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

An amendment to this paper has been published and can be accessed via the original article.

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

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.

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

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.

Male Sex Workers Selling Physical Sex during the COVID-19 Pandemic in Portugal: Motives, Safer Sex Practices, and Social Vulnerabilities

The purpose of this research was to assess the motives, safer sex practices, and vulnerabilities of male sex workers who sold physical sex during the COVID-19 pandemic. This study used a mixed strategy, utilizing purposive sampling techniques to conduct 13 online surveys with male sex workers working in Portugal during the COVID-19 pandemic. Participants were aged between 23 and 47 years old and mostly provided their services to other men. Additionally, half of the participants were immigrants. Participants mentioned paying for essential expenses (rent, food, phone, etc.), having money for day-to-day expenses, wanting to, and enjoying it, as their main motives for engaging in sex work. Regarding sexual practices, 3 to 11 participants did not always or did not consistently use condoms during penetrative sex with their clients. Thematic analysis was used to identify the following repeated patterns of meaning regarding COVID-19-related vulnerabilities, encompassing a loss of clients and income, increased work availability, price reductions and negotiation difficulties, emotional functioning, health care access, safer sex negotiations, age, and immigration status. The findings serve as a basis for recommendations regarding social policies aimed at male sex workers who sell physical sex in Portugal.

Prospective Longitudinal Study of Men Who Have Sex With Men and Transgender Women To Determine HIV Incidence in Two Provinces in Thailand

Background In Thailand, HIV transmission is well characterized in large urban centers such as Bangkok and Chiang Mai but less so outside of these areas. We assessed HIV incidence and associated risk factors in two other locations. Methods Participants assigned male sex at birth were enrolled in Nakhon Ratchasima and Ratchaburi. HIV and syphilis testing and sociobehavioral questionnaires occurred over 18 months. HIV incidence rates and 95% confidence intervals (CIs) were estimated using a Poisson distribution. Cox proportional hazards models were used to estimate unadjusted and adjusted hazard ratios (aHRs) and 95% CIs for associations between potential risk factors and HIV seroconversion. Results A total of 1003 participants were enrolled. Overall HIV incidence was 1.56 per 100 person-years (95% CI:1.02–2.44) and similar at both sites. In the fully adjusted model, receptive anal sex in the past 6 months was associated with seroconversion (aHR:3.05, 95% CI:1.00-9.32), while sex with a sex worker in the past six months was associated with reduced risk of seroconversion (aHR:0.11, 95% CI:0.01–0.80). In the parsimoniously adjusted model, receptive anal sex (aHR:3.35, 95% CI:1.30–8.63) and STI diagnosis in the past six months (aHR:3.39, 95% CI:1.11–10.29) were associated with seroconversion, while sex with a sex worker in the past six months was associated with reduced risk of seroconversion (aHR:0.12, 95% CI:0.02–0.70). Conclusions Recent receptive anal sex practices were associated with HIV acquisition in these populations, highlighting the continued need for interventions encouraging safer anal sex practices to reduce HIV incidence.

Race-Based Sexual Stereotypes, Gendered Racism, and Sexual Decision Making Among Young Black Cisgender Women

Background. Due to their intersecting racial identity and gender identity, Black women are characterized by stigmatizing race-based sexual stereotypes (RBSS) that may contribute to persistent, disproportionately high rates of adverse sexual and reproductive health outcomes. RBSS are sociocognitive structures that shape Black women’s social behavior including their sexual scripts. Objective. The purpose of this study was to explore the influence of RBSS on the sexual decision making of young Black women (YBW). Methods. We conducted four focus groups with 26 YBW between the ages of 18 and 25, living in a New York City neighborhood with a high HIV prevalence. Qualitative analysis was used to identify emergent themes within the domains of sexual decision making as it relates to safer sex practices and partner selection. Results. Thematic analyses revealed that RBSS may cause women to adopt more traditional gender stereotypes and less likely to feel empowered in the sexual decision making. Participants reported that RBSS may lead Black women to being resistant to learning new information about safer sex practices, feeling less empowered within intimate relationships, and jeopardizing their sexual well-being to affirm themselves in other social areas encouraging unprotected sex and relationships with men who have multiple sex partners. Discussion and Conclusion. Future research should focus on understanding the social and cultural factors that influence Black women’s power in maintaining and improving their sexual health, including the aforementioned stereotypes that have influenced how others may view them as well as how they view themselves.

The Extent of Premarital Sex Practices among Secondary Schools Adolescents in Local Government Area of Ebonyi State, South Eastern Nigeria

Aims: This study aimed at determining the extent of premarital sex practices among secondary school adolescents in Ikwo Local Government Area of Ebonyi State. Its objectives were to reveal the extent at which secondary school students engage in premarital sex in the area and how such practices can propel risky behaviors among them. Study Design: The descriptive survey research design was adopted for the study. Methodology: Multi-stage sampling procedure was used to select 844 secondary school adolescents for the study. Information was retrieved from the field through questionnaire administration. Means and standard deviation were used to answer the research questions while the chi-square statistical tool was used in testing the null hypotheses in the study. Results: The result showed that the premarital sex in the study was at low extent with the grand mean score x̅=2.26. However, the result indicated that 16% of the students engage in penetrative virginal sex, anal sex, oral sex and masturbation whereas 84% of the students do not. Recommendation: The study recommended among others that: All the head teachers and principals should play an active role by coming up with awareness program through seminar, rallies with strong guidance on dangers associated with premarital sex. Also, parents should always discus sex education with their children to be adequately informed with the right information about sex and the behaviour to adopt as they grow to puberty period to avoid engaging in premarital sexual practice at this early stage.