Objective-To investigate the characteristics of South African men who have sex with men (MSM) who (1) have been tested for HIV and (2) are HIV-positive.Methods-Data were collected among 1045 MSM in community surveys using questionnaires which were administered either face-to-face, mail, or on the internet. The mean age of the men was 29.9 years. The racial distribution was as follows: 35.3% black, 17.0% coloured, 5.3% Indian, and 41.1% white.Results-The proportion of MSM that were HIV-tested was 69.7%; having been tested was independently associated with being older, being more open about one's homosexuality, and being homosexually instead of bisexually attracted; black MSM, students, and MSM living in KwaZuluNatal were less likely to have been tested. Of the 728 MSM who had ever been tested, 14.1% (n=103) reported to be HIV-positive (9.9% of the total sample). Being HIV-positive is independently associated with two factors: men who were positive were more likely to have a lower level of education and to know other persons who were living with HIV/AIDS; race was not independently associated with HIV status among those who had been tested.
Conclusions-The likelihood of having been tested for HIV seems to decrease with increasing social vulnerability. Racially, the distribution of HIV among MSM seems to differ from that of the general South African population, suggesting that while intertwined with the heterosexual epidemic, there is also an epidemic among South African MSM with specific dynamics. These findings suggest that in-depth research is urgently needed to address the lack of understanding of HIV testing practices and HIV prevalence in South African MSM.
A community-based needs assessment among men who have sex with men (MSM) in South Africa found that 27% (n=280/1045) of MSM had never been tested for HIV. The most frequently reported reasons for not having been tested were the perception of not being at risk (57%) and fear of being tested (52%). This article explores factors associated with these two reasons among the untested MSM. In multiple logistic regressions, the perception of not being at risk of HIV infection was negatively associated with being black, coloured or Indian, being sexually active, knowing people living with HIV, and a history of sexually transmitted infections (STIs) in the past 24 months (adj. OR = 0.24, 0.32, 0.38, and 0.22, respectively). Fear of being tested for HIV was positively associated with being black, coloured or Indian, preferred gender expression as feminine, being sexually active, a history of STIs, and experience of victimization on the basis of sexual orientation (adj. OR = 2.90, 4.07, 4.62, 5.05, and 2.34, respectively). Results suggest that HIV prevention programs directed at South African MSM will be more effective if testing and treatment of STIs are better integrated into HIV testing systems. Finally, social exclusion on the basis of race and sexual orientation ought to be addressed in order to reach hidden, at-risk, populations of MSM.
In this article, we outline the position statement on sexual and gender diversity adopted by the Psychological Society of South Africa's Council on 24 September 2013. In line with the Society's constitution, the statement contributes to transforming and redressing silences in South African psychology in order to promote human well-being and social justice for all. The commemoration of the 20th anniversary of the formation of the Society as well as that of democracy in the country in 2014 makes the aforementioned contribution all the more significant. The statement provides psychology professionals in South Africa and elsewhere, with a framework for understanding the challenges that individuals face in societies that are patriarchal and heteronormative and which discriminate on the basis of sexuality and gender. An affirmative view of sexual and gender diversity is taken as the foundation for providing support and guidance to professionals in all areas of psychological practice when dealing with sexually and gender diverse individuals. We contend that by assuming an affirmative stance towards sexual and gender diversity, psychology professionals can assist in the transformation of unjust sexual and gender systems, the harmful effects of which extend beyond their influence on lesbian, gay, bisexual, transgender, and intersex individuals to all persons in South Africa. In light of recent related developments in other African countries and the imminent launch of the Pan-African Psychology Union, South African psychology may, in fact, in this manner also contribute to similar regional initiatives.
The South African government is currently developing legislation on hate crimes. This follows repeated calls by civil society for an appropriate response to the apparent scourge of hate and bias-motivated crimes that tarnish the image of South Africa as a ‘rainbow nation’. This article is aimed at informing related policy debates and provides discussion of violence targeted at foreign nationals and at those who are (or perceived to be) sexual minorities and/or gender non-conforming. This will give an indication of the trends and challenges that the proposed legislation and policy frameworks will need to address.
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