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

Miller, Charles R. (2014-04)

Thesis (MPhill)--Stellenbosch University, 2014.


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.

AFRIKAANSE OPSOMMING: Ontwikkelende lande soos Lesotho probeer nog steeds om die MIV/Vigs-pandemie onder beheer te kry. Lesotho het tans die derde hoogste voorkoms van MIV in die Wêreld en ondanks alle pogings, word die pandemie nog steeds gedryf deur veral meervoudige, gelyktydige verhoudings. Hierdie studie is gedoen om meer insig en begrip te kry van die uitdagings wat gebied word deur mans-wat-seks –het met-mans en om aan te toon hoe stigma en diskriminasie veral hierdie kwesbare groepe nadelig beïnvloed. Kwantitatiwe data is verkry van 51 mans wat aangedui het dat hulle seks het met ander mans. Inligting is ingesamel deur middel van ‘n 47-item vraelys en onderhoude is met ‘n verdere 16 mans gevoer. Ongeveer 82% van die mans het aangetoon dat hulle wel seks met and mans gehad het in die afgelope 12 maande en 33% van hierdie mans het aangedui dat hulle gedurende hierdie tydperk ook gelyktydige seks met vrouens gehad het. Bykans die helfte van die mans het aangetoon dat hulle kondome slegs sporadies gebruik wanneer hulle seks met ander mans het. Stigma en diskriminasie is baie hoog onder Basoeto mans wat seks het met ander mans. Homoseksualiteit is steeds taboe in Lesotho en dit is nie ongewoon vir hierdie mans om soms selfs fisies aangerand toe word nie. Hierdie studie geen ‘n seldsame insig in die Wêreld van mans-wat-seks-het –met mans en maak ‘n besondere bydrae tot ‘n beter begrip van hierdie grootliks vergete kwesbare groep binne die groter strewe van die bekamping van die verspreiding van MIV/Vigs in sub-Sahara Afrika.

Please refer to this item in SUNScholar by using the following persistent URL:
This item appears in the following collections: