March 18, 2009 – PSI BCC Blog
Men in the Middle: Reaching Non-Gay Identified MSM in Togo
A growing body of evidence around men who have sex with men (MSM) in Africa suggests that this long-ignored population is not only present, but incredibly varied in behavior, beliefs, and lifestyles. One of the few common themes among MSM in this region is – sadly – their enormously high HIV risk, which far outstrips that of the general population in nearly every African country. Identifying MSM -particularly those who don’t self-identify as gay – has proved to be one of the larger challenges facing interventions targeting this population.
PSI/Togo’s HIV project for MSM, which is beginning its third year, is currently launching a new initiative to better reach hidden MSM subgroups. For the past two years, PSI has worked primarily with self-identifying gay men in Lomé, communicating HIV prevention messages through peer education and referrals for HIV counseling and testing. Initial project design was based on qualitative, peer-driven research, which helped to establish trust relationships between PSI staff and leaders in Togo’sMSM community. With the evolution of the project, PSI/Togo determined that tapping into subgroups within this community was an important next step. Non-gay-identified MSM are particularly high priority, for a number of reasons. Due to cultural restrictions, many Togolese MSM are forced to marry and have children to be accepted by society, which drives them to engage in poorly planned and oftentimes unprotected sex with men on the side. These men are often difficult to reach due to their clandestine nature and fear of association with other, more open MSM. Motivation around both condom use and HIV testing appears to be somewhat different among this group than men who self-identify as gay.
PSI/Togo has begun to reach this group through the addition of new peer educators and expansion intothree cities in the interior of the country. With this geographic expansion has come a natural inclusion of new, less gay-identified, MSM subgroups. So what does this narrower segmentation mean in the context of an already-small peer education program? Messages emphasize biological risks to both partners (and children) involved, and avoid referencing gay identity. Non-gay-identifying men are often hesitant to attend activities that cater to gay men, and may prefer smaller, more discrete events. PSI’s efforts to target this group are still nascent – but represent an attempt to segment a small and little-understood audience. We look forward to seeing the results of this new phase!
Guest Blogger Ben Clapham manages PSI/Togo’s MSM program.