By Andrew M. Seaman
(Reuters Health) - Gay and bisexual men in Nigeria are reporting increased reluctance to access healthcare after the country passed a law last year levying additional sanctions against same-sex couples.
While consensual sexual relationships between men were already illegal in Nigeria, the Same-Sex Marriage Prohibition Act, signed into law in January 2014, prohibited participation in organizations supporting gay people or attempts at any kind of civil same-sex relationship.
There were reports of arrests and torture following the enactment of the law, according to a paper in The Lancet HIV by Sheree Schwartz of the Johns Hopkins Bloomberg School of Public Health in Baltimore and colleagues.
Since the law took effect, men who have sex with men may fear that the benefits of medical care don’t outweigh the risks, Schwartz said.
The study, she said, suggests “that they think the (benefit) of HIV prevention care isn’t worth remaining in a system that could potentially out them,” she said.
Schwartz and her colleagues analyzed data from 707 gay and bisexual men in Nigeria who were receiving HIV prevention and treatment services from a community-based clinic in 2013 and 2014. The men made 756 visits to the clinic before the law passed and 420 after it was enacted.
Overall, 38 percent said they’d been afraid to seek healthcare after the law was enacted, compared to about 25 percent before the law was passed.
And 28 percent said they’d avoided seeking healthcare after the law was enacted, compared to about 20 percent before the law.
The number of men who came to the clinic but did not return for a future visit was high - especially among those who were not infected by HIV, the researchers found. This rate did not increase after the law, however.
It seems “people remain engaged in care if we successfully engage in treatment,” Schwartz said.
“One of the important points people can take away from this is that a supportive policy environment is really important to support HIV prevention and treatment programs,” she added.
Schwartz said there is a large HIV epidemic among the population that needs to be addressed.
“Definitely there are a lot of same-sex behavior acts that are illegal, but what is not illegal and remains part of the agenda is that everyone has a right to healthcare,” Schwartz told Reuters Health.
As scientists, she said, her team does not want to get involved with politics.
“I think we’re going to sort of keep our eyes on what’s going on in the population,” she said.