DURATION: 4 min    41 sec

TRANSCRIPT  

KHOPOTSO: Freedom from discrimination on the grounds of sexual orientation in South Africa is one of the human rights enshrined in the Constitution. However, this right does not necessarily guarantee access to proper care in the government health sector. It also does not guarantee access to information about safe and healthy sexual practices to prevent sexually transmitted infections, including HIV. These are the observations of 48 men from Soweto and Hillbrow, in Johannesburg, who took part in a three-month long pilot study conducted by Wits University’€™s Peri-natal HIV Research Unit. Helen Struthers is one of the report authors.    

HELEN STRUTHERS: There’€™s very little information that’€™s directed specifically towards homosexual men in South Africa. And the health care services are generally devoted towards heterosexual communities. People found that, generally, people were quite unfriendly at the clinics. Their specific health needs were not met. And there was, in some cases, quite a lot of discrimination towards people trying to access those services’€¦ There’€™s a lot of stigma attached to being homosexual. The other issue is being gay and being HIV positive is a dual discrimination. People are marginalised because of that.

KHOPOTSO: Because of discrimination, many homosexual men prefer to seek medical care in the private health sector, but this alternative is not always affordable. In other findings participants indicated that even though access to condoms is very easy, the use of condoms may be inconsistent, incorrect or compromised by the use of alcohol. Many expressed a preference for brand name condoms as opposed to free government condoms. This is a pattern notably similar amongst heterosexuals and is based on myths, such as that condoms themselves are a source of HIV. Out of the 48 men interviewed 25 reported having ever tested for HIV and two disclosed their HIV positive status.

HELEN STRUTHERS: People were very scared to be tested; and were concerned about what their results would be; and recognised that some of their behaviour had been risky behaviour. So, they understand that having sex without condoms is a risky behaviour, which many engage in even though they know that having unprotected sex has a high risk of HIV transmission.

KHOPOTSO: Struthers says of all other sexual practices such as oral sex, respondents identified anal sex as the riskiest form of HIV transmission.

HELEN STRUTHERS: Most of the respondents did understand that anal intercourse is probably the most risky behaviour that they engaged in’€¦ Having anal intercourse’€¦ sets a relationship as being an intimate relationship with their partner. Other studies have shown that anal intercourse is kept for a primary partner and other sexual activities (are) engaged in with other partners.

KHOPOTSO: However, it is important to note that anal intercourse is not a practice that is exclusive to men who have sex with men. It occurs between heterosexual couples, too. Furthermore, many men who identify themselves as straight, discreetly have sexual relations with other men while at the same time maintaining heterosexual relationships. HIV in South Africa is an epidemic largely fuelled through heterosexual sex. No reliable figures are available to quantify the contribution of sex between men to the HIV prevalence data in this country. But even so, the risk is there. Although, the Peri-natal HIV Research Unit’€™s study is small, it provides a window through which to see what needs be done to address issues related to HIV amongst men who have sex with men.

HELEN STRUTHERS: A number of ideas have come out of it. The one is to set up a specifically male clinic, not necessarily directed to gay people. But a clinic where men can go to that specifically deals with health care issues around men. The other is to set up more information that is particularly pertinent to men who have sex with men. We found, for example, that although condom use was widely understood and recognised as being one of the preventative measures for HIV, quite often people didn’€™t know how to use the condoms properly. I guess, those sort(s) of issues could be addressed through an education campaign or literature that’€™s directed specifically to that community.  

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