Exploratory study to determine rights violations and HIV prevalence among township men who have sex with men (MSM) in Cape Town, South Africa
Background: It has increasingly been shown that men who have sex with men (MSM) in developing countries are at high-risk of HIV infection. Despite a national HIV prevalence of 24.5% and constitutional protection, there is little recognition of this risk group in South Africa culminating in increased stigma and a lack of health and rights knowledge.
Methods: We conducted an anonymous, venue-based HIV risk behavior and prevalence probe of 200 self-identified MSM in black and coloured townships in Cape Town. A demographics, sexual risk behavior, and rights abuse questionnaire was administered by a health worker and HIV-1/2 assessed via oral mucosal transudate specimens collected and analyzed with the OraQuick® rapid HIV-1/2 antibody test.
Results: To date, 68 men have enrolled and preliminary analysis revealed an HIV prevalence of 30.9% (21/68) with 95.2% (20/21) unaware of their status. The mean age was 28 (SD 8.51, 18-58), with 86.8% (59/68) identifying as homosexual/gay and 2.9% (2/68) as transgender. 3.5 (SD 5.73, 0-30) male partners were reported in the previous 6 months, with 57.4% (39/68) using condoms always, 28.4% (19/68) using petroleum-based lubricants with condoms, and 29.4% (20/68) reporting STI treatment ever. 13.2% (9/68) reported assault due to sexual orientation, 44.4% (4/9) of those by police or government. Ever arrested due to sexual orientation was reported by 8.8% (6/68) and was significantly associated with testing HIV positive (p=0.047). 20.6% (14/68) had been incarcerated, and of these 71.4% (10/14) reported no access to condoms. Rape was reported by 11.8% (8/68), 50.0% (4/8) of whom filed, and 25.0% (2/4) of which were prosecuted.
Conclusions: High HIV prevalence is found in local township MSM communities. MSM here report a disturbing number of human rights abuses based on sexual orientation. South African MSM face systematic homophobia and violence, and are in acute need of security and targeted HIV prevention programs.
-Abstract available at link below-