Population Council Research that makes a difference

Analysis Finds One-third of Nigerian Men Who Have Sex with Men (MSM) Experience Internalized Homophobia

African Journal of Reproductive Health's first published study of MSM in Africa prompts supportive editorial

ABUJA, NIGERIA (7 December 2012) — A new data analysis by the Population Council and the University of Toronto finds that about one-third of men who have sex with men (MSM) in two large Nigerian cities experience varying degrees of internalized homophobia, as well as stigma and discrimination from their families, friends, and the community. Among MSM who self-identify as bisexual and those who are HIV-positive, internalized homophobia is twice as common as among MSM who self-identify as homosexual/gay.

The analysis was published in the December 2012 issue of the African Journal of Reproductive Health. It was the first research paper on same-sex relationships in Africa ever published by the journal and prompted a supportive commentary from the editor.

Stigma regarding same-sex relationships is entrenched in many African countries, and leaders at the highest levels of government often deny the indigenous existence of such relationships. This denial has resulted in a severe lack of data regarding the lives and health needs of MSM in Africa. Individuals with internalized homophobia have negative feelings about their same-sex relationships. It is critical to identify and address internalized homophobia because it can impede the success of HIV prevention services for MSM.

"The findings of this analysis illustrate why it is important for HIV prevention programs to identify internalized homophobia, so that they can address it and protect the mental and physical well-being of MSM," said Population Council researcher Sylvia B. Adebajo, lead author on the data analysis. "It is also important for programs to recognize that there is a real diversity among MSM and that different messages may be needed to meet the health needs of different clients."

The analysis prompted the journal to issue its first editorial on same-sex relationships and HIV and AIDS in Africa, by editor Friday Okonofua. "This report is groundbreaking," writes Okonofua. It "is one of a few documented studies on LGBT in Nigeria and serves to address the current lack of empirical research on the subject in the country. . . . The publication of this paper indicates . . . that it is still possible to open up debate and conduct empirical research in less receptive communities. Indeed we believe that it is only through research and communication of research findings that traditional beliefs and inappropriate laws and legislations on LGBT can be prevented and modulated."

In this study, the researchers from the University of Toronto and University of Lagos, with funding from the Canadian Institute of Health Research (CIHR), used an approach known as respondent-driven sampling to identify men who have sex with men, a hidden and stigmatized population in Nigeria, to participate in the study. Respondent-driven sampling allows researchers to reach, in a systematic way, members of hidden populations by allowing a small number of diverse participants to recruit friends to be additional participants. The approach employs a mathematical model that adjusts the data to allow researchers to arrive at unbiased conclusions, even though the participants were not randomly chosen.

The study reached 1,125 MSM with a median age of 22 years in Lagos and Ibadan, in south west Nigeria. The researchers assessed levels of internalized homophobia using an 11-item scale. The participants either agreed, disagreed, or remained neutral about statements such as "I am glad to be MSM," "If there was a pill to change my sexuality, I will take it," and "I feel my sexuality embarrasses my family." Following the assessment, participants were offered voluntary HIV counseling and testing. Participants who tested positive for HIV were referred to government clinics for treatment.

Since the 1990s, the Population Council has been working across Africa to build the foundation of knowledge regarding the existence, attitudes and beliefs, and health needs of MSM. The Council was characterized as "the first international NGO to recognize that the HIV-related vulnerabilities of MSM in Africa deserved serious attention," by Cary Alan Johnson, executive director of the International Gay and Lesbian Human Rights Commission. The organization continues its groundbreaking work examining the HIV-related vulnerabilities of MSM and other vulnerable populations in Africa.

The article can be accessed at: http://www.ajrh.info/vol16_no4/16_4_article3.pdf

The editorial can be accessed at: http://www.ajrh.info/vol16_no4/16_4_article1.php

For more on the Council’s work with MSM, please visit: http://www.popcouncil.org/topics/vulnerable_msm.asp

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The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees.

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