Although sex between men remains illegal in Kenya, services addressing HIV/AIDS and the sexual health needs of men who have sex with men (MSM) are slowly becoming available to this much-neglected and stigmatised group.
The University of Liverpool’s Voluntary Counselling and Testing Services (LVCT), for instance, has been offering advice to MSM since 2003 and now offers a full range of services, including messages about safer sex, voluntary counselling and testing (VCT) and antiretroviral (ARV) drugs.
Widespread stigma and denial regarding homosexuality make it virtually impossible for men who have sex with men to seek knowledge and treatment openly and, as a result, ignorance about safer sex practices persists.
“There is a strong link between HIV, and vaginal and penile sex for reproduction,” said Angus Parkinson, MSM services coordinator at LVCT. “This creates the illusion that if you have sex that is not reproductive – that is oral or anal – then there is no HIV risk. This creates a gap in prevention services in Kenya.”
According to Parkinson, only a very small proportion – 0.1 percent – of male visitors to LVCT reported having sex with a man, but the true figure was likely to be much higher.
“There are lots of studies from across the globe that suggest that between five [percent] and ten percent of any given male population participate in some form of same-sex sexual behaviour,” he told PlusNews.
Safer sex, with correct and consistent condom use, is a key area of the education provided by LVCT and Iishtar MSM, a nongovernmental organisation (NGO) working for MSM rights in Kenya. A 2005 Population Council study on MSM in the Kenyan capital, Nairobi, found that 75 percent of respondents had used a condom the last time they engaged in male-to-male sexual contact.
However, correct condom use posed a bigger problem. Emmanuel Ilamau, national MSM coordinator at Iishtar, said water-based lubricants were expensive and not locally made, so many men used baby oil or other oil-based lubricants, which could damage the condoms. The Population Council report found that just 26 percent of respondents knew that only water-based lubricants should be used with latex condoms.
Iishtar educates its members about the correct use of condoms and lubricants, but does not have sufficient funds to distribute a lubricant along with condoms. “I have a problem, as I feel it is immoral to distribute condoms without lubricant,” Ilamau said.
An additional risk is the fact that men who have sex with men often have multiple sexual partners and also have sex with women, putting a wider population at risk. The Population Council report found that having multiple sexual partners was common among MSM, with 79 percent of respondents having had sex with more than two partners in the past year, and 30 percent of those “could not remember the actual number”.
SOCIETY NOT READY TO ACCEPT MSM
Iishtar also provides support and advice on safer sex to their members, but signing up members hasn’t been easy because many men are reluctant to admit that they have sex with other men. The NGO has 75 members, but usually attracts more people during functions.
The Population Council report found that 22 percent of respondents had endured verbal, physical and sexual assault in the preceding one-year period as a result of people discovering they were having sex with other men. “Stigma and discrimination are part and parcel of the daily lives of MSM in Kenya,” Ilamau commented.
Male-to-male sex is a criminal offence with a jail sentence of five to 14 years, making it difficult for the government and NGOs to include this group in their AIDS programmes. Calls for a change in the law have been widely condemned by conservatives and the religious right, who feel that homosexuality does not conform to religious teachings and is “un-African”.
“There is a strong public health argument for reforming the law, but possibly a stronger religious and moral reaction to keep the laws in place – this is a political issue,” said LVCT’s Parkinson.
Nevertheless, progress is slowly being made. “We have identified this group [MSM] in our strategic plan and we are facilitating organisations that run programmes for them,” said Stephen Malai, of the National AIDS Control Council. “We help them by providing condoms and education on safer sex practices.”