Online Program

Intersectional identities and the context for HIV risk among men who have sex with men in coastal Kenya

Tuesday, November 3, 2015

Miriam Midoun, ScM, Department of Behavioral and Social Sciences, Brown University, Providence, RI
Don Operario, PhD, Lifespan/Tufts/Brown Center for AIDS Research, Brown University, School of Public Health, Providence, RI
Sylvia Shangani, Department of Behavioral and Social Sciences, Brown University, Providence, RI
MSM are increasingly recognized as one of the nation’s most vulnerable HIV risk groups in Kenya. Homosexual behaviors are highly stigmatized in Kenya, and efforts to provide sexual health services to MSM require a deeper understanding of their lived experiences; this includes how MSM in Kenya construct their sexual identity, and how these constructions affect sexual decision-making. 26 self-identified MSM were recruited, and individual interviews were conducted to learn more about the participants’ backgrounds, living and working environments, social networks, and sexual behaviours. The sample consisted of men living in Malindi, Kenya, aged 18 or older, who had sex with another man during the past 12 months, and were able to communicate in Kiswahili or English. Themes relating to the sociocultural processes that influence identity construction were explored. As emergent themes became more concrete, it was possible to examine common narratives relating sexual identity to HIV risk behaviors. Four themes demonstrating the linkages between identity construction and HIV risk were identified: (i) tensions between perceptions of homosexuality versus being ‘African’; (ii) gender-stereotyped beliefs about sexual positioning; (iii) socioeconomic status and limitations to personal agency; (iv) objectification and commodification of non-normative sexualities. Findings from this analysis emphasize the need to conceive of same-sex sexuality and HIV risk as context-dependent social phenomena. Multiple sociocultural axes were found to converge and shape sexual identity and sexual decision-making among this population. These axes and their interactive effects should be considered to design HIV interventions for MSM in this region as effectively as possible.

Learning Areas:

Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe the ways by which multiple social axes influence sexual identity construction and HIV risk among men who have sex with men in a coastal region of Kenya. Discuss how the sociocultural context surrounding MSM in Kenya poses an inherent challenge to the success of individual-level HIV prevention campaigns that promote condom use, HIV testing and counseling, and empowerment strategies to enable safer sexual choices.

Keyword(s): HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My work includes research and public health interventions among Kenya’s most-at-risk populations, especially men who have sex with men. My research interests include; Social determinants of Health and psychological well-being of those living or affected with HIV/AIDS, social inequalities and HIV risk among vulnerable populations. My research goals include developing culturally and testing acceptable interventions for vulnerable populations in sub-Saharan Africa.
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.