School of Community & Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA.
Department of Epidemiology, School of Public Health, Johns Hopkins Bloomberg, Baltimore, MD, USA.
Glob Public Health. 2022 Jan;17(1):150-164. doi: 10.1080/17441692.2020.1860248. Epub 2020 Dec 11.
Sexual prejudice toward men who have sex with men (MSM) is a pressing concern in sub-Saharan Africa (SSA). Given the high HIV infection risk among this population, sexual prejudice perpetuated by healthcare providers, affects access to and willingness of MSM to seek HIV care services. However, data on healthcare providers' attitudes towards MSM in SSA are limited, and there are no locally-adapted measures of sexual prejudice. We adapted a scale to measure sexual prejudice with a sample of 147 healthcare providers in western Kenya. Results from exploratory factor analysis revealed a single-factor structure. The scale demonstrated high internal consistency with Cronbach's = 0.91. Healthcare providers who had prior interpersonal contact with MSM, had ever been trained on counselling MSM, and had higher knowledge about MSM health needs reported lower sexual prejudice scores, compared with peers who lacked these experiences ( < 0.001). In contrast, healthcare providers who had experienced secondary stigma (negative judgments from peers and community) for providing care to MSM reported higher scores of sexual prejudice scale ( < 0.001) compared with providers who had not experienced secondary stigma. The scale provides a contextualised tool to assess healthcare providers' attitudes toward MSM in Kenya and countries in SSA with similar cultural norms.
性取向对男男性行为者（MSM）的偏见是撒哈拉以南非洲（SSA）的一个紧迫问题。鉴于该人群的 HIV 感染风险较高，医疗保健提供者所延续的性偏见会影响 MSM 获得和愿意寻求 HIV 护理服务的机会。然而，关于 SSA 中医疗保健提供者对 MSM 的态度的数据有限，而且没有针对性偏见的本土化测量工具。我们在肯尼亚西部的 147 名医疗保健提供者中采用了一种量表来测量性偏见。探索性因素分析的结果显示出单一因素结构。该量表的内部一致性很高，克朗巴赫系数为 0.91。与缺乏这些经验的同行相比，有过与 MSM 人际接触、接受过咨询 MSM 培训、对 MSM 健康需求有更高了解的医疗保健提供者，报告的性偏见得分较低（<0.001）。相比之下，经历过次要污名化（来自同行和社区的负面评价）的医疗保健提供者报告的性偏见量表得分更高（<0.001），而没有经历过次要污名化的提供者则较低。该量表提供了一种基于情境的工具，用于评估肯尼亚和 SSA 中具有类似文化规范的国家中医疗保健提供者对 MSM 的态度。
