Associations among experienced and internalized stigma, social support, and depression among male and female sex workers in Kenya

Melissa A. Stockton (), Brian W. Pence, David Mbote, Emmanuel A. Oga, John Kraemer, Joshua Kimani, Stella Njuguna, Joanna Maselko and Laura Nyblade
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Melissa A. Stockton: University of North Carolina At Chapel Hill
Brian W. Pence: University of North Carolina At Chapel Hill
David Mbote: Kuria Foundation for Social Enterprise
Emmanuel A. Oga: RTI International
John Kraemer: RTI International
Joshua Kimani: University of Nairobi
Stella Njuguna: Kenya Medical Research Institute
Joanna Maselko: University of North Carolina At Chapel Hill
Laura Nyblade: RTI International

International Journal of Public Health, No 0, 9 pages

Abstract: Abstract Objectives This study (1) estimated the association between experienced sex work-related stigma and moderate-to-severe depressive symptoms (hereafter depression), (2) examined independent associations between internalized stigma, experienced stigma, and depression among sex workers, and (3) investigated the potential modifying role of social support. Methods A cross-sectional survey was conducted among 729 male and female sex workers in Kenya. Results The prevalence of depression was 33.9%, and nearly all participants reported at least one of the experienced and internalized stigma items. Increasing levels of experienced stigma was associated with an increased predicted prevalence of depression [aPD 0.15 (95% CI 0.11–0.18)]. Increasing internalized stigma was independently associated with higher experienced stigma and depression and appeared to account for 25.5% of the shared variance between experienced stigma and depression after adjustment for confounders. Social support from same-sex sex workers did not appear to modify the association between experienced stigma and depression. Conclusions Addressing the high levels of stigma that sex workers face and their mental health needs should be a public health and human rights imperative.

Keywords: Stigma; Discrimination; Sex work; Depression; Sub-Saharan Africa; Kenya (search for similar items in EconPapers)
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DOI: 10.1007/s00038-020-01370-x

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