Links between stigma, suicidal thoughts and less HIV testing in Nigerian men who have sex with men

By | January 1, 2019

The qualitative subsample differed in that they were more likely to be in the medium or high stigma classes, to have experienced suicidal ideation (46%), to have had an HIV test (75%), and were older on average than the quantitative sample.

Qualitative findings revealed that stigma resulted in isolation, emotional distress, avoidant behavior, enduring feelings of trauma and suicidal ideation. In 2014, Nigeria passed a further law criminalising same-sex practices. MSM expressed having no social support and nowhere to turn to for help.

“Anytime I’m alone, I have the trauma in my head, every minute, it comes on and scares me out… I don’t really go out. I hardly go out, even till now, I find it really difficult for me to go places.” (MSM)

“I feel like dying that time because I don’t have money to do anything. I cannot go to my village and tell them, see what happened so that they will help me with another money. You understand, because if you go to the village, ah, see, see, see, they will hear, you understand, so I feel like, in fact, I don’t know, I feel like hanging myself then.” (MSM, after a homophobic attack)

Participants were fearful of getting tested for HIV and disclosing same-sex practices in public health facilities. Many men felt safe seeking HIV/STI testing and treatment services at the MSM-friendly clinic set up as part of the study. They were often referred by fellow MSM who had advised that it was a safe space, highlighting the importance of peer networks.

“Whenever I’m sick, and I need to go to the hospital, I used to be scared. What if this doctor find out that I’m gay? So I wouldn’t go to the hospital. I would just stay at home and be fine.” (MSM)

“Is an MSM that told me that and gave me the courage. He counseled me very well, please go and know your status, and I tell him don’t worry I will go. The next day I went [to the MSM research clinic] and I do my test. He told me that am HIV positive.” (MSM)

Participants found that the research clinic became a site of psychosocial support, a space to meet other MSM and to get educated about HIV. Some participants expressed a desire for these psychosocial services to be expanded to provide more support for MSM in need.

“We have a lot of victims of suicide, we do. We have a lot of victims of depression, people who are depressed and they need to talk to either a psychologist or someone who can provide a psychosocial counseling for people. This would also help build self-esteem, but the issue of support group would also go a long way of helping this.” (MSM)

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