# Assessing stigma, care seeking, and treatment adherence of MSM living with HIV in Senegalese Muslim communities

> **NIH NIH R21** · UNIVERSITY OF ROCHESTER · 2020 · $169,066

## Abstract

ABSTRACT
HIV prevalence among men who have sex with men (MSM) in Senegal is 19%, compared with 0.5% in the
general population. Stigma against men who have sex with men (MSM) is high in the majority (96%) Muslim
country of Senegal. HIV-related stigma stems from sociocultural and religious beliefs that HIV is a punishment
from God or the consequence of sinful behaviors, including sex outside the bounds of marriage and homosexual
activity. These stigmas can be major contributors to disengagement from HIV care for fear of scorn and
mistreatment. Linkage to and retention in HIV care are critical for improving symptom management and
reducing risk of mortality. Isolation and fear resulting from stigma and discriminatory practices can lead to poor
treatment seeking behaviors and low adherence to antiretroviral therapy. This in turn may result in increases in
HIV symptom distress. Despite the extremely high HIV prevalence in MSM in Senegal, there are gaps in
scientific knowledge regarding how intersecting HIV- and homosexuality-related stigmas are associated with
HIV care linkage and retention in the MSM population. Further, it is unknown if associations between
stigmas and health outcomes are mediated by decreased linkage and retention in HIV care in this
underserved population. Our long-term goal is to implement stigma-reduction interventions in order to increase
linkage to the continuum of HIV care for MSM in Muslim communities in Senegal. To this end, we will: (Aim 1)
Adapt and assess the validity and reliability of stigma scales for use among MSM in the Muslim context. We
will use a community-engaged approach to adapt and test stigma scales among MSM in Senegalese Muslim
communities. Testing processes will consist of face validity and psychometric properties (including correlation
matrices, split-half reliability, criterion validity, and both exploratory and confirmatory factor analysis). Findings
will provide evidence of validated measures for use in future studies. (Aim 2) Assess the association between
the types of and intersectionality between stigmas, and behavioral (treatment seeking behaviors and adherence
to treatment) and symptom distress (mental and physical) among 250 MSM LWH in urban and rural Muslim
communities in Senegal. We hypothesize that level and type of stigma will be associated with (1) treatment
avoidance and low adherence to treatment; and (2) higher HIV physical and psychological symptom distress.
We will also examine whether the observed correlations are partially or fully mediated by association with other
variables, including disclosure avoidance due to stigma. Findings from this study will lay the groundwork for
the design of an intervention to help mitigate the impact of stigmas on treatment related behaviors (linkage
and retention in care) and subsequently improve health outcomes of MSM living with HIV in majority Muslim
African countries.

## Key facts

- **NIH application ID:** 9914146
- **Project number:** 5R21TW011274-02
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** PAULA AMINA ALIO
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $169,066
- **Award type:** 5
- **Project period:** 2019-04-15 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9914146

## Citation

> US National Institutes of Health, RePORTER application 9914146, Assessing stigma, care seeking, and treatment adherence of MSM living with HIV in Senegalese Muslim communities (5R21TW011274-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9914146. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*