title: The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa.
abstract: Ghanaian men who have sex with men (MSM) have a high HIV seroprevalence, but despite a critical need to address this public health concern, research evidence has been extremely limited on influences on sexual risk behavior among MSM in Ghana. To investigate associations between HIV/STD knowledge, HIV stigma, and sexual behaviors in a sample of MSM in Ghana, we conducted a secondary data analysis of cross-sectional survey data from a non-probability sample of Ghanaian MSM (N = 137). Nearly all the men (93%) had more than one current sex partner (M = 5.11, SD = 7.4). Of those reported partners, the average number of current female sexual partners was 1.1 (SD = 2.6). Overall, knowledge levels about HIV and STDs were low, and HIV stigma was high. There was no age-related difference in HIV stigma. Younger MSM (≤25 years) used condoms less often for anal and vaginal sex than did those over 25. Relative frequency of condom use for oral sex was lower in younger men who had higher STD knowledge and also was lower in older men who reported high HIV stigma. Knowledge and stigma were not associated with condom use for anal or vaginal sex in either age group. These descriptive data highlight the need for the development of intervention programs that address HIV/STD prevention knowledge gaps and reduce HIV stigma in Ghanaian communities. Intervention research in Ghana should address age-group-specific HIV prevention needs of MSM youth.
authors: Dean's Endowed Fellow in Health Disparities & Assistant Professor, School of Nursing, University of Rochester, 601 Elmwood Ave., Box SON, Rochester, NY, 14642.
authors: LaRon E
authors: LE
authors: Nelson
authors: Associate Professor, Department of Human Development, State University of New York at Binghamton, Binghamton, NY.|Lecturer, Faculty of Humanities, University of Johannesburg, Auckland Park, South Africa.
authors: Leo
authors: L
authors: Wilton
authors: Lecturer, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
authors: Thomas
authors: T
authors: Agyarko-Poku
authors: Assistant Professor, Department of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Nanhua
authors: N
authors: Zhang
authors: Doctoral Student & US Fulbright Scholar, College of Nursing, University of South Florida, Tampa, FL.
authors: Marilyn
authors: M
authors: Aluoch
authors: Postdoctoral Fellow, College of Nursing, University of South Florida, Tampa, FL.
authors: Chia T
authors: CT
authors: Thach
authors: Deputy Director for Research, Centre for Popular Education & Human Rights, Ghana.
authors: Samuel
authors: S
authors: Owiredu Hanson
authors: Dean and Professor, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
authors: Yaw
authors: Y
authors: Adu-Sarkodie
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012747:Sexual Partners; D013240:Stereotyping; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Ghana; HIV; HIV knowledge; MSM; STI; West Africa; adolescents; condom use; health disparities