Becoming your own doctor: Healthcare-seeking, stigma, and related challenges among persons with same-sex sexuality in East Africa

Project: Dissertation

Research areas and keywords

UKÄ subject classification

  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • Tanzania, Uganda, same-sex sexuality, stigma, healthcare-seeking, healthcare needs, mental health, sexual coercion, respondent-driven sampling, social networks, pharmacy workers, men who have sex with men, sexually transmitted infections

Description

The overall objective of this project is to analyze how homophobia affects and determines the sexual and reproductive health and rights of sexual minority populations in Uganda and Tanzania. Data collected by the supervisors (Agardh and Ross) from the two countries will be analyzed using both quantitative and qualitative methods.

The specific aims are:

1 To analyze the associations between unmet sexual health counseling needs and experience of same–sex sexual behaviors among university students in Uganda (2013)
2 To analyze discrimination of men who have sex with men – in the health care system in Tanzania
(2014)
3 To investigate stigma and homophobia among health care providers (2015)
4 Evaluate a model of stigma management with focus on sexual minority groups in a homophobic environment (2016)

Layman's description

Historically, the shortage of systematic studies of the linkages between sexual identity, homophobia and human rights in sub-Saharan Africa has been a barrier to understanding sexual health among sexual minority populations. Homophobia is here defined any negative reaction and attitude toward homosexuals or bisexuals. Sexual minority populations are those individuals with sexual attractions, emotions and behaviors towards other persons with the same sex- either exclusively or partially.

Available data demonstrate that HIV and sexual transmitted infections (STIs) are generally considerably higher in this group than in the general population. A combination of limited awareness, inadequate access to appropriate risk prevention measures, widespread unsafe sexual practices (i.e. unprotected anal sex) and high involvement in transactional sex contributes to increased HIV and STI risk. However, persistent stigma, violence, harassment and lack of safe social and health resources are further likely to exacerbate their vulnerability to HIV and STIs. Criminalization of same-sex activity renders sexual minorities vulnerable to extortion, exploitation and other forms of abuse, both by state and non-state actors. They contribute to the failure of state protection by preventing victims of homophobia (or bi-; lesbo-; or transphobia) from seeking and being provided assistance.

Few studies have explored the effects of homophobia of the sexual and reproductive health and rights of sexual minority populations in sub-Saharan Africa, although the stigma associated with homosexuality and HIV remains strong and has important health consequences. In a study South Africa, 12% of the respondents had delayed seeking treatment due to fear of discrimination based on sexual orientation. These results concur with the findings from studies on homosexual men and women in Botswana, Namibia and Malawi where only 18% had disclosed their sexual orientation to a health worker and 19% afraid of seeking health care.

The objective of this project is to analyze how homophobia affects and determines the sexual and reproductive health and rights of sexual minority populations in Uganda and Tanzania. Data from collected by the supervisors from the two countries will be analyzed quantitatively and qualitatively.





StatusActive
Effective start/end date2012/07/01 → …

Participants