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The ways in which participants reported sexual risk-taking differed across the five network types revealing diversity in social network profiles. HIV programming and messaging for this population can greatly benefit from recognising the diversity in lived realities and social connections between men who have sex with men. After an early HIV outbreak among white gay-identified men in the s, White men who have sex with men were thought to be disproportionately affected by the epidemic Wilkinson and EngelbrechtSher However, a second pattern of HIV transmission soon emerged revealing a larger, growing epidemic among Black heterosexual South Africans Maartens et al.
As a result, since then national HIV programmes have largely focused on heterosexual and mother-to-child transmission, to the exclusion of other high-risk groups Rispel and Metcalf As the HIV landscape in South Africa matures, evidence continues to emerge suggesting a more diverse HIV epidemic, including concentrated epidemics among key populations including men who have sex with men. These studies highlight the extent of the HIV epidemic among different sub-populations of men who have sex with men as well as variations in HIV-related risk among men who have sex with men sub-populations, particularly by race, locality and sexual identity Sandfort et al.
They have also helped underscore that Black township men who have sex with men, previously undocumented in the characterisation of the South African HIV epidemic, are a particularly vulnerable sub-population Lane