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Social Determinants of HIV Among Men Who Have Sex with Men in Cape Town

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Abstract

Little is known about how social factors influence vulnerability to, and consequences of, HIV infection among men who have sex with men (MSM) in South Africa. This study aimed to analyse social stratification and its links with HIV among MSM in Cape Town, South Africa. Six interviews and six focus group discussions (n = 25) were conducted. Tools were based on the World Health Organisation’s Commission on the Social Determinants of Health framework. Directed content analysis was used to analyse data. Race and education were directly linked to social position. MSM from lower social positions were more vulnerable to HIV, and had more negative consequences of HIV infection, compared to wealthier MSM. Engagement with community leaders, health workers and police to promote inclusion could reduce vulnerability of MSM to HIV. Increased access to free, non-discriminatory HIV-related services would reduce inequities in access to HIV services by MSM.

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Notes

  1. “Coloured” is a recognised South African racial group and refers to people of mixed Black/African, European, and/or Asian ancestry.

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Acknowledgments

The financial assistance of the National Research Foundation (NRF) (via the South African Research Chair in ‘Health and Wealth’) towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at, are those of the author and are not necessarily to be attributed to the NRF. Funding from the Oppenheimer Memorial Trust is also acknowledged. Without the insights and knowledge of participants this research would not have been possible. Participant sampling was enabled by staff from The Inner Circle, The Triangle Project, Desmond Tutu HIV Foundation, Cape Town Pride Shelter and the Anova Health Institute.

Funding

The financial assistance of the National Research Foundation (NRF) (via the South African Research Chair in ‘Health and Wealth’) towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at, are those of the author and are not necessarily to be attributed to the NRF. Funding from the Oppenheimer Memorial Trust is also acknowledged.

Author information

Authors and Affiliations

  1. Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Health Sciences Campus, Observatory, Cape Town, 7705, South Africa

    Andrew Scheibe & Linda-Gail Bekker

  2. Department of Medicine, University of Cape Town, Cape Town, South Africa

    Andrew Scheibe & Linda-Gail Bekker

  3. Cape Town, South Africa

    Rithuli Orleyn

  4. Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

    Anna Mia Ekström

  5. Department of Public Health, Karolinska Institutet, Stockholm, Sweden

    Anna Mia Ekström

  6. Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

    Diane McIntyre

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  1. Andrew Scheibe
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  2. Rithuli Orleyn
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  4. Linda-Gail Bekker
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Correspondence to Andrew Scheibe.

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The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Scheibe, A., Orleyn, R., Ekström, A.M. et al. Social Determinants of HIV Among Men Who Have Sex with Men in Cape Town. Sexuality & Culture 20, 579–601 (2016). https://doi.org/10.1007/s12119-016-9344-3

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  • DOI: https://doi.org/10.1007/s12119-016-9344-3

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