Men who have sex with men and HIV

Men who have sex with men (MSM) are male persons who have sex with other males, regardless of their sexual identity (homosexual or bisexual).

MSM should not be confused with being gay or homosexual. There are men who are married with children but have sexual relations with other men and would not consider themselves gay, but would fit within MSM. Being gay is a cultural/social identity with homosexuality referring to sexual and romantic attractions between people of the same sex.

Men who are bisexual are attracted to both the male and female sex. MSM includes both gay men and men who do not identify themselves as gay or homosexual, but have sexual relations with other men. Men may have sex with men for a variety of reasons, including attraction to other men, for pleasure or experimentation, societal or cultural norms, because of their environment (i.e. prisoners) or for financial reasons.

Some argue that the occurrence of MSM in Africa is recent, but historical studies dating as far back as the 1950s of the Nyakyusa people (of Tanzania and Malawi) highlight same-sex sexual experimentation before marriage and in some South African cultures male to male sex is a necessary traditional practice.

MSM in Africa is a practice that has been around long before the recognition of HIV.

Sex between men, because it can involve anal sex (entry through the buttocks) and in the absence of protection, carries a much higher risk of HIV transmission than vaginal sex.

Behavioural factors that make MSM more vulnerable to HIV include multiple partners, failure to use a condom consistently and correctly and in some MSM communities, alcohol and drugs are a common part of socialising. Failure of governments to acknowledge these groups means prevention campaigns do not target MSM. It is estimated that globally, HIV prevention services reach fewer than one in 10 men who have sex with men.

Fear of stigma, discrimination and criminalisation discourages MSM from disclosing their status.  

As of 2012, same sex relations between consenting adults is a criminal offence in 78 countries with penalties ranging from fines, imprisonment and, in five countries (Iran, Mauritania, Saudi Arabia, Sudan, Yemen and parts of Nigeria and Somalia) death. 

Lest we forget the shocking and sad story when the gay couple Tiwonge Chimbalanga and Steven Monjeza (or he could be bisexual?) were sentenced to 14 years for gross indecency and unnatural acts. Our backward archaic unjust legal system, a then unwieldy political mafia, cultural and religious beliefs have perpetuated stigma towards men who have sex with men.