Johannesburg - The stigma around anal sex in South Africa was hampering the fight against HIV and Aids, Health4Men programme manager Glenn de Swardt said during a recent discussion.
The discussion was about the dangerous gaps in HIV prevention created by narrow assumptions of what constituted sex, and in particular anal sex.
“This is because the anus is associated with shame and guilt, which makes it hard for some people to see it transformed into a sexual organ.”
He said the shame emanated from the macho belief that men were not to be penetrated because this implied having power taken from them.
Male-to-male sex was more common than people thought, De Swardt said, and a lot of men were being raped but chose to keep quiet about it.
“It only comes out in court, or at health centres after someone has had a mental breakdown of some sort, that a man was raped.”
De Swardt highlighted that in his line of work, he had noted that there were a lot of heterosexual men who engaged in sex with other men. This was because of circumstances, such as being in prison, working in a mine, or being in the military where women were not available.
Some men fantasised about anal sex but could not have it with their wives as “it could not be integrated into a healthy, loving relationship”. They would go to sex workers or other men.
De Swardt said quite a number of men did not know the risks of having unprotected anal sex, whether with women or other men, and he lamented the lack of messaging around anal sex.
“Some men just assume that having anal sex does not result in contracting STIs, yet the chance of contracting HIV for a man having receptive unprotected anal sex is 18 times higher than for one who has unprotected sex with a woman, because of the physiology of the rectum.”
He spoke about homophobic health-care workers who made it difficult for men who had sex with other men to talk to them freely. It was rare to find a nurse who would ask to check the anus of a patient with an STI, yet it was essential as people were having anal sex. “The behaviour is happening. What do we do about it? Let’s not moralise.” - The Star