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Male Sex Workers Hesitant To Test for HIV, Syphilis - Study

According to Richard Muhindo, the Principal investigator on the study in which researchers assessed 240 female and 100 male sex workers from Kampala and Mbarara, even as these males are not seeking testing services they are also not using condoms in their encounters. He says the respondents were asked about their last sexual encounter and test for syphilis and HIV and they found whereas 85% of women acknowledged using condoms at the last sexual encounter, only 34% of males used protection.

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Majority of males who engage in sex work don’t regularly go for HIV and other sexually transmitted infections (STIs) testing, a new study by the Makerere University Infectious Diseases Institute (IDI) has found.

According to Richard Muhindo, the Principal investigator on the study in which researchers assessed 240 female and 100 male sex workers from Kampala and Mbarara on uptake of key HIV prevention measures, they found that in addition to not testing, males are also not using condoms in their encounters.

He says the respondents were asked about their last sexual encounter and test for syphilis and HIV and they found whereas 85% of women acknowledged using condoms at the last sexual encounter, only 34% of males used protection. This percentage went further down to 10% when the men were asked about consistent condom use.

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Generally, results of the study show that 80% of the males and 90% of females had carried carried out tests for STIs, although Muhindo who is also a lecturer in the department of nursing at the College of Health Sciences says they went ahead to ask all their respondents about whether they are willing to go for periodic testing as recommended by the World Health Organisation and the Ministry of Health.

When asked about testing for HIV, 85% had done a test in the last six months compared to 35% of their male counterparts.  When it comes to syphilis only 32% of males had done a test compared to 81%.

Again more than female sex workers, males were not willing to seek an additional HIV test in the next six months or a syphilis test in the next three months. He said some of the men interviewed had a perception that the six monthly testing service was uncommon. The majority of the services that they hear about they said only focus on their female counterparts.

Because of this knowledge gap highlighted in the report, Dr. Barbara Castelnuovo an Italian clinical researcher and Infectious Diseases Specialist recommends specific campaigns that target men especially regarding where to find services and the importance of consistent condom use.

She said male sex workers in Uganda remain a hidden population.

Agreeing with this, Muhindo said they faced immense challenges to find men to work with in the study until they asked for referrals through their female colleagues.  While the females mainly access their clients on the streets and homes, he says males are a silent group who access their clients through mainly social media and dating sites.  He says 61% of them said they get one to two clients per week and don’t do this as a full time job. 

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Majority of the females do it as a full time job. 

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So far, there are no definite studies that estimate populations of male sex workers in Uganda.  But general statistics show, of the 730,000 new infections that happened in East and South Africa last year, 28% happened among sex workers.

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