title: Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.
abstract: In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors.
authors.affiliation: Global Health Sciences, University of California, San Francisco, California, United States of America ; Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: Rachel
authors.initials: R
authors.lastname: King
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda ; Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Joseph
authors.initials: J
authors.lastname: Barker
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Nakayiwa
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Katuntu
authors.affiliation: Makerere University School of Public Health (MakSPH), Kampala, Uganda.
authors.forename: George
authors.initials: G
authors.lastname: Lubwama
authors.affiliation: Makerere University School of Public Health (MakSPH), Kampala, Uganda.
authors.forename: Danstan
authors.initials: D
authors.lastname: Bagenda
authors.affiliation: Global Health Sciences, University of California, San Francisco, California, United States of America.
authors.forename: Tim
authors.initials: T
authors.lastname: Lane
authors.affiliation: Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Alex
authors.initials: A
authors.lastname: Opio
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda ; Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands ; Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hladik
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015497:HIV-1; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012309:Risk-Taking; D014454:Uganda / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult