Journal of the International Association of Providers of AIDS Care (Mar 2021)

Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa

  • Lily Y. Gu MPH,
  • Nanhua Zhang PhD,
  • Kenneth H. Mayer MD,
  • James M. McMahon PhD,
  • Soohyun Nam PhD, APRN, ANP-BC, FAHA,
  • Donaldson F. Conserve PhD,
  • Marian Moskow MS,
  • Judith Brasch MS, RN,
  • Yaw Adu-Sarkodie MD, MPH,
  • Thomas Agyarko-Poku MD, PhD, FRSM,
  • Francis Boakye BFA,
  • LaRon E. Nelson PhD, RN, FNP, FNAP, FAAN

DOI
https://doi.org/10.1177/2325958220978113
Journal volume & issue
Vol. 20

Abstract

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In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM ( N = 225) living with HIV in Ghana. Autonomy-supportive healthcare climate ( OR = 1.63, p < .01), vicarious HIV stigma ( OR = 2.73, p < .01), and age ( OR = 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC ( OR = 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.