The health and wellness of sexual minority students should be in line with the South African Constitution, said Deputy Minister of Higher Education Mduduzi Manana.
He is calling for zero-discrimination against student males who engage in sex with men (MSM) and lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) students at all campuses countrywide.
The survey aimed to investigate MSM and LGBTQI students’ knowledge, attitudes, perceptions and behaviours relating to sex, HIV and alcohol and substance use and was conducted by the Higher Education and Training HIV/AIDS Programme (HEAIDS) and the Networking HIV/AIDS Community of South Africa (Nacosa) in 2014 at 14 higher education institutions.
From the total sample group of 8 869 students, 10 percent identified as MSM. Of the total sample, 69 percent identified themselves as heterosexual, 16 percent as homosexual, six percent as bisexual and nine percent as “other” forms of sexual orientation.
Gaps in HIV programmes
The study found an absence of adequate and dedicated education and health services to MSM students, while other students have extensive resources at their disposal that mitigate the risk of sexual infection for them.
"The current situation is in contrast with the inclusive, non-sexist, non-racist human rights that are enshrined in the South African Constitution and many other laws, policies and programmes – including the mandate of the Department of Higher Education and Training," said Manana.
He said the department, through the HEAIDS Programme, intends on using the findings of the report to understand and address issues that affect student MSM and LGBTQI populations.
Quiz: Test your STI knowledge
Manana encouraged a strong push to bring MSM and LGBTI populations into the fold of protection and risk-reduction in relation to their sexual health and psychological and overall wellness.
He said the department will be working closely with the Department of Health on the following three factors:
- Ensuring that at-risk populations take the lead in the creation and implementation of programmes that address stigma and discrimination.
- Ensuring that donors and other stakeholders support interventions that are responsive to the LGBTI and MSM populations.
- Ensuring that healthcare interventions among the student population adopt a human rights based approach as embedded in our Constitution.
The department also aims to collaborate with human rights advocacy groups, other government departments, civil society and the LGBTI and MSM community to work towards fostering an attitude of tolerance in the higher education sector, said Manana.
"We need to strengthen responses to stigma and discrimination through health interventions which better address needs of students in sexual minorities, campus-based information and education campaigns."
Although the sample of student MSM had scored high for basic HIV knowledge, the study found that they still engage in sexual behaviours that put them at a place them at an increased risk of contracting HIV and other sexually transmitted diseases (STIs).
These included having unprotected anal and/or vaginal sex, low rates of lubricant use, having multiple sexual partners and multiple concurrent sexual-partners, meeting partners through the Internet and engaging in transactional sex.
The health risks
In the MSM sample, 14.2% of participants reported having had STIs. 19.8% of MSM reported having had genital sores, nine percent had experienced a discharge from the genitals and/or anus, while 26.5% reported the past experience of burning while urinating.
Three-quarters of MSM participants said they had been tested for HIV in their lifetime and two-thirds said they had had their last HIV test less than a year before the survey. Most (more than 80%) said they planned to get tested for HIV again.
More than half of student MSM had chosen to take an HIV test on campus and three-quarters said they would use campus testing facilities in future.
Three-quarters of student MSM indicated they were comfortable using sexual health services on campus but only one-third reported having actually used these services in the preceding 12 months. More than 40% had used off-campus sexual health services in the past year.
Just over 10% of student MSM reported being subjected to some form of abuse and/or violence at an HEI because of their sexual orientation. Fewer than 10% reported having been hit by a current or previous sex partner.
Executive Director of Nacosa Dr Maureen van Wyk told Health24 that there are many reasons why MSM operate in silence or are highly “invisible”. "This makes it even more difficult to access sexual health care."
She explained to Health24 that the health danger for MSM is when they don't manage their body fluids when having sex.
"This increases the risk for transmission or contracting HIV when a condom is not used or when water-based lubrication is not used."
When MSM have unprotected sex, they also engage in unprotected sex with their female partners, said Van Wyk.
HEAIDS director Dr Ramneek Ahluwalia told Health24 the data of the survey will help to fine-tune HIV responses on campuses and make them more inclusive and relevant to specific needs among MSM and LGBTQI student populations.
"In addition, it is a useful awareness-raising and advocacy initiative which allows us to pay attention and initiate dialogue on an issue that has to a large degree been marginalised within health and support programmes for students."
Dr Ahluwalia said the following higher education institutions were invited to participate in the study: Central University of Technology, Durban University of Technology, Mangosuthu University of Technology, Nelson Mandela Metropolitan University, Stellenbosch University, Tshwane University of Technology, University of Cape Town, University of the Free State, University of KwaZulu-Natal, University of Limpopo, University of South Africa, University of Venda, University of the Western Cape and Walter Sisulu University.
Download the full study here