Monday, December 24, 2007

HIV and Gay men

Its always a wonder to me. The fact that I can and do affirm that I am gay. That I am a gay Ugandan. And that I can actually be proud of the fact.

Yeah, pride is an important thing to have in oneself. Because of the fact that we can and easily believe that what the world believes of us is correct.

I got to this article, called an ‘abstract’, a summary of a scientific research paper. It was done in Kenya, and the statistics that I see here are frightening to me.

In Kenya, our neighbours to the east, they have managed to start doing HIV prevention amongst gay Kenyans. Kudos to them.

In Uganda, it is the opposite. The Ministry of Health does not comment. The Uganda AIDS Commission, re-known all over the world, does not apparently cater for gay men.

And the Churches (and Government) believe firmly that this should be so.

I do not understand all that is written in this paper. But I understand one statistic. Amongst the gay men who were tested in Kenya, the HIV infection was at least 43%.

What is the rate amongst gay Ugandans? We are supposed (in Uganda) to have a higher HIV infection rate. But even I know that it has never been 43% of the population. Indeed we (gay Ugandans) are at risk.

Yeah. I have to learn to be safe. But it galls me that homophobia in Uganda is so blatant in its capacity to prevent something as basic as HIV prevention amongst a vulnerable population. And they call themselves a ‘very religious….’

Here is the article.

HIV-1 infection in high risk men who have sex with men in Mombasa, Kenya.

22 Dec

AIDS. 21(18):2513-2520, November 30, 2007.

Sanders, Eduard J a,b; Graham, Susan M c; Okuku, Haile S a; van der Elst, Elise M a; Muhaari, Allan a; Davies, Alun a; Peshu, Norbert a; Price, Matthew d; McClelland, R Scott c; Smith, Adrian D e


Background: The role of homosexuality and anal sex practices in the African HIV -1 epidemic is not well described. We aimed to assess the risk factors for prevalent HIV-1 infection among men who have sex with men (MSM) to guide HIV-1 prevention efforts.

Methods: Socio-behavioural characteristics, signs and symptoms of sexually transmitted diseases (STD), and serological evidence of HIV-1 were determined for 285 MSM at enrolment into a vaccine preparedness cohort study. We used multivariate logistic regression to assess risk factors for prevalent HIV-1 infection.

Results: HIV-1 prevalence was 43.0% [49/114, 95% confidence interval (CI), 34-52%] for men who reported sex with men exclusively (MSME), and 12.3% (21/171, 95% CI, 7-17%) for men who reported sex with both men and women (MSMW). Eighty-six (75%) MSME and 69 (40%) MSMW reported recent receptive anal sex. Among 174 MSM sexually active in the last week, 44% reported no use of condoms with casual partners. In the previous 3 months, 210 MSM (74%) reported payment for sex, and most clients (93%) were local residents. Prevalent HIV-1 infection was associated with recent receptive anal sex [odds ratio (OR), 6.1; 95% CI, 2.4-16], exclusive sex with men (OR, 6.3; 95% CI, 2.3-17), and increasing age (OR, 1.1 per year; 95% CI, 1.04-1.12). Only four MSM reported injecting drug use.

Conclusions: The high prevalence of HIV-1 in Kenyan MSM is probably attributable to unprotected receptive anal sex. There is an urgent need for HIV-1 prevention programmes to deliver targeted risk-reduction interventions and STD services to MSM in Kenya.

(C) 2007 Lippincott Williams & Wilkins, Inc.

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