Multi-level manifestations of sexual stigma among men with same-gender sexual experience in Ghana

BMC Public Health

Research

Melissa A. Stockton¹  Ransford Akrong²  Richard Vormawor²  Prince Amu-Adu³  Laura Nyblade⁴  Khalida Saalim⁴  Kwasi Torpey⁵  Gamji Rabiu Abu-Ba’are⁶  LaRon E. Nelson⁷  Richard Panix Amoh-Otu⁸ 

[1] Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA;New York State Psychiatric Institute, New York, NY, USA;Educational Assessment and Research Center, Accra, Ghana;Priorities on Rights & Sexual Health, Accra, Ghana;RTI International, Research Triangle Park, NC, USA;University of Ghana, Legon, Ghana;University of Rochester, Rochester, NY, USA;Yale School of Nursing, New Haven, CT, USA;Yale Institute for Global Health, New Haven, CT, USA;Yale Center for Interdisciplinary Research on AIDS, New Haven, CT, USA;Yale School of Public Health, New Haven, CT, USA;Youth Alliance for Health & Rights, Kumasi, Ghana;

关键词: Men who have sex with men;    MSM;    Anticipated stigma;    Perceived stigma;    Enacted stigma;    Internalized stigma;    Ghana;    West Africa;    Sexual stigma;    Same-gender sexuality;   

DOI  :  10.1186/s12889-023-15087-y

 received in 2022-09-15, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

Sexual stigma and discrimination toward men who have same-gender sexual experiences are present across the globe. In Ghana, same-gender sexual desires and relationships are stigmatized, and the stigma is sanctioned through both social and legal processes. Such stigma negatively influences health and other material and social aspects of daily life for men who have sex with men (MSM). However, there is evidence that stigma at the interpersonal level can intersect with stigma that may be operating simultaneously at other levels. Few studies provide a comprehensive qualitative assessment of the multi-level sexual stigma derived from the direct narratives of men with same-gender sexual experience. To help fill this gap on sexual stigma, we qualitatively investigated [1] what was the range of sexual stigma manifestations, and [2] how sexual stigma manifestations were distributed across socioecological levels in a sample of Ghanaian MSM. From March to September 2020, we conducted eight focus group discussions (FGDs) with MSM about their experiences with stigma from Accra and Kumasi, Ghana. Data from the FGDs were subjected to qualitative content analysis. We identified a range of eight manifestations of sexual stigma: (1) gossiping and outing; (2) verbal abuse and intrusive questioning; (3) non-verbal judgmental gestures; (4) societal, cultural, and religious blaming and shaming; (5) physical abuse; (6) poor-quality services; (7) living in constant fear and stigma avoidance; and (8) internal ambivalence and guilt about sexual behavior. Sexual stigma manifestations were unevenly distributed across socioecological levels. Our findings are consistent with those of existing literature documenting that, across Africa, and particularly in Ghana, national laws and religious institutions continue to drive stigma against MSM. Fundamental anti-homosexual sentiments along with beliefs associating homosexuality with foreign cultures and immorality drive the stigmatization of MSM. Stigma experienced at all socioecological levels has been shown to impact both the mental and sexual health of MSM. Deeper analysis is needed to understand more of the lived stigma experiences of MSM to develop appropriate stigma-reduction interventions. Additionally, more community-level stigma research and interventions are needed that focus on the role of family and peers in stigma toward MSM in Ghana.

【 授权许可】

CC BY   
© The Author(s) 2023