No HIV-Positive MSM in Screening

Viewpoint

Djamil Bangoura, president of Association Prudence, Senegal’s largest LGBT health and human rights advocacy group, lists HIV prevention and treatment for men who have sex with men (MSM) as one of the organization’s most urgent priorities. Even though systematic homophobia in Senegal limits the organization’s ability to improve health outcomes for the LGBT community, Prudence organizes HIV testing for MSM by using its network of 500 members.

“We need to be careful, but not so careful that we can’t take action on the ground,” Bangoura said. “We’re careful, but we take actions for key populations. We target the community in which we are a part of, the LGBT population.”

Prudence connects key populations to LGBT-friendly health services for testing and helps to refer HIV-positive MSM for treatment.

“We’re here as an organization to sensitize and to organize testing zones, and if we test one of our brothers who is positive, we try to counsel him so that he knows it’s not the end of the world,” Bangoura said. “He can live like everybody.”

Amadou, a member of Prudence, took part in a recent HIV testing and sensitization campaign with key populations in Dakar. Prudence frequently hosts these screenings for the LGBT community.

“By the grace of God, we had zero cases, and that’s a victory for us as the LGBT community to know that people took precaution against this disease,” Amadou said.

Although he explains that no men tested positive for HIV during this one screening, the HIV prevalence is 44% among Senegalese MSM 25-years and younger and 38% among MSM 25-years and older.

“We’re here as an organization to sensitize and to organize testing zones, and if we test one of our brothers who is positive, we try to counsel him so that he knows it’s not the end of the world,” Bangoura said. “He can live like everybody.”

 

The Joint United Nations Programme on HIV/AIDS (UNAIDS) Key Populations Atlas, a new visualization tool, allows users to navigate country-specific data on populations particularly vulnerable to HIV. These key populations include sex workers, people who inject drugs, transgender people, prisoners, and MSM.

UNAIDS maps eight indicators of key population health in countries where data sources are available. These indicators estimate HIV prevalence, population size estimate, condom use, HIV testing rates, ART coverage, denied health services, a measure of fear of seeking health services, and health laws.

msm_senegal_chart_sm

Because UNAIDS estimates the HIV prevalence at 0.5% in the Senegalese general population, these data reveal disparities in HIV rates in the country.

“We went to battle,” Amadou said. “We fight, but I don’t think from now until 2020 we’ll have what we want. We hope with all our heart, but we can say that we’re truly vulnerable.”

The UNAIDS Key Populations Atlas indicates 72.6% of Senegalese MSM use condoms and 41.9% are tested for HIV. Notably, the average HIV prevalence among MSM was 18.5% in 2013 and 41.9% in 2014 and 2015, though it ranges depending on age.

Bangoura worries for MSM who are not tested for HIV and for those who are not included in UNAIDS estimates. He knows the stories of men who flee Senegal seeking refuge abroad in countries like Morocco and Mauritania.

“We realized there have been a lot of loss of life,” Bangoura said. “There are a lot of displacements.”

This is part four in a Public Health Post series about LGBT health in Senegal. Click here to read parts one, two, and three.

The informants’ names are changed to protect their safety. Interviews were conducted in French and translated to English.

Featured Image: An HIV/AIDS message on the exterior wall around a hospital in the Casamance regional capital of Ziguinchor, Senegal. © 2006 Sara A. Holtz, Courtesy of Photoshare

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