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Abstract：
OBJECTIVE: Sexual and gender minority (SGM) populations in sub-Saharan Africa (SSA) are disproportionately impacted by HIV and often face multiple HIV-related stigmas. Addressing these stigmas could reduce SGM HIV vulnerability but little is known about how the stigmas operate and intersect. Intersectional stigma offers a lens for understanding the experiences of stigmatised populations and refers to the synergistic negative health effects of various systems of oppression on individuals with multiple stigmatised identities, behaviours or conditions. This review aims to (1) assess how often and in what ways an intersectional lens is applied in HIV-related stigma research on SGM populations in SSA and (2) understand how intersectional stigma impacts HIV risk in these populations.
METHODS: Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.
METHODS: Public health and regional databases were searched in 2020 and 2022.
METHODS: Articles in French and English on HIV-related stigma and HIV outcomes among men who have sex with men, women who have sex with women and/or transgender individuals in SSA.
METHODS: Articles were screened and extracted twice and categorised by use of an intersectional approach. Study designs and stigma types were described quantitatively and findings on intersectional stigma were thematically analysed.
RESULTS: Of 173 articles on HIV-related stigma among SGM in SSA included in this review, 21 articles (12%) applied an intersectional lens. The most common intersectional stigmas investigated were HIV and same-sex attraction/behaviour stigma and HIV, same-sex attraction/behaviour and gender non-conformity stigma. Intersectional stigma drivers, facilitators and manifestations were identified across individual, interpersonal, institutional and societal socioecological levels. Intersectional stigma impacts HIV vulnerability by reducing HIV prevention and treatment service uptake, worsening mental health and increasing exposure to HIV risk factors.
CONCLUSIONS: Intersectional approaches are gaining traction in stigma research among SGM in SSA. Future research should prioritise quantitative and mixed methods investigations, diverse populations and intervention evaluation.
METHODS: Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.
METHODS: Public health and regional databases were searched in 2020 and 2022.
METHODS: Articles in French and English on HIV-related stigma and HIV outcomes among men who have sex with men, women who have sex with women and/or transgender individuals in SSA.
METHODS: Articles were screened and extracted twice and categorised by use of an intersectional approach. Study designs and stigma types were described quantitatively and findings on intersectional stigma were thematically analysed.
RESULTS: Of 173 articles on HIV-related stigma among SGM in SSA included in this review, 21 articles (12%) applied an intersectional lens. The most common intersectional stigmas investigated were HIV and same-sex attraction/behaviour stigma and HIV, same-sex attraction/behaviour and gender non-conformity stigma. Intersectional stigma drivers, facilitators and manifestations were identified across individual, interpersonal, institutional and societal socioecological levels. Intersectional stigma impacts HIV vulnerability by reducing HIV prevention and treatment service uptake, worsening mental health and increasing exposure to HIV risk factors.
CONCLUSIONS: Intersectional approaches are gaining traction in stigma research among SGM in SSA. Future research should prioritise quantitative and mixed methods investigations, diverse populations and intervention evaluation.
摘要：
目标：撒哈拉以南非洲地区（SSA）的性和性别少数群体（SGM）人群不成比例地受到艾滋病毒的影响，并且经常面临多个与艾滋病毒相关的柱头。解决这些柱头问题可以减少SGMHIV的脆弱性，但对柱头如何运作和相交知之甚少。交叉的污名提供了一个镜头来理解污名化人群的经历，并指的是各种压迫系统对具有多重污名化身份的个体的协同负面健康影响。行为或条件。这篇综述旨在（1）评估交叉透镜在SSA中SGM人群的HIV相关污名研究中的应用频率和方式，以及（2）了解交叉污名如何影响这些人群的HIV风险。
方法：在系统审查的首选报告项目和范围审查的荟萃分析扩展之后进行范围审查。
方法：在2020年和2022年检索了公共卫生和区域数据库。
方法：关于男男性行为者与艾滋病毒相关的耻辱和艾滋病毒结局的法文和英文文章，在SSA中与女性和/或变性人发生性关系的女性。
方法：对文章进行两次筛选和提取，并使用交叉方法进行分类。定量描述了研究设计和柱头类型，并对交叉柱头的发现进行了主题分析。
结果：在本综述中纳入的173篇关于SSA中SGM与HIV相关的污名的文章中，21篇文章(12%)应用了交叉透镜。调查的最常见的交叉柱头是艾滋病毒和同性吸引/行为污名和艾滋病毒，同性吸引力/行为和性别不一致的耻辱。交叉的污名驱动因素，推动者和表现形式是在个人中确定的，人际关系,制度和社会生态水平。交叉的污名通过减少艾滋病毒预防和治疗服务的吸收来影响艾滋病毒的脆弱性，精神健康恶化和艾滋病毒风险因素暴露增加。
结论：交叉方法在SSA中SGM的柱头研究中越来越受到关注。未来的研究应该优先考虑定量和混合方法的调查，不同的人群和干预评估。
方法：在系统审查的首选报告项目和范围审查的荟萃分析扩展之后进行范围审查。
方法：在2020年和2022年检索了公共卫生和区域数据库。
方法：关于男男性行为者与艾滋病毒相关的耻辱和艾滋病毒结局的法文和英文文章，在SSA中与女性和/或变性人发生性关系的女性。
方法：对文章进行两次筛选和提取，并使用交叉方法进行分类。定量描述了研究设计和柱头类型，并对交叉柱头的发现进行了主题分析。
结果：在本综述中纳入的173篇关于SSA中SGM与HIV相关的污名的文章中，21篇文章(12%)应用了交叉透镜。调查的最常见的交叉柱头是艾滋病毒和同性吸引/行为污名和艾滋病毒，同性吸引力/行为和性别不一致的耻辱。交叉的污名驱动因素，推动者和表现形式是在个人中确定的，人际关系,制度和社会生态水平。交叉的污名通过减少艾滋病毒预防和治疗服务的吸收来影响艾滋病毒的脆弱性，精神健康恶化和艾滋病毒风险因素暴露增加。
结论：交叉方法在SSA中SGM的柱头研究中越来越受到关注。未来的研究应该优先考虑定量和混合方法的调查，不同的人群和干预评估。
