Depression and Sexual Stigma Are Associated With Cardiometabolic Risk Among Sexual and Gender Minorities Living With HIV in Nigeria.
Sylvia B Adebajo, Ruxton Adebiyi, John Chama, Segun Bello, Uche Ononaku, Abayomi Aka, Shenghan Lai, Stefan D Baral, Typhanye V Dyer, Trevor A Crowell, Rebecca G Nowak, Man Charurat, TRUST/RV368 Study Group
Author Information
Sylvia B Adebajo: Center for International Health Education Biosecurity, University of Maryland Baltimore, Abuja, Nigeria. ORCID
Ruxton Adebiyi: Center for International Health Education Biosecurity, University of Maryland Baltimore, Abuja, Nigeria.
John Chama: Center for International Health Education Biosecurity, University of Maryland Baltimore, Abuja, Nigeria.
Segun Bello: Center for International Health Education Biosecurity, University of Maryland Baltimore, Abuja, Nigeria.
Uche Ononaku: Institute of Human Virology, Abuja, Nigeria.
Abayomi Aka: International Centre for Advocacy on Right to Health-ICARH, Abuja, Nigeria.
Shenghan Lai: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
Stefan D Baral: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Typhanye V Dyer: University of Maryland School of Public Health, College Park, MD.
Trevor A Crowell: Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
Rebecca G Nowak: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
Man Charurat: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
BACKGROUND: People living with HIV are vulnerable to cardiometabolic diseases. We assessed the prevalence of cardiometabolic risk factors (CMRF) and associations with sexual stigma and depression among sexual and gender minorities (SGM) in Abuja and Lagos, Nigeria. METHODS: The TRUST/RV368 study enrolled SGM between March 2013 and February 2020. Participants were assessed for depression, sexual stigma, and CMRF. Robust multinomial logistic regression was used to estimate adjusted odds ratio (aORs) and 95% confidence intervals (CIs) for associations of depression, sexual stigma, and other factors with increasing numbers of CMRF. RESULTS: Among 761 SGM, the mean age was 25.0 ± 6.0 years; 580 (76%) identified as cisgender men, 641 (84%) had ≥1 CMRF, 355 (47%) had mild-severe depression, and 405 (53%) reported moderate-high sexual stigma. Compared with individuals without depression, those with mild (aOR 8.28; 95% CI: 4.18 to 16.40) or moderate-severe depression (aOR 41.69; 95% CI: 9.60 to 181.04) were more likely to have 3-5 CMRF. Individuals with medium (aOR 3.17; 95% CI: 1.79 to 5.61) and high sexual stigma (aOR 14.42; 95% CI: 2.88 to 72.29) compared with those with low sexual stigma were more likely to have 3-5 CMRF. Participants age 25-34 years were less likely to have 3-5 CMRF (aOR 0.41; 95% CI: 0.23 to 0.73) compared with participants age younger than 25 years. CONCLUSION: CMRF increased with severity of depression and sexual stigma, potentially predisposing SGM living with HIV to cardiometabolic diseases. Integrating interventions that address depression and sexual stigma in HIV care programs for SGM may improve cardiometabolic outcomes.
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