Helping prevent the spread of HIV/AIDS among men at risk

Saadou Ba*, right, discusses HIV/AIDS information tools with a representative of USAID’s implanting partner, Family Health International. Photo by Richard Nyberg, USAID/Senegal

Saadou Ba*.  Thirty-something.  Strong.  Healthy.  Outspoken.  And exceedingly brave.  A leader among Senegal’s MSM – “Men having Sex with other Men” – Saadou has accepted to reveal his homosexuality and bear weighty social consequences within this traditional Muslim society.

Since 1994, Saadou has played a critical role in encouraging other MSM to have regular medical check-ups.  At the time, one young neighborhood doctor accepted to maintain strict confidentiality and treat their sexually transmitted infections (STIs) without passing judgment.
 
Senegal has been one of the first countries in Africa to introduce HIV prevention and care activities targeting this high-risk group that has an estimated HIV prevalence of more than 20% in comparison to less than 1% in the general population.  In 2002, USAID took on the challenge of extending prevention and care activities to reach as many MSM as possible.  With USAID, Saadou went into other large cities in Senegal to identify one or two local physicians willing and able to treat the local MSM population.  USAID also finances activities that raise awareness and provide health care among other population groups at high risk of contracting HIV/AIDS in Senegal, such as commercial sex workers, transport workers, and fishermen.

“I couldn’t dream of a better program,” says Saadou.  “At last someone cares about our health.” Implemented by Family Health International and the Ministry of Health, this program now covers six regions and provides HIV prevention and care for MSM.  In each region, several doctors have been trained to recognize and treat STI symptoms.  The MSM community trusts these doctors to protect their identity while providing them with needed treatment. 

Saadou is now a leading member of the “MSM facilitator group” that has taken over from the Ministry of Health the role of conducting evening focus groups in secret locations to persuade MSM to access both HIV prevention and care services.  Saadou’s message: “Be confident, get yourself tested for STI and HIV to protect your health” has been well received by his peers.  His greatest achievement has been to reduce the number of MSM who, out of fear, try to care for themselves rather than seek medical treatment from a trained doctor. 

“My friends are getting tested for STIs and HIV and we are all more willing to use condoms now that we know how to protect our own health,” he says.  Saadou has taken his job beyond the medical community and even ventures into local police stations and prisons.  In his official role as MSM facilitator, Saadou has been called into these institutions to negotiate safe prison cells for MSM to avoid further transmission of STI or HIV.  His biggest challenge now is to help his peers who have tested HIV+ to share this information with their families.

*Not his real name.