The study, conducted by the Human Sciences Research Council (HSRC) in South Africa and Namibia, found that poor mental health and stress caused by high levels of stigma lead the group to engage in behaviour that can lead to contracting HIV.
Heidi van Rooyen, executive director HSRC, explained how the group faces ridicule, leading them to engage in acts such as having unprotected sex, having multiple sexual partners and substance abuse.
“This group is left on the margins and pushing people who are different away has some real consequences. The different kinds of stress because of marginalised positions leads to behaviour such as hiding things or acting straight, which heightens the HIV risk,” she said.
One of the key findings is that health-care facilities do not adequately cater to the needs of the group. Participants of the study felt the need to “act straight” when seeking health-care services and cited experiences with homophobic stigma and discrimination amongst public health-care services.
“Sensitising health-care workers to these issues is needed,” said Van Rooyen.
The research found that most of the participants had either an implicit or explicit sexual agreement with their partner. Most described their relationship as monogamous with fewer describing open relationships and only a small minority saying they had female sexual partners outside their male partner.
Zaynab Essack, research specialist HSRC, said that society needs to have an open dialogue about these findings because of the risk factors.
“While most are monogamous relationships, those that had open relationships with females would not tell the female that they were also engaging in sex with males. The risk of contracting HIV is higher with these men and we need to have an open conversation about who we’re having sex with,” she said.
The study was conducted amongst 440 participants in two parts. The first was the qualitative research, which conducted focus group discussions with 64 partnered MSM in South Africa and 45 partnered MSM in Namibia. The second was the survey, which involved 220 male-male partners, 150 from South Africa and 70 from Namibia.
Lynae Darbes, associate professor at the University of Michigan, said that while the qualitative data sample was small, it was comparable to other studies done in the rest of the world.