Criminalisation, stigma, and survival: A qualitative study of men who have sex with men and HIV prevention in Lagos, Nigeria

BACKGROUND: In Nigeria, HIV prevalence among men who have sex with men (MSM) continues to rise due to sociocultural barriers hindering prevention efforts. AIM: This study investigated the barriers MSM face in HIV prevention. METHODS: Informed by the social ecological model (SEM), a qualitative study was conducted with 12 participants via online semi-structured interviews. Participants were men over the age of 18 years who were HIV negative and recruited from a non-governmental organisation (NGO) in Lagos, Nigeria. RESULTS: Using a thematic analysis approach, six themes appeared as common barriers to HIV prevention, including (i) adult violence and extortion, (ii) perceptions of HIV biomedical approaches, (iii) condom attitudes, (iv) access to HIV and sexually transmitted infection services and education, (v) internalised stigma, and (vi) externalised stigma. These themes reflected the systemic and multipart sociocultural environment that inhibits MSM from seeking HIV prevention resources. CONCLUSION: There is a need to improve access to community-based NGOs and trauma-informed mental health resources. Furthermore, until policy reforms are implemented and homophobia is significantly reduced, the development of intersectional, community-informed interventions is particularly important for addressing inadequacies in healthcare for MSM.