Pilot Award Recipient: Rachel Robinson, PhD

Increasing Financial Security to Reduce HIV Risk among MSM in Abuja, Nigeria

June 04, 2019

Stigma, poverty, and biology put men who have sex with men (MSM) at great risk for HIV globally. These risks are even higher in places like Nigeria, where homosexuality is a crime and homophobia is pervasive, increasing stigma and making it difficult for MSM to access HIV prevention and treatment. If outed, MSM often lose their jobs or housing. Even if not outed, stigma creates extra hurdles to finding and maintaining employment and housing. Such financial insecurity increases HIV risk by making transactional sex more likely and reducing consistent condom use. Among MSM living with HIV, financial insecurity may also reduce care engagement and treatment adherence. The proposed study will conduct research to help develop an intervention to increase financial security among MSM in order to reduce HIV risk and increase HIV treatment adherence. The proposed research will use existing survey data from the TRUST/ RV368 Study, a sample of 1480 MSM in Abuja and Lagos, Nigeria, and collect complementary qualitative data from MSM in Abuja in partnership with a community-based organization named ICARH that serves the MSM community.

The specific aims are to: (1) assess the association between financial insecurity and HIV outcomes including HIV incidence and viral suppression among MSM in Nigeria, and (2) develop the content of a pilot intervention to reduce financial insecurity. They believe a community savings group that meets regularly to facilitate savings and loans and also provides psychosocial support would increase MSMs’ financial stability, resilience, and ability to engage in protective and health-seeking behaviors. The end result of the study will be the details a financial security intervention appropriate to the economic and social context experienced by MSM in Abuja. They will then apply for funding from the National Institute of Mental Health to pilot and test the intervention. The potential impact of this research is great as it will lead to an intervention designed to reduce HIV risk and increase treatment adherence among MSM. They will share the results of the research through a presentation at their local partner’s offices in Nigeria, as well as through scientific conferences and journal articles. An intervention to reduce financial insecurity among MSM has potential applications to Washington, D.C. given high levels of stigma and significant financial insecurity. They will thus also seek out a community-based organization in DC, such as Us Helping Us, where they can share the results in the hopes of developing a strategy to create a financial security intervention appropriate for the context of MSM in DC.