KENYA: Rural MSM too afraid to access HIV health services
Discriminatory laws and a largely homophobic society mean that men who have sex with men (MSM) in Kenya generally find it difficult to access HIV-related information and health services, but rural MSM have an especially hard time.
Too afraid to come ot of the closet
When Kibet Kipsowen*, 30, a cattle keeper in Kenya's Rift Valley Province, and his partner have sex, they use the oil-based jelly he applies when milking his cows; he's never heard of a water-based lubricant, let alone used one. "Milking jelly is the only lubricant I have known for the last four years," he told IRIN/PlusNews at his home in the village of Lanjuera.
Health practitioners discourage the use of oil-based lubricants for anal sex, as the oil degrades condoms, increasing the likelihood that they will break. Studies have found that most African MSM use oil-based lubricants, heightening their risk of contracting HIV.
According to a 2008 Modes of Transmission study conducted by UNAIDS and the government, MSM and prisoners account for 15.2 percent of new HIV infections in Kenya annually.
Kipsowen and his partner have been an item for a few years now, but dare not let anyone in their village know they are a couple. "Even people who have 'normal' sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast, or even be killed," he said.
The only other person in the village who knows about his sexuality is Soita Wellapondi, a local nurse and social worker, and that's only because Kipsowen visited her when he developed a sexually transmitted infection.
"At that time I had a lot of wounds in my anus; I felt so much pain that I thought I would die, yet I could not even confide to my own mother, brother or sister, and I could not visit a health centre," he said.
He knew that by confiding in Wellapondi he risked his secret being revealed to the community, but he felt she was his only chance of accessing health care. "I bought him some antibiotics and pain killers; it was absolutely impossible to convince him to visit a health centre, even one far away where he is not known," said Wellapondi.
Local health workers have very little experience and no training in dealing with MSM. A clinical officer at the Mogotio health centre near Lanjuera says he has only ever had one MSM client.
"He came here for treatment of injuries resulting from anal sex, and was advised to come for further treatment but he never came back," said the clinical officer, who declined to be named.
"A rumour spread in the neighbourhood about the man's sexuality - that could be the reason he never returned," he added. "Unfortunately, the rumour could have originated from hospital workers, most of whom were shocked by the 'strange' patient."
The local District AIDS Officer, Dr Festus Kanyako, says there is a definite need for MSM in rural areas to know that they have the same rights to health care as other members of the community.
"Their issues are treated as extremely private and this deprives them of. the information, counselling and facilities that they need in their sexual lives. I have never had any of them come out in the open [but] if I had, I would arrange for access to protection and health care." he told IRIN/PlusNews.
"It is saddening because at major meetings [on HIV] in towns, I see MSM speaking freely and socializing open about their sexuality," Kanyako commented. "I wonder if this will ever happen in the remote district where I work."
Source:IRIN
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