This is one of the conclusions of the first-ever study undertaken to investigate MSM and lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) students’ knowledge, attitudes, perceptions and behaviours relating to sex, HIV and alcohol and substance use. The study was undertaken by Jaco Greeff Brink, from the Stellenbosch University Institional HIV Office, on behalf of the Networking HIV/AIDS Community of South Africa (NACOSA).

Launched on the 4th of May 2015, the “National Student Sexual Health HIV Knowledge, Attitude and Behaviour Survey: Focusing on Student Men who have Sex with Men at 14 Higher Education Institutions in South Africa” shows that student MSM are not radically different from other young people in their pattern of risk-taking in relation to sex and HIV.

But while other students have extensive resources at their disposal that mitigate the risk for them, little has been done to provide specific support to MSM students. They are therefore left more exposed to the risk of infection by the absence of adequate and dedicated education and health services, rather than due to their own behaviour.

These insights are intended to refine and improve campus-based HIV and sexual health programmes, not only for MSM but also for other sexual minority populations.

The research was conducted in 2014 by the Higher Education & Training HIV/AIDS Programme (HEAIDS) and NACOSA with grant support from the Global Fund.

Its sample group of 8869 students included 10 percent who are MSM – viewed by researchers as a positive sign of openness about their sexuality, despite overall feelings of vulnerability and marginalisation. Of the total sample, 69 percent identified themselves as heterosexual, 16 percent as homosexual, six percent as bisexual and nine percent
as “other” forms of sexual orientation.

Its findings identify a number of social factors that impact on the health of MSM and in turn affect their ability to successfully complete their studies:

  • An unaccepting campus environment for MSM and LGBTQI populations, and discrimination based on sexual preference.
  • Threats of abuse or violence.
  • Frequent use of online channels by MSM to meet partners.
  • Lower levels of self-esteem and higher levels of alcohol and drug use by MSM, relative to their non-MSM peers.

The survey suggests that same-sex practices are not confined to those who identify themselves as homosexual or bisexual, and that MSM should not be seen as a homogenous group. For example, 54.5% of the MSM sample reported having had at least one female sex partner in the past year. The majority (71.2%) of MSM self-identified themselves as homosexual, but 20% reported being bi-sexual and 7.4% were heterosexual.

Encouraging findings are that many MSM are well informed about HIV, they have tested previously and intend to test again.

About a half (52%) of MSM said they at some point used alcohol and/or drugs during sex while about a fifth had used it during the last sexual act, and both MSM and non-MSM students inconsistently use protective measures such as condoms and lubricants.

But, sex with someone other than a primary partner is more common among MSM (71.9%) than in the non-MSM group (45.1%), which raises MSM’s risk of STIs, including HIV.

The study is also the first of its kind to address issues related to MSM and LGBTQI youth, who are identified as a “key population” in the SA National Strategic Plan for HIV, STIs and TB 2012-2016 (NSP).

Commenting at the launch of the study, Mduduzi Manana, Deputy Minister of Higher Education and Training said that the sector is a key role player in the realisation of the NSP goals – and particularly the objective to enhance the protection of human rights and improve access to justice for “key populations” in South Africa.

Said Deputy Minister Manana: “We appreciate that the youth population is diverse. In the context of the HIV, TB and STI epidemics, it is important to recognise the multiplicity of sexual orientations among students and the behaviours associated with various sexual orientations. This report provides a glimpse of the diverse ways in which young people experience sex, relationships and intimacy – and it explores the implications of this diversity for sexual health.

“MSM and non-MSM students score similarly on having knowledge about HIV – but this study also shows that we have not focused on the former group’s specific health and psychological needs and adequate support. We have been leaving them behind – and we must now change this,” urged Deputy Minister Manana.

He was concerned that this situation is perpetuated by homophobia and stigmatisation which are a daily reality for many MSM. They also felt let down by their institutional management and leadership in terms of protection, riskreduction in relation to sexual health and psychological and overall wellness.

Dr Ramneek Ahluwalia, director of HEAIDS said that the findings of the survey will inform further research and programmes aiming to protect students of all sexual orientations from HIV, and support them in other areas of health and lifestyle.

Dr Ahluwalia said it was proven that early detection and treatment can prolong life expectancy for people living with HIV by more than 30 years: “This provides a return on our investment in healthcare, allowing young people to contribute to the welfare of their own families, to our sector and to the economy of the nation as a whole.”

He also said that this was an important consideration for HEAIDS, which facilitates the implementation of health programmes in the sector, promotes student attendance and retention, boosts the through-put of graduates and increases their competency.

Dr Ahluwalia emphasised that narrow-minded views which fuel stigma towards MSM and LGBTQI obstruct equitable provision of information, education and services. He called on all the leadership from the post-school education system – including vice-chancellors, recors and principals – to tackle this issue head-on and create a viable environment to protect the human rights of students and youth.

Dr Maureen van Wyk, Executive Director of NACOSA said: “It is becoming clear that if we invest in the specific health needs of key populations and reduce their vulnerability, we can have a huge impact on the number of new HIV infections and help achieve the HIV prevention, treatment and stigma reduction goals of the National Strategic Plan.”

Source: HEAIDS (Higher Education & Training HIV/AIDS Programme)