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Characterizing Cross-Culturally Relevant Metrics of Stigma among Men who have Sex with Men across Eight Sub-Saharan African Countries and the United States.
Am J Epidemiol. 2020 Jan 13 [Online ahead of print]AJ

Abstract

Overcoming stigma affecting gay, bisexual, and other men who have sex with men (MSM) is a foundational element of an effective HIV pandemic response. Quantifying the impact of stigma mitigation interventions necessitates improved measurement of stigma for MSM around the world. This study explored the underlying factor structure and psychometric properties of 13 sexual behavior stigma items among 10,396 MSM across eight sub-Saharan African countries and the United States (U.S.) using cross-sectional data collected between 2012 and 2016. Exploratory factor analyses were used to examine the number and composition of underlying stigma factors. A three-factor model was found to be an adequate fit in all countries (Root Mean Square Error of Approximation = 0.02-0.05; Comparative Fit Index/Tucker Lewis Index = 0.97-1.00/0.94-1.00; Standardized Root Mean Square Residual = 0.04-0.08), consisting of "stigma from family and friends", "anticipated healthcare stigma", and "general social stigma" with internal consistency estimates across countries of (α=0.36-0.80), (α=0.72-0.93), and (α=0.51-0.79), respectively. The three-factor model of sexual behavior stigma cut across social contexts among MSM in the nine countries. These findings indicate commonalities in sexual behavior stigma affecting MSM across sub-Saharan Africa and the U.S., which can facilitate efforts to track progress on global stigma mitigation interventions.

Authors+Show Affiliations

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, Maryland, USA.Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.Metabiota, Cameroon.Enda Santé, Dakar, Senegal.Enda Santé, Dakar, Senegal. Department of Geography, School of Social Sciences, Gaston Berger University, Saint-Louis, Missouri, USA.Institut de Recherche en Sciences de la Santé-IRSS, Ouagadougou, Burkina Faso. Institut Africain de Santé Publique, Ouagadougou, Burkina Faso.Ministere de la Santé et de l'Hygiene Publique, Programme National de Lutte Contre le SIDA Abidjan, Lagunes, Côte D'Ivoire.Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, Maryland, USA.Matrix Support Group, Maseru, Lesotho.Arc-en-ciel, Lomé, Togo.Ministry of Health, Mbabane, eSwatini.Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31942619

Citation

Augustinavicius, Jura L., et al. "Characterizing Cross-Culturally Relevant Metrics of Stigma Among Men Who Have Sex With Men Across Eight Sub-Saharan African Countries and the United States." American Journal of Epidemiology, 2020.
Augustinavicius JL, Baral SD, Murray SM, et al. Characterizing Cross-Culturally Relevant Metrics of Stigma among Men who have Sex with Men across Eight Sub-Saharan African Countries and the United States. Am J Epidemiol. 2020.
Augustinavicius, J. L., Baral, S. D., Murray, S. M., Jackman, K., Xue, Q. L., Sanchez, T. H., Nowak, R. G., Crowell, T. A., Zlotorzynska, M., Olawore, O., Lyons, C. E., Njindam, I. M., Tamoufe, U., Diouf, D., Drame, F., Kouanda, S., Kouame, A., Charurat, M. E., Anato, S., ... Kane, J. C. (2020). Characterizing Cross-Culturally Relevant Metrics of Stigma among Men who have Sex with Men across Eight Sub-Saharan African Countries and the United States. American Journal of Epidemiology. https://doi.org/10.1093/aje/kwz270
Augustinavicius JL, et al. Characterizing Cross-Culturally Relevant Metrics of Stigma Among Men Who Have Sex With Men Across Eight Sub-Saharan African Countries and the United States. Am J Epidemiol. 2020 Jan 13; PubMed PMID: 31942619.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterizing Cross-Culturally Relevant Metrics of Stigma among Men who have Sex with Men across Eight Sub-Saharan African Countries and the United States. AU - Augustinavicius,Jura L, AU - Baral,Stefan D, AU - Murray,Sarah M, AU - Jackman,Kevon, AU - Xue,Qian-Li, AU - Sanchez,Travis H, AU - Nowak,Rebecca G, AU - Crowell,Trevor A, AU - Zlotorzynska,Maria, AU - Olawore,Oluwasolape, AU - Lyons,Carrie E, AU - Njindam,Iliassou M, AU - Tamoufe,Ubald, AU - Diouf,Daouda, AU - Drame,Fatou, AU - Kouanda,Seni, AU - Kouame,Abo, AU - Charurat,Man E, AU - Anato,Simplice, AU - Mothopeng,Tampose, AU - Mnisi,Zandile, AU - Kane,Jeremy C, Y1 - 2020/01/13/ PY - 2019/03/25/received PY - 2019/11/29/revised PY - 2019/12/02/accepted PY - 2020/1/17/entrez KW - Men who have sex with men KW - sexual behavior stigma KW - stigma metrics JF - American journal of epidemiology JO - Am. J. Epidemiol. N2 - Overcoming stigma affecting gay, bisexual, and other men who have sex with men (MSM) is a foundational element of an effective HIV pandemic response. Quantifying the impact of stigma mitigation interventions necessitates improved measurement of stigma for MSM around the world. This study explored the underlying factor structure and psychometric properties of 13 sexual behavior stigma items among 10,396 MSM across eight sub-Saharan African countries and the United States (U.S.) using cross-sectional data collected between 2012 and 2016. Exploratory factor analyses were used to examine the number and composition of underlying stigma factors. A three-factor model was found to be an adequate fit in all countries (Root Mean Square Error of Approximation = 0.02-0.05; Comparative Fit Index/Tucker Lewis Index = 0.97-1.00/0.94-1.00; Standardized Root Mean Square Residual = 0.04-0.08), consisting of "stigma from family and friends", "anticipated healthcare stigma", and "general social stigma" with internal consistency estimates across countries of (α=0.36-0.80), (α=0.72-0.93), and (α=0.51-0.79), respectively. The three-factor model of sexual behavior stigma cut across social contexts among MSM in the nine countries. These findings indicate commonalities in sexual behavior stigma affecting MSM across sub-Saharan Africa and the U.S., which can facilitate efforts to track progress on global stigma mitigation interventions. SN - 1476-6256 UR - https://www.unboundmedicine.com/medline/citation/31942619/Characterizing_Cross-Culturally_Relevant_Metrics_of_Stigma_among_Men_who_have_Sex_with_Men_across_Eight_Sub-Saharan_African_Countries_and_the_United_States L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwz270 DB - PRIME DP - Unbound Medicine ER -
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