an Eldis Resource
Exploring HIV risk among MSM in Kigali, Rwanda
Behavioural surveillance study of men who have sex with men in Kigali, Rwanda
Authors:
A. Binagwaho; J. Chapman; Y. Utazirubanda
Publisher:
Carolina Population Center, University of North Carolina, 2009
Internationally men who have sex with men (MSM) have been identified as a high risk group for HIV acquisition, due to a tendency towards higher risk sexual behaviours and greater numbers of casual (and often commercial) sexual partners. This report from the National AIDS Control Commission Rwanda presents findings from a behavioural surveillance study (BSS) of men who have sex with men in Kigali, Rwanda. Ninety nine questionnaires were carried out which aimed to describe the population of MSM in Kigali and explore the nature of sexual activity between MSM. It was found that MSM in Kigali are at elevated risk for HIV infection compared to the general population, and require specific HIV/STI prevention services/support. The research uncovered a high level of commercial and transactional sex among MSM in Kigali and a high degree of overlap of sexual networks between MSM living in different regions in Rwanda, and perhaps in different countries in East Africa. Approximately one-quarter of respondents reported sex with a woman in the past 12 months. Nearly 40% of these respondents also reported engaging in transactional sex with a woman in the past 12 months.
The authors suggest that further research is urgently needed to assess HIV/other STI prevalence among MSM. They also recommend additional research into MSM sexual networks (i.e. commercial and transactional sex, sex with women, sex and travel). It is recommended that within a sensitive human rights framework, HIV/STI awareness-raising campaigns targeting MSM should be carried out in a method that maximises privacy and safety, and avoids any unintended population-directed stigma and discrimination. The document additionally highlights that health services should be reoriented to ensure that they are MSM-friendly and focused on the specific sexual health needs of MSM. Most urgently, efforts should be made to improve access to sexuality-sensitive psychosocial services, e.g. counselling, for MSM.
