Role of Stigma and Alienation on the HIV Treatment Cascade for Burkinabé MSM

Background

MSM in Burkina Faso consistently face significant stigma and discrimination.  The urban HIV prevalence in MSM is estimated at 25% with limited provision and uptake of specific HIV care.  This study investigates the role of stigma and alienation on Burkinabe MSM’s engagement of the HIV treatment cascade. Methods

Three types of qualitative techniques were used in this project: key informants interviews with allies, in-depth interviews with MSM, and focus groups with MSM. Interviews were semi-structured using a guide. Participants in Ouagadougou and Bobo-Dioulasso were asked to describe the MSM context, MSM knowledge of existing HIV-related services in all clinics, MSM-specific services and how to improve services.

Coded text was extracted from 30 transcripts with Word Macros.  These texts were analyzed for recurring themes that were developed into results. Results

First, among those MSM participants seeking HIV services, many reported experiences of discrimination and physical violence outside the health care setting. 

Second, MSM declared that there was a significant psychological toll on them due to the lack of social support and health care access.  Several individuals recounted feelings of alienation, loneliness and depression; their alienation greatly discouraged them from seeking HIV prevention, treatment, and care services. Conclusions

Public healthcare-related stigma impacts the mental well-being of Burkinabe MSM.  Alienation among MSM also represents a common obstacle for MSM-oriented HIV/AIDS services. These data suggest an MSM-sensitization, stigma-reduction intervention for Burkinabe health care and social workers.  This intervention may increase the uptake of HIV prevention, treatment, and care for a a high burden-HIV population.