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Sexual behavior stigma and depression among transgender women and cisgender men who have sex with men in Cote d'Ivoire
Journal article   Open access   Peer reviewed

Sexual behavior stigma and depression among transgender women and cisgender men who have sex with men in Cote d'Ivoire

Ayden Scheim, Carrie Lyons, Rebecca Ezouatchi, Benjamin Liestman, Fatou Drame, Daouda Diouf, Ibrahima Ba, Amara Bamba, Abo Kouame and Stefan Baral
Annals of epidemiology, v 33
01 May 2019
PMID: 30955993
url
https://europepmc.org/articles/pmc6980364View
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology
Purpose: Transgender women (TGW) and cisgender men who have sex with men (cisMSM) across sub-Saharan Africa experience health inequalities relative to other adults. Recent research has also revealed health inequalities between these often-conflated groups. Among TGW and cisMSM in Cote d'Ivoire, we sought to determine whether transgender female identity was associated with probable depression, and whether sexual behavior stigma mediated this association. Methods: In 2015-2016, a cross-sectional respondent-driven sampling survey of adult TGW and cisMSM was conducted across five cities. We conducted a three-way decomposition of mediation and interaction of gender identity and sexual behavior stigma. Depression was measured by the nine-item Patient Health Questionnaire (PHQ-9). Results: Of 1301 participants, 339 (26.1%) were TGW. The prevalence of probable depression was 22.7% among TGW and 12.2% among cisMSM (P < .001). After confounder adjustment, the relative risk of depression attributable to transgender female gender identity was 1.68 (95% CI = 1.36, 2.00) with 69.9% (95% CI = 42.6, 97.1) of this effect mediated by sexual behavior stigma. The effect of stigma on depression did not differ significantly by gender. Conclusions: These data suggest that stigma mitigation interventions specifically addressing the stigma affecting transgender women may also address mental health inequalities between transgender women and cisMSM in Cote d'Ivoire. (C) 2019 Elsevier Inc. All rights reserved.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being

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Public, Environmental & Occupational Health
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