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A Package of Combination HIV Prevention Interventions for MSM in Southern Africa


The overarching aim of this project is to develop an optimized combination package of HIV prevention interventions and services (CPHI) for men who have sex with men (MSM) in southern Africa, to develop preliminary data about the acceptability of the candidate package, and to develop a rational project for a subsequent efficacy trial of the prevention package. The rationale for this study is simple: virtually no work, in either research or program, has focused on HIV preventive interventions for MSM in the southern African region—despite emerging evidence that a severe epidemic of HIV is underway among these men. Communities of MSM are beginning to emerge in southern Africa and they are doing so in the context of the world’s most advanced and generalized epidemic of HIV. The understanding of these men, their social and sexual lives, and the multiple vulnerabilities and risks associated with their sexual behaviors in the African context has just begun to be investigated. Indeed, the very existence of these men and their networks remains a contentious issue in several African States. African MSM remain among the most hidden and stigmatized groups at risk in the global HIV epidemic, and one for whom optimized prevention packages, fit to challenging local environments, are an urgent public health and research priority. Our group has conducted the first epidemiologic studies of MSM in Malawi, Namibia, Botswana, Lesotho and the first such studies among African and Colored MSM communities in peri-urban Cape Town. These studies have yielded expertise in how to safely conduct HIV research in these challenging environments, and have demonstrated the primacy of partnership with MSM and LGBT community organizations in the successful conduct of this critically needed research. This application is the next step in an effort to develop, implement and evaluate HIV preventive services for African MSM. We have brought together community groups, two U.S. academic partners with long track records of research and research training in the two target cities in South Africa including Cape Town and Port Elizabeth and the modeling expertise of Professor Ron Brookmeyer, who has long been in a leader in the use of statistical approaches to exploring the complex challenges of HIV.


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