The impact of social and internalized stigma on HIV risk among men who have sex with men in Lesotho

[摘要] ENGLISH ABSTRACT: As the HIV epidemic moves well into its third decade, developing countries like Lesotho are still struggling to come to terms with the effect of this pandemic. At 23.3%, Lesotho is third from the top of an infamous list of countries with the highest HIV prevalence rates. While many gains have been made in this tiny kingdom, multiple concurrent partnerships continue to drive the epidemic and stigma and discrimination exacerbates low levels of knowledge.This study was undertaken to seek clarity on the challenges of men who have sex with men in Lesotho and how stigma and discrimination might increase HIV risk for an already vulnerable population.Quantitative data was collected from fifty-one men who self-reported having had sex with at least one other man in the last twelve months via a 47-item questionnaire. Further qualitative data was collected from 16 of these men in semi-structured interviews which sought additional information on HIV knowledge, stigma, discrimination, and HIV risk.Findings revealed that 82% of men reported multiple concurrent partnerships in the last twelve months, and 33% of men reported those multiple concurrent partnerships included sexual relationships with women. Forty-two percent of men reported sporadic use of condoms when having sex with men and of those men who reported sexual activity with women in the last year, 28% reported only using condoms sometimes or never.Stigma and discrimination exacerbates an already delicate situation where 52% of men surveyed report knowing Basotho who have spoken derogatorily of men who have sex with men. The same percentage of men also reported knowing someone who had experienced physical abuse due to sexuality. Almost 50% of men reported possible plans to marry a woman in the future and 56% of these men reported doing so in order to meet familial expectations and traditional demands of manhood. Some participants were not aware of the HIV risk involved with unprotected sex between two men and interview participants echoed the need for including this and other information in more comprehensive HIV-knowledge and prevention campaigns which include men who have sex with men.

[发布机构] Stellenbosch University