Bigotry and Oppressive Laws in Africa Drive HIV in Men

Published: June 19, 2013

The study in this week’s issue of PLOS Medicine by Jewkes and colleagues on the
prevalence of consensual male-male sexual activity and non-consensual male-on-male sexual violence, and their respective associations with HIV infection in South Africa [1], makes an important contribution to the dearth of literature on population- based HIV prevalence amongst men who have sex with men (MSM) in
the African context. The paper highlights several important findings, including that HIV prevalence amongst South African MSM also has public health implications for South African women, given high levels of bisexuality and sexual concurrency amongst South African MSM. Assuming these findings are generalizable to the rest of sub-Saharan Africa, addressing the
health needs of African MSM will require policymakers to meaningfully address significant socio-cultural and legal barriers that hinder access by MSM to HIVrelated health services. Failing to do so will fuel the spread of HIV in African men who engage in consensual male-male sexual activity and/or who are victims of male-on-male sexual violence.

Socio-Cultural Barriers
Open bigotry against homosexuals by such African leaders as Kenya’s former
President Daniel arap Moi, Uganda’s current President Yoweri Museveni, and
Zimbabwe’s current President Robert Mugabe have hardened views by some
African traditionalists that homosexuality is ‘‘un-African’’ [2,3]. Such attitudes have stigmatised and spurred violence against African MSM and have deterred their access to health facilities [4–6]. African traditionalists, politicians, and religious leaders must appreciate that inciting violence and perpetuating African MSM denialism and bigotry breeds stigma and ostracism against MSM, which drives consensual MSM activities underground. Such behaviour also condemns male-on male sexual assault victims to shameful silence. The end result is that men who engage in consensual sexual activities, and men who are sexually assaulted, are denied the opportunity to access vital HIV-related health services. Such missed opportunities to manage HIV and other sexually transmitted infections in these vulnerable populations also hold major public health implications for female sexual partners of bisexual MSM and male-on-male sexual assault survivors.

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