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New research examining HIV among men who have sex with men (MSM) in the township of Soweto in Gauteng has found that a third of gay-identified men are infected with HIV.
The researcher also found that a high percentage of men who define themselves as straight, have sex with men - and that they are at lower risk of HIV infection than men who identify themselves as gay, though at greater risk than men who define themselves as bisexual.
The researchers, from the University of California's Centre for Aids Prevention, found that men who have sex with men in Soweto identified themselves as straight, bisexual or gay. Those who identify themselves at gay have the highest HIV rate, at 33.9%. The researchers estimated the rate of HIV infection for bisexual MSM in Soweto to be 6.4% and 10% for straight identified MSM.
"Our findings clearly indicate that targeted prevention and treatment for men who have sex with men in townships is urgently needed. We also found that, despite South Africa's legal advances in gay rights, stigma and de facto segregation are reflected in the disproportionate rates of HIV infection," said the study's principal investigator, Tim Lane, assistant professor at the University of California, San Francisco (UCSF) Centre for Aids Prevention Studies.
The findings appear in the journal AIDS and Behaviour.
Sexual identities
Of the study's 378 participants, 34.1% identified as gay, 30.4% as bisexual and 31.7% as straight.
The study showed that MSM's sexual identities predicted their sexual behaviour with other men.
Gay identity was highly correlated with the exclusive practice of receptive anal intercourse; and straight and bisexual self-identification was highly correlated with the exclusive practice of insertive anal intercourse with male partners.
"With the correlation of sexual identity and sexual practice, control of condom use in same-sex partnerships tends to be in the hands of bisexual and straight MSM. This finding demonstrates the pressing need to promote condom use among bisexual and straight-MSM for same-sex as well as heterosexual relationships," said Lane.
Other risk factors
The authors also looked at other risk factors and found that HIV infection was also associated with being older than 25, lower incomes, purchasing alcohol or drugs for a male partner in exchange for sex, having receptive anal intercourse and having any unprotected anal intercourse with a man.
HIV infection was significantly less likely among men who have sex with men who were circumcised, smoked marijuana, had a regular female partner or reported unprotected vaginal intercourse with women.
"The circumcision findings clearly suggest that for this population of MSM, circumcision could be protective and that MSM should not be excluded from circumcision programs," said Lane. – (EurekAlert!, August 2009)
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