Unprotected anal intercourse is recognized as an important driver of the HIV pandemic. An act of unprotected anal intercourse is 5–80 times more likely to result in HIV transmission compared to an act of unprotected vaginal intercourse. Men who have sex with men (MSM), and engage in anal intercourse, remain a hidden, highly stigmatized, and marginalized population in much of the world. In the absence of policies and programs designed to meet their sexual and psychosocial health needs, and because of high-risk sexual behavior that remains criminalized in some countries, these men are particularly vulnerable to infection with HIV.
Population Council focus
The Council is a leader in bringing the issue of MSM in Africa to the forefront, advocating for their health needs to policymakers and piloting and evaluating programs to fill the gaps in health and prevention services for this diverse population. Council researchers have conducted descriptive studies of MSM networks and risk behaviors, examined the impact of stigma and discrimination on health-seeking behaviors, worked with health providers and MSM themselves to build appropriate services, and were the first to use capture-recapture methods to enumerate male sex workers.
Population Council impact
- Council research on MSM, including enumeration of male sex workers, has been used to inform national AIDS programs in Kenya, Mali, and Senegal and has formed the basis for interventions.
- The Council evaluated the feasibility and acceptability of innovative programs bringing "MSM-friendly" health services to MSM and training providers, media, police, and community-based organizations on MSM needs in Kenya and Senegal.
- A Council study in Brazil contributed substantially to the development of the guidelines for the implementation of national HIV surveillance among high-risk populations.
- In 2008, the Council and Kenya’s National AIDS Control Council convened representatives from national HIV programs from ten countries in sub-Saharan Africa in a groundbreaking consultation that identified research and programmatic priorities for reaching and addressing the HIV needs of MSM.
Future directions
Council researchers are building on past enumeration work to estimate the size of the population of male sex workers in three cities in Nigeria and three cities in South Africa. In South Africa, Council researchers are investigating the extent of mistrust in evidence-based HIV information among MSM and its impact on preventive behaviors, use of HIV-related services, and willingness to participate in HIV treatment and vaccine trials. In Nigeria, the Council is establishing the Men’s Health Network Nigeria, a network of health care providers, community-based organizations, and opinion leaders, that is designed to improve knowledge of risk practices, reduce barriers to STI detection and treatment and HIV testing, improve sexual health care–seeking behaviors, and promote individual and group assistance through supportive social networks. In Kenya, the Council is working with the National AIDS and STI Control Programme, the CDC and other partners to implement MSM surveillance and incorporate routine and ongoing surveillance of MSM populations into Kenya’s national surveillance framework.
Projects
Documenting Avahan, the India AIDS Initiative (more)
The Population Council is synthesizing and analyzing the wealth of data collected by Avahan to gain insight that will guide future initiatives for HIV prevention in India and other countries with similar concentrated epidemics.
(1/2009 - 1/2014)
India
Men’s Health Network Nigeria: Providing Appropriate and Comprehensive Sexual Health and HIV Prevention Services (more)
The Men’s Health Network Nigeria seeks to ensure that all men in Nigeria receive appropriate, comprehensive sexual health and HIV prevention services and targets populations considered most at risk.
(10/2008 - 10/2013)
Nigeria
Biological and Behavioral Surveillance of Most-at-risk Populations in Kenya (more)
In collaboration with the Kenyan government and partners, Council researchers are implementing the first HIV biological and behavioral surveillance surveys to facilitate, inform, and evaluate the impact of HIV preventive interventions for most-at-risk populations (men who have sex with men, sex workers, and injecting drug users).
(7/2010 - 2/2012)
Kenya
HIV/AIDS Misinformation and Beliefs Among Men Who Have Sex with Men in Pretoria, South Africa (more)
In South Africa, the Council investigated the extent of HIV misinformation and beliefs among men who have sex with men, the factors that may influence HIV misinformation and mistrust, and the impact HIV misinformation and mistrust have on HIV preventive behaviors.
(9/2008 - 8/2009)
South Africa
Reducing HIV Risk Behavior Among Key Populations by Strengthening Programs Through Community Involvement (more)
Council researchers explored issues of social capital, stigma and discrimination, HIV knowledge and behaviors, self-esteem, and service delivery among three key populations (female sex workers, men who have sex with men, and people living with HIV) in Andhra Pradesh, India, before and after exposure to interventions designed to empower them to practice HIV prevention behaviors.
(7/2003 - 7/2007)
India
Reducing HIV/STI Risk and Improving Treatment for Male Sex Workers in Mombasa, Kenya (more)
The Council’s Horizons program conducted an intervention study in Mombasa, Kenya, to meet male sex workers’ health needs and promote behavior change among this population.
(1/2006 - 7/2007)
Kenya
Assessment of the Risk Factors for HIV Infection in Vulnerable Populations in Ciudad del Este, Paraguay (more)
Council researchers with the Horizons program conducted an operations research study to estimate HIV and syphilis seroprevalence and determine contextual and behavioral factors that increase syphilis and HIV vulnerability among male and female sex workers and men who have sex with men in Ciudad del Este, Paraguay.
(7/2005 - 6/2007)
Paraguay
Risk Factors for HIV Infection in the MSM Population in the Metropolitan Area of Campinas City, Brazil, Using Respondent-driven Sampling (more)
Council research aims to contribute to the reduction of HIV in the population of men who have sex with men in Brazil by establishing subgroups who are at greatest risk for HIV infection and understanding the sociodemographic, behavioral, and environmental factors associated with such high risks.
(6/2005 - 6/2007)
Brazil
Resources
"Addressing HIV among the most at-risk populations," fact sheet (PDF)
Population Council
Publication date: 2012
"The Population Council's HIV and AIDS program," fact sheet (PDF)
Population Council
Publication date: 2012
A decade of research involving men who have sex with men in sub-Saharan Africa: Current knowledge and future directions (abstract) (PDF)
Muraguri,Nicholas; Temmerman,Marleen; Geibel,Scott
Journal of Social Aspects of HIV/AIDS 9(3): 137-147
Publication date: 2012
An ethnographic study of injecting drug users and men who have sex with men in selected states in Nigeria (PDF)
Enhancing Nigeria's HIV/AIDS Response (ENR) Programme
Publication date: 2012
Biological and behavioural surveillance for most at-risk populations in Kenya (PDF)
from Most-at-Risk Populations: Unveiling New Evidence for Accelerated Programming, pp. 1-5
Publication date: 2012
Changing epidemiology of HIV in Mumbai: An application of the Asian epidemic model (abstract) (PDF)
Mishra,Ram Manohar; Dube,Madhulika; Sahu,Damodar; Saggurti,Niranjan; Pandey,Arvind
Global Journal of Health Science 4(5): 100-112
Publication date: 2012
Evidence for action: Quarterly newsletter of the Population Council, Nigeria (PDF)
Issue no. 1, April
Publication date: 2012
HIV-related conspiracy beliefs and its relationships with HIV testing and unprotected sex among men who have sex with men in Tshwane (Pretoria), South Africa (abstract)
Tun,Waimar; Kellerman,Scott E.; Maime,Senkhu; Fipaza,Zukiswa; Sheehy,Meredith; Vu,Lung; Nel,Dawie
AIDS Care 24(4): 459-467
Publication date: 2012
Levels and correlates of internalized homophobia among men who have sex with men in Pretoria, South Africa (abstract)
Vu,Lung; Tun,Waimar; Sheehy,Meredith; Nel,Dawie
AIDS and Behavior 16(3): 717-723
Publication date: 2012
MARPs sensitization: A diversity training guide for health care providers in Nigeria (PDF)
Enhancing Nigeria's HIV/AIDS Response (ENR) Programme
Series 1: Working with Men who have Sex with Men (MSM)
Publication date: 2012
The experiences of men engaged in transactional sex with other men in urban Nigeria--A size estimation and qualitative study (PDF)
Population Council
Publication date: 2012
The impact of peer outreach on HIV knowledge and prevention behaviours of male sex workers in Mombasa, Kenya (abstract)
Geibel,Scott; King'ola,Nzioki; Temmerman,Marleen; Luchters,Stanley
Sexually Transmitted Infections 88(5): 357-362
Publication date: 2012
Using capture-recapture methodology for enumerating most-at-risk populations (MARPs) (PDF)
Population Council
Publication date: 2012
HIV integrated biological and behavioural surveillance survey (IBBSS) 2010 (PDF)
Federal Ministry of Health
Publication date: 2011
Levels and correlates of unprotected anal intercourse and not testing for HIV among men who have sex with men in Abuja, Lagos and Ibadan, Nigeria (abstract) (PDF)
Poster presentation at the 6th International AIDS Society Conference, Rome, Italy, 17-20 July
Vu,Lung; Adebajo,Sylvia; Sheehy,Meredith; Tun,Waimar; Karlyn,Andrew; Anene,Oliver; Sangowawa,Segun; Toyese,Akinade; Ankomah,Augustine; Balami,Wada; Ahonsi,Babatunde
Publication date: 2011
Population-based estimates of prevalence of HIV, HBV and HCV and HIV-related risk behaviors among male injecting drug users in Lagos, Nigeria (abstract) (PDF)
Presentation at the 6th International AIDS Society Conference, Rome, Italy, 17-20 July
Tun,Waimar; Adebajo,Sylvia; Abiodun,Lolade; Karlyn,Andrew; Vu,Lung; Anyanti,Jennifer; Kawu,Issa; Sheehy,Meredith
Publication date: 2011
Prevalence of sexually transmitted infections among men who have sex with men and injecting drug users and validation of audio computer-assisted self interview (ACASI) technique in Abuja, Lagos, and Ibadan, Nigeria: Report fact sheet (PDF)
Enhancing Nigeria's HIV/AIDS Response (ENR) Programme
Publication date: 2011
Prevalence of sexually transmitted infections among men who have sex with men and injecting drug users and validation of audio computer-assisted self interview (ACASI) technique in Abuja, Lagos, and Ibadan, Nigeria: Technical report (PDF)
Enhancing Nigeria's HIV/AIDS Response (ENR) Programme
Publication date: 2011
Understanding the HIV risk and sexual health needs of men who have sex with men (PDF)
Population Briefs 17(1)
Publication date: 2011
Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya (abstract) (PDF)
Luchters,Stanley; Geibel,Scott; Syengo,Masila; Lang'o,Daniel; King'ola,Nzioki; Temmerman,Marleen; Chersich,Matthew F.
BMC Public Health 11: 384-
Publication date: 2011
HIV vulnerability of men who have sex with men in developing countries: Horizons studies, 2001-2008 (abstract)
Geibel,Scott; Tun,Waimar; Tapsoba,Placide; Kellerman,Scott E.
Public Health Reports 125(2): 316-324
Publication date: 2010
Looking back, moving forward: Understanding the HIV risk and sexual health needs of men who have sex with men, Horizons studies 2001 to 2008 (PDF)
Geibel,Scott; Tun,Waimar; Tapsoba,Placide; Kellerman,Scott E.
Horizons Synthesis Background Papers
Publication date: 2010
Engaging men who have sex with men in operations research in Kenya (abstract)
Onyango-Ouma,Washington; Birungi,Harriet; Geibel,Scott
Culture, Health and Sexuality 11(8): 827-839
Publication date: 2009
Medical response to male same-sex sexuality in western India: An exploration of 'conversion treatments' for homosexuality (PDF)
Ranade,Ketki
Health and Population Innovation Fellowship Programme Working Paper (no. 8)
Publication date: 2009
Men who have sex with men and HIV/AIDS in sub-Saharan Africa (abstract) (PDF)
Smith,Adrian D.; Tapsoba,Placide; Peshu,Norbert; Sanders,Eduard J.; Jaffe,Harold W.
Lancet 374(9687): 416-422
Publication date: 2009
Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya (abstract)
Okal,Jerry; Luchters,Stanley; Geibel,Scott; Chersich,Matthew F.; Lango,Daniel; Temmerman,Marleen
Culture, Health and Sexuality 11(8): 811-826
Publication date: 2009
The overlooked epidemic: Addressing HIV prevention and treatment among men who have sex with men in sub-Saharan Africa (PDF)
National AIDS Control Council of Kenya; Population Council
Publication date: 2009
Addressing the HIV prevention needs of men who have sex with men in Africa (PDF)
Population Briefs 14(2)
Publication date: 2008
Assessment of risk factors for HIV infection among men who have sex with men in the metropolitan area of Campinas City, Brazil, using respondent-driven sampling (PDF)
de Mello,Maeve; de Araujo Pinho,Adriana; Chinaglia,Magda; Tun,Waimar; Barbosa Junior,Aristides; Ilario,Maria Cristina F.J.; Reis,Paulo; Salles,Regina C.S.; Westman,Suzanne; Diaz,Juan
Horizons Final Report
Publication date: 2008
Assessment of risk factors for HIV infection in female sex workers and men who have sex with men in Ciudad del Este, Paraguay (PDF)
Chinaglia,Magda; Tun,Waimar; Mello,Maeve; Insfran,Magdalena; Diaz,Juan
Horizons Final Report
Publication date: 2008
Exploring context and dynamics of homosexual experiences among rural youth in India (abstract) (HTML)
Singh,Ajay Kumar; Mahendra,Vaishali Sharma; Verma,Ravi K.
Journal of LGBT Health Research 4(2,3): 89-101
Publication date: 2008
Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya (abstract)
Geibel,Scott; Luchters,Stanley; King'ola,Nzioki; Esu-Williams,Eka; Rinyiru,Agnes; Tun,Waimar
Sexually Transmitted Diseases 35(8): 746-752
Publication date: 2008
Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil (abstract)
Tun,Waimar; de Mello,Maeve; Pinho,Adriana A.; Chinaglia,Magda; Diaz,Juan
Sexually Transmitted Infections 84(6): 455-457
Publication date: 2008
'Are you on the market?': A capture-recapture enumeration of men who sell sex to men in and around Mombasa, Kenya (abstract)
Geibel,Scott; van der Elst,Elisabeth M.; King'ola,Nzioki; Luchters,Stanley; Davies,Alun; Getambu,Esther M.; Peshu,Norbert; Graham,Susan M.; McClelland,R.Scott; Sanders,Eduard J.
AIDS 21(10): 1349-1354
Publication date: 2007
Challenges for the sexual health and social acceptance of men who have sex with men in Nigeria (abstract) (PDF)
Allman,Dan; Adebajo,Sylvia; Myers,Ted; Odumuye,Oludare; Ogunsola,Sade
Culture, Health and Sexuality 9(2): 153-168
Publication date: 2007
Conspiracy beliefs and trust in information about HIV/AIDS among minority men who have sex with men (abstract)
Hutchinson,Angela B.; Begley,Elin B.; Sullivan,Patrick; Clark,Hollie A.; Boyett,Brian C.; Kellerman,Scott E.
Journal of Acquired Immune Deficiency Syndromes 45(5): 603-605
Publication date: 2007
Implementing STI/HIV prevention and care interventions for men who have sex with men in Senegal (PDF)
Moreau,Amadou; Tapsoba,Placide; Ly,Abdoulaye; Niang,Cheikh Ibrahima; Diop,Abdou Khoudia
Horizons Research Summary
Publication date: 2007
Context and dynamics of male-to-male sexual behavior of truckers in India: Findings from a multi-site qualitative research study (PDF)
Verma,Ravi K.; Mahendra,Vaishali Sharma; Pelto,Pertti J.; Pradhan,Sarat Chandra; Singh,Vibha
Research Brief
Publication date: 2006
Context and dynamics of same-sex behavior among long-distance truckers in India: Findings from qualitative research (PDF)
Mahendra,Vaishali Sharma; Verma,Ravi K.; Pelto,Pertti J.; Pradhan,Sarat Chandra; Singh,Vibha; Rao,Asha; Vij,Tarun
Publication date: 2006
Stigma, discrimination and violence against female sex workers and men who have sex with men in Andhra Pradesh, India (PDF)
Samuels,Fiona; Verma,Ravi K.; George,C.K.; van der Kwaak,Anke; Wegelin-Schuringa,Madeleen; Cummings,Sarah; van Dam,Henk; Valk,Minke
Gender, Society & Development book series, pp. 95-109
Publication date: 2006
Understanding the HIV/STI prevention needs of men who have sex with men in Kenya (PDF)
Onyango-Ouma,Washington; Birungi,Harriet; Geibel,Scott
Horizons Research Summary
Publication date: 2006
Understanding the HIV/STI risks and prevention needs of men who have sex with men in Nairobi, Kenya (PDF)
Onyango-Ouma,Washington; Birungi,Harriet; Geibel,Scott
Horizons Final Report
Publication date: 2005
'It's raining stones': Stigma, violence and HIV vulnerability among men who have sex with men in Dakar, Senegal (abstract)
Niang,Cheikh Ibrahima; Tapsoba,Placide; Weiss,Ellen; Diagne,Moustapha; Niang,Youssoupha; Moreau,Amadou; Gomis,Dominique; Wade,Abdoulaye Sidibe; Seck,Karim; Castle,Christopher
Culture, Health and Sexuality 5(6): 499-512
Publication date: 2003
Meeting the sexual health needs of men who have sex with men in Senegal (PDF)
Niang,Cheikh Ibrahima; Diagne,Moustapha; Niang,Youssoupha; Moreau,Amadou; Gomis,Dominique; Diouf,Maye; Seck,Karim; Wade,Abdoulaye Sidibe; Tapsoba,Placide; Castle,Christopher
Horizons Final Report
Publication date: 2002
Meeting the sexual health needs of men who have sex with men in Senegal (PDF)
Horizons Research Summary
Publication date: 2002
New study examines lives of MSM in Senegal (HTML)
Dadian,Margaret
Global AIDSLink 72: 15-15
Publication date: 2002
Satisfaire aux besoins de santé des hommes qui ont des rapports sexuels avec d'autres hommes au Sénégal (PDF)
Niang,Cheikh Ibrahima; Diagne,Moustapha; Niang,Youssoupha; Moreau,Amadou; Gomis,Dominique; Diouf,Maye; Seck,Karim; Wade,Abdoulaye Sidibe; Tapsoba,Placide; Castle,Christopher
Horizons Final Report
Publication date: 2002
Satisfaire les besoins de santé des hommes qui ont des rapports sexuels avec d'Autres hommes au Sénégal (PDF)
Horizons Resume de Recherche
Publication date: 2002
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