Table 2: Literature on behavioral, social and structural factors contributing to HIV risk among gay, bisexual, and other MSM in South Africa (N=10).

Source Sample size Age range Study site Study year Study design Study methods Key findings
Heusser & Elkonin (2013)j 237 MSM 18+ South Africa (online) n.d. Online, recruited via emails through South African dating site Survey (online) Participants who experienced childhood sexual assault were more likely to report dissociation and depression, drug use, drug use before sex, one-night stands, and recent abusive relationship.
Imrie et al. (2013)k (“Impilo Yamadoda”) 223 Zulu males 18 - 35 Rural, Hlabisa sub-district,
Kwazulu-Natal
n.d. Prospective cohort study Survey (x4) 3.1% (n=7) reported sex with a man in the last 3 months and all reported female partner(s).
Eaton et al. (2013)l 1060 MSW & 143 MSMW Mean 31 MSW & 28 MSMW Shebeens,
Peri-urban, township in Cape Town.
2009-11 Priorities for Local AIDS Control
Efforts (PLACE) community mapping methodology
Survey MSM as well as women were twice as likely to report being HIV positive and to report high levels of risk taking compared to men who had sex with women only.
Jobson et al. (2013)m 31 MSM N/A Peri-urban, townships of Cape Town 2009 Purposive sampling Interviews & focus group discussions (FGDs) Factors that increased HIV risk: structural violence with high levels of poverty and unemployment, and an intolerant and homophobic cultural and social context.
Arnold et al. (2013)n
(“Soweto Men's Study”)
377 MSM 18+ Peri-urban township, Soweto, Gauteng 2008 Rapid HIV testing using blood samples Survey Factors that increased risk of UAI: Increased length of partnerships, number of sexual episodes with partner, “regular” partner type, experiences of homonegativity, lack of self-efficacy, low income, and being circumcised.
Dunkle et al. (2013)o 1220 males 18 - 49 Urban/Rural, Eastern Cape &
KwaZulu-Natal
2008 Multistage proportionate sampling design, dried blood spots for HIV testing Survey 27.4% reported any consensual MSM contact; 31.4% reported oral/anal MSM contact.
Sandfort et al. (2013)p 300 MSM 18 - 40 Urban and peri-urban Pretoria 2008 Targeted recruitment Surveys Factors that increased risk of UAI: Partnership types of non-regular same neighborhood partners and familiar partners compared to similar (age-race-economic) partnership types.
Lane et al. (2008)q 199 black MSM 18+ Peri-urban townships, Gauteng 2004-5 Purposive sampling Survey 59.0% reported UAI. Factors that increase risk of UAI included: regular drinking, regular drinking to intoxication, and reporting symptoms of rectal trauma resulting from anal intercourse.
Sandfort et al. (2008)r 1045 MSM 16+ Gauteng,
KwaZulu-Natal, & Western Cape
2003 & 2005 Purposive non-proportional quota sample, self-reported status Survey Self-reported HIV prevalence (among previously tested) was 14.1%. High levels of testing were reported (69.7%). HIV infection was associated with lower education and knowing other PLHIV.
Jewkes et al. (2006)s 1277 Xhosa males 15 - 26 Rural, 70 villages, Eastern Cape 2002-3 Randomized controlled trial, blood testing for HIV Survey Having had sex with a man significantly increasing odds of HIV infection (OR 3.61).

j[76], k[31], l[72], m[75], n[73], o[30], p[74], q[20], r[25], s[71]