Sexual identity and risk behavior among men who have sex with men (MSM) in Accra, Ghana and Lomẻ, Togo

Moore, Ami R.; Driver, Nichola; Owusu, Adobea Yaa; Amey, Foster

doi:10.1080/2331205x.2017.1333696

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…Of these, only the 87 studies containing qualitative data or behavioral quantitative data referring to recent sexual relationships of MSM with women were selected for the present synthesis [26–118]. Details of selected studies are presented in Supplementary File 2, http://links.lww.com/QAD/D49.…”

Section: Resultsmentioning

confidence: 99%

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Fiorentino,

Yanwou,

Gravier-Dumonceau Mazelier

et al. 2024

Aids

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In sub-Saharan Africa (SSA), MSM – a high HIV prevalence group – experience strong social stigma and pressure to have female partners. Accordingly, they could constitute a bridging group for HIV transmission to cisgender women. We developed a multilevel summary of MSM sexual behaviors and risk with women in various SSA regions. Following PRISMA guidelines, we conducted a mixed-method systematic review of data of sex with women in MSM in SSA. We performed meta-analyses on quantitative data (i.e. percent of recent sex and condomless sex with women) for each SSA region (when proportions reported in ≥4 studies). Pooled proportions were calculated using random-effects models. Qualitative data were analyzed using the three-step thematic synthesis methodology. The pooled proportion of MSM who had sex with women was 58% (33–83%) in East Africa (in the previous 3 months), and 27% (13–48%) in Southern Africa and 50% (95% CI 39–62%) in West Africa (in the previous 6 months); 23% (16–32%) of MSM in West Africa had condomless sex with a woman (during the most recent encounter). Approximately one quarter of MSM had recent multiple female partners. MSM reported having sex with women because of heteronormative pressure, erotic/romantic attraction, or financial needs leading to transactional sex. MSM may act as a bridging population to women in SSA, as they commonly practice sex with women and risky sexual behaviors with them. HIV programmes and community-based support for MSM should be adapted to this population to reduce this risk.

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Section: Resultsmentioning

confidence: 99%

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Fiorentino,

Yanwou,

Gravier-Dumonceau Mazelier

et al. 2024

Aids

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“…This finding by Owusu [ 43 ] is consistent with research on the intersectionality of cultural norms and expected risky sexual behaviours of young people in Ghana [ 49 , 56 ] and South Africa [ 53 ]. Meanwhile, there is glaring evidence of high-risk sexual behaviour between young boys, older men, and older females in the municipality [ 45 , 46 ]. Thus, the gendered focus of teachers on girls’ risky behaviour may be limiting in any attempt to comprehensively address the dangerous behaviour of both boys and girls who live on their own and are potentially vulnerable to HIV.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, a mixed-methods study into how power dynamics shape the sexual initiation of 215 male youth found that more than half experienced sexual debut before age 16. Of this number, more than 42% consisted of consensual sex activities between older women and younger men, with older women using verbal encouragement, gifts, and alcohol to achieve coercive sexual consent [ 45 ]. Next to Kumasi, Agormanya has the second-highest level of consensual activities between young men who have sex with men (MSM) and older men [ 46 ].…”

Section: Methodsmentioning

confidence: 99%

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Conflicting HIV/AIDS Sex Education Policies and Mixed Messaging among Educators and Students in the Lower Manya Krobo Municipality, Ghana

Ocran

Talboys

Shoaf

2022

IJERPH

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While school-based comprehensive sex education (CSE) is effective in HIV prevention among young people ages 10–24 years, Ghana’s national sexual and reproductive health education policy promotes abstinence. Meanwhile, the Ministry of Health’s HIV prevention programs provide more comprehensive school-based education. This qualitative study evaluated the HIV/AIDS education program in the Lower Manya Krobo Municipality to assess the perspectives of students and educators in 10 schools on school-based sexual and reproductive health programs, including HIV/AIDS education and conflicting HIV/AIDS sex education policies. HIV prevalence in the Lower Manya Krobo Municipality of Ghana was more than twice the national average at 5.64% in 2018, and prevalence among youth in the municipality aged 15–24 was the highest in the nation at 0.8%. Educators have mixed feelings regarding abstinence-based and CSE approaches. However, students generally endorse abstinence and describe the limitations of condom use. Ambiguity in overarching policies is identified as a factor that could influence the orientation of school-based health educators, create disharmony in sex education interventions, introduce confusing sex education messages to young people, and create a potentially narrow curriculum that limits the gamut of HIV/AIDS sex education to exclude young people’s risky sexual behaviours and diverse teaching and implementation strategies. Policies and the scope of sex education should be realigned to ensure the transparent implementation of HIV/AIDS sex education programs in Ghana.

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“…Crucially, the limited information on health seeking behaviour among the GBM limits the extent to which the health system intervenes on HIV/AIDS spread within the special population. Stigma, sexual identity and a hostile environment have been implicated in non-disclosure and the secrecy associated with GBM [13, 14]. Besides, GBM is criminalized in Ghana [15, 16, 17].…”

Section: Introductionmentioning

confidence: 99%

Experiences of care-seeking behaviour for sexually transmitted infections among gay and bisexual men: A phenomenological study

Adoma

Yeboah²,

Nantomah

et al. 2023

Preprint

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IntroductionGay and bisexual men (GBM) are stigmatized in the Ghanaian society and that negatively affect their care-seeking behaviour. We sought to understand the experiences of care-seeking behaviour (CSB) for STIs among gay and bisexual men in Bono region, Ghana.MethodsA respondent-driven sampling was used to collect data from 17 gay and bisexual men in Bono region based on phenomenological qualitative approach. The data were thematically analysed using the Atlas.ti software.ResultsResults were presented under various themes with appropriate accompanying excerpts. Two broad themes emerged from the data; personal and health system experiences of treating STIs. Personal experiences such as economic conditions, knowledge on STI, marital experiences and bisexual’s partner awareness of sexual orientation had influences on CSB. Experience with the cost of treatment, stigmatisation by health care workers (HCW) and perceived quality healthcare were the health system factors found to influence CSB.ConclusionTo help improve STIs care-seeking behaviour, government need to encourage and economically empower GBM, while at the same time, improving their knowledge on STI prevention and control. The National Health Authority should intensify and monitor the implementation of the national health insurance at the private healthcare sectors without favour and discrimination for gay and bisexual men.

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Sexual identity and risk behavior among men who have sex with men (MSM) in Accra, Ghana and Lomẻ, Togo

Cited by 5 publications

References 25 publications

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Conflicting HIV/AIDS Sex Education Policies and Mixed Messaging among Educators and Students in the Lower Manya Krobo Municipality, Ghana

Experiences of care-seeking behaviour for sexually transmitted infections among gay and bisexual men: A phenomenological study

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