Amsterdam 2015
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| Abstract #2376 - Cape to Casablanca: MSM in Africa | ||||
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Session: 20.5: 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 Theo Sandfort - Columbia University, United States |
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| Additional Authors: | ||||
| Aim: Studies among African men who have sex with men (MSM) show that, compared to Western MSM, they are more likely to also have had sex with women. This suggests that African MSM are more likely to be in an intimate relationship with a man who also engages in sex with women, which may have distinct implications for HIV transmission. This study explores how these intimate relationships differ from relationships with men who exclusively have sex with men? | ||||
| Method / Issue: An HIV prevalence study with behavioral surveys, using respondent driven sampling (N=480), following extensive ethnographic fieldwork, in Pretoria and surrounding townships. Men between 18 and 44 years were eligible to participate. Data were weighted for participants’ network size. | ||||
| Results / Comments: Of all participants currently in an intimate relationship with a man (272/480 56.7%), 28 (10.3%) had a male partner who also had sex with a woman (MSMW) during the relationship. Men with MSMW partners were about the same age as men with MSM partners (23.3 versus 25.0, ns) and were equally likely to have college or higher education (46.9%). There was no difference between these men in terms of economic status. The men did not differ in terms of mental health status (self-esteem, depression, anxiety), although men with MSMW partners had significantly more alcohol use problems than men with MSM partners (13.5 versus 8.1, t=-3.71, p<.000).These relationships did not differ in length (46% of all relationships were ongoing for over one year). MSMW partners were more frequently somewhat older than MSM partners in relation to the participant. Men with MSMW partners were more likely to see their partner as more masculine than men with MSM partners (82.1% versus 57.6% OR=3.16 95%CI: 1.18-8.47). Men with MSMW partners and men with MSM partners were equally likely to think that their partner usually has more money to spend (62.4%). Intimate partner violence was more frequently experienced by men in relationships with MSMW partners compared to men in relationships with MSM partners (1.31 versus 1.75 t=-5.00, p<.000). There was no difference in relationship satisfaction between men with MSMW and MSM partners. Compared to men with MSM partners, men with MSMW partners were more likely to have engaged in sex while the partner was under the influence of alcohol or drugs (39.8% versus 92.6% OR=16.33 95%CI: 4.20-63.54) or the participant himself was (44.7% versus 82.1% OR=5.80 95%CI: 2.12-15.96) to have engaged in unprotected receptive anal intercourse with the intimate partner (30.2% versus 70.4% OR=5.35 95%CI: 2.27-12.57 no difference for unprotected ive anal sex) to have had sex with another person during the relationship (50.6% versus 85.2% OR=5.22 95%CI=1.82-14.92) or to test HIV positive (30% versus 54% OR=2.68 95%CI: 1.21-5.93). | ||||
| Discussion: Being in an intimate relationship with a man who concurrently has sex with women is seems to place MSM at risk for HIV transmission compared to men who are in a relationship with a man who does not engage in sex with women. Further understanding of this increased risk can facilitate targeted prevention and individual counseling. | ||||
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