Prevalence of Consensual Male-Male Sex and Sexual Violence, and Associations with HIV in South Africa: A Population-Based Cross-Sectional Study

August 2013 - Behavioral Prevention

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Dunkle, K.L., Jewkes, R.K., Murdock, D.W., et al. PLOS Medicine (June 2013), Vol. 10 No. 6.

The authors conducted a cross-sectional household survey with 1,705 adult men in the Eastern Cape and KwaZulu-Natal, South Africa in 2008 to assess the prevalence of men who have sex with men (MSM) in consensual relationships, male-on-male sexual violence and victimization, and sociodemographic factors and HIV prevalence associated with these behaviors. One in twenty men, or 5.4 percent, reported having consensual sexual activity with another man; of these, 48 percent reported having had oral or anal sex with another man. MSM behavior was reported more frequently by men in lower socioeconomic households. Nearly all men also reported having sex with women. Further, 1 in 10 reported male-on-male sexual violence, including oral or anal rape (3.3 percent), and perpetration of this behavior (2.9 percent). MSM with a history of consensual sex with men were seven times more likely to experience sexual violence from another man, and three times more likely to perpetrate this sexual violence against another man, compared to those who did not. Among 1,220 men who consented to an HIV test, prevalence was higher among men with a history of consenting to sex with a man and among perpetrators of male sexual violence. Research is needed on the overlap between male-male and heterosexual behaviors, and on male-on-male sexual violence, and the implications for HIV risk and prevention strategies.

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