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The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa
BACKGROUND: In Cote D’Ivoire, there has been limited coverage of evidence-based sexual health services specifically supporting men who have sex with men (MSM). To date, there has been limited study of the determinants of engagement in these services including multiple intersecting stigmas and depres...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399955/ https://www.ncbi.nlm.nih.gov/pubmed/30832673 http://dx.doi.org/10.1186/s12914-019-0186-6 |
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author | Ulanja, Mark B. Lyons, Carrie Ketende, Sosthenes Stahlman, Shauna Diouf, Daouda Kouamé, Abo Ezouatchi, Rebecca Bamba, Amara Drame, Fatou Liestman, Ben Baral, Stefan |
author_facet | Ulanja, Mark B. Lyons, Carrie Ketende, Sosthenes Stahlman, Shauna Diouf, Daouda Kouamé, Abo Ezouatchi, Rebecca Bamba, Amara Drame, Fatou Liestman, Ben Baral, Stefan |
author_sort | Ulanja, Mark B. |
collection | PubMed |
description | BACKGROUND: In Cote D’Ivoire, there has been limited coverage of evidence-based sexual health services specifically supporting men who have sex with men (MSM). To date, there has been limited study of the determinants of engagement in these services including multiple intersecting stigmas and depression. METHODS: 1301 MSM aged 18 years and older, were recruited using respondent-driven sampling in Abidjan, Yamoussoukro, Gagnoa and Bouake, Cote d’Ivoire from January 2015 to October 2015. Inclusion criteria included anal sex with another man in the past 12 months were to complete a structured questionnaire including the Patient Health Questionnaire (PHQ)-9 to screen for depression. Chi-Square tests were used to test difference in healthcare utilization across variables, and multiple logistic regression was used to test the association between depression and health care utilization represented by HIV and sexually transmittable infection testing and treatment. RESULTS: Depression (aOR:1.40, 95% CI: 1.07–1.84), being aged 25–29 years (aOR:1.84, 95% CI: 1.11–3.03),unemployed (aOR:0.64, 95% CI: 0.42–0.98), being a student (aOR:0.67, 95% CI: 0.48–0.96), being identified as male (aOR:0.44, 95% CI: 0.29–0.67), and identifying as homosexual (aOR:0.74, 95% CI:0.56–0.99) were significantly associated with utilization of sexual health care services in the final multivariable model. Healthcare enacted stigma (aOR: 1.55, 95% CI: 1.03–2.33) was associated with utilizing sexual health care services, but perceived healthcare stigma, social stigma and family stigma were not. CONCLUSION: Given higher levels of depressive symptomatology among those engaging in sexual health care services, this engagement represents an opportunity for service integration which may have synergistic benefits for both sexual and mental health. Moreover, MSM in Cote D’Ivoire who had engaged in sexual health services were more likely to report having experienced health-care enacted stigma. Taken together, these results reinforce the need for stigma mitigation interventions to support sustained engagement in HIV prevention, treatment and care services as a means of reducing health disparities among MSM in Cote d’Ivoire. |
format | Online Article Text |
id | pubmed-6399955 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63999552019-03-14 The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa Ulanja, Mark B. Lyons, Carrie Ketende, Sosthenes Stahlman, Shauna Diouf, Daouda Kouamé, Abo Ezouatchi, Rebecca Bamba, Amara Drame, Fatou Liestman, Ben Baral, Stefan BMC Int Health Hum Rights Research Article BACKGROUND: In Cote D’Ivoire, there has been limited coverage of evidence-based sexual health services specifically supporting men who have sex with men (MSM). To date, there has been limited study of the determinants of engagement in these services including multiple intersecting stigmas and depression. METHODS: 1301 MSM aged 18 years and older, were recruited using respondent-driven sampling in Abidjan, Yamoussoukro, Gagnoa and Bouake, Cote d’Ivoire from January 2015 to October 2015. Inclusion criteria included anal sex with another man in the past 12 months were to complete a structured questionnaire including the Patient Health Questionnaire (PHQ)-9 to screen for depression. Chi-Square tests were used to test difference in healthcare utilization across variables, and multiple logistic regression was used to test the association between depression and health care utilization represented by HIV and sexually transmittable infection testing and treatment. RESULTS: Depression (aOR:1.40, 95% CI: 1.07–1.84), being aged 25–29 years (aOR:1.84, 95% CI: 1.11–3.03),unemployed (aOR:0.64, 95% CI: 0.42–0.98), being a student (aOR:0.67, 95% CI: 0.48–0.96), being identified as male (aOR:0.44, 95% CI: 0.29–0.67), and identifying as homosexual (aOR:0.74, 95% CI:0.56–0.99) were significantly associated with utilization of sexual health care services in the final multivariable model. Healthcare enacted stigma (aOR: 1.55, 95% CI: 1.03–2.33) was associated with utilizing sexual health care services, but perceived healthcare stigma, social stigma and family stigma were not. CONCLUSION: Given higher levels of depressive symptomatology among those engaging in sexual health care services, this engagement represents an opportunity for service integration which may have synergistic benefits for both sexual and mental health. Moreover, MSM in Cote D’Ivoire who had engaged in sexual health services were more likely to report having experienced health-care enacted stigma. Taken together, these results reinforce the need for stigma mitigation interventions to support sustained engagement in HIV prevention, treatment and care services as a means of reducing health disparities among MSM in Cote d’Ivoire. BioMed Central 2019-03-05 /pmc/articles/PMC6399955/ /pubmed/30832673 http://dx.doi.org/10.1186/s12914-019-0186-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Ulanja, Mark B. Lyons, Carrie Ketende, Sosthenes Stahlman, Shauna Diouf, Daouda Kouamé, Abo Ezouatchi, Rebecca Bamba, Amara Drame, Fatou Liestman, Ben Baral, Stefan The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title | The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title_full | The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title_fullStr | The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title_full_unstemmed | The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title_short | The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa |
title_sort | relationship between depression and sexual health service utilization among men who have sex with men (msm) in côte d'ivoire, west africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399955/ https://www.ncbi.nlm.nih.gov/pubmed/30832673 http://dx.doi.org/10.1186/s12914-019-0186-6 |
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