"Too Much Sex and Alcohol": Beliefs, Attitudes, and Behaviors of Male Adolescents and Young Men Who Have Sex with Men in Ghana

Overview

Journal Open AIDS J

Publisher Bentham Open

Specialty Infectious Diseases

Date 2018 Sep 28

PMID 30258509

Citations 9

Authors

Lora L Sabin

Jennifer Beard

Thomas Agyarko-Poku

Mary DeSilva

Paul Ashigbie

Tami Segal

Michael Esang

Mabel Kissiwah Asafo

Peter Wondergem

Kimberly Green

Samuel Wambugu

Yaw Adu-Sarkodie

Affiliations

Soon will be listed here.

Abstract

Background: Research suggests that men who have sex with men (MSM) often engage in high-risk sex and use illicit substances.

Objective: To increase understanding of HIV knowledge and vulnerability among adolescent and young adult MSM, with a focus on alcohol and drug use and transactional sex.

Methods: We conducted in-depth interviews and Focus Group Discussions (FGDs) with adolescent (aged 15-17 years) and young adult (aged 18-29 years) MSM in Kumasi, Ghana. MSM who reported recent alcohol and/or substance use or engagement in transactional sex were eligible. Questions covered HIV-related knowledge, experiences with substance-use and transactional sex, and attitudes regarding sexual risk-taking and HIV-related services. Data were analyzed thematically using NVivo 10.0 software.

Results: Ninety-nine MSM participated in 44 interviews and 8 FGDs. Most were attending or had completed secondary school. HIV knowledge was high, but with major gaps. Most consumed alcohol; one-fourth used drugs. Alcohol and substances were consumed to enhance pleasure during sex with another man. Transactional sex was common and positively viewed. Half of the participants used condoms inconsistently or never, and self-perceived HIV risk was high. Nearly half faced stigma-related barriers to accessing HIV-related services.

Conclusion: As Ghana strives to achieve the UNAIDS's 90-90-90 global targets (90% of people living with HIV know their status, 90% who know their status are on sustained treatment, and 90% of those on treatment are virally suppressed), we recommend enhancing MSM-targeted prevention programs, improving care options, and increasing use of critical clinical HIV-services by ensuring that MSM receive unbiased, confidential care.

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