Abara, W.E. and Garba, I. Global Public Health (October 2015), E-publication ahead of print.
This review paper examined the HIV epidemic among men who have sex with men (MSM) in sub-Saharan Africa (SSA) and highlighted factors that facilitate its spread. The authors organized by these categories:
- Epidemiology: Studies under this category demonstrated the concentrated nature of the HIV epidemic and transmission risk among MSM in SSA; the public health impact of ignoring the epidemic on the continent’s current HIV prevention efforts; and the need to prioritize HIV prevention and care, surveillance, and research programs for MSM.
- Social determinants: Among MSM, internalized homophobia leads to negative attitudes and actions that can manifest as shame, fear, anxiety, and loss of self-worth. Additionally, stigma affects social vulnerability and is fundamental to access to health care.
- Stigma, discrimination, the law, and HIV risk among MSM: Many countries in SSA criminalize male-to-male sexual relationships. These laws obstruct HIV prevention, care, and health policies that target MSM, while prompting behaviors and practices that facilitate HIV transmission.
The authors urged implementation of rights-based standards, along with continued collaborative partnerships, collective advocacy, and concerted action to ensure that MSM and all HIV-positive individuals in SSA have access not only to HIV prevention and care, but also to the full range of rights that help ensure equal opportunities for health and wellness.