Experiences of minority stress among gay, bisexual, and other men who have sex with men (GBMSM) in Nigeria, Africa: The intersection of mental health, substance use, and HIV sexual risk behavior

ABSTRACT

Nigerian gay, bisexual, and other men who have sex with men (GBMSM) experience social marginalisation, discrimination and violence due to their sexual orientation and same-sex attraction, which may affect mental health, substance use, and HIV sexual risk behavior. The goal of the current study was to conduct formative qualitative research to gain better understanding of these issues among GBMSM in Lagos, Nigeria. Face-to-face, semi-structured, in-depth interviews were conducted with 30 GBMSM in Lagos, Nigeria. Data were analysed using a deductive content analysis approach. We found that Nigerian GBMSM experienced both general life stressors as well as proximal and distal sexual minority identity stressors, including rejection by family members, harassment, and physical violence perpetrated by the general public and police officers. Participants described dealing with mental health problems within the context of family rejection, experienced stigma due to sexual orientation, and feelings of social isolation. Substance use was described as occurring within the context of social settings. Lastly, some participants mentioned that they engaged in risky sexual behaviour while under the influence of alcohol and drugs. These findings call for comprehensive and innovative, GBMSM-affirming behavioural healthcare, substance cessation services, and innovative HIV prevention interventions specifically designed and tailored for Nigerian GBMSM.

KEYWORDS:

• Minority stress
• GBMSM
• Nigeria
• mental health
• substance use

Acknowledgements

We will like to thank all the participants of the study for their time and efforts. We would also like to thank the staff at Centre for Right to Health (Abuja) Equality Triangle Initiative (Delta), Improved Sexual Health and Rights Advocacy Initiative (ISHRAI, Lagos) and Hope Alive Health Awareness Initiative (Plateau). We also extend our gratitude to Olubiyi Oludipe (ISHRAI), Bala Mohammed Salisu (Hope Alive Health Awareness Initiative), Chucks Onuoha, Prince Bethel, Eke Chukwudi, Tochukwu Okereke, Josiah Djagvidi, and Odi Iorfa Agev, for providing logistical support to the project. This work was supported by grant R36 DA047216 from the National Institute on Drug Abuse (PI: Adedotun Ogunbajo), and the Robert Wood Johnson Health Policy Research Scholars Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Robert Wood Johnson Foundation. Dr Sandfort’s contribution to this work was supported by grant P30-MH43520.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by [grant R36 DA047216] from the National Institute on Drug Abuse (PI: Adedotun Ogunbajo), and the Robert Wood Johnson Health Policy Research Scholars Program. Dr Sandfort’s contribution to this work was supported by [grant P30-MH43520].