To date, there is a dearth of surveillance data on the prevalence of HIV and associated risk behaviours among men who have sex with men (MSM) in South Africa. This is particularly true for data collected from several sites using the same sampling approach.
This study called the Marang Men's Project was undertaken to fill this information gap. It was implemented among MSM in the three largest cities of South Africa, namely, Cape Town in the Western Cape, Durban in KwaZulu-Natal and Johannesburg in Gauteng.
The high HIV prevalence estimates found in our study among MSM in each of the three study cities call for a need to implement a national HIV bio-behavioural surveillance programme for MSM.
The Marang Men's Project has demonstrated that there is an urgent need for interventions, which respond not only to the heterosexual HIV epidemic but also to the HIV epidemic among MSM in South Africa.
This survey therefore provides valuable information to SANAC, the national and provincial Departments of Health (DoHs), and lesbian, gay, bisexual, transgender and intersex (LGBTI) organisations to both implement and advocate for improved programmes for the health of MSM.
Product information
List of tables
List of figures
Contributors
Foreword
Acknowledgements
Acronyms and abbreviations
Executive Summary
Background
Methodology
Results
Socio-demographic characteristics
HIV prevalence
Behavioural risks
Use of health care services
Knowledge of HIV information
Sources of useful HIV information
Experiences of police discrimination due to sexual orientation
Ever been in prison and reported unprotected anal intercourse (UAI) (forced
or consensual)
Recommendations
Points for consideration
1 Introduction
1.1 Background and context
1.2 Aims and objectives of the study
2 Methodology
2.1 Phase 1: Pre-surveillance formative research
2.1.1 Semi-structured interviews to determine network size questions, selection of seeds and other survey logistics
2.1.2 Structured observations to find appropriate locations for RDS sites
2.2 Phase 2: HIV biological and behavioural survey
2.2.1 Sampling design
2.2.2 Survey study cities and survey sites
2.2.3 Sample size estimation
2.2.4 Recruitment and respondent selection
2.3 Survey procedures
2.3.1 Data management
2.3.1.1 Behavioural survey using ACASI or CAPI
2.3.1.2 HIV testing
2.3.1.3 Incentives and reimbursement
2.4 Data analysis
2.5 Ethical considerations
2.5.1 Voluntary participation
2.5.2 Informed consent
2.5.3 Risks to respondents
2.5.4 Benefits to respondents
2.5.5 Protection of privacy of individual
2.5.6 Protection of confidential information
3 Results
3.1 Realisation of calculated sample sizes
3.1.1 Cape Town recruitment
3.1.2 Durban recruitment
3.1.3 Johannesburg recruitment
3.2 Socio-demographic characteristics
3.3 HIV prevalence
3.4 Behavioural risks
3.4.1 Condom use at last sex with a male partner
3.4.2 HIV-testing history
3.4.3 Sexual practices in the previous six months
3.4.4 Number of male sex partners and regular male/female sex partners in the previous six months
3.4.5 Transactional sex with men in the previous six months
3.4.6 Alcohol use and sexual intercourse
3.5 Use of health care services
3.6 Knowledge and main sources of HIV information
3.7 Sources of useful HIV information
3.8 Experiences of police discrimination due to sexual orientation
3.9 Ever been in prison and reported UAI (forced or consensual) in prison
4 Discussion
4.1 Summary of main findings
4.2 Discussion of main findings
4.2.1 Socio-demographic characteristics
4.2.2 HIV prevalence
4.2.3 Behavioural risks
4.2.3.1 Condom use at last sex with a male partner
4.2.3.2 HIV-testing history
4.2.3.3 Sexual practices of MSM in the previous six months
4.2.3.4 Transactional sex with men in the previous six months
4.2.3.5 Alcohol use and sexual intercourse
4.2.4 Use of health care services
4.2.5 Knowledge of HIV information
4.2.6 Experiences of police discrimination due to sexual orientation
4.2.7 Ever been in prison and reported UAI (forced or consensual) in prison
4.3 Limitations of the study
5 Recommendations
Appendices
Appendix 1: List of fieldwork staff
Appendix 2: Qualitative characteristics of seeds selected for the Marang Men's Project
References
Index
