Casual Sex, Sex Work and Unprotected Sex among Men Who Have Sex with Men in the Human Papilloma Virus (HPV) Clinical Trial —North-West Region of Tshwane, South Africa

Abstract

Background: The gap in the understanding of the context of the sexually transmitted infections (STIs) and risky behaviours among men who have sex with men (MSM) could lead to the development and implementation of inappropriate interventions, which could exacerbate the rapid spread of STIs, especially HIV, among MSM. The aim of the study was to qualitatively assess the understanding of the STIs and the risky sexual behaviours of men who have sex with men in the NorthWest region of Tshwane. Methods: An exploratory qualitative design was employed to assess the STIs and the risky sexual behaviour of the MSM population. The study participants were enrolled in an HPV clinical trial at MECRU, which is a clinical research unit at the Sefako Makgatho Health Sciences University. Data collection occurred from September 2016 to May 2017. A convenience sampling method was used and n = 30 participants were selected. Face-to-face in-depth interviews were conducted on MSM 18 years and older, using a semi-structured interview guide. Thematic content analysis was used for data analysis, using NVivo version 10 software. Results: The mean age of the sample was 26 years, and the age range was 18 to 44 years. All were unmarried, and all of them came from townships, rural villages and informal settlements in the vicinity of the clinical research unit. The high-risk behaviours noted among the majority of the MSM in this study were having multiple sexual partners and exchanging How to cite this paper:

Sexual History Taking: Perspectives on Doctor-Patient Interactions During Routine Consultations in Rural Primary Care in South Africa

“…With the high unemployment and poverty rate in the country, more men enter the commercial sex arena. 51 , 52 If that was the situation and he was HIV negative (which was not elicited or tested), the doctor could have offered pre-exposure prophylaxis, 7 also something could have been done to reduce future risks.…”

Holistic Sexual-Reproductive Healthcare Services and Needs for Queer Individuals: Healthcare Providers’ Perspectives

“…Furthermore, SRHSNs, such as HIV and STI testing, cervical cancer screening, and contraceptive care, are critical for the prevention, identification, and treatment of a variety of sexual and reproductive health consequences [6]. In addition, the provision and inclusion of other services and needs for genderqueer individuals would improve their health and well-being by preventing unintended pregnancies [7], lowering the increased risk of unplanned pregnancies and abortions [8], and mitigating high-risk sexual behaviors such as having several sexual partners, switching partners, irregular condom use, unprotected anal sex, and transactional sex [9]. Providing these services coincides with multiple sustainable development goals (SDGs) for 2030, including SDG 3, Good Health and Well-Being; SDG 5, Gender Equality; and SDG 10, Reduce Inequalities [10].…”

“…If HCPs are unfamiliar with, lack understanding of, and are not knowledgeable about SRHSNs for genderqueer individuals, it increases risks for genderqueer individuals. Such risks entail the following: the prevalence of STIs (especially HIV and acquired immunodeficiency syndrome [AIDS]) would rise and remain high [18,19]; genderqueer individuals might have sexual issues such as lack of access to fertility preservation and gender-affirming hormonal therapy, and unintended pregnancies; and they might suffer from sexual harassment [18], indulge in risky sexual practices such as having numerous sexual partners and sharing partners, use condoms inconsistently, engage in unprotected anal sex, pursue transactional sex [9,20], and practice high-risk sexual behaviors like performing or receiving "rimming" and exchanging sexual devices [20]. In addition, HCPs' discriminatory attitudes toward genderqueer individuals might prevent them from accessing healthcare services [21], leading to uncertainty about whether or not they would be approved for assisted reproduction [15], placing some genderqueer individuals at a higher risk of unintended pregnancies [7].…”