Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Biscayne Bay Campus-Academic 1, 277A, 3000, NE 151st Street, Miami, FL, 33181, USA.
Behavioral Science Research Institute, Miami, FL, USA.
Sci Rep. 2022 May 7;12(1):7511. doi: 10.1038/s41598-022-11647-1.
Vulnerability to contracting HIV among Men who have Sex with Men and Women (MSMW) was recognized early in the epidemic. However, while global HIV efforts have made tremendous progress for the heterosexually-identified population, the specific needs of MSMW were not directly addressed with tailored and context-adapted interventions. The purpose of this study was to inform this area of research by exploring patterns of stigma through sexual identity developmental history as well as coping mechanisms among MSMW living with HIV in Haiti. A qualitative descriptive study comprised of in-depth interviews with 32 MSMW living with HIV was carried out. Participants were recruited using snowball techniques. An inductive thematic analysis was conducted in NVivo, contextualized by the socio-ecological context of Haiti. MSMW reported struggling with their sexuality since their adolescence, often because of enacted stigma from family members, the community, and cultural conflicts. Most participants described experiencing anxiety, psychological distress, depression, social isolation, suicidal ideation and suicide attempts. Mechanisms for coping with stigma included self-acceptance, social support, hiding their sexual orientation, and tolerance of the voodoo religion. To combat stigma, and improve HIV treatment adherence and retention among MSMW, culturally-tailored multilevel initiatives should be implemented.
男男性行为者和女性中的艾滋病毒易感性在疫情早期就被认识到。然而，尽管全球艾滋病毒防治工作在异性恋人群中取得了巨大进展，但针对男男性行为者和女性的具体需求并未通过量身定制和适应环境的干预措施直接解决。本研究旨在通过探索艾滋病毒感染的男男性行为者和女性的性认同发展历史以及应对机制中的污名模式，为这一研究领域提供信息。这项定性描述性研究包括对 32 名艾滋病毒感染的男男性行为者和女性进行深入访谈。参与者是通过滚雪球技术招募的。在 NVivo 中进行了归纳主题分析，并结合了海地的社会生态背景。男男性行为者和女性报告说，他们从青春期开始就一直在与自己的性取向作斗争，这通常是因为家庭成员、社区和文化冲突导致的污名化。大多数参与者描述了经历焦虑、心理困扰、抑郁、社会孤立、自杀意念和自杀企图。应对污名的机制包括自我接受、社会支持、隐藏自己的性取向和对伏都教的宽容。为了消除污名，提高男男性行为者和女性的艾滋病毒治疗依从性和保留率，应实施文化上量身定制的多层次举措。
