Rwanda has responded strongly to HIV/AIDS, but prevention among men who have sex with men (MSM) has not yet been addressed due to a strong cultural resistance to homosexuality, and a lack of data showing the public health value of attending to the sexual health needs of this group. We conducted an exploratory study on HIV risk among MSM in Kigali using snowball sampling involving peer leaders. The 99 respondents were demographically, socially, and sexually diverse. Respondents reported relatively high numbers of male and female partners, and considerable HIV risk behaviors including commercial sex with men and women, low condom use during anal and vaginal sex, and high mobility. Many respondents reported verbal and/or physical abuse due to their sexuality. This first study of MSM in Rwanda has brought attention to a previously neglected HIV risk group and their potential driving role in the Rwandan epidemic, demonstrating the need for sensitive and targeted interventions.
The present study has highlighted the importance of unique cultural structures in Chinese FSW sexual decision-making, an understanding of which will enhance the success of HIV-prevention efforts globally.
Partner notification (PN) in the UK is of limited effectiveness. Expedited partner therapy improves PN outcomes but does not comply with existing UK professional guidance. We developed two new strategies, known as accelerated partner therapy (APT), based on elements of PN practice for which there is evidence of efficacy, and which conform to UK prescribing guidance. We explored the acceptability and feasibility of these models qualitatively in genitourinary medicine clinic attenders. Both strategies were viewed favourably. Preference was influenced by age, relationship type, whether participants were delivering or receiving APT and whether the sex partner was aware of the participant's clinic visit. APT provides a new approach to PN, which has strong patient support and complies with existing UK regulations. The complex factors that influence patients' choice of PN method suggest that provision of a range of PN options including APT may be central to improving the effectiveness of PN in the UK.
The paper explores the HIV risk context of migrant men who have sex with men, or tongzhi, in Shenzhen, China. Findings from 42 qualitative interviews indicate that respondents are living within a complex risk environment, characterised by the realities of migration and a 'weak ties', virtual men who have sex with men community, which offers little emotional support but many opportunities for sexual engagement. Male sex work has proliferated in Shenzhen, with respondents informally participating in a type of buy-sell circuit. Respondents' portrayal of their environment and conflicts were underscored by three interacting elements: sexual freedom, migration and traditional Chinese values. The confluence of these factors, and how they may influence risk prioritisation in a multi-risk environment, is explored.
Efforts to prevent HIV among adolescent girls and young women (AGYW) should focus on providing male sexual partners of AGYW with HIV prevention, testing, and treatment programming and providing AGYW, particularly those who are less educated, pregnant, or single mothers, with prevention methods that do not require negotiating safer sex with their partners.
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