Publisher Correction To: Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries

Abstract Background For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma. Methods We performed mixed-effects regressions on pooled data from MSM in Cameroon, Senegal, Côte d’Ivoire, Lesotho, and eSwatini to assess associations between disclosure and sexual behavior stigma in healthcare contexts; we used logistic regressions to analyze country-specific data. Results Compared to participants who had not disclosed to either family or HCWs, those who had disclosed only to family were more likely to have been gossiped about by HCWs (aOR = 1.70, CI = 1.18, 2.45); the association between having disclosed to family and having felt mistreated in a health center approached, but did not achieve, statistical significance (aOR = 1.56, CI = 0.94, 2.59). Those who had disclosed only to HCWs were more likely to have feared to seek health services (aOR = 1.60, CI = 1.14, 2.25), avoided health services (aOR = 1.74, CI = 1.22, 2.50), and felt mistreated in a health center (aOR = 2.62, CI = 1.43, 4.81). Those who had disclosed to both were more likely to have feared to seek health services (aOR = 1.71, CI = 1.16, 2.52), avoided health services (aOR = 1.59, CI = 1.04, 2.42), been gossiped about by HCWs (aOR = 3.78, CI = 2.38, 5.99), and felt mistreated in a health center (aOR = 3.39, CI = 1.86, 6.20). Country-specific analyses suggested that data from Cameroon drove several of these associations. Conclusions Research to determine the factors driving disclosure’s differential effect on healthcare stigma across contexts is needed. Ultimately, supportive environments enabling safe disclosure is critical to understanding HIV-acquisition risks and informing differentiated HIV-prevention, treatment, and testing services for MSM across SSA.

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Being Gay and African: A View from an African Philosopher

Phronimon ◽

10.25159/2413-3086/2056 ◽

2017 ◽

Vol 18 ◽

pp. 59-78 ◽

Cited By ~ 5

Author(s):

Bernard Matolino

Keyword(s):

Same Sex ◽

African Countries ◽

Sex Orientation ◽

Sex Practices

In recent times there has been an upsurge in the rejection of gay orientation. A number of African countries have openly legislated against homosexual acts to undergird the belief that such orientation is alien to being African. The vitriol directed at gay people does not make much sense apart from displaying either a deep-seated resentment for the persons or their orientation. What seems valuable and worth of engagement is the claim that being gay or upholding same-sex orientation, is essentially un-African. By setting up a charitable interpretation of what opponents of same-sex relations could possibly take African reality to be, I chart a way that seeks to establish whether their interpretation of that reality is philosophically sound. What could be the basis of objections to homosexuality? What values do they articulate? Crucial to this consideration is the idea of harm. While societies are entitled to protecting themselves (through legislation and other actions if need be) from threats both from within and without, are there good grounds to think that same-sex practices pose an authentic form of harm to warrant taking the steps that some African nations have taken against their gay citizens?

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Context Within Which Female Same-Sex Develops and Practiced in Tanzania: Qualitative Study among Women Who Have Sex with Women in Dar-es-Salaam City

Journal of Medical Research and Surgery ◽

10.52916/jmrs214059 ◽

2021 ◽

pp. 1-5

Author(s):

Jackline V. Mbishi ◽

Switbert R. Kamazima ◽

Happiness P. Saronga ◽

Saidah M. Bakari

Keyword(s):

Peer Influence ◽

Dar Es Salaam ◽

Sex Behavior ◽

Same Sex ◽

Cross Sectional ◽

Opt Out ◽

Sex With Men ◽

Heterosexual Sex ◽

Sex Orientation ◽

Sex Practices

Background: Homosexual identification among women as lesbian, bisexual or transgender does not encompass the whole pool of women who practice same-sex behavior. Straight women especially youths are more increasingly willing to have sex with fellow women. This article establishes the reasons that influence same-sex orientation and behaviors among women in Tanzania. It explores the self-reported push/pull reasons that ultimately leads women to same-sex behavior among sampled through individuals. Method: This is a cross-sectional descriptive and retrospective study which was conducted in Dar es Salaam between January and February, 2021. The participants of the study were WSW, proxy WSW, and women who at one time had female same-sex relationships. The study also used community members aged 18 years and above but only those who met the inclusion criteria. Data were collected through qualitative in-depth interviews, focus group discussions, interviews, and life stories. All the data generated through the study were analyzed thematically. Results: The findings indicate that women who practice same-sex behavior believe that their behavior occurs naturally through biological reasons. Some of them attribute earlier negative experiences with men as a trigger to opt out of heterosexual sex. Most participants also cited past unpleasant sexual experiences with men such as rape, being emotionally detached from men as factors that lead to developing desires to have sex with fellow women. Conclusion: There are biological and social-economic factors that lead women to practice same-sex behaviors. Women, who are born with male attributes become sexually unattracted to males, opt to engage in same-sex practices because of displeasure from having sex with men. Further, economic hardships in societies force women to engage in same-sex practices through peers who are financially well-off and are searching for peers to exploit sexually. Research should focus on investigating peer influence and social media’s effects on women’s decision to engage in same sex practices.

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Prevalence and factors associated to disclosure of same-sex practices to family members and health care workers among men who have sex with men in Togo

AIDS Care ◽

10.1080/09540121.2019.1612000 ◽

2019 ◽

Vol 31 (8) ◽

pp. 1019-1025

Author(s):

Horacio Ruiseñor-Escudero ◽

Carrie Lyons ◽

Sosthenes Ketende ◽

Vincent Pitche ◽

Anato Simplice ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Family Members ◽

Same Sex ◽

Factors Associated ◽

Care Workers ◽

Sex With Men ◽

Sex Practices

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Characterizing Cross-Culturally Relevant Metrics of Stigma Among Men Who Have Sex With Men Across 8 Sub-Saharan African Countries and the United States

American Journal of Epidemiology ◽

10.1093/aje/kwz270 ◽

2020 ◽

Vol 189 (7) ◽

pp. 690-697 ◽

Cited By ~ 4

Author(s):

Jura L Augustinavicius ◽

Stefan D Baral ◽

Sarah M Murray ◽

Kevon Jackman ◽

Qian-Li Xue ◽

...

Keyword(s):

United States ◽

Sexual Behavior ◽

Root Mean Square ◽

Factor Model ◽

The United States ◽

Sub Saharan Africa ◽

Mean Square ◽

African Countries ◽

Sub Saharan ◽

Sex With Men

Abstract Overcoming stigma affecting gay, bisexual, and other men who have sex with men (MSM) is a foundational element of an effective response to the human immunodeficiency virus (HIV) pandemic. Quantifying the impact of stigma mitigation interventions necessitates improved measurement of stigma for MSM around the world. In this study, we explored the underlying factor structure and psychometric properties of 13 sexual behavior stigma items among 10,396 MSM across 8 sub-Saharan African countries and the United States using cross-sectional data collected between 2012 and 2016. Exploratory factor analyses were used to examine the number and composition of underlying stigma factors. A 3-factor model was found to be an adequate fit in all countries (root mean square error of approximation = 0.02–0.05; comparative fit index/Tucker-Lewis index = 0.97–1.00/0.94–1.00; standardized root mean square residual = 0.04–0.08), consisting of “stigma from family and friends,” “anticipated health-care stigma,” and “general social stigma,” with internal consistency estimates across countries of α = 0.36–0.80, α = 0.72–0.93, and α = 0.51–0.79, respectively. The 3-factor model of sexual behavior stigma cut across social contexts among MSM in the 9 countries. These findings indicate commonalities in sexual behavior stigma affecting MSM across sub-Saharan Africa and the United States, which can facilitate efforts to track progress on global stigma mitigation interventions.

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Age-dependent inequalities in HIV/STI burden and care receipt among men and transgender persons who have sex with men in Nairobi

10.1101/2021.06.23.21259373 ◽

2021 ◽

Author(s):

Adrian Smith ◽

Elizabeth Fearon ◽

Rhoda Kibuti ◽

Erastus Irungu ◽

Mary Kungu ◽

...

Keyword(s):

Viral Load ◽

Self Report ◽

Sub Saharan Africa ◽

Hiv Care ◽

Hiv Diagnosis ◽

African Countries ◽

Hiv Viral Load ◽

Transgender Persons ◽

Sub Saharan ◽

Sex With Men

Background Gay, bisexual and other men who have sex with men (GBMSM) and transgender persons (TP) bear high burdens of HIV and other sexually transmitted infections (STIs) in sub-Saharan Africa, yet evidence of HIV care coverage for these groups is sparse from the region despite prevailing stigma and discrimination towards these groups. Methods 618 GBMSM/TP were recruited in Nairobi between May to December 2017 using respondent-driven sampling. Participants reported recent sexual behaviour, HIV testing and care receipt, and symptoms of STIs. Participants tested for HIV using Kenyan testing algorithms and GeneXpert methods, syphilis, viral hepatitis and ano-genital gonorrhoea and chlamydia. We assessed associations with HIV status and detectable HIV viral load using multivariable robust Poisson regression models. Findings 26.4% (286/618) were HIV positive of whom 76.5% were status aware, 65.3% were on ART, and 47.4% were virally suppressed (<50 copies/ml). Participants 18-22 years old were less likely to be status aware, be receiving ART or to have achieved viral suppression. Mean log viral load was 3.14 log higher in 18-22 year olds compared to older participants. Bacterial STIs were frequently detected at both urethral and rectal sites and a majority of infections at both sites were asymptomatic by self-report (rectal 82.2%, urethral 90.8%). Interpretation Engagement in the HIV diagnosis and care cascade among GBMSM/TP in Kenya is markedly better than in most sub-Saharan African countries. However it falls short of achievements among the general population in the country and cascades achieved in GBMSM in high income settings. Young men and transgender persons who have sex with men are least well served by the current configuration of adult key population services, and programmes should identify and address the sexual, social and developmental needs of adolescent and young key populations

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Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

10.2196/preprints.26347 ◽

2020 ◽

Author(s):

Ngozi A Erondu ◽

Sagal A Ali ◽

Mohamed Ali ◽

Schadrac C Agbla

Keyword(s):

Public Health ◽

Sub Saharan Africa ◽

Specific Information ◽

Surveillance Systems ◽

Health Seeking ◽

African Countries ◽

Cross Sectional Survey ◽

Local Networks ◽

The World ◽

Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

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Managing African Urbanization in the Context of Environmental Change

INTERdisciplina ◽

10.22201/ceiich.24485705e.2014.2.46528 ◽

2014 ◽

Vol 2 (2) ◽

Cited By ~ 13

Author(s):

Shuaib Lwasa

Keyword(s):

Climate Change ◽

Economic Growth ◽

Social Services ◽

Urban Areas ◽

Urban Governance ◽

Sub Saharan Africa ◽

African Countries ◽

Sub Saharan ◽

Urbanization Rate ◽

Development And Management

Africa’s urbanization rate has increased steadily over the past three decades and is reported to be faster than in any other region in the world . It is estimated that by 2030, over half of the African population will be living in urban areas . But the nature of Africa’s urbanization and subsequent form of cities is yet to be critically analyzed in the context of city authorities’ readiness to address the challenges . Evidence is also suggesting that urbanization in African countries is increasingly associated with the high economic growth that has been observed in the last two decades . Both underlying and proximate drivers are responsible for the urbanization, and these include population dynamics, economic growth, legislative designation, increasing densities in rural centers, as well as the growth of mega cities such as Lagos, Cairo and Kinshasa, that are extending to form urban corridors . With the opportunities of urbanization in Sub–Saharan Africa, there are also challenges in the development and management of these cities . Those challenges include provision of social services, sustainable economic development, housing development, urban governance, spatial development guidance and environmental management, climate change adaptation, mitigation and disaster risk reduction . The challenge involves dealing with the development and infrastructure deficit, in addition to required adaption to and mitigation of climate change . This paper examines the current state of urban management in Africa .

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Monetary Policy in Sub-Saharan Africa

10.1093/oso/9780198785811.001.0001 ◽

2018 ◽

Cited By ~ 1

Keyword(s):

Monetary Policy ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

African Countries ◽

Policy Regimes ◽

Export Prices ◽

Policy Work ◽

Sub Saharan ◽

Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

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Financing Energy Access in Africa

10.1093/oso/9780198819837.003.0006 ◽

2018 ◽

Author(s):

Peter Kayode Oniemola ◽

Jane Ezirigwe

Keyword(s):

Oil And Gas ◽

Sub Saharan Africa ◽

Capital Investments ◽

Energy Access ◽

African Countries ◽

Sustainable Technologies ◽

Energy Technologies ◽

Sub Saharan ◽

Diesel Motors

To achieve universal energy access will attract huge capital investments. If sub-Saharan Africa is to realize anything close to the ambitious goals set for its energy access, then new actors, innovative funding mechanisms and sustainable technologies will have to be attracted. Finance is needed for activities such as rural electrification, clean cooking facilities, diesel motors and generators, other renewable energy technologies, oil and gas infrastructures, etc. Finance is also needed in research and development of suitable technologies and funding options as well as investment in the capacity to formulate and implement sound energy policies. This chapter examines the varied financing options for energy access in sub-Saharan Africa. It argues that with appropriate laws in place and effective mechanism for implementation, African countries can significantly engage private sector financing, international financial institutions and foreign donors. The role of the law here will be in creating an enabling environment for financing.

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