Stigma, Social Cohesion, and HIV Risk Among Sexual and Gender Minorities in Two Cities in Zimbabwe

AIDS Behav. 2022 Sep;26(9):2994-3007. doi: 10.1007/s10461-022-03622-8. Epub 2022 Mar 18.

Abstract

Though stigma is a recognized contributor to the disproportionate HIV burden among sexual and gender minorities (SGM) in sub-Saharan Africa, data describing this association among Zimbabwean SGM are limited. We examined relationships between SGM stigma and HIV and the potential for social cohesion to moderate the association among Zimbabwean men who have sex with men, transgender women, and genderqueer individuals. Consenting participants (n = 1511) recruited through respondent-driven sampling for a biobehavioral survey in Harare and Bulawayo completed structured interviews and received HIV testing. Reported SGM stigma was common (68.9% in Harare and 65.3% in Bulawayo) and associated with HIV infection in Harare (adjusted prevalence ratio [aPR] = 1.82, 95% confidence interval [CI] = 1.27-2.62) and Bulawayo (aPR = 1.51, 95% CI = 1.15-2.00) in relative risk regression. Social cohesion did not moderate these relationships. Findings demonstrate stigma's association with HIV vulnerability among Zimbabwean SGM, highlighting the need for stigma-mitigation to reduce HIV transmission in this population.

Keywords: HIV; MSM; Social cohesion; Stigma; Sub-Saharan Africa.

MeSH terms

  • Cities
  • Female
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Social Cohesion*
  • Social Stigma*
  • Zimbabwe / epidemiology