N. Madubela(1), P. Smith(2), L.-G. Bekker(3)

Affiliates

(1)The Desmond Tutu HIV Centre, Cape Town, South Africa, (2)University of Cape Town, Medicine, Cape Town, South Africa, (3)Desmond Tutu HIV Centre, Medicine, Cape Town, South Africa

Abstract

Background:
Young South African men (15-30y), are disproportionately less likely than women to know their HIV status (62% vs 82% in women) and their risk of HIV infection increases steeply after age 20 (1.2% in 15-19 years rising to 24.2% in 35-39y). Despite this, condom usage is declining. To design more effective prevention interventions, this study assessed the risk awareness and risk behaviours of young men who visited health care facilities in high HIV burden areas.
Methods: Klipfontein/Mitchells Plain district, in Cape Town, a high HIV disease burden area, where young men (at high risk of HIV infection) infrequently access Sexual reproductive health services. Through stratified convenience based sampling at 5 public health clinics, self-identifying males were screened. The participants completed an anonymous, researcher administered survey, which explored demographics, recent sexual experiences/sexual debut, knowledge of contraception, knowledge of HIV/sexual transmitted infections (STIs), use of health services and circumcision.
Results: Overall, 103 participants (mean age 21y) enrolled, from which 68% had not completed secondary school and 71% had no income. All participants reported sex with more than 1 person in the past 3 months (average 2 sexual partners). Data showed that there was low usage of HIV preventative strategies, as demonstrated by: 29% HIV testing in the last 6 months, 55% had not used a condom in their last sexual encounter, 40% did not know their sexual partners status, 6 % received STI treatment in past 6 months and 93% had no knowledge of PreP. Unwanted pregnancy was perceived as worse than contracting HIV (46% and 54% respectively). Overall, 41% used drugs (19% in the past 6 months) and 49% perceived their risk of contracting HIV as low, 6% as high and 13% as not being at risk. Furthermore, 14% reported that their sex partners had other sex partners, 19% were not sure.
Conclusions: The data indicated that men from a low socio-economic setting regularly engaged in high risk behaviours and had poor risk awareness. Further research should explore how to improve overall male engagement in health, HIV and prevention services.