Cultural adaptation and validation of a measure of prejudice against men who have sex with men among healthcare providers in western Kenya

ABSTRACT

Sexual prejudice toward men who have sex with men (MSM) is a pressing concern in sub-Saharan Africa (SSA). Given the high HIV infection risk among this population, sexual prejudice perpetuated by healthcare providers, affects access to and willingness of MSM to seek HIV care services. However, data on healthcare providers’ attitudes towards MSM in SSA are limited, and there are no locally-adapted measures of sexual prejudice. We adapted a scale to measure sexual prejudice with a sample of 147 healthcare providers in western Kenya. Results from exploratory factor analysis revealed a single-factor structure. The scale demonstrated high internal consistency with Cronbach’s α = 0.91. Healthcare providers who had prior interpersonal contact with MSM, had ever been trained on counselling MSM, and had higher knowledge about MSM health needs reported lower sexual prejudice scores, compared with peers who lacked these experiences (p < 0.001). In contrast, healthcare providers who had experienced secondary stigma (negative judgments from peers and community) for providing care to MSM reported higher scores of sexual prejudice scale (p < 0.001) compared with providers who had not experienced secondary stigma. The scale provides a contextualised tool to assess healthcare providers’ attitudes toward MSM in Kenya and countries in SSA with similar cultural norms.

KEYWORDS:

• HIV
• psychometric measure
• healthcare providers
• sexual prejudice
• MSM
• Kenya

Acknowledgements

We wish to gratefully acknowledge all the study participants for taking part in the study. We also thank personnel that helped data collection, in particular, Tanvee Singh who assisted with data entry and management. This research was supported by grants from NIAID (P30AI042853), NIMH (R01MH118075 and K01MH112443), NIH Fogarty International (D43-TW000237), the Nora Kahn Piore Research Fellowship, and the Brown University Global Mobility Program.

Disclosure statement

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

Additional information

Funding

This work was supported by National Institute of Mental Health: [grant number K01MH112443, R01MH118075]; NIH Fogarty International Center: [grant number 5D43TW000237-21]; NIAID: [grant number P30AI042853].