Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria

BMC Public Health

Research

Aaron Sunday¹  Morenike Oluwatoyin Folayan²  Hasiya Yunusa Nyako³  Anna Yakusik⁴  Erik Lamontagne⁵  Rilwan Mohammed Abdullah⁶  Amaka Enemo⁷  Amira Muhammad⁸  Henry Okiwu⁹ 

[1] African Network of Adolescent and Young Persons Development, Barnawa, Nigeria;Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria;Nigeria Institute of Medical Research, Yaba, Lagos State, Nigeria;Jami Al Hakeem Foundation Jimeta-Yola, Jimeta, Nigeria;Joint United Nations Programme on HIV/AIDS, Geneva, CH, Switzerland;Joint United Nations Programme on HIV/AIDS, Geneva, CH, Switzerland;School of Economics, Aix-Marseille University, Marseille, France;National Association of Persons with Physical Disability, Abuja, Nigeria;Nigeria Sex Workers Association, Kubwa, Nigeria;Northern Nigerian Transgender Initiative, Abuja, Nigeria;YouthRise, Abuja, Nigeria;

关键词: LGBT;    Transgender;    Public health;    Risk-taking;    HIV;    COVID-19;    Vulnerability, Inequality, Socioeconomic, Well-being;   

DOI  :  10.1186/s12889-023-16482-1

 received in 2022-08-31, accepted in 2023-08-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe aimed to explore socioeconomic inequality, health inequity, and the well-being of transgender people during the COVID-19 crisis in Nigeria.MethodsBetween June and December 2021, a cross-sectional survey was conducted collaboratively with community-based organisations in Nigeria. Participants living with or at risk of HIV were recruited voluntarily, online and face-to-face, using a combination of venue-based and snowball sampling. We assessed the association between gender identity (transgender and vulnerable cisgender women), and (i) socioeconomic inequality measured with socioeconomic status, social status, economic vulnerability, macrosocial vulnerability; (ii) health inequity measured with self-assessment of health, recency of HIV test, access to HIV and sexual and reproductive health services, gender-affirming care, financial and non-financial barriers to accessing health services; and (iii) well-being, measured with gender-based violence, mental health, psychoeconomic preferences. We used multivariable logistic regressions and controlled for interactions and confounders.ResultsThere were 4072 participants; 62% were under 30, and 47% reported living with HIV. One in ten (11.9%; n = 485) was transgender, and 56.5% reported living with HIV. Compared to vulnerable cisgender women, the results showed significantly higher odds (aOR:3.80) of disruption in accessing HIV services in transgender participants; gender-based violence (aOR:2.63); severe (aOR:2.28) symptoms of anxiety and depression. Among the barriers to accessing health and HIV services, transgender had three-time higher odds of reporting additional non-official fees compared to vulnerable cisgender women. The disclosure of their gender identity or sexual orientation was the most important non-financial barrier to accessing health services (aOR:3.16). Transgender participants faced higher housing insecurity (aOR: 1.35) and lower odds of using drugs (aOR:0.48). Importantly, they are more likely to have performed a recent HIV test and less likely to not know their HIV status (aOR:0.38) compared to vulnerable cisgender women.ConclusionsSocioeconomic inequality, health and well-being inequity in transgender people appear to be exacerbated by the COVID-19 pandemic in Nigeria. Interventions are necessary to mitigate socioeconomic challenges, address structural inequality, and ensure equitable access to health services to meet the Sustainable Development Goals for transgender people.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 4