Marseille 2007
| Abstract #491 - The need for in-depth epidemiological research on South African MSM | ||||
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Session: 50.6: Transmission and social epidemiology (Parallel) on Wednesday @ 08.30-10.30 in PR Chaired by Brenda Spencer, Helene Sylvain Authors: Presenting Author: Dr Theo Sandfort - Columbia University, United States |
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| Additional Authors: Dr Theo Sandfort, Mr Robert Sember, Dr Vasu Reddy, | ||||
| Aim: Although the first South African cases of HIV/AIDS were diagnosed in gay men, the epidemic soon generalized, with heterosexual sex as the major mode of transmission. While the development of the epidemic has been systematically followed, no attention has been paid to homosexual transmission. Currently, there is no knowledge of transmission of HIV among MSM or the role of homosexual transmission in the HIV/AIDS epidemic. Given the enormity of the problem, a focus on heterosexual transmission is understandable. The neglect of men who have sex with men (MSM) from the epidemiological picture is, however, not fair from a social justice perspective and might weaken efforts to successfully combat the HIV/AIDS epidemic. | ||||
| Method / Issue: In response to this situation, we explored the need for knowledge from a health policy perspective, by interviewing researchers, policy makers, prevention workers, community leaders, and men from the target population. Based on this fieldwork, a working conference was held in Pretoria in 2007 to further document and discuss research priorities, explore opportunities for research and ways to address practical barriers, and develop a research infrastructure involving researchers and community members. | ||||
| Results / Comments: Our initial explorations demonstrated a marked absence of homosexuality in the public health and behavioral sciences literature about HIV/AIDS in South Africa. Recently, NGOs have started to survey health issues in gay and lesbian populations which strongly suggest the need for more in-depth and large scale studies. Various barriers to research focused on MSM were identified, including the difficulty of gaining access to relevant populations and the barriers to participation in research due to homophobic climate; the diversity of same-sex expressions of sexuality; the lack of social scientific research infrastructure focused on same sex sexuality; and the scarcity of financial and material resources. Our interviews showed that there is a need for in-depth exploration of the diverse psychosocial, contextual, and public health issues faced by persons involved in homosexual activity, tacking into account gender, race/ethnicity, and class. In relation to HIV, the major research questions are: What is the prevalence of HIV among MSM, and what is the contribution of homosexual transmission to the South African HIV epidemic. Interest in these questions came from epidemiologists, LGB community members, and health care workers. While studies focusing on MSM were seen as important, it was also stressed that attention to homosexuality should be integrated in general population surveys. The presentation will include outcomes of the 2007 working conference. | ||||
| Discussion: Research is needed to understand the organization of same-sex sexuality and the role of homosexual transmission in the South African HIV/AIDS epidemic. This information is essential for the identification of target groups and the development of effective interventions that take into account the experience world of those involved. The political need for epidemiological is to have data to legitimize increased attention for HIV prevention aimed at MSM and to claim needed resources to do so. | ||||
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