In southern Africa, prevention campaigns highlighting the HIV risks of having more than one partner at the same time have largely targeted heterosexuals and ignored the fact that men who have sex with men also have multiple partners.
"Men who have sex with men" (MSM) describes men who have reported ever having had sex with another man, but who may not necessarily identify themselves as homosexual, or "gay".
In one of the first studies to investigate multiple concurrent partnerships (MCPs) among African MSM, just over half of the 537 men surveyed in Malawi, Namibia and Botswana reported that they had had sex with both men and women in the last six months, and about a third of these men reported that the relationships had been concurrent. MCPs have been identified as a main driver of the HIV epidemic in southern Africa.
Presented at the annual meeting of the African Network for Strategic Communication in Health and Development (AfriComNet) in Johannesburg, the study also found that about a third of the men surveyed had a wife or long-term girlfriend.
The men in relationships with both men and women were more likely to pay for sex and to use condoms than those who reported only having sex with men, but the study found no difference in HIV prevalence between the two groups, according to researcher Gift Trapence with the Malawi-based Centre for the Development of People (CEDEP).
|The breakthrough was getting that  study done, and then the support just snowballed from there. People in Togo were transformed by that research into advocates...|
About 17 percent of all the men surveyed were HIV-positive, and their HIV prevalence rates were almost twice the national average in their respective countries. Trapence said that the findings point to an urgent need to target programming and more research at MSM having multiple concurrent partnerships.
"These issues have never been involved in our HIV prevention work," he told IRIN/PlusNews. "When we try to design these programmes, we need to look at all the sexual behaviours [of men]."
Trapence said a larger, population-based study was planned to explore the findings and provide evidence crucial to prevention efforts targeting MSM, and to decriminalizing homosexuality in African countries.
CEDEP supported the two Malawian men who were recently prosecuted under laws criminalizing sexual acts between people of the same sex. Activists argue that such laws discourage MSM, who are often at increased risk of HIV, from using HIV testing and treatment services, and have a detrimental effect on prevention efforts in general.
At the meeting, representatives of Togo's national AIDS commission, and Manya Andrews, former country head of Population Services International Togo, said research into HIV risk behaviours among MSM by Togo's national university in 2006 had helped influence recent moves in the small West African country towards decriminalising same-sex relationships.
"The breakthrough was getting that  study done, and then the support just snowballed from there," Andrews told IRIN/PlusNews. "People in Togo were transformed by that research into advocates [for MSM HIV prevention programmes and rights]."