access to healthcare, from 4000 undergraduates in 10 randomly selected faculties in two universities. During analysis, inter-university and inter-faculty comparison was carried out between medical and nonmedical students.
Outright denial of healthcare services to MSM was supported by 37.6% of the 3537 undergraduates who responded, whereas denial of HIV prevention services was supported by 32.5%. However, compared with 38.7% and 34.1% of undergraduates from other faculties, 23.7% and 18.2% of medical students agreed that healthcare providers should not provide services to MSM and that MSM should not have access to HIV prevention services, respectively (P = 0.000). Although a significant proportion of the medical students supported the statement that doctors and other healthcare workers should be compelled to give priority to other groups before MSM (29.4% of medical vs. 47.2% of students from other faculties), a statistically significant difference was observed between the two groups of students. The homophobic statement with the highest support was that doctors and healthcare workers should be compelled to report MSM who come to access treatment (48.1% of medical vs. 57.4% of students from other faculties).
A very high proportion of the undergraduate students had a negative attitude toward provision of healthcare services to MSM in Nigeria; the medical students were, however, less homophobic than their nonmedical counterparts. If attitudes translate to a lack of healthcare service provision to MSM, with the high burden of HIV among MSM in Nigeria, it is unlikely that the country will achieve the UNAIDS 90-90-90 target of 90% of the population knowing their HIV status, 90% of people living with HIV receiving sustained antiretroviral medication, and 90% of those receiving antiretroviral medication having viral suppression by 2020.
在 2013 年尼日利亚签署《同性婚姻（禁止）法案》后，媒体报道描绘了社会对女同性恋、男同性恋和双性恋群体的广泛不容忍。本研究旨在评估尼日利亚拉各斯州大学生对男男性行为者（MSM）医疗服务提供的态度，因为 2014 年的同性婚姻禁止法规定，为 MSM 提供服务的组织将被判处监禁。
采用横断面描述性研究，使用自填式问卷从两所大学的 10 个随机选定院系中收集 4000 名本科生的信息，包括恐同态度和获取医疗保健服务的观点。在分析过程中，对医学生和非医学生进行了校际和院系间的比较。
3537 名回应的本科生中，37.6%完全支持拒绝向 MSM 提供医疗服务，而 32.5%则支持拒绝提供 HIV 预防服务。然而，与其他院系的 38.7%和 34.1%的本科生相比，医学生分别有 23.7%和 18.2%的人同意医疗保健提供者不应该向 MSM 提供服务，而且 MSM 不应该获得 HIV 预防服务（P=0.000）。尽管相当一部分医学生支持医生和其他医疗工作者应该被迫在 MSM 之前优先考虑其他群体的说法（29.4%的医学生比其他院系的学生 47.2%），但这两个学生群体之间存在统计学上的显著差异。支持率最高的恐同言论是医生和医疗工作者应该被迫报告前来接受治疗的 MSM（48.1%的医学生比其他院系的学生 57.4%）。
尼日利亚相当一部分本科生对向 MSM 提供医疗服务持负面态度；然而，医学生比非医学生的恐同程度要低。如果这些态度转化为向 MSM 提供医疗服务的不足，而尼日利亚 MSM 中 HIV 的负担又很高，那么该国不太可能实现 UNAIDS 到 2020 年实现 90-90-90 目标，即 90%的人口知晓其艾滋病毒状况，90%的艾滋病毒感染者接受持续的抗逆转录病毒药物治疗，90%接受抗逆转录病毒药物治疗的人病毒得到抑制。
