AIDS and Behavior

, Volume 15, Issue 6, pp 1088–1097 | Cite as

Stigma, Health Care Access, and HIV Knowledge Among Men Who Have Sex With Men in Malawi, Namibia, and Botswana

  • Heather Fay
  • Stefan D. Baral
  • Gift Trapence
  • Felistus Motimedi
  • Eric Umar
  • Scholastika Iipinge
  • Friedel Dausab
  • Andrea Wirtz
  • Chris BeyrerEmail author
Original Paper


Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM.


Stigma Discrimination HIV/AIDS Men who have sex with men (MSM) Namibia Botswana Malawi 



The study was supported, in part, by a grant from the Sexual Health and Rights Program, SHARP, of the Open Society Institute, New York, NY.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Heather Fay
    • 1
  • Stefan D. Baral
    • 1
  • Gift Trapence
    • 2
  • Felistus Motimedi
    • 3
  • Eric Umar
    • 4
  • Scholastika Iipinge
    • 5
  • Friedel Dausab
    • 6
  • Andrea Wirtz
    • 1
  • Chris Beyrer
    • 1
    Email author
  1. 1.Department of Epidemiology, Center for Public Health and Human RightsJohns Hopkins School of Public HealthBaltimoreUSA
  2. 2.Center for the Development of PeopleBlantyreMalawi
  3. 3.Botswana Network on Ethics, Law, and HIV/AIDSGaboroneBotswana
  4. 4.Department of Community HealthUniversity of Malawi, College of MedicineBlantyreMalawi
  5. 5.University of NamibiaWindhoekNamibia
  6. 6.The Rainbow ProjectWindhoekNamibia

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