Transactional Sex Is Associated with Income Level and Psychosocial Health Problems among Gay and Bisexual Men (GBM) in Nigeria, Africa

ABSTRACT

Gay and bisexual men (GBM) who report engagement in transactional sex are at increased risk for HIV acquisition. The current study aimed to assess the prevalence of transactional sex and its association with demographic characteristics, social marginalization, HIV sexual risk behaviors, psychosocial health problems, and access to healthcare services among a multi-site sample of GBM in Nigeria. Bivariate and multivariable logistic regression were used to examine factors associated with engagement in transactional sex in the previous 3 months. More than a third (39.6%) of the participants reported engagement in transactional sex in the previous 3 months. In the multivariable model, factors associated with engagement in transactional sex included: reporting a monthly income of 30,000 Naira [adjusted odds ratio (aOR) 1.98; 95% CI: 1.12 to 3.35], compared to 30,000 or more Naira monthly income, reporting 4 or more receptive anal sex acts in the previous 30 days (aOR 2.45; 95% CI: 1.31 to 4.57) compared to reporting none, and having depressive symptoms (aOR 1.82; 95% CI: 1.06 to 3.14). There is an urgent need for interventions that address the economic disenfranchisement and psychosocial problems experienced by GBM in Nigeria, which has implications for sexual health.

Acknowledgments

We would like to thank all the participants of the study for their time and efforts. We would also like to thank the staff at the 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, Victor Brownson, and Odi Iorfa Agev, for providing logistical support to the project.

Additional information

Funding

This study was supported by a R36 dissertation grant from the National Institute on Drug Abuse [DA047216] (principal investigator [PI]: Adedotun Ogunbajo) and by the Robert Wood Johnson Foundation Health Policy Research Scholars Program, for which the first author is a scholar but the foundation did not provide direct project support.