Research report: Exploring the beliefs, attitudes, and behaviors of MSM engaged in substance use and transactional sex in Ghana

Abstract

This report presents findings from a qualitative study examining the vulnerability to HIV of young men who have sex with men (MSM) in Kumasi, Ghana, and their prevention needs. The study was jointly conducted in Kumasi, Ghana’s second largest urban center, by Boston University’s Center for Global and Health and Development (CGHD) and the Kwame Nkrumah University of Science and Technology (KNUST). It was carried out as a component of Project SEARCH funded by the United States Agency for International Development. The study was designed and conducted in collaboration with FHI 360 (formerly Family Health International (FHI)), an international non‐governmental organization based in the capital city of Accra which operates programs targeting MSM and other key populations in Kumasi, and the Ghana AIDS Commission (GAC). Preventing HIV among key populations in Ghana is a major goal for the National AIDS Control Program (NACP) and the GAC.1 MSM are a particularly stigmatized population in Ghana, in part because male‐to‐male sex has traditionally been viewed as illegal, making them a difficult yet critical to reach population with HIV/AIDS‐related services. This qualitative study was conducted in order to enhance understanding of the beliefs, attitudes, and behaviors of adolescent and young MSM (aged 15‐29). In this population, we particularly sought to focus on two sub‐groups: MSM who engage in transactional sex and those who use alcohol or illicit substances (hereinafter “substances”). The specific objectives were to explore: 1) the types and extent of substance use by MSM; 2) the overlap between substance use and transactional sex among MSM; 3) the beliefs and attitudes related to substance use and transactional sex; 4) knowledge and risk behaviors of both subgroups. The study’s broader goal was to collect and analyze in‐depth data that can be used to improve the outreach and effectiveness of local programs that aim to reach these groups with important HIV prevention and treatment information and with services appropriate to their needs.