At a nightclub in Mombasa, on the Kenyan coast, Tito Bakari* a local man, and Leonard Smithberger, a tourist, make out in a dark corner before the bouncer asks them to leave. Hand in hand they walk to another bar nearby, where they party through the night.
"My love from Germany has been here since Easter - the party has just begun," Bakari told IRIN/PlusNews. Smithberger visits Kenya a few times every year and showers gifts and money on Bakari, who moves out of the house he shares with his wife and child and into his lover's hotel.
Up to 60 percent 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," the study noted.
"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."
Kenya's latest AIDS Indicator Survey attributed 15.2 percent of new HIV infections to men who have sex with men, and they are widely thought to be a bridge for HIV transmission to the general population.
The government is conducting a survey that will inform its first HIV campaigns targeted at MSM, who have so far been left out of HIV prevention efforts, allowing them to gain a mistakenly low perception 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 doesn't always use condoms with his clients, and never with his wife.
|My wife knows that I am bisexual, but I provide her needs and equally satisfy her sexually...so she never complains|
In 2007, another study in Mombasa found that the high prevalence of HIV in Kenyan MSM was probably due to unprotected receptive anal sex and low condom use.
Despite the risks and the lack of acceptance by society, Maina makes too much money to consider leaving the trade - in a country where half the population lives on less than US$1 per day, he can earn up to $365 per week. "The cash assists me in providing for my family," he said.
Dr Mary Mwangombe, a researcher at the Kenya Medical Research Institute (KEMRI), in the coastal town of Kilifi, said HIV programming for men who have sex with men and their partners - both male and female - was difficult because of the illegal nature of homosexuality and the public's intolerance of it.
"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," she told IRIN/PlusNews.
In February a "gay wedding" in the coastal town of Mtwapa was halted by the police and an angry mob, who also stormed KEMRI's offices, claiming the organization was harbouring gay men.
Mwangombe said, "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."
* Not their real names