Combination HIV Prevention

The World Health Organisation has recently released a report on basic health care for MSM and transgender people entitled “Prevention and Treatment of HIV and Other Sexually Transmitted Infections among Men Who Have Sex with Men and Transgender People: Recommendations for a Public Health Approach.

The HIV prevalence rate among men-who-have-sex-with-men (MSM) in South Africa has been found to be consistently higher than the general population in a number of research studies. The reasons for this increased vulnerability to HIV infection have not been widely researched. This exploratory research offers a broad overview of the various elements that affect HIV risk among MSM in Cape Town, South Africa and offers recommendations for HIV prevention efforts and further research.

While research now highlights that men who have sex with men (MSM) in places such as South Africa are at particular risk of HIV infection, left relatively unexplored are potential relationships between one of the most pressing social issues affecting peri-urban MSM – namely homophobic stigma – and sexual risk-taking behaviour. Drawing on research from the Ukwazana baseline study of 316 township MSM in Cape Town we examine how homophobic stigma relates to psychosocial factors such as depression and self-efficacy and the risk activity of unprotected anal intercourse (UAI). By deploying cross-sectional association models, we examine a series of relationships between these variables and offer evidence to suggest that HIV prevention programmes aimed at sexual minority groups should be mindful of potentially complex relationships between social stigmas such as homophobia and sexual risk-taking behaviour.