Psycho-social-cultural barriers among sexual minority men living with HIV in Nigeria.

BackgroundMen who have sex with men (MSM) in Nigeria experience a disproportionate burden of HIV, shaped by stigma, criminalization, and limited access to care. This study examined the multi-level social and structural factors influencing the lived experiences of MSM living with HIV in Nigeria.MethodsParticipants were recruited from a non-governmental organization in Lagos, Nigeria, for virtual interviews. The analysis was restricted to MSM (age: 21-33) living with HIV. Guided by the Social Ecological Model, interviews explored intrapersonal, interpersonal, community, and structural influences on HIV-related experiences. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.ResultsTwenty-four MSM (median age = 25) were interviewed. Three primary themes emerged. At the interpersonal level, family functioned as both a source of support and a site of stigma, influencing disclosure, housing stability, and engagement in care. At the community level, religious institutions reinforced stigma through homophobic messaging and promotion of faith-based healing, contributing to concealment and reduced healthcare utilization. At the societal level, cultural norms and criminalizing policies, including the Same Sex Marriage Prohibition Act, created an environment of fear, violence, and social exclusion. These intersecting factors contributed to delayed testing, limited disclosure, and challenges in sustained HIV care engagement.ConclusionHIV-related experiences among MSM in Nigeria are shaped by interconnected social and structural forces across multiple levels. Effective interventions must extend beyond individual behavior change to address family dynamics, religious influences, and structural barriers, including criminalization, to improve HIV outcomes and quality of life among MSM.