Trading sex and building Capital: Sexual Identity and the Programmatic Challenges of reaching young African MSM S. Leclerc-Madlala 1, U. Amanyeiwe 1 & Y. Naidoo 2 1 USAID, Office of HIV/AIDS, Global Health Bureau, Washington D.C., United States 2 Human Science Research Council, Durban, South Africa

INTRODUCTION Age-mixing in sexual relationships has been identified as a major risk factor for HIV among young women in sub- Saharan Africa Study examined sexual identity and age-mixing patterns among a group of young men who have sex with other men (MSM) in South Africa Aim was to assess the adequacy of current public health target population categories and approaches for addressing the vulnerability of young African MSM

METHODS An ethnographic study among a community of 34 men aged was conducted over a three-year period. Participants were affiliated with an informal ‘safe-house’ for MSMs, either as semi-permanent, temporary or visiting members located in an urban suburb of KwaZulu-Natal. In-depth interviews focused on life histories, sexual identity, future aspirations and the role of the ‘safe-house’ in the men’s lives. Study site: KwaZulu-Natal, South Africa

RESULTS A majority of study participants reported having compensated, age- disparate sexual relations during the 3-year period. Almost 50% did not identify as gay and many were eager to maintain and emphasize a heterosexual male identity Concurrent partnerships with women were common, and sex with other men was often characterized as a hyper-masculine performance Relationships with older men were often seen as a type of stepping- stone towards life improvement and beneficial in helping men to build the economic and social capital needed to achieve successful manhood, including sexual success with women. CONCLUSION There is a great need to be better informed, more strategic and more culturally sensitive when programming for MSM in African contexts. Approaches that focus on behavior and overlook identity, are limiting the capacity of programmatic responses to reach and resonate with young African men at heightened risk for HIV. ACKNOWLEDGEMENTS We thank the participants who generously shared their views and experiences. We hope these findings will be used to develop more culturally relevant and effective prevention strategies that account for local understandings of gender and sexuality.

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