R.J. Jolly1, S. Fergus2, A. Jeeves3
1Queen’s University, Department of English, Kingston, Canada, 2Queens’ University, School of Kinesiology and Health Studies, Kingston, Canada, 3Queen’s University, Department of History, Kingston, Canada
Background: Recent work suggests that sub-Saharan African men who have sex with men (MSM) are an overlooked population at enhanced HIV risk. Yet, few studies have investigated the prevalence of same-gender partners among rural African men, or have examined how HIV-related characteristics among MSM may differ from those among non-MSM.
Methods: Using area-based, quasi-probability sampling to maximize generalizability, and an audio, computer-assisted self-interviewing (ACASI) system to minimize social desirability bias, we surveyed 451 males (mean age = 22.0) in rural KwaZulu-Natal, asking about the genders of their sexual partners over the previous two months. We then compared participants with one or more male partners to those without a male partner on demographics, socioeconomics, perpetration of gender-based violence, and gender role attitudes.
Results: Of the participants who had sex in the previous two months, 15% reported having at least one male partner. Of those, almost half reported also having a female partner. As compared to non-MSM, MSM were 55% more likely (p< .05) to practice traditional religion, 54% more likely (p< .05) to have left the area to look for work in the previous year, and more than twice as likely (p< .05) to report having perpetrated sexual violence against any female in the previous year. Finally, MSM exhibited higher scores on a measure of gender role confusion (p< .05).
Conclusions: Our study suggests that, despite strict cultural taboos, some men in rural South Africa are having sex with other men. Further, MSM may be different from non-MSM on a number of characteristics related to HIV prevention and transmission for both men and women. Researchers should consider using ACASI or similar systems with general populations in sub-Saharan Africa to capture same-gender sexual behaviour. The results of such studies may be useful for improving services for an overlooked yet important group.