In a nightclub in the coastal city of Mombasa in Kenyan, Tito Bakari*, a native, and Leonard Smithberger, a tourist, are seen kissing in a dark corner. The bouncer asks them to leave. Hand in hand, they walk out and move to another bar in the neighborhood, where they party until the wee hours of the morning.
“My love from Germany has been here since Easter – the party has just begun,” said Bakari. Mr. Smithberger travels to Kenya several times a year and showers Tito with gifts and money. And whenever he arrives Tito leaves his home, where he lives with his wife and child, and moves in with him.
Up to 60 per cent of male sex workers in Mombasa also have female sexual partners, according to a recent study presented at the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco.
“Although most sex partners of MSM-SW [men who have sex with men sex workers] are men, sex with local women is also common, usually transactional, and often unprotected,” reads the study.
“Little is known of the personal risk awareness and motivations for women seeking sex with MSM-SW; however, these issues risk being overlooked by interventions targeting risk reduction between MSM alone.”
According to the latest AIDS Indicator Survey in Kenya, 15.2 per cent of all new HIV infections affect men who have sex with men, and this group is generally seen as the HIV transmission link within the general population.
Misunderstood risks
The Kenyan government is now conducting a survey that focuses on HIV campaigns that target MSM, previously excluded from HIV prevention campaigns. Their exclusion from earlier campaigns have contributed to the failure of MSM to realize the level of their own risk.
“My wife knows that I am bisexual, but I provide her needs and equally satisfy her sexually. I even have two children with her, so she never complains,” said Ben Maina*, a male sex worker in Mombasa, who sometimes doesn’t use condoms with clients. He never wears a condom with his wife.
Another study, conducted in 2007 in Mombasa, indicated that the high prevalence of HIV among Kenyan MSM could be attributed to unprotected receptive anal sexual practices and limited use of condoms.
Notwithstanding the risks and the intolerance associated with his sexuality, Maina earns too much money to bother dropping the male sex trade, in a country where half the population lives on less than a dollar a day. He makes up to $ 365 per week. “The money helps me provide for my family,” Maina said.
Denial
According to Dr. Mary Mwangombe, researcher at the Kenya Medical Research Institute (KEMRI) in Kilifi, a coastal town, anti-HIV focused programs that target men who have sex with men and their partners (both men and women) are difficult to conduct due to the illegality of homosexuality as well as the public’s intolerance.
“Most male commercial sex workers live and go about their business secretively to avoid being victimized, either by the council officials, the police or the public at large,” said Dr. Mary Mwangombe.
In February, at the coastal town of Mtwapa, a “gay wedding” was interrupted by the police, followed by an angry mob who also stormed the offices of KEMRI, claiming that the body was harboring homosexuals.
“Doctors and counsellors have faced stiff challenges, not only on the misconceptions about HIV transmission and prevalence, but also in convincing other stakeholders and the general public that high-risk sexual behaviour such as this is a reality in Kenya,” said Ms. Mwangombe.
