Online Program

Diverse expressions of same-sex sexuality in black south African men who have sex with men (MSM): Implications for public health

Monday, November 4, 2013 : 1:30 p.m. - 1:45 p.m.

Theo G. M. Sandfort, PhD, Division of Gender, Sexuality, & Health: HIV Center for Clinical & Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
Vasu Reddy, Human and Social development, HSRC, Pretoria, South Africa
Kate L. Collier, MPH, CHES, CPH, Division of Gender, Sexuality, & Health, New York State Psychiatric Institute and Columbia University, New York, NY
Tim Lane, PhD, Center for AIDS Prevention Studies, University of California San Francisco Department of Medicine, San Francisco, CA
Richard Parker, PhD, Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
Background/Purpose: Same-sex sexuality is expressed in a variety of ways that are concealed by the use of the label “MSM”. This diversity of expression is likely to be related to men's health and has consequences for how these men can be reached. Methodology: In-depth interviews were conducted with 81 purposively sampled Black MSM from four South African townships; interview transcripts were processed using ATLAS.ti. In addition, 480 Black MSM (aged 18 – 44) from the same area participated in a survey including HIV testing. Using qualitative and quantitative data, we explored participants' understandings of their sexual and gender identities, and sexual practices, and how these relate to health status, including HIV infection. Findings: Qualitative data showed five intersecting dimensions that distinguish MSM expressions: (1) exclusiveness of same-sex attraction and self-labeling; (2) gender identification and performance; (3) visibility and openness; (4) preference for partner type and sexual role; and (5) sexual interaction strategies. Gender identification turned out to be a key factor in explaining HIV status: feminine men were more likely to be HIV positive (most, however, were unaware of their status). Feminine men also experienced more discrimination, but were, at the same time, more open about their sexual orientation and experienced less identity confusion and internalized homophobia. Conclusions: There are critical differences among MSM which are of crucial importance in guiding development of prevention and care programs that meet their diverse needs. It is also necessary to address prejudices that may prevent MSM from accessing HIV testing and care.

Learning Areas:

Diversity and culture
Social and behavioral sciences

Learning Objectives:
Assess the diversity of same-sex sexual expressions among Black South African men who have sex with men Identify how the variety in expressions of same-sex sexuality is related to health status, including HIV.

Keyword(s): HIV/AIDS, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal/co investigator on federally funded grants focusing on HIV prevention in men who have sex with men. Among my scientific interests has been the development of strategies for preventing HIV and STDs in this population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.