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Risk from the frontlines of a hidden epidemic sexuality, masculinities and social pressures among men who have sex with men in South Africa: an overview
This paper discusses HIV risk among young men who have sex with men (MSM) in South Africa. It frames risk in the context of the dynamics governing sexuality, underlined by a combination of masculinity notions and ‘hiddenness’. The paper notes that MSM are a diverse group, and in diverse settings such as South Africa, they span a range of socio-economic backgrounds, sexualities, racial profiles, and ages. MSM risk and practice, in these contexts, are consequently shaped by various factors in highly complex ways, from wider historical and socio-economic dynamics, through race and gender relations, and policies and articulation of rights and health service delivery. These factors are discussed in this paper with stress put particularly on the hiddenness of the MSM HIV epidemic, and it is concluded that the complex mix of factors and determinants calls for broad-based and multi-level intervention frameworks for young MSM.