The relationship between stigma, religiosity, and the quality of life of HIV-positive MSM in Medan, Indonesia

Role of sociodemographic characteristics on self-stigma among young MSM living with HIV in Yogyakarta, Indonesia: A cross-sectional study

BACKGROUND

Our study aimed to determine the role of sociodemographic characteristics on self-stigma among young men who have sex with men (MSM) living with HIV in Yogyakarta, Indonesia.

METHODS

This cross-sectional observational study was conducted from August-November 2022. Participants were recruited from outpatient clinics at Dr. Sardjito, Yogyakarta, Indonesia. The Indonesian version of the Berger HIV Stigma Scale measured self-stigma. The statistical analysis utilized a 95% confidence level and determined significance by p-values <0.05.

RESULTS

72 young MSM were enrolled and completed questionnaires assessing sociodemographic and self-stigma. The average self-stigma score was 98.97. Education level was significantly associated with severe self-stigma in the bivariate analysis (p < .05). In the multivariate analysis, those with higher levels of education were significantly more likely to experience severe self-stigma (r = 2.938, p < .05). Employment status, family support, and education level were significantly associated with increased concerns in the disclosure, negative self-image, and public attitudes subscales (all p < .05).

CONCLUSIONS

The results demonstrate associations between sociodemographic and self-stigma levels among young MSM living with HIV in Yogyakarta, Indonesia. Further research regarding the educational level, employment status, and family support that can influence the perception and quality of life of PLHIV may need to be carried out.

Prevalence of Stigma and Discrimination Amongst Men Who have Sex with Men (MSM) and Transgender Women (Waria) in Bali, Indonesia

Men who have sex with men (MSM) and transgender women (waria) in Indonesia experience stigma and discrimination. The prevalence of stigma and discrimination experienced by 416 MSM and waria living in Bali, Indonesia and associations with socio-demographic characteristics are described. High levels of stigma were reported by 50.5% of MSM and 62.7% of waria. Discrimination was reported by 35.5% of MSM and 72.4% of waria. Family rejection, or no family awareness of MSM status, equated to higher levels of stigma compared to those where MSM status was accepted. Homosexual and bisexual waria reported lower odds of experiencing stigma compared to heterosexual waria. MSM who were not single were twice as likely to experience discrimination compared to single participants. Non-Hindu MSM were nearly three times as likely to experience discrimination compared to Hindu participants. Waria who were studying were less likely to experience discrimination compared to those who reported regular employment jobs. Specific policy and practice to reduce experiences of stigma and/or discrimination specific to MSM and waria are needed.

What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis

BACKGROUND

Depression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).

OBJECTIVES

This study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.

METHODS

This study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.

RESULTS

The results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%-39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.

CONCLUSION

The pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.

Factors affecting healthrelated quality of life of HIVinfected key population in Myanmar

This cross-sectional study examined factors affecting Health-related Quality of Life (HRQoL) among 273 HIV-infected key populations. This included, men who have sex with men (MSM), people, who inject drugs (PWID), and sex workers (SW), who were currently receiving antiretroviral therapy (ART) in Myanmar. Participants were recruited from four non-government clinics in four main cities. Overall HRQoL score derived from the WHOQOL-HIV BREF questionnaire was 86.08 ± 10.78. The lowest score was found in the environment domain (13.64 ±  2.06), while the highest score was found in the spirituality domain (15.54 ± 3.04). According to the multiple logistic regression analysis, participants, reported having an adequate income (OR = 3.32, P = 0.006), regularly taking meditation (OR = 3.79, P = 0.009), living in Tachileik (OR = 15.43, P = 0.011), and reported having no symptoms during previous 2 weeks (OR = 14.50, P < 0.001), were more likely to have good HRQoL level. In contrast, patients receiving ART < 1 year (OR = 0.163, P = 0.028) reported having low ART adherence (OR = 0.17, P = 0.018) and reported anticipated stigma (OR = 0.23, P < 0.001) and internalized stigma (OR = 0.29, P = 0.006) were less likely to have good HRQoL level.

Determinants of the Discriminatory Behavior Experienced by People Living with HIV in Indonesia: A Cross-sectional Study of the Demographic Health Survey

Introduction:

The discriminatory behavior experienced by People Living With HIV (PLWH) remains an unresolved problem in Indonesia. The aims of this research were to determine the factors associated with the discriminatory behavior experienced by PLWH in Indonesia.

Methods:

This study used cross-sectional design data by processing secondary data from the Indonesian Demographic Health Survey (IDHS) conducted in 2017. The total sample in this study was 15,413 records obtained via the two-stage stratified cluster sampling technique. The variables in this study were knowledge, information, socioeconomic and demographic details and the discriminatory behavior experienced by PLWH. The instrument refers to IDHS 2017. The data were analyzed using a chi-squared test and multinomial logistic regression.

Results:

The results obtained show that approximately 78.87% of respondents exhibited discriminatory behavior against PLWH in Indonesia. Respondents who had more knowledge about HIV [RRR: 25.35; CI: 2.85, 225.18] and who had earnings [RRR: 2.15; CI: 1.18, 3.92] were more at risk of discriminatory behavior than others. Respondents who lived in a rural area were less likely to engage in discriminatory behavior against PLWH than those who lived in urban areas [RRR: 0.51; CI: 0.29, 0.91].

Conclusion:

An increased understanding of HIV-AIDS and Indonesian people's acceptance of PLWH can occur through the provision of accurate information that is designed to prevent discriminatory behavior against PLWH. The government can consider this problem and further related policies so that PLWH can coexist in society and enjoy the same rights as those living without discrimination.