Stigma and other correlates of self-esteem and depression in cisgender men and transfeminine persons with HIV who have sex with men in Kenya, Malawi, and South Africa (HPTN 075)

ABSTRACT HIV-related stigma profoundly impacts individuals living with HIV, hindering self-esteem and access to treatment. Few studies, if any, have assessed the effects of stigma on depression and self-esteem among men who have sex with men (MSM) and transfeminine persons (TFP) with HIV in African settings. We explored factors, including various forms of stigma, contributing to low self-esteem and poor mental health among 71 MSM and TFP in Kenya, Malawi, and South Africa, using data from the HPTN (HIV Prevention Trials Network) 075 study. Lower self-esteem was associated with moderate to severe depression and was significantly lower among those who experienced HIV as a stigma. Moreover, participants who had encountered MSM-related stigma in healthcare settings were more likely to exhibit moderate to severe depression. Being employed was a protective factor against depression. These results suggest that interventions aimed at reducing MSM-related stigma in healthcare settings and enhancing self-esteem through employment opportunities for MSM and TFP living with HIV might contribute toward ending the HIV epidemic.