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.
Combination prevention is a strategy of combining two or more proven HIV prevention methods that suit your lifestyle.
If these methods are used properly, they will either:
- Reduce your risk of becoming HIV positive and of contracting other sexually transmitted infections (STIs), or
- Reduce your risk of infecting your partner with HIV and prevent you from contracting other STIs if you are already positive.
Combination prevention relies on changing behaviours that might increase the risks of HIV transmission (referred to as behavioural interventions) coupled with technology such as medication, condoms and latex-compatible lubricants (referred to as biomedical interventions) to reduce infection risks. No single HIV prevention method is foolproof or provides 100% protection. A combination of methods is best, and there are several options available so that you can find the best combination that works for you.
What Can You Do?
- Avoid barebacking (anal sex without condoms). Unprotected anal sex facilitates the spread of HIV and other STIs.
- Reducing your number of sexual partners will reduce your potential exposure to HIV.
- Avoid having sex while using drugs or alcohol so that you can make responsible decisions. If you inject drugs never share needles.
- Consider negotiating an open relationship rather than cheating on your partner, and develop a plan that ensures you both remain healthy. Stick to the agreed plan.
- Sero-sorting is a strategy of only having sex with people with the same HIV status as you − if you are negative, choosing to have sex only with negative guys. Be careful; many guys have not been tested for HIV and therefore assume that they are negative without confirming it. Sero-sorting works best for HIV positive guys who are networked with other positive guys.
- Get tested for STIs and HIV every six months.
- Sero-positioning is choosing your role during anal sex according to your HIV status. An HIV positive guy who sero-positions will be the bottom (receptive) partner during anal sex with an HIV negative partner, to prevent the semen of the positive partner entering the anus of the negative partner.
- Masturbate more often so that you don’t need to have sex with a partner. You can also satisfy yourself with toys, such as a dildo, if you want to.
- Treatment as prevention (TasP) involves treating HIV positive men with antiretroviral drugs to lower the amount of HIV in their bodies and thus in their blood and semen, reducing their risk of infecting a partner. Have you heard of U=U?