Coming Out of the Nkuta: Disclosure of Sexual Orientation Associated with Reduced Risk Behavior Among MSM in Cameroon

Abstract

The situation of sexual minorities in Cameroon is a human rights issue (Alternatives Cameroun, Adefho, Human Rights Watch, IGLHRC, 2010; Alternatives Cameroun, IGLHRC, Center for Human Rights, Global Rights, 2010). In this country, homosexuality is not only subject to social rejection but is also punishable by prison sentences. Although local MSM organizations, supported by a few human rights organizations, are fighting against this situation, legislation shall shortly become harsher,passing from 5 to 15 years imprisonment. Studies and reports have shownthatMSMarevictimsofdiverse formsofphysicaland/or psychological violence (Gueboguo, 2006, 2008), such as blackmail using disclosure of sexual orientation as a threat. In Cameroon, HIV prevalence is estimated to be 5.3% in the general population (UNAIDS, 2009). Among the MSM population, high proportions of sexual risk practices have been documented (Henry et al., 2010). Although country-level prevalence data in MSM are unavailable, studies in neighboring countries have shown much higher prevalence in MSM than in the general population (Baral, Sifakis, Cleghorn, & Beyrer, 2007; Wade et al., 2005). Access to existing national prevention and care programs remains difficult for MSM in Cameroon. The national strategy to fight the HIV epidemic and provide sexual prevention messages is still almost uniquely directed at heterosexuals (Henry et al., 2010). Prevention actions for MSM are often left to the goodwill of local community-based organizations working in complex and hostile social, political, and sometimes legal environments, where few people are mobilized on the subject. The difficulty in disclosing one’s sexual orientation compounds these problems. Thecriminalizationofsame-sexrelationshipsandsocial rejection as outlined above emphasize the importance of researching sexual orientation disclosure in Cameroon. A greater understanding of factors associated with disclosure could help actors better respond to basic needs of MSM, including health issues. Data on sexual orientation disclosure were collected and analyzed as part of a study in 2008 (local CBO Alternatives Cameroun initiative supported by Coalition PLUS and AIDES) on a convenience sample of 168 MSM in Douala. Participation eligibility criteria were as follows: aged 18 or older, living in Douala for at least 6 months, and having had sexual intercourse with a man at least once during one’s life. Study participants were administered an 85-item questionnaire during face-to-face interviews with trained Alternatives-Cameroun members. The questions explored the following domains: sociodemographic charE. Henry (&) Coalition PLUS, Tour ESSOR, 14 rue Scandicci, 93500 Pantin, France e-mail: ehenry@coalitionplus.org