“Too Much Sex and Alcohol”: Beliefs, Attitudes, and Behaviors of Male Adolescents and Young Men Who have Sex with Men in Ghana
Lora L. Sabin1, *, Jennifer Beard1, Thomas Agyarko-Poku2, Mary DeSilva3, Paul Ashigbie1, Tami Segal4, Michael Esang5, Mabel Kissiwah Asafo6, Peter Wondergem7, Kimberly Green8, Samuel Wambugu9, Yaw Adu-Sarkodie6
Identifiers and Pagination:Year: 2018
First Page: 69
Last Page: 80
Publisher Id: TOAIDJ-12-69
Article History:Received Date: 22/4/2018
Revision Received Date: 17/6/2018
Acceptance Date: 27/7/2018
Electronic publication date: 31/08/2018
Collection year: 2018
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Research suggests that men who have sex with men (MSM) often engage in high-risk sex and use illicit substances.
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.
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.
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.
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.