Evans, M.G., Cloete, A., Zungu, N., and Simbayi, L.C. The Open AIDS Journal (April 2016), 10: 49–64, doi: 10.2174/1874613601610010049, eCollection 2016.
The authors reviewed articles published between 2006 and 2014 on HIV prevalence and risk for lesbian, gay, bisexual, and transgender (LGBT) populations in South Africa. Findings from 35 articles were grouped into categories for gay, bisexual, and other men who have sex with men (MSM):
- HIV prevalence estimates and risk: In all studies, HIV prevalence estimates revealed that MSM had at least four times greater risk of HIV infection than their heterosexual counterparts; prevalence ranged from 10 percent to 50 percent
- Behavioral, social, and structural risks: Structural violence, high levels of poverty, unemployment, and an intolerant cultural and social context were structural risk factors.
- Stigma, mental health, and drug use: For MSM, the review found evidence of stigma, internalized homophobia, poor mental health, and risk of drug use. However, the authors found no peer-reviewed articles on transgender populations and HIV in South Africa, suggesting that although transgender people have been identified as a key population, there is a stark gap in the literature. The authors concluded that HIV research in South Africa should prioritize research with MSM, women who have sex with women, and LGBT populations to inform prevention strategies that meet the specific needs of these marginalized populations.