Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa
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Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
Objectives Sexual and gender minority (SGM) populations
in sub-Saharan Africa (SSA) are disproportionately
impacted by HIV and often face multiple HIV-related
stigmas. Addressing these stigmas could reduce SGM HIV
vulnerability but little is known about how the stigmas
operate and intersect. Intersectional stigma offers a lens for
understanding the experiences of stigmatised populations
and refers to the synergistic negative health effects of
various systems of oppression on individuals with multiple
stigmatised identities, behaviours or conditions. This
review aims to (1) assess how often and in what ways an
intersectional lens is applied in HIV-related stigma research
on SGM populations in SSA and (2) understand how
intersectional stigma impacts HIV risk in these populations.
Design Scoping review following the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis extension
for Scoping Reviews.
Data sources Public health and regional databases were
searched in 2020 and 2022.
Eligibility criteria Articles in French and English on HIV related stigma and HIV outcomes among men who have
sex with men, women who have sex with women and/or
transgender individuals in SSA.
Data extraction and synthesis Articles were screened
and extracted twice and categorised by use of an
intersectional approach. Study designs and stigma
types were described quantitatively and findings on
intersectional stigma were thematically analysed.
Results Of 173 articles on HIV-related stigma among SGM
in SSA included in this review, 21 articles (12%) applied
an intersectional lens. The most common intersectional
stigmas investigated were HIV and same-sex attraction/
behaviour stigma and HIV, same-sex attraction/behaviour
and gender non-conformity stigma. Intersectional stigma
drivers, facilitators and manifestations were identified
across individual, interpersonal, institutional and societal
socioecological levels. Intersectional stigma impacts HIV
vulnerability by reducing HIV prevention and treatment
service uptake, worsening mental health and increasing
exposure to HIV risk factors.
Conclusion Intersectional approaches are gaining
traction in stigma research among SGM in SSA. Future
research should prioritise quantitative and mixed methods
investigations, diverse populations and intervention
evaluation.
Description
Research Article
Keywords
sexual, gender minorities, HIV-related
Citation
Dada D, Abu-Ba’are GR, Turner DA, et al. Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub Saharan Africa. BMJ Open 2024;14:e078794. doi:10.1136/ bmjopen-2023-078794