title: Human Rights Violations among Men Who Have Sex with Men in Southern Africa: Comparisons between Legal Contexts.
abstract: In 1994, South Africa approved a constitution providing freedom from discrimination based on sexual orientation. Other Southern African countries, including Botswana, Malawi, and Namibia, criminalize same-sex behavior. Men who have sex with men (MSM) have been shown to experience high levels of stigma and discrimination, increasing their vulnerability to negative health and other outcomes. This paper examines the relationship between criminalization of same-sex behavior and experiences of human rights abuses by MSM. It compares the extent to which MSM in peri-urban Cape Town experience human rights abuses with that of MSM in Gaborone, Botswana; Blantyre and Lilongwe, Malawi; and Windhoek, Namibia. In 2008, 737 MSM participated in a cross-sectional study using a structured survey collecting data regarding demographics, human rights, HIV status, and risk behavior. Participants accrued in each site were compared using bivariate and multivariate logistic regression. Encouragingly, the results indicate MSM in Cape Town were more likely to disclose their sexual orientation to family or healthcare workers and less likely to be blackmailed or feel afraid in their communities than MSM in Botswana, Malawi, or Namibia. However, South African MSM were not statistically significantly less likely experience a human rights abuse than their peers in cities in other study countries, showing that while legal protections may reduce experiences of certain abuses, legislative changes alone are insufficient for protecting MSM. A comprehensive approach with interventions at multiple levels in multiple sectors is needed to create the legal and social change necessary to address attitudes, discrimination, and violence affecting MSM.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Ryan
authors.initials: R
authors.lastname: Zahn
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Ashley
authors.initials: A
authors.lastname: Grosso
authors.affiliation: Institute of Infectious Disease and Molecular Medicine, Desmond Tutu HIV Centre, Cape Town, South Africa.
authors.forename: Andrew
authors.initials: A
authors.lastname: Scheibe
authors.affiliation: Institute of Infectious Disease and Molecular Medicine, Desmond Tutu HIV Centre, Cape Town, South Africa.
authors.forename: Linda-Gail
authors.initials: LG
authors.lastname: Bekker
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.affiliation: The Rainbow Project, Windhoek, Namibia.
authors.forename: Friedel
authors.initials: F
authors.lastname: Dausab
authors.affiliation: School of Nursing and Public Health, University of Namibia, Windhoek, Namibia.
authors.forename: Scholastica
authors.initials: S
authors.lastname: Iipinge
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
authors.affiliation: Center for the Development of People, Lilongwe, Malawi.
authors.forename: Gift
authors.initials: G
authors.lastname: Trapance
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baral
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male; D006806:Human Rights; D045809:Human Rights Abuses; D006801:Humans; D008297:Male; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult