title: Sexual identity stigma and social support among men who have sex with men in Lesotho: a qualitative analysis.
abstract: Men who have sex with men (MSM) face sexual identity stigma in many settings, which can increase risk for HIV by limiting access to care. This paper examines the roles of social support, sexual identity stigma, and sexual identity disclosure among MSM in Lesotho, a lower-middle income country within South Africa. Qualitative data were collected from 23 in-depth interview and six focus group participants and content analysis was performed to extract themes. Four primary themes emerged: 1) Verbal abuse from the broader community is a major challenge faced by MSM in Lesotho, 2) participants who were open about their sexual identity experienced greater stigma but were more self-sufficient and had higher self-confidence, 3) relationships between MSM tend to be conducted in secrecy, which can be associated with unhealthy relationships between male couples and higher risk sexual practices, and 4) MSM community organisations provide significant social and emotional support. Friends and family members from outside the MSM community also offer social support, but this support cannot be utilised by MSM until the risk of disclosing their sexual identity is reduced. Greater acceptance of same-sex practices would likely result in more open, healthy relationships and greater access to social support for MSM.
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Shauna
authors.initials: S
authors.lastname: Stahlman
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kali
authors.initials: K
authors.lastname: Bechtold
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: sstahlm1@jhu.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sweitzer
authors.affiliation: Matrix Support Group, Maseru, Lesotho.
authors.forename: Tampose
authors.initials: T
authors.lastname: Mothopeng
authors.affiliation: Population Services International, Johannesburg, South Africa.
authors.forename: Noah
authors.initials: N
authors.lastname: Taruberekera
authors.affiliation: Ministry of Health, Maseru, Lesotho.
authors.forename: John
authors.initials: J
authors.lastname: Nkonyana
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baral
mesh_terms: D005195:Family Relations; D005783:Gender Identity; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D007927:Lesotho; D008297:Male; D036301:Qualitative Research; D012111:Residence Characteristics; D012725:Sexual Behavior / Q000523:psychology; D057545:Social Stigma; D012944:Social Support
keywords: Lesotho; male homosexuality; sexual behavior; social support; stigma