Addressing gay men’s HIV risk
Men who have sex with men (MSM) in Africa are twice as likely as the general population to be HIV positive, mostly because their health needs are not being met by clinics.
Although South Africa has made great strides in the provision of HIV-related healthcare services, the health needs of MSM are often misunderstood by healthcare practitioners and neglected in HIV service programmes, according to the Anova Health Institute.
Anova’s Dr Kevin Rebe said that even when clinics were friendly towards MSM, they were usually not asked about anal sex and not screened for their health care needs
“You find that the clinic can be very friendly to the MSM but it is not very competent to meet their health care needs,” said Rebe.
Gordon Khoza, Anova’s outreach ambassador, added that the MSM community is stigmatised and discriminated against in health facilities.
The MSM community is stigmatised in a way that they cannot access the health services fully like other populations, but we have started sensitising the health facilities so they can be MSM friendly.
“The MSM community is stigmatised in a way that they cannot access the health services fully like other populations, but we have started sensitising the health facilities so they can be MSM friendly,” Khoza told an MSM forum in Johannesburg attended by representatives from southern and eastern African countries.
Nine years ago, Anova established a model called Health4Men (H4M) to lead South Africa’s response to HIV among gay, bisexual and other men who have sex with men (MSM).
This model provides direct health care services at two centre of excellence in MSM sexual health care, and also by building support network of MSM competent sites.
H4M’s David Motsoagae said that they are training public health facilities to become MSM-friendly and provide services that ensure people’s dignity. “We are actually a bridge between H4M and the public health facilities,” said Motsoagae
The H4M centres offer health interventions aimed at protecting men who have sex with men, including offering antiretroviral drugs as pre-exposure prophylaxis (PreP).
“It is absolutely clear from multiple clinical trials that PreP will prevent HIV in MSM if used correctly even if they have high risks of sexual exposure to the virus,” said Rebe.
PrEP, for HIV prevention, involves the use of ARVs to reduce the risk of infection in people who are HIV-negative. A single pill taken once daily, it is highly effective against HIV when taken every day. The medication interferes with HIV’s ability to copy itself in your body after you’ve been exposed. This prevents it from establishing an infection and making you sick. It’s estimated that it takes at least seven days for PrEP to reach high levels of protection in the body. When used correctly PrEP can reduce the risk of HIV infection in people who are at high risk by more than 90%.
According to Rebe, two H4M sites are providing PreP for MSM one in Cape Town and one in Johannesburg, and the Department of Health will also be increasing access of PreP to MSM from this month (April).
An edited version of this story appeared on Health24.