Amsterdam 2015
Menu
AIDSImpact.com
Conference Details
Authors
International Committee
Plenary Speakers
Presenting Speakers
Programme
Sessions
Scientific Committee
Acknowledgements
| Abstract #2375 - Cape to Casablanca: MSM in Africa | ||||
|
Session: 20.3: Cape to Casablanca: MSM in Africa (Parallel) on Wednesday @ 16.30-18.00 in C104 Chaired by Theo Sandfort, Mike Ross Authors: Presenting Author: Dr Jack Tocco - HIV Center for Clinical and Behavioral Studies, Columbia University, United States |
||||
| Additional Authors: | ||||
| Aim: Studies of contemporary gay life in Africa have generally been undertaken in major metropolises. Less is known about gays living in small cities and towns, particularly explorations from qualitative research perspectives. This study examines Black gay-identified men’s perceptions of their acceptance in and alienation from community institutions, including their families and gay peers, churches, and health clinics in smaller cities and towns in Mpumalanga province, South Africa. | ||||
| Method / Issue: We conducted targeted ethnography (150 hours of structured observations in gay social spaces, 41 semi-structured key informant interviews, and 8 focus group discussions with Black gay men) in two districts in Mpumalanga between March and September 2011. Qualitative data were thematically coded and analysed. The current analysis pertains to “Health and HIV,” “stigma,” and “gossip” thematic codes. | ||||
| Results / Comments: Discrimination in the community, including in families and in health care settings, was a major challenge faced by gay men. Even in “gay-friendly” social settings, gay men perceived that many community members were grudgingly tolerant of homosexuality, believing it to be “imported” from urban areas like Johannesburg. Many gay men expressed a sense of responsibility for adjusting their behaviour to fit community norms and refrained from what was perceived as overtly gay behaviour and dressing in stereotypically feminine clothing in public to avoid social opprobrium: “The way in which we present ourselves determines the way in which they will also treat us.” Self-respect, self-acceptance and gay pride were described as protective when facing overt and covert discrimination. Providers in public-sector health clinics were frequently characterised as morally judgemental and unfamiliar with gay men’s sexual health needs, resulting in gay men avoiding them when able to access private sector doctors. Private care was beyond the means of most gay men in these communities. Many described public clinic nurses as devout Christians who expressed the Biblical notion that homosexuality is a sin, and insulted gay men who presented for care. “A gay person will be told that he is sick because of the life he is living, whereas a straight person might be a whore but they will nurse her properly.” Being HIV-positive compounded gay stigma. Few gay men disclosed being HIV-positive for fear of gossip and social exclusion from their gay peers. Potential social consequences of being seen at a public sector clinic, which included becoming the topic of rumours and gossip in the community, deterred gay men from accessing care. | ||||
| Discussion: Gay men in smaller towns face considerable pressure to conform to social norms and have little recourse to experiences of discrimination, particularly in health care. Training to ensure culturally competent care for gay and other MSM in public clinics is an important structural intervention. Gay community mobilization is a potentially effective strategy to reduce barriers to HIV care, combat the damage done by gossip, and increase gay community support for people living with HIV. | ||||
| Go Back | ||||