Men Who Have Sex with Men (MSM) in Kisumu, Kenya: Membership in a Support Group and Knowledge of HIV Risk Factors

INTRODUCTION:  Men who have sex with men (MSM) are an important yet marginalized population for HIV prevention in Africa.  Social organizations provide psychosocial benefits to members of marginalized groups, such as MSM in Africa, and can serve as a source of accurate health information.  Study objectives were to: 1) assess determinants of MSM membership in support groups in Kisumu, western Kenya, 2) describe the percentage of MSM who could correctly identify specific risk factors for HIV, and 3) identify unmet needs of MSM and their support groups.

METHODS:  We conducted a two-phase study (in-depth interviews and a survey) of MSM, 18-34 years of age, and  living in Kisumu, Kenya. Participants were recruited through a multi-faceted strategy using 1) link persons: persons with specific knowledge of MSM population 2) peers: MSM referring other MSM and 3) direct staff contact with MSM.  Exact logistic regression models were used for survey data analysis.  

RESULTS:  Approximately half (27/51) of survey respondents reported belonging to an MSM support group. Odds of belonging to support groups were greater for older men [aged 24-34 versus 18-23 years (OR=5.20; CI=1.27-26.66)].  Most respondents (94.1%) correctly reported lack of condom use during vaginal sex as a risk factor for HIV, but slightly fewer (82.4%) recognized lack of condom use during anal sex as an HIV risk factor. There was no association between knowledge of HIV risk factors and being in an MSM support group. Among the 15 interviewees, the following were noted as greatest needs: health information (n=5), safe lubricants (n=4), condoms (n=3), health care facility or MSM friendly health services (n=3), and advocacy (n=2). 

CONCLUSIONS:  Kenyan MSM have developed support groups and have unmet needs for services.  Partnering with MSM support groups offers an opportunity for organizations to reach MSM with accurate health information, provision of safe sexual lubricants, condoms and other health and social services.