Study finds high levels of HIV in men who have sex with men

JOHANNESBURG - HIV prevalence is high among men who have sex with men (MSM) in the three largest cities of South Africa.

This is according to the Marang Men’s Project study released by the Human Sciences Research Council on Tuesday. 

The study was conducted in three cities, Johannesburg, Durban and Cape Town.

In Cape Town, the overall prevalence among MSM recruited into the study was 22.3 percent, in Johannesburg it was 26.8 per cent. In Durban, the prevalence was unusually high among respondents, namely 48.2 percent.

The report was that in each city, HIV prevalence was higher among MSM aged 25 years and older than among MSM in the 18–24 years age category.

"This is a very crucial study on key populations - those populations with HIV prevalence above the national average - using the same methodology in all three cities. The study confirms that MSM face a higher risk for HIV infections. The findings provide much needed information to guide relevant policy development which may ultimately improve uptake of services among MSM," said Professor Thomas Rehle, one of the researchers.

Risky behaviour

Unprotected anal intercourse (barebacking) puts MSM at increased risk of HIV infection. According to the report, condom use at last sex with a male partner was found to be more than 80.0 percent.

The association between alcohol use before sex and HIV infection has been highlighted by various studies conducted among men and women in the general population. In this study, a few of the respondents (7.0%–16.0 per cent) in each of the three study cities reported ‘always’ engaging in sexual intercourse after consuming alcohol.

Use of health care services

More than 80 percent of respondents in each of the three cities reported that they have been tested for HIV. 

The most recent tests were done at gay-friendly health centres followed by public hospitals.  In Durban, in contrast to the other cities, almost a quarter of the respondents (23.8 percent) indicated that their most recent HIV test had been done by a traditional healer.

High estimates in police discrimination due to sexual orientation were also discovered. 37.1 percent of respondent reported police discrimination in Cape Town reported while 26.2 percent and 20.8 percent in Durban and Johannesburg reported police discrimination.

Marang Men’s Project noted that HIV is rampant in prisons because of the cramped single-sex living conditions as well as prolonged periods of being locked up in overcrowded cells which are believed to promote casual or forced same sex sexual relations among men mostly involving anal sex.

The study recommended among other things a national combination HIV prevention programme for MSM that would entail targeted HIV prevention, care, treatment and counselling services and the implementation of a national HIV bio-behavioural surveillance programme for MSM.

"The survey provides valuable information to the South African National AIDS Council (SANAC), the national and provincial Departments of Health, and lesbian, gay, bisexual, transgender and intersex (LGBTI) organisations to both   advocate for and implement improved evidence-based programmes for the health of MSM in the country," said Professor Leickness Simbayi, who was also involved in the research.