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HIV Testing, Knowledge and Willingness to Use PrEP Among Partnered Men Who Have Sex With Men in South Africa and Namibia

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Abstract

There is strong evidence that gay, bisexual and other men who have sex with men (GBMSM) in African countries experience high prevalence of HIV. However, missing from the literature is an understanding of the HIV risk behaviors and prevention needs of partnered GBMSM in African countries. The Together Tomorrow project sampled 440 partnered GBMSM (220 couples) in South Africa and Namibia. Prevalence of HIV was high at 42%, with 33% of men in sero-discordant relationships. Despite high levels of HIV testing in the past 6 months (65%), condom use with main and outside sex partners was low. Men reported low levels of willingness to use pre-exposure prophylaxis (PrEP) (16%). HIV testing in the past 12 months and willingness to use PrEP were significantly associated with recent binge drinking and substance use. Men in sero-discordant relationships, those with sexual agreements and those who had experienced any form of IPV were all less likely to report that they had recently tested for HIV. There is a need to develop interventions that meet the unique needs of African partnered GBMSM and tackle stigma and discrimination as drivers of HIV risk in these settings.

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Authors and Affiliations

  1. Department of Systems, Population and Leadership, School of Nursing, University of Michigan, Ann Arbor, USA

    Rob Stephenson

  2. Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, USA

    Rob Stephenson, Lynae A. Darbes & Tanaka Chavanduka

  3. Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, USA

    Lynae A. Darbes

  4. Centre for Community-Based Research, Human Sciences Research Council, Pretoria, South Africa

    Zaynab Essack & Heidi van Rooyen

  5. School of Law, University of KwaZulu-Natal, Pietermaritzburg, South Africa

    Zaynab Essack

  6. School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Heidi van Rooyen

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  1. Rob Stephenson
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  2. Lynae A. Darbes
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Correspondence to Rob Stephenson.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for this study was obtained from the Human Sciences Research Council, South Africa, and Ministry of Health, Namibia Institutional Review Boards.

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Stephenson, R., Darbes, L.A., Chavanduka, T. et al. HIV Testing, Knowledge and Willingness to Use PrEP Among Partnered Men Who Have Sex With Men in South Africa and Namibia. AIDS Behav 25, 1993–2004 (2021). https://doi.org/10.1007/s10461-020-03129-0

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