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Correlates of Substance Misuse, Transactional Sex, and Depressive Symptomatology Among Partnered Gay, Bisexual and Other Men Who Have Sex with Men in South Africa and Namibia

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Abstract

Despite having some of the world’s highest rates of HIV, there is a lack of knowledge on correlates of transmission risk among gay, bisexual and other men who have sex with men in Southern Africa. There is even less known about the factors that shape HIV risk in male-male couples. Using data from Together Tomorrow, a study of partnered GBMSM in South Africa and Namibia, this study assessed the individual and dyadic correlates of three major HIV risk factors in this population: substance misuse, transactional sex, and depressive symptomatology. Data were collected during November 2016–March 2017 via a quantitative survey conducted with 140 partnered MSM (70 couples) in Windohoek, Keetmanshoop, Walvis Bay, and Swakopmund, Namibia and 300 partnered MSM (150 couples) in Pietermaritzburg and Durban, KwaZulu-Natal, South Africa for a total sample size of 440 partnered MSM (220 couples). Results of multilevel modeling analyses show several significant factors present in partnered GBMSM that differ from studies of single GBMSM, with intimate partner violence being a significant correlate across all three risk factors. Future interventions should consider dyadic approaches and integrate IPV prevention and mitigation efforts to reduce HIV in this population as part of a multisectoral approach. To reduce rates of HIV in partnered GBMSM in Namibia and South Africa multilevel, multisectoral work is needed in policy, social norms change, and relationship-focused dyadic interventions to reduce the social and structural stigma facing male couples.

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Data Availability

Anonymized data is available from the authors upon request.

Code Availability

Analysis was completed using Stata version 16 using custom code. Code is available from the authors upon request.

Notes

  1. This term is a social category in Southern Africa that commonly refers to people of mixed European and Black African or South Asian descent. It was an official census designation from 1950 to 1991 under the Apartheid governments that ruled South Africa and Namibia and is now a self-designated racial category in both countries’ official census forms.

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Funding

Funding for Together Tomorrow was obtained from the UK Department for International Development (DfID) and the MAC AIDS Foundation.

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Authors and Affiliations

  1. School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL, 33146, USA

    Nicholas Metheny

  2. University of Michigan School of Nursing, Ann Arbor, MI, USA

    Rob Stephenson, Lynae A. Darbes & Tanaka M. D. Chavanduka

  3. University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, USA

    Rob Stephenson, Lynae A. Darbes & Tanaka M. D. Chavanduka

  4. Human Sciences Research Council of South Africa, Pretoria, Gauteng, South Africa

    Zaynab Essack & Heidi van Rooyen

  5. School of Law, University of KwaZulu-Natal, KwaZulu-Natal, Pietermaritzburg, South Africa

    Zaynab Essack

  6. MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa

    Heidi van Rooyen

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  1. Nicholas Metheny
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  2. Rob Stephenson
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Contributions

NM conceptualized the study and led manuscript development, RS was PI on Together Tomorrow, conceptualized the study, and co-led manuscript development, LD was Co-I on Together Tomorrow and assisted in manuscript development, TC led data analysis and contributed to manuscript editing, ZE was affiliated with the study management of Together Tomorrow and assisted in manuscript development, HvR was co-PI on Together Tomorrow and assisted with writing/editing.

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Correspondence to Nicholas Metheny.

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Ethical approval for this study was obtained from the Human Sciences Research Council, South Africa, and Ministry of Health, Namibia Institutional Review Boards.

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Metheny, N., Stephenson, R., Darbes, L.A. et al. Correlates of Substance Misuse, Transactional Sex, and Depressive Symptomatology Among Partnered Gay, Bisexual and Other Men Who Have Sex with Men in South Africa and Namibia. AIDS Behav 26, 2003–2014 (2022). https://doi.org/10.1007/s10461-021-03549-6

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