Behind the Mask LGBT African website
July 11, 2000 – The Namibian, Windhoek, Namibia
Sister Namibia’s Office Gutted In Suspected Anti-Gay Attack
by Tangeni Amupadhi
Windhoek, Namibia – A fire gutted the office of the Sister Namibia magazine yesterday, prompting the editor of the publication to blame gay bashers. The fire was discovered yesterday morning in the Sister Namibia Windhoek office on Nelson Mandela Avenue. It had already burnt most files and research material before fire fighters could extinguish it.
Sister Namibia is an organisation that campaigns for women’s rights and gender equality. Liz Frank, editor of the magazine, said somebody broke into the office in the early hours of yesterday and set fire to bookshelves before closing the door, resulting in the gutting of the room where the magazine is published. Frank ruled out the possibly that electricity might have caused the fire, saying that the corner where the electrical appliances were standing did not burn. Computers, blackened by smoke, were still switched on after firefighters had killed the fire.
"Maybe we are being targeted because we are a human rights organization [dealing with gay issues]," said Frank. "I don’t think the President [Sam Nujoma] and those who speak out [against gays and lesbians] realize that other people turn violent when they these statements," she added.
President Nujoma has said on numerous occasions that homosexuality is unacceptable and has criticised gays and lesbians as unAfrican and ungodly. Frank said three gay men were beaten up by people in Rescue 911 vehicles and charges were laid on the night of the same day last month that Nujoma verbally attacked gays and lesbians at a memorial for late Swapo leader Nathaniel Maxuilili at Walvis Bay. A Rescue 911 spokesperson confirmed the incident but could not give details.
The amount of goods destroyed by the fire has not yet been estimated, but Frank said work on the magazine had been delayed. She ruled out the possibility that insiders were involved. Another employee of the publication, who was the first person to get into the building, said the alarm was not on.
Pandemonium in Namibian Parliament
Homophobic members of Parliament from the ruling Swapo party continuously disrupted proceedings in Namibia’s National Assembly Oct. 31 to delay debate on creation of the African Court on Human and People’s Rights. The outbreak began when MP Rosa Namises noted that gays and lesbians have been under attack from Namibian authorities. "As far as I know, sodomy is still a crime in this country," shouted MP Jerry Ekandjo.
In October at a police academy graduation ceremony, Ekandjo, who is also the minister of home affairs, told 700 new police officers: "We must make sure we eliminate them [gays] and lesbians] from the face of Namibia. [The] constitution does not guarantee rights for gays and lesbians." Deputy Home Affairs Minister Jeremiah Nambinga has said: "Homosexuality is evil. Homosexuality is anti-social and should not only be condemned but should also be legislated against. Homosexuals are patients of psychological and biological deviations." Namibian President Sam Nujoma has said: "Those who are practicing homosexuality in Namibia are destroying the nation….Homosexuals must be condemned and rejected in our society."
December 21, 2000 – Minneapolis Star Tribune, Minneapolis, MN,
Hard times for Gay Dogs in Namibia
In October, Jerry Ekandjo, Namibia’s home affairs minister, told police academy graduates in the capital city of Windhoek that constables must "eliminate [gays and lesbians] from the face of Namibia" and must also kill any "gay dog" that belonged to a gay or lesbian. (George Stephens Finley, 58, was convicted in June in Ocala, Fla., of killing his male poodle-Yorkie because he thought it was gay; it had become very playful with the other male family dog.)
March 22, 2001 – Daily Dispatch
Gay Rights Challenge to Nujoma
Windhoek, Namibia A Namibian gay rights coalition challenged President Sam Nujoma yesterday to state under which laws gays and lesbians could be prosecuted, after remarks against homosexuals he made earlier this week. "Nowhere does our constitution state that gay and lesbian people are not members of the human family and therefore do not enjoy the same rights as all other citizens," said a spokesperson for the Rainbow Project coalition, Ian Swartz.
"We would also like to know whether the president has made arrangements with the prison authorities to accommodate some 10 percent of the population." Swartz demanded to know whether Namibia had made deals with other countries for the deportation of its homosexual population.
Nujoma told university students earlier this week the constitution did not allow for homosexual practices and called on police to arrest, imprison and deport gays. "The Republic of Namibia does not allow homosexuality, lesbianism here. Police are ordered to arrest you, and deport you and imprison you," Nujoma said at the University of Namibia.
Swartz responded that Namibia’s constitution forbade any discrimination based on individual differences and it did not exclude the rights of sexual minorities. The South West Africa People’s Organisation claims homosexual practices result from foreign influences. But those contesting this point out nearly all indigenous languages, including Oshiwambo spoken by most Swapo supporters, have a word for homosexuals.
Over the past few years, Swapo’s conservative culture has repeatedly been at odds with the civil rights enshrined in the constitution. Prime Minister Hage Geingob was forced to explain to parliament last year that Home Affairs Minister Jerry Ekandjo’s call to police recruits to "eliminate" gays and lesbians from Namibia was made in Ekandjo’s private capacity. — Sapa-AFP
March 26, 2001 – Wall Street Journal
Another African Epidemic
Add another item to the list of Africa’s woes: state-sanctioned gay bashing. Last week, Namibian President Sam Nujoma ordered his police to "arrest, deport and imprison" homosexuals. This follows on recent comments by other African leaders that homosexuals are a "scourge" (Kenya’s Daniel arap Moi), and "lower than pigs and dogs" (Zimbabwe’s Robert Mugabe).
Similar vitriol from Zambia and especially Uganda. "I have told the [police] to look for homosexuals, lock them up and charge them," said Yoweri Museveni, the newly re-elected leader of that country. The subtext of these attacks is sub-Saharan Africa’s skyrocketing HIV-infection rates. In South Africa, an estimated one in eight adults is HIV-positive; in Namibia, Zimbabwe and Zambia the figure is closer to one in five.
By contrast, the HIV infection rate among adults in the U.S. was never more than about 0.3%, and most of the infected now have access to life-prolonging medication. For Africa’s failed leaders, blaming a national catastrophe on a minority is certainly convenient. It is also totally misleading. While HIV infection in the West is in fact a largely homosexual phenomenon (notwithstanding politically correct scaremongering that heterosexuals were equally at risk), in Africa the reverse holds.
Why? First, because the prevalence of other venereal diseases in the population tends to increase the risk of HIV infection. And second, because prostitution and solicitation, through which the disease is quickly disseminated, remains disturbingly commonplace in Africa. In other words, AIDS in Africa is not a "gay disease," and targeting homosexuals for attack, aside from being odious in itself, only distracts attention from the real sources of the problem.
These are manifold, but perhaps chief among them is the frightful poverty into which African leaders have led their people through decades of corruption and incompetence. Mr. Mugabe — recently welcomed by Europe’s ever-cynical heads of state — is perhaps the worst offender, having gone to war against Zimbabwe’s law-abiding and productive white farmers. But Mr. Nujoma isn’t far behind; among other things, he maintains a force of 2,000 soldiers at war in the Congo, despite a declining economy at home.
Recently, too, the government of this erstwhile national liberator has been making threatening noises against independent media and other nongovernmental organizations. One would wish that some day African leaders will eschew the politics of scapegoating, be it against their former colonizers, multinational corporations, nonblack minorities, and so on.
Alas, this latest attack on homosexuals — along with the current demonization of pharmaceutical corporations — gives little reason to hope. Meanwhile, perhaps this latest episode of African gay bashing will serve as notice to campus "multiculturalists" and other fashionable purveyors of anti-Western cliches that the enemy, after all, is not us.
March 28, 2001 – The Gully
Namibia–The Bermuda Triangle of African Homophobia
by Ana Simo
On Monday, March 19, two days before his nation celebrated the 11th anniversary of its independence, President Sam Nujoma of Namibia used the occasion of a major speech at the University of Namibia to attack lesbians and gay men.
" The Republic of Namibia does not allow homosexuality, lesbianism here. Police are ordered to arrest you, and deport you, and imprison you, too," he told a hushed audience. He then once again blamed "foreign influences" for homosexuality in Namibia, which he said threatened to destroy the nation.
President Nujoma’s homophobic outburst is just the latest in a chilling campaign to demonize Namibian queers as a national threat. It started in 1995, when Nujoma’s then Finance Minister Helmut Angula, Minister Nahas Angula, and Deputy Minister Hadino Hishongwa, first denounced homosexuality as "an un-African social evil." Helmut Angula also called it a "mental disorder" which "can be cured." The two Angulas are big shots in Nujoma’s ruling SWAPO Party: they are members of its Political Bureau, the top decision-making body.
Hishongwa, who was Deputy Lands, Resettlement and Rehabilitation Minister, said, "Homosexuality is like cancer or AIDS and everything should be done to stop its spread in Namibia." Gay men and lesbians, he declared, "should be operated on to remove unnatural hormones in them."
In December 1996, President Nujoma himself told the national conference of the SWAPO Women’s Council that gay men and lesbians were "un-African and unnatural." He added, "Homosexuals must be condemned and rejected in our society."
" Extinction of the Nation"
A year later, in 1997, Nujoma heightened the rhetoric when he accused gay men and lesbians of being "European" and destroying Namibian culture by imposing "gayism," and he vowed to "uproot" homosexuality. "It [homosexuality] is a foreign and corrupt ideology and such elements are exploiting our democracy," he said.
At the National Assembly, in 1998, Nujoma’s Home Affairs Minister, top cop, and new anti-gay point man, Jerry Ekandjo, threatened to increase penalties for "lesbianism and homosexual acts," telling the Assembly that "the so-called gay rights can never qualify as human rights" and "if not guarded against, will lead to the extinction of the nation."
Ekandjo sparked violence in 1999 when he asserted that the police had been ordered "to eliminate all gays and lesbians" in Namibia. Although the police itself took no such action, several people were attacked, according to Phil na Yangoloh, the Executive Director of the National Society for Human Rights in Namibia (NSHR).
Last year, Ekandjo urged newly graduated police officers to "eliminate [gays and lesbians] from the face of Namibia" and compared being gay to "other unnatural acts, including murder." Like Nujoma, his Home Affairs Minister blames his country’s rising HIV-infection rate on gay people.
Shockwaves of Fear
President Nujoma’s latest threats sent shockwaves of fear through Namibia’s lesbian and gay community. The morning following his speech, the Rainbow Project, the country’s only lesbian and gay rights organization, was besieged with phone calls, many by frightened queers who wanted help leaving the country. Founded in 1989, The Rainbow Project has about 1,000 members, according to its coordinator, Ian Swartz, who told BBC News Online that there are "many more Namibians who are afraid to reveal their sexual orientation."
Both The Rainbow Project and NSHR, the country’s preeminent human rights group, publicly slammed Nujoma for his attack on queers. The Rainbow Project called it "shocking" and "malicious and hateful" and questioned which laws he would use to carry out his threat to arrest, imprison, and deport gay men and lesbians. While sodomy is a crime in Namibia, being lesbian or gay is not. And in spite of the authoritarian Nujoma, the country still has a democratic framework, however hobbled, which includes a constitution with an equal protection clause.
Homophobia, Racism: Same Cancer
NSHR called Nujoma’s "orders" to the police "not only unconstitutional, but devoid of mature logic." The President’s "latest homophobic attack [is] dangerous, as violent words from a popular leader may lead to violence against innocent citizens," the human rights group added.
" Targeting people because of their sexual orientation is extremely similar to discriminating against people because of the color of their skin. In a country that has emerged from the horrors of apartheid, it should not be such a leap in logic to recognize that homophobia is a form of the same cancer that is racism," the group said, asking Nujoma "to publicly retract these recent remarks and desist from attacking this minority group."
NSHR’s Phil ya Nangoloh told the Nairobi-based IRIN news agency on March 21 that "We cannot pretend that gays or lesbianism were imported by Europeans. It is African. I know that in my own language (Ovambo) there is a word, ‘Eshinge,’ for a gay person. We would not have a word for it if it was imported."
The only logical explanation for Nujoma’s comments, according to Phil ya Nangoloth, "is that it is a diversionary tactic aimed at taking public attention away from burning issues like unemployment and other social ills in this country—things like Namibia’s involvement in foreign wars (in the Democratic Republic of Congo and in Angola.)"
The African Bermuda Triangle of Homophobia
The diversionary use of lesbian and gay people as national scapegoats has turned parts of the region into a kind of dangerous Bermuda Triangle of homophobia. It was neighboring Zimbabwe’s President Robert Mugabe who was the first in the area to identify gay people as a useful national enemy, ripe for consolidating dictatorial powers. And since the beginning of Namibia’s anti-gay campaign, the homo-rants by Nujoma and other SWAPO hierarchs have sounded eerily like Mugabe’s.
Jerry Ekandjo was badly paraphrasing Mugabe’s snappier "If cats and dogs know their mates, why not you?" when he told the Namibian legislators in 1998, "Gay and lesbian rights can never qualify as fundamental rights because, if a male dog know its right partner is a female dog, how can a human being fail to notice the difference?" Not coincidentally, Mugabe’s deliriously logical conclusion had been the terse, "Gays and lesbians are sick-minded people who should not be given rights."
Ironically, both Zimbabwe’s Robert Mugabe and Namibia’s Sam Nujoma had begun as respected liberation movement leaders and first presidents of their newly independent nations. Both had enjoyed international adulation and funding, and little close scrutiny, partly because their enemies were so awful (racist Rhodesia and apartheid-era South Africa). Both now feel irresistible autocratic urgings—Mugabe, so far, acting out on them with more alacrity than his neighbor.
Like other autocrats everywhere, both now use the vague national threat of the homosexual menace to undercut democratic political competition, and the efforts of civil rights workers, including feminists. Nujoma’s 1996 attacks on lesbians at the SWAPO Women’s Council conference were seen as a swipe at Sister Namibia, an independent feminist group that supported human and civil rights for lesbians and gay men, and was perceived as a potential threat to the governmental SWAPO female group’s lock on "women’s issues." (Both the official women’s group and the Namibian Minister for Women’s Affairs are bitterly opposed to lesbian and gay rights.)
The escalating war of words by Mugabe homophobic-copycats like the President of Uganda, Yoweri Museveni, and Zambia’s President Frederick Chiluba, besides Namibia’s Nujoma, may well translate into a disaster—a flood of tortured, dead, imprisoned, deported queers, instead of the current, nearly invisible trickle.
No Democracy Without Queers
Over the years, government attacks against queers in Namibia have only elicited faint peeps from human rights groups abroad, for whom gay rights continue to be a poor relation. Locally, however, the government has been criticized harshly, and often, but only by the few groups that dare confront SWAPO’s virtual one-party state dominance, notably NSHR, The Rainbow Project, the Legal Assistance Center, and Sister Namibia, whose office was gutted by fire in a suspected anti-gay attack last July. Some of the local independent media has also covered the issue impartially, in particular the daily newspaper The Namibian.
The newspaper risks becoming the first casualty of President Nujoma’s latest hate speech. On the same day The Namibian covered critical reactions to the speech, the government announced that it was cutting off all its advertising in the newspaper because it was "too critical of its policies."
The measure apparently had been taken in December, but not enforced until now. Another independent newspaper, the Windhoek Advertiser, folded a few years ago when it also lost crucial government advertising. The Namibian government is the country’s biggest advertiser.
The advertising ban on The Namibian was announced on March 22, a day after Namibia’s independence celebration.
27 August 2002 – BBC News
Namibia gay rights row Namibia’s controversial Home Affairs Minister
Jerry Ekandjo is reported by state television to have urged newly graduated police officers to "eliminate" gays and lesbians "from the face of Namibia". He was reported to have told the 700 police men and women "even if gays and lesbians had a gay dog they would murder it." A spokeswoman for an organisation promoting gay and lesbian rights in Namibia called on the government publicly to reject the remarks.
Namibia’s President Sam Nujoma has previously criticised gays and lesbians calling them "unnatural", thereby taking a similar stance to his close ally, Zimbabwean President Robert Mugabe. Unrepentant Speaking to the BBC’s Focus on Africa, Mr Ekandjo refused to confirm or deny the remarks, but asked the journalist if he was a homosexual. "Have the homosexuals there sent you?" he asked, and added he would only discuss the matter with homosexuals.
"Let the homosexuals themselves phone me, then I can give them the answer." Mr Ekandjo said, "in Namibia they are happy about my statement". Dispute A representative of the Rainbow Project, an organisation that promotes gay and lesbian rights, Elizabeth Kahas, condemned Mr Ekandjo’s statement. "I think it is a very outrageous statement to make from a minister who is supposed to protect all the people of Namibia regardless of their sexual orientation," she said.
She also disputed Mr Ekandjo’s claim that the constitution did not guarantee rights to homosexuals. "I think that we have to do a lot of human rights education for our politicians in that this particular minister is not knowledgeable about the constitution of this country," she said. Constitution She added that the constitution guaranteed the rights of all Namibians, regardless of sexual orientation.
This is not the first time Mr Ekandjo has been in the news for his views. In August he said he would withdraw the work permits of foreign judges who made judgements that were perceived as against government policy. He was later forced to retract his remarks and issue an apology.
May 20, 2003 – The Namibian)
Politicians Accused of Failing Gay Community
by Lindsay Dentlinger
Windhoek, Namibia – Namibia’s gay community says despite the country’s leaders having vowed to defend and protect all citizens, homosexuals are being failed by the system. In effect, only one piece of Namibian legislation pronounces itself specifically on sexuality – the Labour Act.
Yesterday, Human Rights Watch (HRW), in conjunction with the International Gay and Lesbian Human Rights Commission, launched a report in Windhoek entitled ‘More Than a Name: State-Sponsored Homophobia and its Consequences in Southern Africa’. HRW investigates human rights abuses in about 70 countries worldwide.
The report details research carried out between 1998 and 2002 on discrimination against lesbian, gay, bisexual and transgendered people in Botswana, Namibia, Zimbabwe, South Africa and Zambia. In particular it focuses on the spread of so-called "state-sponsored homophobia". In this light, Namibian politicians follow hot on the heels of their Zimbabwean counterparts in discriminating against gay citizens. Widney Brown, Deputy Program Director for HRW, conducted a substantial proportion of the research documented in the report, and says homophobia has become a very "politicised" topic in the region.
In Namibia, the President and a number of politicians have in the past publicly vilified the gay community, interestingly enough, at totally unrelated occasions. Brown, however, commended civil society in Namibia for speaking out against this kind of defamation, unlike in Zimbabwe, where she says, they are too scared to do so. While South Africa is noted as the only country in the region whose constitution has an equality clause, the research found that prejudice against the gay community is still rife.
The Rainbow Project (TRP) and Sister Namibia, both advocates of the rights of homosexuals locally, say politicians are too scared to stand up for gay rights, for fear of pressure they will receive from their colleagues. The two groups are most disappointed to note that same sex relationships have been omitted from the recently passed Domestic Violence Bill. Informal research by the TRP indicates that both verbal and physical attacks on male and female homosexuals are daily occurrences which go largely unreported out of fear of further discrimination by health officials and the Police. The TRP’s co-ordinator, Ian Swartz, says it is really disheartening to note that President Sam Nujoma, whom he has always considered one of his heroes, is among the perpetrators when it comes to discrimination.
In 1998, Home Affairs Minister Jerry Ekandjo went as far as to tell the National Assembly that he planned to introduce new legislation against homosexual acts saying that so-called gay rights can never qualify as human rights. No such legislation was ever introduced. However, two years later the Minister returned to the subject, urging newly graduated Police officers to "eliminate gays and lesbians "from the face of Namibia".
Following President Nujoma’s 1996 call to "reject and condemn homosexuals in our society", Swapo swung strongly behind its leader, effectively making homophobia a political platform in Namibia. The President has repeated his threats regularly since then. On the other hand, advocates for gay rights note that ironically politicians have in recent years become gay rights activists, by putting the issue on the front burner. The country’s gay rights activists have however vowed not to back down and to face the discrimination head-on by lobbying for inclusion in Namibian laws.
June 9, 2004 – Chicago Tribune
Africa’s gays persecuted as cause of ills Even blamed for drought, homosexuals are widely condemned, increasingly threatened
by Laurie Goering, Tribune foreign correspondent
Windhoek, Namibia – As a boy, Telwin Owoseb wanted to wear lime green. His mother told him blue was for boys and pushed him out the door to play ball, over his protests. At the end of high school, he told his family he was gay. While his mother accepted the news, his brothers and family friends were horrified. "A man should be a man and marry and have kids," he remembers them saying. Since then he has been called a "moffie" – an Afrikaans slur for homosexuals – on the streets of Namibia’s capital, and he has faced trouble finding work and a partner in this nation where being gay is considered unnatural, un-Christian and un-African.
But he considers himself lucky compared with Namibia’s rural gays and lesbians, an estimated eight out of 10 of whom are forced to marry and have children as a result of fear, ignorance and social pressures, according to gay-rights activists in Namibia. "The government says homosexuality is a European import," said Owoseb, 21, a member of the country’s Damara ethnic group, which tends to be more accepting of homosexuality. But "if it were European there wouldn’t be names for homosexuals in our own languages, from before the Europeans arrived. It’s not a European thing. I’m not a European." Africa is not an easy place to be homosexual.
Across the continent, millions of gays and lesbians find themselves increasingly under threat and pointed to as a source of Africa’s ills. Homosexuals have been shot by warlords in lawless Somalia and stoned in northern Nigeria, activists say. Hundreds have been arrested in Egypt on debauchery charges. Zanzibar has proposed 25-year prison sentences for men convicted of sodomy. Zimbabwe’s Robert Mugabe, the most homophobic of Africa’s presidents, dismisses gays as "lower than pigs and dogs." Uganda’s Yoweri Museveni has threatened them with arrest, prosecution and deportation. And former Kenyan President Daniel arap Moi long characterized them as a "scourge."
In Namibia, homosexuals have been blamed for severe drought by religious leaders, who insist their wicked behavior displeases God. Government officials, who have threatened to deport gays, accuse them of trying to depopulate the country and describe their lifestyle as a kind of cancer, threatening to lead to "social disorder." While gays generally are not blamed for the spread of AIDS in Africa – the disease is a largely heterosexual one on the continent – they are dismissed as "unnatural." "Homosexuality is an unnatural behavioral disorder, which is alien to African culture," Helmut Angula, Namibia’s agriculture minister, once observed.
Some Namibian gays find themselves subject to brutal "cures." Families arrange to have lesbian daughters raped to show them the "right" way to behave. Gay men are held down by police and earrings are ripped from their ears. A leading government official has written a treatise describing how homosexuals can be "cured" by sawing off the top of the skull and washing the brain with a chemical solution.
What is remarkable is that Namibia’s outspoken homophobia is relatively new. A decade ago, gay men held hands on the streets of Windhoek, seen as a homosexual mecca for southern Africa. For generations lesbians and to a lesser extent gay men were quietly accepted in at least some of Namibia’s ethnic cultures.
What has changed, gay activists believe, is the country’s confidence in its future. Since Namibia won its independence from South Africa in 1990, "the euphoria has been wearing off," said Ian Swartz, director of The Rainbow Project, a gay-rights organization. Namibian leaders promised better times after independence but have found stubborn problems such as poverty and southern Africa’s AIDS epidemic difficult to solve.
In frustration – and sometimes to divert the public’s attention from their own shortcomings – they have begun looking for someone to blame and have settled on minorities, including homosexuals, according to human-rights activists. "There’s a sense of economic and political powerlessness, and when you feel powerless about your economy and your country’s politics there’s a tendency to turn to culture as the one thing you can exert control over," said Scott Long, director of the Gay, Lesbian, Bisexual and Transgendered Rights Project at Human Rights Watch. Namibia’s public campaign against homosexuals began in 1996, after a group of cross-dressing gay men used the women’s bathroom during a meeting of the ruling South West Africa People’s Organization.
Days later, President Sam Nujoma gave his first anti-gay speech, insisting that "homosexuals must be condemned and rejected in our society." Since then government officials – most of them from northern Owamboland, Namibia’s richest, most populous and most traditionally homophobic region – have tried to criminalize gay sex and threatened to deport homosexuals. In heavily Christian Namibia, the government has promoted a view of homosexuality as un-Christian and as an imported European deviation. The problem with that view, gay-rights activists say, is that Christianity itself is a European import in much of Africa. Over centuries of colonization most of the continent’s rich oral tradition was lost, making Africa’s traditional views on homosexuality unclear. What is evident, however, is that gays were an accepted part of at least some African societies. In northern Namibia, many homosexuals traditionally served as healers and spiritual leaders, said Daniel Somerville, editor of Behind the Mask, a Web site for gay Africans.
Even today, large numbers of lesbians practice as traditional healers in neighboring South Africa, one of the few nations worldwide where homosexual rights are protected under the constitution. "People say it’s imported colonial behavior," Somerville said. "But in fact the opposite is true. The colonialists, if anything, tried to stamp it out. They were, after all, the Victorians."
`Welcoming and belonging’
The All Africa Rights Initiative, a gay-rights movement that met in Johannesburg in February, issued a statement saying "we have and have always had a place in Africa." African traditional culture, the statement said, is based on "principles of welcoming and belonging," not on exclusion. Reversing the image of homosexuality as a European import has been difficult, largely because Africa’s gay activists have tended to be white.
That is changing, but only slowly. Most gay Africans, like their heterosexual neighbors, are too busy trying to feed themselves, earn a living and take care of their families to get involved in politics. "That white people brought [homosexuality] here is a lot of nonsense, but our own black community believes that," said Linda Baumann, 21, a lesbian who lives in Windhoek. "The only answer is education, and more of us speaking up for ourselves." That isn’t easy, particularly in the conservative Owambo community where Baumann grew up. Her partner and housemate was thrown out of her childhood home when her family discovered her orientation a few years ago. Baumann, who said she lost most of her friends when she came out, counts herself lucky that she got only a lecture, largely because her strict father had moved out years ago. "I was lectured about the Bible and God, and mom cried and said I wasn’t raised this way," she said.
Today her mother and one of her two sisters accept her, but it is an acceptance forged out of necessity – her salary puts food on the table. "If my father knew, he would say I am no longer his child, that the devil is in me and I need to go to a traditional healer and be healed," she said. But she is thankful she doesn’t live in a rural Owambo community. If so, "I would have a husband and kids by now."
Many Namibian gays who emerged from the closet in the 1990s have gone back in as a result of the government support of homophobia, activists said. Gay men who married and later divorced have married again, Swartz said. But the attacks also have spurred new activism.
Gay Namibians have turned to the country’s hugely influential churches, seeking their acceptance and help in rebuffing myths about homosexuality. The response has been mixed, but at least some denominations, especially the Lutherans, have been relatively welcoming.
Gay-rights activists also have teamed with other troubled minorities – white farmers, AIDS patients, abused women – to work for improved human-rights protections for all. The country now has an annual human-rights parade, dominated by gays.
Across the continent, gay-rights groups have formed in nations such as Zimbabwe, Sierra Leone and Uganda, largely in response to government hate speeches.
That mobilization suggests "it’s not always a bad thing to have these outrageous statements," Somerville said. Perhaps the best news for Africa’s gay men and lesbians, however, is that plenty of their neighbors do not take homophobic government messages to heart. Gays and lesbians have quietly been part of African society for centuries, anthropologists argue.
Too hungry to care
And on a continent struggling to feed itself, "a whole number of issues come before worrying about other people’s sexual behavior," Somerville said. That means "the levels of homophobia one hears about in the press and from leaders is not necessarily reflected in the populace. People could care less." Activists say the best way for gay Africans to overcome prejudice is to be good neighbors. "You have to take away all the myth, and the best way to do that is just to live and be open," Swartz said. "When all you talk about is sex, you forget there’s a person behind that label."
Namibia Chips Away at African Taboos on Homosexuality
by Emily Wax
Windoek, Namibia – As a boy of 14, Petrus Gurirab worried that he was gay. Seeking advice from a trustworthy adult, he went to see a teacher who had treated him kindly. " I have feelings for other boys," Gurirab recalled telling her. "Like love feelings." There was a long silence. " My advice is that it’s not African" to be gay, the teacher replied, using a slur for the term. "Ignore those feelings and try girls."
She also apparently gossiped with colleagues. Other teachers started teasing Gurirab, asking him why he didn’t play soccer and why he spent so much time around his mother. Then one morning, he said, the gym teacher invited him into his office, locked the door and forced him onto the desk for sex. " Let’s see how good you are at it," the teacher said, according to Gurirab, now 25, who recounted the story through tears. The ordeal left his legs and arms with red bruises. The next day, distraught and confused, he had sex with a female classmate. " I wanted to change so badly and not be gay . . . but I couldn’t," he said. "I knew I liked men. I decided I would kill myself. . . . I was so desperate I called a lifeline in London. They saved my life."
Un-African. Un-Christian. Anti-family. Witchcraft.
In many African countries, being gay is considered all of those things. It is also illegal in most of them, so taboo that a conviction for homosexual acts may bring more jail time than rape or murder. Only in South Africa is being gay widely accepted and protected by law.
From Uganda, where homosexuality is punishable by life imprisonment, to Sierra Leone, where a lesbian activist was raped and stabbed to death at her desk last year, homophobia has long trapped gays in a dangerous, closeted life. With no places to meet openly, no groups to join, it seems sometimes that gay men and lesbians in Africa don’t exist at all. But in Namibia, a growing national debate about homosexuality has followed a period of harsh condemnation, and gay rights groups now operate openly in the capital, Windhoek.
One of them is the Rainbow Project, where Gurirab works as a suicide prevention counselor. The organization has interviewed gay Africans from across the continent, and its leaders say they believe the time is right to challenge prejudices and start a wider discussion on what being gay really means. " The only answer is education," said Linda Baumann, 21, who grew up in a tribal community and was expelled from it when she revealed she was a lesbian. She now lives in Windhoek and hosts a radio program about gay issues. "We have to have courage and stick up for ourselves."
The Rainbow Project has joined forces with other interest groups, including the women’s movement, people with AIDS and progressive political parties, which have been lobbying for equal rights for all Africans. Unlike in many Western countries, gays have never been blamed for the AIDS pandemic in Africa, where the disease is largely transmitted through heterosexual sex and blood transfusions.
The continent’s gay population, which is mostly youthful and active in cities, has also benefited from Africa’s rapid urbanization. These days, TV programs such as "Queer Eye for the Straight Guy" are beamed via satellite from the West, and a smorgasbord of gay-oriented Web sites can be accessed at Internet cafes. One Web site based in South Africa, "Behind the Mask," receives hundreds of hits each day, along with e-mail messages from gay men and lesbians across the continent asking about how they should reveal their sexual orientation to their parents or how to meet the right partner.
Even so, the Rainbow Project must use extreme discretion when trying to conduct research outside Namibia — let alone urging other gays across Africa to demand their rights. In Somalia, for example, armed militiamen frequently stone gays. In Egypt, Baumann said, "you will just get killed." Ian Swartz, the Rainbow Project director, said that even when he was in Nairobi, the cosmopolitan capital of Kenya, he had difficulty meeting gay men until he arranged a late-night meeting with a stranger. He arrived at a club after midnight, "and there it was — an underground gay community in Kenya." The men he met told him "harrowing" stories, he said. "I felt really sad afterward, but I learned a lot."
Treatment of gays, group members said, ranges from social ostracism to physical attacks. In rural Namibia, they found, about 80 percent of gay men and lesbians were forced to marry and have children. In many countries, gay people were often depressed and reported having covert same-sex relations outside heterosexual marriages. Gay students may drop out of school or face beatings for being "funny," Baumann said. Some are put through violent "cures." In Tanzania and Botswana, there were more than a dozen reports of lesbians being raped in an effort to persuade them to marry men. But Swartz said the Rainbow Project also found a long history of ethnic groups giving tribal labels to those who are gay — some negative, but others neutral.
" That proves that it wasn’t a European import," Swartz said. "It’s as African as being straight, and it was always here." Throughout African history, gays have been accepted in some tribes. Lesbians were sometimes seen as having mystical powers, and in South Africa they acted as traditional healers. In times of conflict or drought, however, gays were used as scapegoats and blamed for not producing babies to repopulate their regions, according to researchers of same-sex practices in Africa.
European missionaries further demonized homosexuality, and church pulpits remain bastions of anti-gay rhetoric in Nigeria and several other countries. Politicians also have found gay-bashing a useful way to deflect criticism from unpopular policies. Daniel arap Moi, who ruled Kenya for 24 years, once declared: "Kenya has no room or time for homosexuals and lesbians. It is against African norms and traditions and is a great sin." Zimbabwean President Robert Mugabe recently dismissed gays as "lower than pigs and dogs."
In Namibia, gays said there was a relatively relaxed climate in large cities in the years before and after independence from South Africa in 1990, and gay couples in Windhoek could hold hands in the street. But in the mid-’90s, they said, a chilling change occurred. " The first five years after independence it was like a utopia," Swartz said. "People were proud to be gay. But when Namibian leaders’ promises fell through and poverty did not improve, the government became increasingly unpopular. . . . The leaders were looking for a smokescreen and someone to blame."
In 1996, the public campaign against homosexuals began, after a group of cross-dressing men used a women’s restroom during a rally of the ruling party. At the time, unemployment was at 60 percent and opposition parties were on the attack.
Days later, then-President Sam Nujoma gave his first anti-gay speech, saying that "homosexuals must be condemned and rejected." Suddenly, many officials were bashing gays. One minister called homosexuality a "behavioral disorder which is alien to African culture." In response, the Rainbow Project was formed. Members went to churches and schools, and showed up on TV talk shows. They held workshops with Namibia’s Human Rights Organization, which was respected for protesting corruption, police brutality and domestic violence.
There were heated debates, with some people saying that homosexuality was a threat to tradition and that men needed sons to inherit their land. That raised the issue of women’s rights in the country’s largest ethnic group, the Ovambo, which is deeply patriarchal and does not allow women to own land.
As the climate has improved in Namibia, Rainbow Project members now say they hope to replicate their success in other countries. " What is hopeful is that we are having a national conversation. When I saw people from the Rainbow Project on TV, I knew they were helping young gay people out there who were really suffering," said Helmuth Oxurub, 35, who works in a furniture store in the coastal town of Swakopmund. "We want to say to people, ‘You know us in everyday life, we are here and we aren’t so bad.’ People really seem to accept that message."
One recent evening, Oxurub arrived at a cafe in Swakopmund with his partner of seven years, Harold Uchman, 30, who works in the uranium mining industry. They were joined by another openly gay friend, Victor Honeb, 34, who works for the government.
They spoke about how they had revealed their sexual orientation to their parents and how stressful and confusing their childhoods had been. Oxurub said his mother had ordered him out of the house after neighbors started telling her he was gay.
" I said, ‘Mom, accept me or not . . . I am your son and I am still the same person,’ " Oxurub recalled. "She just started crying and hugged me. Then no one bothered us."
Lately, the three friends agreed, being gay in cities such as Windhoek and Swakopmund has even begun to acquire a certain image of urban hipness and going against the grain. So should there be a "Queer Eye for the Namibian Guy"? " Maybe," Honeb said with a smile, adjusting his fashionable black-rimmed glasses. "A neighbor came over to me recently and said, ‘Gay people are really cosmopolitan. . . . Being gay is so in right now.’ I was really surprised and so happy. I hope that spreads to all of Africa — one day."
January 06, 2006 – Kaiser Network
Namibia Law Banning Male-to-Male Sex Is Hindering Condom Distribution, HIV Prevention in Prisons, Advocates Say
A 30-year-old law in Namibia banning male-to-male sex is preventing condom distribution in the country’s prisons and hindering HIV prevention efforts, according to HIV/AIDS advocates, South Africa’s Mail & Guardian reports. According to government officials, condom distribution would promote sex between men, which is outlawed under the 1977 Criminal Procedures Act.
Ignatius Mainga, a spokesperson for the country’s Ministry of Safety and Security’s prison services, said, "By giving (prisoners) a condom, you are telling them to go ahead and do it." Mainga added that the "majority" of cases involving men who have sex with men in prison are consensual and that inmates do not want condoms because they do not "want to be known as having sex with other men."
However, Michaela Hubscle, former deputy minister at the now-closed Ministry of Prisons and Correctional Services, said instances of rape still occur between men in prison and condoms are needed to protect inmates. "We are sitting on a time bomb. The prevalence rate will increase if we do not protect those who enter prison (HIV-)negative and those who are positive from reinfection," Hubscle said (Tibinyane, Mail & Guardian, 1/4).
July, 2007 – BNET
Linda Magano Baumann: champion for the rights of sexual minorities
by Liz Frank
As a proud and outspoken lesbian activist, Linda Baumann has been one of the public faces of the rainbow project (trp) for the past five years. In her capacity as Information Officer, she has addressed university students, religious leaders, civil society, miners, listeners of Katutura Community Radio, parents of children with diverse sexual orientations and many others on the need to overcome hatred, prejudice and stigma born out of ignorance of the lived realities of lesbian, gay, bisexual, transgender and intersex (lgbti) people in the various cultures of Namibia.
Reaching out through media
Recently Linda was promoted to the position of Project Officer, responsible for trp’s video outreach project; the weekly Talking Pink broadcasts on Katutura Community Radio; the bi-monthly Talking Point forum held by trp on issues of relevance to the lgbti community and their ‘straight’ friends and supporters; and the on-going documentation of human rights violations experienced by the lgbti community in all parts of Namibia.
The Talking Pink programme on K.CR that she regularly hosts together with her partner Gina Tibinyane is close to her heart. "Talking Pink is one of the programmes where the number of listeners has steadily grown, judging by the feedback we get on and off air," she says proudly. "Of course you also get critical responses like listeners asking why we need a programme dedicated to lgbti issues, talking about people’s personal lives. For me that’s a challenge to spice things up and bring more information, and I feel gratified when that same person calls back after two programmes and says, ‘This is a nice programme, I want to withdraw my statement and say that for me it is very good.’
"But it’s still hard to get public servants and others to join us in discussions about these things, because they are afraid to be associated with being gay. And many people from the lgbti community are still afraid to speak out on their issues for fear of exposing themselves to attack, even though we can make their voices unrecognisable through the editing process."
Working as a volunteer
Linda’s passion for radio led her to host an additional Sunday programme on KCR, The Cocktail Show, a fusion of music with emphasis on African instrumental music, in which she guides her listeners to feel the effects of the various instruments on the mind, body and soul. Working as a volunteer is not new for Linda. "At school I was involved with activities of the Namibian Planned Parenthood Association, the Namibian Red Cross Association, the Namibian Girl Child Organisation, and also Teenagers Against Drug Abuse. That’s where my activism and community service started off," she explains.
Not afraid of taking on leadership roles, Linda currently serves as the chairperson of the Namibian chapter of GEMSA (Gender and Media Southern Africa), the chairperson of the Centaurus Secondary School Board, and on the executive committee of the Tigers sports club. "I recently resigned from the Namibian Paralegal Association because my plate is full," she says with a smile, adding that she believes in balance in life and therefore engages in so many diverse activities. Another aspect of this balance is her current preparation for a relay race sponsored by the gym where she goes three times a week to keep fit.
27th February 2008 – PinkNews
African lesbian conference demands equal rights
by PinkNews.co.uk staff writer
Lesbians from across Africa have held a conference in Mozambique to highlight the homophobia and prejudice they face across the continent. Most nations in Africa criminalise same-sex relationships and in some countries gay people can be put to death. The Coalition of African Lesbians conference was attended by more than 100 delegates.
Women from 14 African countries gathered in Namibia’s capital Windhoek in August 2004 to develop the Coalition of African Lesbians. Lesbian organisations and a number of individual women from Sierra Leone, Ghana, Nigeria, Liberia, Rwanda, Kenya, Uganda, Tanzania, Zambia, Zimbabwe, Botswana, South Africa, Mozambique and Namibia are members of the organisation. "Our main goal is that lesbian and homosexuality can no longer be seen as a criminal offence," the group’s director and conference spokeswoman Fikile Vilakazi told Reuters. "You should not be arrested and charged for how you use your own body."
The coalition lobbies for political, legal social, sexual, cultural and economic rights of African lesbians by engaging strategically with African and international structures and allies and to eradicate stigma and discrimination against lesbians. South Africa, one of the few countries on the continent where gay men and lesbians are allowed to marry and legally protected from discrimination, has been rocked by several murders of prominent lesbian activists.
Sizakele Sigasa, 34, an activist for HIV/AIDS and LGBT rights, and Salome Masooa, 24, were discovered dead at field in Soweto, Johannesburg, on July 8th. They had both been shot and, it is suspected, raped.
On 22nd July Thokozane Qwabe, 23, was found in a field in Ladysmith, KwaZulu-Natal with multiple head wounds. She was naked and it is thought she was also raped.
March 2008 – UMI
The visibility of sexual minority movement organizations in Namibia and South Africa
by Currier, Ashley McAllister, Ph.D., University Of Pittsburg, 2007, 244 pages; 3284544
The South African state has responded favorably to lesbian, gay, bisexual, and transgender (LGBT) social movement organizations’ (SMOs) efforts to protect and extend sexual and gender minority rights, whereas Namibian state leaders have verbally attacked LGBT organizing and threatened to arrest sexual and gender minorities. In these countries, LGBT persons have organized themselves into publicly visible social movement organizations (SMOs) over the last ten years. Amid such different official responses to LGBT organizing, how, when, and why do Namibian and South African LGBT social movement organizations become publicly visible or retreat from visibility? To answer this question, I turn to sociologist James M. Jasper’s (2004, 2006) concept of "strategic dilemma." LGBT social movement organizations encountered strategic dilemmas of visibility or invisibility when they decide whether and how to become visible, modify their public profile, or forgo political opportunities. To understand the micropolitical dynamics of how LGBT social movement organizations negotiated such strategic dilemmas of visibility and invisibility, I engaged in intensive, continuous ethnographic observation of four Namibian and South African LGBT social movement organizations for approximately 800 hours and analyzed my ethnographic fieldnotes. I also analyzed more than 2,100 newspaper articles and LGBT SMO documents and conducted 56 in-depth interviews with staff, members, and leaders of LGBT SMOs. In this dissertation, I explore the varied strategic dilemmas of visibility and invisibility that Namibian and South African LGBT SMOs faced. My findings advance social movement theorizing by demonstrating the importance of studying social movements in the global South. In addition, my findings contribute to postcolonial feminist and queer theorizing by showing how marginalized sexual and gender minorities in post-apartheid Namibia and South Africa used public visibility as a strategy to argue for their democratic inclusion.
April 2009 – plosone.org
HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana
by Stefan Baral1,7*, Gift Trapence2, Felistus Motimedi3, Eric Umar4, Scholastika Iipinge5, Friedel Dausab6, Chris Beyrer1
(1 Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America, 2 Center for the Development of People, Blantyre, Malawi, 3 Botswana Network on Ethics, Law, and HIV/AIDS, Gaborone, Botswana, 4 Department of Community Health, University of Malawi,-College of Medicine, Blantyre, Malawi, 5 HIV/AIDS Coordinator, University of Namibia, Windhoek, Namibia, 6 The Rainbow Project, Windhoek, Namibia, 7 Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada)
In the generalized epidemics of HIV in southern Sub-Saharan Africa, men who have sex with men have been largely excluded from HIV surveillance and research. Epidemiologic data for MSM in southern Africa are among the sparsest globally, and HIV risk among these men has yet to be characterized in the majority of countries.
A cross-sectional anonymous probe of 537 men recruited with non-probability sampling among men who reported ever having had sex with another man in Malawi, Namibia, and Botswana using a structured survey instrument and HIV screening with the OraQuick© rapid test kit.
The HIV prevalence among those between the ages of 18 and 23 was 8.3% (20/241); 20.0% (42/210) among those 24–29; and 35.7% (30/84) among those older than 30 for an overall prevalence of 17.4% (95% CI 14.4–20.8). In multivariate logistic regressions, being older than 25 (aOR 4.0, 95% CI 2.0–8.0), and not always wearing condoms during sex (aOR 2.6, 95% CI 1.3–4.9) were significantly associated with being HIV-positive. Sexual concurrency was common with 16.6% having ongoing concurrent stable relationships with a man and a woman and 53.7% had both male and female sexual partners in proceeding 6 months. Unprotected anal intercourse was common and the use of petroleum-based lubricants was also common when using condoms. Human rights abuses, including blackmail and denial of housing and health care was prevalent with 42.1% (222/527) reporting at least one abuse.
MSM are a high-risk group for HIV infection and human rights abuses in Malawi, Namibia, and Botswana. Concurrency of sexual partnerships with partners of both genders may play important roles in HIV spread in these populations. Further epidemiologic and evaluative research is needed to assess the contribution of MSM to southern Africa’s HIV epidemics and how best to mitigate this. These countries should initiate and adequately fund evidence-based and targeted HIV prevention programs for MSM.
Citation: Baral S, Trapence G, Motimedi F, Umar E, Iipinge S, et al. (2009) HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana. PLoS ONE 4(3): e4997. doi:10.1371/journal.pone.0004997
Editor: Lisa F. P. Ng, Singapore Immunology Network, Singapore
Received: December 21, 2008; Accepted: March 4, 2009; Published: March 26, 2009
Copyright: © 2009 Baral et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by the Sexual Health and Rights Project (SHARP) of the Open Society Institute and the Open Society Initiative for Southern Africa (OSISA). The decision to publish was made by the community partners and not the funders. Publication costs were offset by a grant from The Himmelfarb Family Foundation to the Center for Public Health and Human Rights.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: email@example.com
While southern Sub-Saharan Africa has long been the most HIV/AIDS affected region globally, it has been arguably the most understudied for the risk of HIV associated with male to male sexual contact – The crude characterization of these epidemics as generalized and driven by heterosexual risks has obscured the component of Southern Africa’s epidemics which may be due to risks among men who have sex with men (MSM). The marked homophobia, discrimination, and criminalization of same-sex behavior in much of Africa have likely limited investigation among these men. , . Data regarding the prevalence of MSM in the region are among the sparsest globally, but there is evidence that male to male sexual contact is a reality on this continent as on all others . To date, there have been published papers from only Senegal and Kenya describing HIV risk and prevalence among MSM in Africa , . However, a systematic review found studies from other African countries either not presenting HIV prevalence data or studies that to-date have only been presented as abstracts . These studies suggest that African MSM are at substantial risk for HIV infection, and that they have been markedly underserved and marginalized. Reported HIV rates, where available, have been higher than among other men of reproductive age in the same populations, yet these men tend to have limited knowledge of the health related risks of anal intercourse –. The lack of data on MSM and HIV are paradoxically the most marked for the world’s highest prevalence zone; the southern region of Sub-Saharan Africa. No published studies have reported HIV prevalence among MSM in Namibia, Malawi, and Botswana, three profoundly HIV/AIDS affected southern states. MSM have not been included in the HIV/AIDS strategies in these countries and same sex behavior among consenting adults is criminalized in all three states in 2008.
Concurrency of sexual relationships has been posited by several groups as a key driver of the high rates of prevalence in the southern African region , . Yet concurrency of same and opposite sex partners has been little studied, and may play important roles as well.
To address these lack of HIV prevalence and risk and rights data among MSM in these states, and to support the emerging community groups advocating for recognition and health services for these men, our collaborative group developed a technically simple epidemiology and human rights study protocol which could be implemented by LGBT (Lesbian, Gay, Bisexual, and Transgender) rights groups with minimal cost, and with maximum protection for participants. The results presented here are the first epidemiologic probe of HIV among MSM in Namibia, Botswana, and Malawi.
This study was completed in Blantyre and Lilongwe in Malawi, Windhoek, Namibia, and Gaborone, Botswana. These countries were chosen based on being within the encashment area of the Open Society Initiative for Southern Africa, having generalized HIV epidemics, no data available characterizing HIV risk among MSM, and having community-based organizations that were keen and able to collaborate on a study characterizing MSM in their community.
Study population and sampling methods
Eligible participants were 18 years old or older, had a history of ever having had anal intercourse with another man, and were able to give verbal informed consent for HIV screening in local languages. Inclusion criteria were not based on sexual orientation or identity, frequency of sexual contacts, previous HIV testing, or known HIV serostatus. Given the hidden nature of MSM in these communities, participants were recruited by in-country community-based organizations (CBO) with experience working with gay, bisexual, and other MSM. In-country technical support was provided as requested by the CBOs. In Namibia, investigators from the University of Namibia HIV/AIDS unit played a central role in providing ongoing support for this work. Similarly, researchers from the Malawi College of Medicine supported the Malawian CBO. The study staff was provided on–site training in outreach and recruitment, obtaining informed consent, and in interviewing techniques. The study was anonymous, confidential, and no written communications were shared with participants to minimize the risk of disclosure of MSM status. Sample size calculations were based measuring risk associated with unprotected anal intercourse (UAI). Assuming that UAI increases risk of HIV transmission by approximately 80% with a significance level of 0.05 and a power of 80%, the minimum necessary sample size was 150 men. Rounding up, the planned sample size was 200 for each of the three sites for a total of 600 men.
Given the lack of gay venues, recruitment was done through snowball sampling. In Malawi, 20 seeds were identified by the local CBO, Center for Development of People (CEDEP), and each of the seeds recruited either 9 or 10 participants resulting in a total sample size of 202. In Namibia, 20 seeds were identified by the local CBO, the Rainbow Project (TRP) and through chain-referral recruited 20 participants each for a total sample size of 218. In Botswana, the partner was the Botswana Network on Ethics, Law, and HIV/AIDS (BONELA), who recruited 10 seeds. However, ultimately only 117 MSM were accrued in Botswana because of difficulty in accessing this population and significant delays in the local approval processes.
Saliva samples were obtained for anonymous rapid HIV screening among interviewees. Oral fluid HIV was done testing using the OraSure Oraquick HIV-1/2 kit (Orasure Technologies, Bethlehem, PA, USA), licensed by the US FDA, with a sensitivity of 99.1% for oral fluid (compared to 99.7% with serum), and a specificity of 99.6% with oral fluid (compared to 99.9% with serum) . This HIV screen was for study purposes, not for confirmative diagnosis of HIV infection: participants were encouraged to seek appropriate venues for HIV counseling and testing.
Study Instrument and Interviews
A short structured survey instrument containing 45 questions was developed with a modified Delphi Method including experts in determinants of health, HIV epidemiology, and human rights. The instrument was piloted with MSM CBO members in each of the countries, and revised and locally adapted. Interviews took approximately 25 minutes to complete, and collected no identifiable information. After the interview, the oral fluid sample was obtained and the study participants were remunerated at different levels (between 5–10 USD) as determined by the partner CBO for their time and transportation costs. To maintain confidentiality and anonymity of the participants in the study, two separate rooms were required to ensure that the person reading the test result did not make direct contact with the respondent. Instead, non-traceable alphanumeric participant codes linked the HIV screening data to the surveys.
Survey instruments were linked anonymously to HIV testing results using participant codes. Data were doubly entered into Microsoft Excel and subsequently imported to Stata 9.2 for analysis. Univariate analyses included two-sample tests for differences in proportions, ?2 tests of independence, and logistic regression assessing the relationship between risk factors and HIV status. Backward elimination with a p-value set to 0.1 was used to determine which variables were included in the multivariate model. .In the multivariate logistic regression models, variables that were significantly (p<0.05) or moderately significantly (p<0.1) associated with HIV status were reported by presenting adjusted odds ratios (aOR) with 95% confidence intervals.
The study was approved by the Institutional Review Board of the Johns Hopkins Bloomberg School of Public Health and the University of Namibia, and the Ministry of Health in Botswana. Ethics approval was also sought from the National AIDS Council (NAC) in Malawi. While receipt of the application was confirmed on numerous occasions over many months, no answer was given. A thorough consultation with the MSM community in Malawi demonstrated overwhelming support to move forward with the study. And since the protocol was identical to that approved by the two other in-country human subjects committees, CEDEP employed an internal review mechanism and approved the study.
Sociodemographics and Sexual Practices of study participants
The participants tended to be young overall with mean ages of 24–26 in each of the three countries (Table 1). The majority had at least a secondary education, and approximately half were currently employed. There were high levels of bisexual concurrency observed, defined as concurrent regular partnerships with both men and women, but was most common in Malawi (p<0.05).
In all three countries, MSM had more male sexual partners than female sexual partners with a mean of between 1–1.5 female sexual partners in last 6 months, again positively skewed. MSM reported medians of between 3–4 male sexual partners over the preceding 6 months, though the distributions were positively skewed for all three countries with a minority of men reporting large number of male partners. Active bisexual practices–both male and female sexual partners in the same time frame was common across all three countries, but again, was most common in Malawi (p<0.05).
Disclosure of sexual orientation to family was more common in both Namibia and Botswana than Malawi (p<0.05). In Malawi, less than 10% of respondents disclosed their sexual orientation at any interaction with a health care worker, and the rate was below 25% in both Namibia and Botswana.
8.7% (38/435) of MSM admitted to injecting drugs, but more participants refused to answer this question than any other (18.1% – 97/536). The total sample size varied because participants refused to answer certain questions of the survey instrument.
In the pooled analysis, 44.7% (238/533) had used the internet to find a male sexual partner in the last 6 months, with the highest rates being in Botswana (p<0.05). Across all three sites, the biggest self-reported risk to one’s health was from HIV/AIDS, though 8.0% of the participants considered violence as the most important threat to their personal health. Compared to Malawi and Botswana, MSM in Namibia were less likely to consider HIV/AIDS as the biggest threat to their health (p<0.05), and most likely to consider violence as the single biggest threat to their health (p<0.05).
HIV Related Knowledge
Men were more likely to have received any information about how to prevent HIV infection from women than from men in all three sites (p<0.05) (Table 2). Men were more likely to know that HIV can be transmitted by vaginal intercourse than by anal intercourse in both Botswana and Malawi (p<0.05). In the pooled analysis, 85.3% (44/516) knew that HIV could be transmitted through injecting drug use. Only 70.3% of men in Malawi knew that HIV could be transmitted by these three modalities, whereas this was again higher in Botswana and Namibia (p<0.05), predominantly because of the dearth of knowledge about IDU.
Always using condoms among MSM with male or female partners was equivocal in Malawi and Botswana, but in Namibia, MSM were more likely to use condoms with men than women (p<0.01). In Namibia and Botswana, MSM were more likely to always use condoms with casual partners as compared to their regular sexual partners (p<0.05), whereas condom use between casual and regular partners was equivalent in Malawi. Of those who used lubricants during anal intercourse, a minority (38.2%, 130/340) overall used water-based lubricants as compared to petroleum-based products including petroleum jelly, fatty and body creams, with highest rates of WBL use in Botswana (50.7%, 36/71, p<0.05). Finally, only 3.3% (13/389) of the study sample were practicing safe anal sex as defined by always using condoms and water-based lubricants.
Transactional sex, as defined by anal intercourse in exchange for money or gifts with a casual partner, was common across all three sites. Overall, it was more common in Malawi (62.6% – 124/198), then Namibia (37.3%-81/217), and least prevalent in Botswana (29.3% – 34/116) (p<0.05). In Malawi, the sample was more likely to have received money/gifts for anal intercourse, but this difference was not found in the sample in Namibia or Botswana. MSM had been most commonly previously tested for HIV in Botswana (82.9% 97/117), followed by Namibia (59.4%- 129/217), and then Malawi (35.2% 69/196) (p<0.05). 18.5% (40/216) of MSM had ever been told by a health care worker that they had a STI in Namibia, whereas 8.5% (17/199) of MSM in Malawi had received this diagnosis similar to 9.4% (11/117) of MSM in Botswana.
Human Rights Contexts
Human rights abuses among MSM in the study sample were prevalent across all three countries. Between 5–10%, depending on the site, of the study participants had been denied housing in the past for reasons other than the ability to pay (Table 3). Being afraid to seek health services because of sexual orientation was reported by 17.6% (35/199) in Malawi, 18.3% (40/218) in Namibia, and 20.5% (24/117) in Botswana. While having been denied health care was less common with a pooled prevalence of 5.1% (27/533), disclosing sexual orientation to a health care worker was significantly associated with having been denied health care (OR 4.2,95% CI 1.9–9.3).
MSM reported being afraid to walk down streets in their own community most commonly in Botswana , but also to a lesser extent in Malawi and in Namibia (p<0.05). Overall 42.1% (222/527) of MSM answered yes to any of these markers of human rights violation. 12.2% (65/533) of the total sample indicated that they had been physically abused by a government or police official, with the highest rates in Namibia (p<0.05). Finally, 11.4% (61/534) of the sample reported ever having been raped by another man, with similar rates across the three sites.
Blackmail or extortion on the basis of sexual orientation or behavior was quite prevalent in the sample with an overall rate of 21.2%. In the pooled analysis, univariate associations with blackmail included having either paid or received money or gifts for casual sex (p<0.01); having told a member of the family of one’s sexual orientation (p<0.01); and having a told a clinic or health care worker of one’s sexual orientation (p<0.05), and not having had an HIV test in the preceding 6 months (p = 0.06) (data not shown). Multivariate analysis was completed adjusting for these covariates and blackmail was significantly associated with having taken part in transactional sex (aOR 2.5,95%CI 1.6–3.8), not having had a HIV test in last 6 months (aOR 0.56,95%CI 0.3–1.0), having disclosed same sex behavior to a member of the immediate or extended family (aOR 2.3,95% CI 1.4–3.6), but not to health care workers (aOR 0.9,95%CI 0.5–1.6).
Associations with HIV Infection
The overall HIV prevalence was 17.4% (93/536); however, there was significant variation of HIV prevalence with increasing age (Table 4). The HIV prevalence among those between the age of 18 and 23 was 8.3% (20/241), then 20.0% (42/210) among those 24–29, and 35.7% (30/84) among those older than 30. Overall, 23.7% (22/93) were aware of their HIV status, though this varied significantly between countries (p<0.05). In Malawi, more than 95% were unaware of their status, whereas in Botswana 76.3% were unaware and in Namibia, 41.8% were unaware of their status.
Univariate predictors varied between countries and can been seen in Table 5. In the pooled analysis, increasing age, being employed, not always wearing condoms with men, casual and regular partner, having been diagnosed with an STI, and having had transactional sex were significantly associated with HIV (p<0.05). Furthermore, self-reporting as homosexual or bisexual compared to heterosexual was associated with HIV (p = 0.06). In the multivariate model, ever having been diagnosed with an STI, being older than 25 (aOR 4.0, 95% CI 2.0–8.0) and not always wearing condoms (aOR 2.6, 95% CI 1.3–4.9) were significantly associated with being infected with HIV in the pooled analysis (Table 6). Country-specific associations also included having been diagnosed with an STI was strongly linked to being HIV-positive (aOR 33.7, 95% CI 3.4–148.2) in Botswana and having used the internet to find male sexual partners in Malawi (aOR 3.6 95% CI1.0–13.7).
This is the first study to investigate HIV status and risks for HIV infection among MSM in Namibia, Botswana, and Malawi. It is also the first attempt, to our knowledge, to evaluate the human rights contexts among MSM and to link individual level rights abrogation to HIV biological outcomes in the African context.
Overall, HIV rates were substantial, and risks for HIV infection from sex with both were men and women were common. The participants were generally young, though there was a significant association between HIV and age. Excluding the few men above the age of 49, overall more than one-third (35.7%, 95%CI 26.3–46.4) of MSM between the ages of 30–49 were HIV infected. These data suggest that this is not a new epidemic of HIV among African MSM which is spreading more rapidly among younger MSM, as has been seen observed among MSM in other settings such as Russia . Because younger men were much less likely to be HIV infected, prevention programs targeting younger MSM in these populations could have marked potential for avoiding future infections. All possible combinations of biomedical and behavioural interventions need to be evaluated including those directed at MSM who are already HIV seropositive. While very little is known about the benefit of targeted HIV prevention programming among MSM in Africa, in other contexts these approaches are known to be very effective in decreasing unprotected anal intercourse (UAI) , . Prevention research and optimization of existing prevention tools for MSM are a clear public health priority for Southern Africa.
Approximately two-thirds of MSM had received any information about preventing HIV infection from other men, which was higher than expected. However, given that these men were largely recruited from within the same networks of men who are served by these CBOs, this likely overestimates the men exposed to this information in each country. Basic knowledge and condom access and availability are necessary for increased condom usage, but not sufficient. Recent studies have demonstrated that African MSM are less likely to have UAI if they use water-based lubricants (WBL), have been counseled about the risks of UAI, and more likely to have UAI if they regularly drink alcohol or do not know that HIV can be transmitted via anal intercourse , . Understanding condom use among MSM in the African context is especially relevant as in all three countries, not always wearing condoms was highly predictive of being HIV positive. If safe sex is defined as the usage of WBL in addition to always wearing condoms, then less than 1 in 20 MSM practiced safe sex in this study. The more common use of oil-based products, including vaseline and body/fatty creams appears partly due to cost and partly to availability. Increasing the availability of affordable and practical WBL should be a key focus of prevention strategies.
A significant proportion of MSM self-identified as either heterosexual or bisexual, and many were married or had at least one female sexual partner in the preceding six months. These results were consistent with a previous knowledge, attitudes, and perceptions study of MSM in Malawi. Concurrency of sexual relationships, which has been posited by many investigators as a key driver of heterosexual transmission in this region, appears to be relevant to MSM as well, . Some 17% of men overall were in concurrent stable relationships with men and women and over half of the respondents had both male and female sexual partners in previous 6 months, suggesting that concurrency of sexual relationships which include both same and opposite sex partnerships may be an under—appreciated component of HIV spread in this region.
Approximately one tenth of men reported the injection of illegal drugs. There is an increasing appreciation that IDU behavior is also a reality in the African context, and more work is needed to better characterize this risk and its relationship to sexual risk exposures among African men .
The use of the internet to find male sexual partners was common across all three countries with nearly half of the respondents reporting using the internet for this purpose. In settings where homosexuality is criminalized and the police harass MSM, with no open venues for gay people to congregate, the internet has preceded the development of openly gay physical venues. Given the hidden nature of this population, the internet may represent a powerful tool in efficiently accessing and delivering HIV prevention education to these men .
Self-reported sexual orientation as homosexual or bisexual compared to heterosexual was significantly associated with HIV. While not explored here, this differential risk between identities may relate to sexual positioning, and will be relevant to HIV prevention programming . Disclosure of sexual orientation to either any one member of their immediate or extended family, or any one health care worker was very low. These are hidden populations of men, currently only accessible for study and prevention programming through sexual and social networks with other MSM. In Kenya, where being MSM has become more of an accepted identity, the MSM community continues to evolve a gay identity and become more socially visible . While there is a real risk for backlash, the self-identification of these men and community development may allow for better dissemination of education and prevention measures.
This study served as an assessment of human rights contexts for MSM in these countries. The results are a powerful reminder of the level of stigma, discrimination and human rights abuses that these men face in their everyday lives, including being denied housing and healthcare, being afraid to walk down the streets of one’s community, or being afraid to seek health care services. Though each of these rights abrogation likely limit access to HIV preventive services, none were significantly associated with HIV at the individual level. This could have been because abrogations were so common that ceiling effects made attribution difficult, as well as the fact that country sample sizes were small. However, having disclosed sexual orientation to family members was significantly associated with blackmail, and, having disclosed sexual orientation to a health care provider was significantly associated with having been denied health care. In the short term, these two factors will continue to limit disclosure of sexual orientation. In addition, those who reported blackmail were also less likely to have been tested for HIV in last 6 months. These structural barriers to available health care services will limit the efficacy of any interventions targeting individual level determinants of HIV transmission among MSM and must arguably, be mitigated to effectively decrease HIV incidence .
There are several limitations to this cross-sectional study. Resources and the constraints of working with small CBOs in these rights constrained environments limited the scale and scope of these probe studies. Due to the nature of the study we were unable to establish directions of causality. There are known biases in questionnaire-based estimates of sexual violence . Specifically, using narrowly defined terms of sexual violence such as rape in a study instrument, as was done in this study, may underestimate its prevalence. The study samples are convenience samples generated by use of chain-referral techniques rather than population-based samples, which is a key limitation with this study methodology and limit the generalizability of the results to the wider population of MSM in respective countries. This problem, referred to as homophily, will likely be best addressed by larger respondent-driven sampling (RDS) studies, and by venue-time sampling approaches, where feasible. Even with RDS or venue-based sampling, there will be biases in the sample recruited and calculated estimates, though likely of lesser magnitude than when using convenience samples. Non-random sampling may also have overestimated the level of HIV-related knowledge seen in the results. Finally, MSM tend to congregate in urban areas, which is why recruitment took place in urban centers; again, this may limit generalizability.
One conclusion of this research perhaps bears stating openly: MSM exist in Malawi, Namibia, and Botswana, and are at high risk for HIV infection and human rights abuses. Piot et al. recently published a call to action for HIV prevention indicating that each country should appropriate HIV prevention expenditures in an evidence-based manner . To date, there have been no dedicated government expenditures funding evidence-based and targeted HIV prevention programs for MSM in these three countries. To comprehensively address the HIV epidemic, African national AIDS strategies should allocate funds based on evidence such as presented here, ensuring that the right to health care is respected for all. Community partners willing and able to do this challenging work also exist, and supporting these partners and including them in HIV/AIDS fora in country and internationally is likely critical to the success of prevention, treatment, and care programs in these countries.
We would like to acknowledge all of the community groups who continue to provide front-line human rights advocacy and health services for MSM in Africa, often with very limited funding and significant personal risk. The authors would like to acknowledge all of the study staff belonging to the following organization: Lesbians and Gays and Bisexuals of Botswana (LeGaBiBo), Botswana Network on Ethics, Law, and HIV/AIDS (BONELA), The Center for Development of People (CEDEP) in Malawi, and The Rainbow Project (TRP) in Namibia. We would also like to thank the team at IGLHRC-Africa for providing ongoing support to the community members. Benaifer Badha and Christina Alexander of the Sexual Health and Rights Project (SHARP) at OSI were responsible for duplicate data entry. Thoko Budaza, Sisonke Msimang, and Vicci Tallis of the Open Society Initiative for Southern Africa provided significant administrative support to each of the community partners as well as input into study design and the questionnaire. Joseph Amon of Human Rights Watch and Sam Avrett of amfAR also provided significant input into the study questionnaire. Finally, the authors would like to thank Sue Simon and Heather Doyle, founding and active director of SHARP, respectively, for being a driving force in initiating this work and providing ongoing support for this work and our partners.
Conceived and designed the experiments: SB GT FM EU SI FD CB. Performed the experiments: GT FM EU SI FD. Analyzed the data: SB EU SI. Wrote the paper: SB CB. Acted as the Study Coordinator: FD
July 2009 – Open Society Institute
Rights Not Rescue
Female, Male, and Trans Sex Workers’ Human Rights in Botswana, Namibia, and South Africa
Date: June 2009
Author: Jayne Arnott and Anna-Louise Crago
Sex workers are subjected to widespread human rights abuses, including police violence and unequal access to health care, in Botswana, Namibia, and South Africa. Despite enormous challenges, sex workers are organizing to protect their rights and demand an end to violence and discrimination.
Published by the Open Society Institute, Rights Not Rescue is based on a series of interviews and focus groups with sex workers and advocates throughout the three countries.
24 July 2009 – Aids Portal
HIV Prevalence among men who have sex with men n Windhoek, Namibia
by Naume Kupe
This 2008 cross-sectional anonymous probe of 220 men who report ever having anal sex with another man in Windhoek using a structured survey instrument and HIV testing was conducted on behalf of a number of organisations includng the Rainbow Project and OSISA. The report makes the following conclusions:MSM are a hidden group within Namibia at risk of HIV. There could be a link between MSM and human rights abuse which merit further research.
The study sample was young, but HIV prevalence was highly associated with age suggesting that HIV prevention program targeting MSM has great potential and is needed. There is a need to increase access to appropriate care by sensitizing and training medical care professionals on the appropriate protocols for treating MSM. Namibia should include MSM as an at risk population in their national AIDS strategy and fund evidence-based HIV prevention programs for MSM. (summary from report)
3 September 2009 – All Africa
Namibia: Gay, Lesbian Rights March At Keetmans
by Luqman Cloete
Kettmanshoop’s first ever march to raise awareness of gay and lesbian rights will take place on Saturday. About 40 people are expected to take part in the event supported by Czech Republic NGO People in Need (PiN). In a press statement issued yesterday, PiN Sexual Minorities Co-ordinator Jacobus Witbooi said the march would also mark the inauguration of a new project for sexual minorities known as Ada Ma /Hao, meaning ‘Let’s Stand Together’.
Witbooi said the project advocates equal rights and opportunities for gender minorities in southern Namibia. According to Witbooi, the project would focus on enhancing empowerment of marginalised sexual minorities in areas of human rights and HIV-AIDS.
"Human rights, including justice, equality, humanity, respect and freedom of expression, and the rule of law are the foundations upon which democratic states are built," Witbooi said. "Indeed, International Human Rights Law is grounded on the premise that all individuals are entitled to the same rights and freedoms, as set out in the Universal Declaration of Human Rights," he added.
Members of the Karas Regional Council described the gay and lesbian initiative as "funny" after a presentation at a council meeting at the end of July. "Do we really need to promote homosexuality in Karas?" Keetmanshoop Urban Constituency councillor Hilma Nikanor asked at the time.
Supported by Karas Constituency councillor Paulus Efraim, she charged that it was "immoral to promote homosexuality", while Oranjemund Constituency councillor Toivo Nambala said PiN had "brandished a funny project".Witbooi urged local people to join the march."Join us as we embrace the concept of unity and equality and commit ourselves to achieving a world in which all people can live in safety and freedom, no matter who they are or whom they love," Witbooi said.
2 November 2009 – AllAfrica
Political Parties Ponder Homosexuality
by Nangula Shejavali
Various political parties last week set out their position on homosexuality – a subject often regarded as taboo. The topic has enjoyed very little, if any, discussion in the National Assembly at all, though Jerry Ekandjo in 1998 reportedly stated that he would table anti-homosexual legislation in Parliament. This never happened.
However, much anti-gay rhetoric has reared its head in the past, with former President Sam Nujoma in 2001 being quoted as saying that "the Republic of Namibia does not allow homosexuality [or] lesbianism here", and "the Police must arrest, imprison and deport homosexuals and lesbians found in Namibia". At a forum with political parties as part of the Women Claiming Citizenship Campaign, respecting and ensuring the rights of gay, lesbian, transgender, bisexual and intersex Namibian citizens – who are often discriminated against for their gender or sexual orientation – was highlighted as a major issue for political parties to address.
When push came to shove in stating their positions, most of the eight parties present – the All People’s Party (APP), the Congress of Democrats (CoD), the National Democratic Party (NDP), the Namibia Democratic Movement of Change (NDMC), Nudo, the Rally for Democracy and Progress (RDP), Swanu, UDF – declared that human rights were for everyone, irrespective of their sexual orientation. Only NDP and UDF remained silent on the issue.
The NDP’s representative, Lukato Lukato, who stated that the party’s policy on HIV-AIDS is that "the Lord will respond to this killer disease", made no comment on the homosexuality discussion. The UDF’s Werner Claasen was also silent on his party’s position, instead launching into an unwelcome electioneering campaign before being brought to order by the audience, who had come to hear political parties’ positions on various issues. NDMC representative Joseph Kauandenge said: "If a person is lesbian or gay, whose issue is it? It’s not a problem as long as it is done in their own private home and in their own private time."
Swanu representative Unaani Kauami expressed the same sentiment, and both came under fire for trying to make the issue of discrimination an insignificant one, with one audience member questioning, "If I am in a relationship, and I am being abused and having my rights violated, is that a private issue? Talking about privatising issues is making it okay. Let’s talk about this, dialogue, publicise it," she said. Swanu later clarified its position, stating that as far as the party was concerned, "it is a violation of human rights to discriminate against someone for their sexual orientation".
APP representative Lena Nakatana also cited human rights as the point of departure, saying that Namibian homosexuals were still Namibians, taxpayers and voters, entitled to the same rights as any other Namibian. "Whether I support them or not is not the issue," she said.
When a member of the audience questioned the ‘human rights’ argument of the political parties by terming homosexuality as unethical and saying that gays and lesbians would not go to heaven, Nakatana countered that "whether or not we accept it, gays and lesbians were also made by God". While Nudo described homosexuality as a "strange new" issue, party representative Utjiua Muinjangue also made it clear that Nudo’s position was to respect human rights, irrespective of sexual orientation.
She emphasised that there was a need for openness in discussing homosexuality, adding that "the fact of the matter is that we have these people amongst us, and we need to look at the issue differently, accept them, and all live happily." RDP representative Steve Bezuidenhout stated that "the supreme law of this land has given rights to all citizens of the country, to all people, irrespective of sex and creed. I don’t want to make a special issue of gays and lesbians because they are Namibians, they are taxpayers, and they have rights just as with all Namibians".
He added that "the RDP Government will defend and protect the Constitution. With this protection, the rights of gays and lesbians will be respected." Noting current national legislation, Congress of Democrats representative Ben Ulenga said that sodomy laws still exist and remain in force in Namibia, stating that this was in stark contrast to ensuring universal human rights, as enshrined in the Namibian Constitution. He added that his party does not discriminate against anyone in society.
"Gays and lesbians are human beings just like any other person. They are all welcome in the party as anybody else, and are free to run for office in the party," he said. He added that describing gays and lesbians as a "new or strange" phenomenon was incorrect, as they had been present since time immemorial, adding that there had been homosexuals in the army during his time as a PLAN soldier, and during his time in prison. Ulenga also promised to introduce the subject in Parliament, noting that there hadn’t been any debate on the issue.
Though invited and slated to speak on the programme, the DTA, Swapo, RP and DPN did not send representatives to participate in the discussion.
February 2010 – PlosOne
HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana
In the generalized epidemics of HIV in southern Sub-Saharan Africa, men who have sex with men have been largely excluded from HIV surveillance and research. Epidemiologic data for MSM in southern Africa are among the sparsest globally, and HIV risk among these men has yet to be characterized in the majority of countries.
Read Report HERE
21 April 2010 – Sexually Transmitted Infections
Bisexual concurrency, bisexual partnerships, and HIV among Southern African men who have sex with men (MSM)
by Chris Beyrer, Gift Trapence, Felistus Motimedi, Eric Umar, Scholastika Iipinge, Friedel Dausab, Stefan Baral1, + Author Affiliations
Dr Stefan Baral, Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, E7146, 615 N Wolfe Street, Baltimore, MD 21205, USA; firstname.lastname@example.org
Contributors SB and CB designed the template protocol. CB led the writing of the manuscript, and SB led the data analysis. The in-country coordinators were FD in Namibia, GT in Malawi and FM in Botswana. EU and SI participated as coinvestigators providing in-country technical assistance and guidance on data analysis and the writing of the manuscript.
Accepted 9 February 2010
Published Online First 21 April 2010
Objectives The sexual behaviour of men who have sex with men (MSM) in southern Africa has been little studied. We present here the first data on bisexual partnerships and bisexual concurrency among MSM in Malawi, Namibia and Botswana.
Methods A cross-sectional probe of a convenience sample of 537 men who have ever reported anal sex with another man using a structured survey instrument and rapid-kit HIV screening.
Results 34.1% of MSM were married or had a stable female partner, and 53.7% reported both male and female sexual partners in the past 6 months. Bisexual concurrency was common, with 16.6% of MSM having concurrent relationships with both a man and a woman. In bivariate analyses, any bisexual partnerships were associated with lower education (OR 1.6, 95% CI 1.1 to 2.3), higher condom use (OR 6.6, 95% CI 3.2 to 13.9), less likelihood of having ever tested for HIV (OR 1.6, 95% CI 1.1 to 2.3), less likelihood of having disclosed sexual orientation to family (OR 0.47, 95% CI 0.32 to 0.67) and being more likely to have received money for casual sex (OR 1.9, 95% CI 1.3 to 2.7). Bisexual concurrency was associated with a higher self-reported condom use (OR 1.7, 95% CI 1.0 to 3.1), being employed (OR 1.8, 95% CI 1.2 to 2.9), lower likelihood of disclosure of sexual orientation to family (OR 0.37, 95% CI 0.22 to 0.65) and having paid for sex with men (OR 2.0, 95% CI 1.2 to 3.2).
Conclusions The majority of MSM in this study report some bisexual partnerships in the previous 6 months. Concurrency with sexual partners of both genders is common. Encouragingly, men reporting any concurrent bisexual activity were more likely to report condom use with sexual partners, and these men were not more likely to have HIV infection than men reporting only male partners. HIV-prevention programmes focussing on decreasing concurrent sexual partners in the African context should also target bisexual concurrency among MSM. Decriminalisation of same-sex practices will potentiate evidence-based HIV-prevention programmes targeting MSM.