High rates of HIV are being addressed by innovative pilot project aimed at underprivileged citizens in particular.
OUT LGBT, an organisation providing stigma-free health and legal services to the LGBTQIA+ community, has partnered with the Elton John Aids Foundation (EJAF) to launch a pilot project targeted at MSM (men who have sex with men) individuals that engage in chemsex, the use of certain stimulant drugs such as cocaine and meth for sex.
A study commissioned by the Human Sciences Research Council determined that there was a high prevalence of HIV among MSM individuals, with Johannesburg having a rate of over 26% and an astonishing prevalence rate in Durban nearing 50%.
OUT LGBT corroborated this as they discovered that among a group of 1,662 chemsex practicing MSM individuals tested over a 12-month period in Johannesburg, a prevalence of 20% existed.
“[Chemsex is specifically] the intention to use drugs to have sex… not just you’re high and you have sex. That’s sexualized drug use,” says OUT LGBT Executive Director, Dawie Nel. “Crystal [meth] is used the most.”
The 16-month project, which started in April 2024 and will conclude in July 2025, adopts a harm reduction approach in treating their 16 patients, contracting licensed psychologists and psychiatrists, alongside specially trained OUT LGBT staff.
The project looks at multiple aspects of treatment which are often overlooked in ordinary treatment plans, such as mental health, housing and food security, as well as the actual relationships and sex lives of patients.
“[They are] exposed to multiple risks. The sex is usually unprotected, quite extended sex. [It] can go up to 2-3 days at a time. When you’re on drugs, you are… rougher, wilder than you would usually be” which Nel says can often result in tearing.
OUT LGBT has run multiple programmes since 2021 specifically targeting people from lower socio-economic backgrounds from squatter camps in Yeoville, Soweto, Marlboro and the Orange Farm.
“What is important to realise is that [chemsex practicing] MSM individuals face different levels of stigma and harm, so we want to provide the services. If we can show it can be done affordably then it can take effect in other areas,” says technical advisor for the EJAF, Marriete Slabbert.
“The internalised shame makes it difficult for people to open up that they use drugs as they fear they will be rejected. This means that drug use medically [is] not dealt with sensibly… We want to see what does work to keep people in treatment,” said Nel.
Drug users drop out of HIV treatment programmes more frequently, Nel said OUT LGBT attempts to fill the gap by being a service provider that does not judge a patient’s history. The organisation aims to create a sustainable model that can be extended to the rest of the country which will ensure that men remain on their HIV treatment.
FEATURED IMAGE: Out LGBT contracted doctor treating a patient. Photo: Supplied/Out LGBT
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