One aspect of our society that has either not been recognised, or is being denied, but which could reverse any gain made in the fight against HIV/AIDS, is ?same-sex sex? particularly ?men that have sex with men? (MSM) since sex is the commonest mode of transmission of HIV.
Known MSM Sites - Not just in Accra.
According to respondents, ?men that have sex with men? (MSM) is practically happening everywhere. Sites that were listed include homes, out with friends, nightclubs, gay-friendly bars, hotels, restaurants, schools and campuses, and harbours.Geographically, 66 areas/suburbs of the Accra Metropolis and its environs, and 37 urban areas outside the capital have been mentioned as known MSM locations. Areas in and around Accra mentioned by at least 10 respondents are listed in Table 8 below.
Table 8: - Areas of Operation of MSM in and around the Accra Metropolis
| MSM Locations | No. of Respondents | MSM Locations | No. of Respondents |
| 91 |
| 21 |
| 82 |
| 20 |
| 54 |
| 18 |
| 41 |
| 16 |
| 38 |
| 15 |
| 29 |
| 14 |
| 27 |
| 11 |
| 26 |
| 11 |
| 26 |
| 10 |
| 24 |
| 10 |
| 23 |
MSM is not only limited to the capital city and its environs. Other known MSM locations outside of the capital city mentioned by at least 6 respondents are also urban areas. These are listed in Table 9 below.
Table 9: - Known MSM Locations Outside the Accra Metropolis
| MSM Locations | No. of Respondents | MSM Locations | No. of Respondents |
| 89 |
| 9 |
| 58 |
| 6 |
| 51 |
| 6 |
| 41 |
| 6 |
| 10 |
| 6 |
| 9 |
Respondents engage in MSM for a number of reasons. Some of these include:
Pleasure Versus Economic Reasons
The role played by money in MSM cannot be over-emphasised. A total of 137 respondents or 91.3% engage in MSM for pleasure while 80 or 53.3% do it for economic reasons, even though only 2 or 1.3% regard themselves as commercial sex workers.
Almost half of the respondents (71 or 47.3%) do it both for pleasure and for economic reasons. Some of these claim money may not be the prime reason for MSM but they are in a relationship in which they benefit economically just as a man showers his girlfriend with money and gifts for sexual favours.
Some 56 respondents or 37.3% do it for pleasure only, 6 or 4.0% do it for economic reasons only and a small number 4 or 2.7% find themselves in it neither for money nor fun.
Table 10: - Reasons for engaging in MSM
| Pleasure | Total (for money) | ||||
| Economic Reasons | Yes | No | Not stated | ||
| Yes | 71 | 6 | 3 | 80 (53.3%) | |
| No | 56 | 4 | 0 | 60 (40.0%) | |
| Not stated | 10 | 0 | 0 | 10 (6.7%) | |
| Total (for pleasure) | 137 (91.3%) | 10 (6.7%) | 3 (2.0%) | 150 (100%) | |
Influencing Factors -For love and money For those who are engaged in it purely for economic reasons, Caucasians and foreigners from developed countries are the priority customers because of the belief that they will pay more, and the possibility of establishing connections to travel to the ‘greener pastures’. It has also been gathered that some of the youth are involved purely out of adventure, curiosity and the thrill of being exposed to the genitals of other men.
— "I do it for pleasure, but sometimes I have sex to get money for school. My dad's friend who is also gay introduced me to it." According to this respondent, he has found gay partners all over Accra and also in Cape Coast. He does not negotiate for the use of condoms because he fears he will lose out; 'If I do, I feel my clients will neglect me.' This is not known to the rest of the family, but he claims that he is stigmatised by his classmates who "call me names of women e.g. Kojo Besia etc."
A student who says he is exclusively gay
— "I met a guy whom I know to be gay, and he said he would buy things I needed and he did. So that led me to doing it. I wanted to go to my father in the village for financial help, and he offered to assist me, but now I don't do that effectively."
Unemployed Gay
— "Most of us are into this due to its high financial benefits. In Ghana the fast way to make a living is through gay relationships. The high demands of Ghanaian women is also a contributing factor."
A bisexual who has an average of 6 customers a day but fears to go for VCT
— "Making money to finance my trips abroad."
A gay Student
— "There are a lot of refugees involved in this due to financial problems, and all these people need to be treated when they are sick. How can they come if the law is against them?"
Unemployed Liberian Bi-sexual who does it solely for money
How Respondents were introduced to MSM
Peers account for the major mode by which respondents were introduced to MSM representing over half of them followed by older/superior persons; then close relatives. Only 3 (2.0%) were introduced through rape, 2 of them by policemen. Beside the 17 (11.3%) who believe that they were born this way, many other respondents believe that irrespective of the modes of introduction they were born gay.
Table 11: - How Respondents were introduced to MSM
| How introduced | No. of respondents | Percentage |
| Peer | 80 | 53.3 |
| Older or superior person | 32 | 21.3 |
| Parent or a relative | 17 | 11.3 |
| Rape | 3 | 2.0 |
| Born this way | 17 | 11.3 |
| Not stated | 1 | 0.7 |
| Total | 150 | 100 |
— "I identify boys with some special feminine tendencies and introduce them to gay life. Such people become only receptive partners."
A married bisexual man
— "I was falsely accused of homosexuality, verbally abused and sent to the Police Station twice. I came to accept my fate because the Policemen who were on duty those days raped me on both occasions. I now have one regular partner but pressure from men force me to have sex with them about five times a week."
The story of a young gay who was introduced to MSM through rape but now believes he was born to be exclusively gay:
Even though the role of technology in promoting MSM has not been explored by the study; its influence cannot be under estimated. At least one respondent claims he uses the Internet to actively seek and meet foreign partners.
Type of Sex Respondents Engage in
Most respondents engage in a combination of different types of sex including mutual masturbation by 92.7%, oral sex by 72.7% and anal sex by 98.0%. Only 3 or 2% said they did not engage in anal sex.
Roles played by those who engage in anal sex are also varied. Of those who engaged in anal sex, the majority i.e. 46.0% engage in both insertive and receptive intercourse, while 28.7% engage in only receptive intercourse and 22.7% in only insertive intercourse.
| Table 12: - Type of sex engaged in | Table 13: - Anal sex role of Respondents | |||||
| Type of Sex | Number of Respondents | Percentage (n=150) | Sex Role | Number of Respondents | Percentage (n=150) | |
| Mutual masturbation | 138 | 92.0% | Receptive intercourse only | 43 | 28.7 | |
| Oral sex (felatio) | 109 | 72.7% | Insertive intercourse only | 34 | 22.7 | |
| Anal sex | 147 | 98.0% | Both receptive & insertive | 69 | 46.0 | |
| No anal intercourse | 3 | 2.0 | ||||
| Not stated | 1 | 0.7 | ||||
| Total | 150 | 100 | ||||
Male sex partners of respondents include regular partners, casual sex partners for fun and customers for those who do it for economic reasons.
Information volunteered by a respondent on how the cycle is maintained and growing
— "There are usually more Queens (i.e. receptive partners) than Kings (insertive partners). The Queens lure students and other young men with money, parties and other social gatherings and train them to become insertive partners or Kings. As this goes on, the fears of the newcomer who is now an insertive partner is allayed about anal sex being traumatic. The veteran Queens then coach the young men and keeps them as their Kings while showering them with gifts and money to maintain the relationship.
"Armed with this new knowledge about anal sex, the newcomer introduces his other colleagues to MSM as he assumes the role of the receptive partner. The cycle then repeats itself creating a pool of willing youth entering into MSM."
(Point to reflect on: Could this also explain why there are so many men who play the roles of the insertive as well as the receptive partners?)
Multiple Male Sex Partnership among Respondents
The study recorded a very high rate of sexual promiscuity among those who engage in MSM for fun or pleasure. Only 43 or 31.4% of respondents claim to have 1 regular male sex partner, with the majority 82 or 59.9% having 2-4 regular partners and others having 5 or more. Most respondents admit having casual partners besides the regular ones. Others who could not be specific described the number of their partners as ‘uncountable’ ‘more’ and ‘a lot’. One said, "I don’t have any regular partner. I have it with anyone who asks for it."
| Table 14: - Regular male sex partners | Table 15: - Male customers of respondents | |||||
| Number of Partners | No. of Respondents (n=137) | Percentage | Number of daily customers | No. of Respondents (n=80) | Percentage | |
| 1 | 43 | 31.4% | <6 a week | 18 | 22.5% | |
| 2-4 | 82 | 59.9% | 1 daily | 9 | 11.3% | |
| 5 and above | 9 | 6.6% | 2-4 daily | 24 | 30.0% | |
| Not stated | 3 | 2.2% | 5 and above daily | 20 | 25.0% | |
| Total | 137 | 100 | Not stated | 9 | 11.3% | |
| Total | 80 | 100.0% | ||||
In spite of the fact that only 2 regarded themselves as commercial sex workers, almost half of the respondents did have customers, the number of which varies widely from less than 6 a week in 22.5% of cases to 2-4 customers a day for 30.0% and 5 or more customers a day for 25.0% of respondents.
The majority of male partners and customers of respondents are Ghanaians in 98.0% of cases and blacks in 98.6% of cases. Foreigners make up 37.4% of cases and Whites 32.7% of cases. MSM can therefore not be said to be alien to Ghana and perpetrated by foreigners or Caucasians on Ghanaians. Ghanaians and Blacks are actively involved.
Table 16: - Origin of partners and customers
| Type of partners / customer | Number of Respondents (n=147) | Percentage |
| Ghanaian | 144 | 98.0% |
| Black | 145 | 98.6% |
| Foreigner | 55 | 37.4% |
| White | 48 | 32.7% |
Sharing of Body piercing Instruments and Use of Drugs
Body piercing and sharing of sex toys and the use of drugs are not very common among respondents. Only 10 or 6.7% are involved in body piercing and sharing of sex toys. Apart from alcohol in all its forms and cigarette in some cases, drugs do not seem to play a role in MSM in the metropolis. Only 3 respondents (2%) have reported using methamphetamines or inhaled nitrites (poppers) for MSM. One respondent who was introduced through rape claims he likes to be inflicted with some kind of pain such as biting during sex.
Social Problems and Coping Strategies
In the face of the stiff abhorrence of the Ghanaian communities to homosexuality, the survival of the homosexual in Ghana is dependent on the adoption of strategies to cope or live with the associated social problems. The study found out that the majority of respondents i.e. 58% practise MSM on the blind side of their friends and relatives without them knowing or suspecting it. This strategy paid off by ensuring that they did not face any social problem from their immediate neighbours. Only 16.0% and 24.7% of respondents claim they faced rejection and stigmatisation respectively and 9.3% faced denial or family and relatives refusing to recognise them as such. The remaining 10% claim they are accepted as gays by their relatives.
Table 17: - Social problems faced by respondents
| No. of Respondents (n=150) | Percentage | |
| Practice in secret | 87 | 58.0% |
| Stigmatisation | 37 | 24.7% |
| Rejection | 24 | 16.0% |
| Denial | 14 | 9.3% |
| Accepted | 15 | 10% |
Below are samples of the comments on how respondents have managed to hide this part of their identity.
— "I have been staying with my boyfriend for the past 3 years, and I don't know if others in the house have discovered I am gay, but I get along well with them."
— "Since I am a refugee, no one recognises me as a gay. All my people from Liberia like me as a gay."
— "My relatives and friends don't know. I practise in school and outside the home."
— "My family and friends think I look like a woman. They don?t know I am MSM."
— "This is secretly done. No one in my house knows I am MSM. I make sure that nobody knows I am MSM."
— "I am not very feminine, so it is hard for people to see except for those who know"
— "Silent practice."
Respondents resort to various strategies in coping with insults and being called feminine names. These strategies vary from ‘I do nothing’ or ‘I mind my own business’ believing ‘people are living in ignorance’ to replying to the insults and in some cases outright brawl or fisticuffs. "I fight people who call me names."
— "I was insulted, abused and forced out by my landlord."
— "I was blackmailed by a young friend and later arrested by the police. The law was applied and I was released."
— "I don't care! I know one day Ghana will change and our sexual rights will be respected."
A bisexual who has received beatings from family, and faced rejection, denial and discrimination.
— "I was dismissed from work. Initially I was very much disturbed, but when I came to accept my situation, I gathered courage and went about my life without any fear and intimidation."
A waiter in his early 20's who was introduced to homosexual sex through rape and had remained MSM for 12 years.
— "I was beaten by my family and forced to leave the house to stay with friends. I see it as normal since gay life is not acceptable in Ghana I am trying to deal with the social stigma calmly."
Still others said they have tried to stop, but failed. A teenager said, "I blame myself and try daily to change but I can’t change from this".
A few however, find strength in associating in small clandestine social groups in the communities known only to members for social events such as funerals and parties. Some of these groups are the Saso Kpee in Ga Mashie with about 14 members and in Kaneshie with about 9 members, and M_waam_ Kpee in Jamestown with a membership of about 27.
One registered NGO, which has been involved in organising homosexual men and women for the purposes of awareness creation, information dissemination, communication and education and provision of care and support is the NGO called CPEHRG, which assisted in the study. CPEHRG, which currently has a membership of 30 members is itself plagued with a number of problems due to difficulties in accessing funds and other resources for its activities even from the GAFUND. The NGO therefore depends on contributions from its members and some unofficial support from UNAIDS and international MSM networks such as "Behind the Mask."
CPEHRG, individual social groups and some members have strong links with other gay networks in the international community. These networks provide fora and avenues for sharing of information, exchange of ideas, advocacy, encouragement and advice.
Membership of these social networks among respondents is however very low. Only 22 (14.7%) of the 150 respondents belong to any association at all, and most are not interested in belonging to any association for fear of exposure.
Gay in Ghana From gay-bashings to AIDS
by PrinceJUNE 24, 2004. Growing up as a gay man in Ghana is really hard. People imagine that gay people are pedophiles and criminals. You are taunted and harassed even as a child. At school, if people think you are gay, no one wants to play with you, or even talk to you unless it is to call you names. Anybody that does befriend you risks being harassed, too, at any age. I had a friend who was recently told that he was evil and would never go to heaven because he talked to me. Pentecostal churches perform exorcisms on people seen as being gay. We're blamed for AIDS. You get the picture.
I was evicted from the first room that I rented because my landlord said no woman visited me and that meant I was gay. On the street once, when I defended myself to a woman who insulted me, I was beaten up by her husband. He wanted to know how I dared answer back, "Who are you, a homosexual, to talk to my wife like that?"
Muggers and thieves prey on gay men because they know the police won't do anything about it, and most victims are too ashamed to report it.
Gay Bashed
It happened to me a couple of years ago. I met this guy on the beach. When we hit it off, I agreed to meet him at the market where he sold shoes. There, several men and women accused me of forcing their friend to have sex. They beat me and took everything I had, while loudly blaming gay people for causing AIDS in Ghana. We were evil people, they said, who made God destroy Sodom and Gomorrah. They would not allow this to happen in Ghana. They would beat out of me the evil spirit of homosexuality.
When others at the market asked what was going on, they told them that I was a thief, and they all wanted to beat me, too. I prayed to God to save me. I was sure I was going to die.
Afterwards, I naively went to the police. My attackers told them I made a pass at their friend. The police took their statement, but sent them away when they couldn't show any evidence. Then the officers offered to write my statement for me, but I quickly took the pen and started writing my own because I knew they might try to implicate me in some crime.
When I asked them to do something to get back my money and the other things that had been stolen, they threatened to lock me up. There aren't any laws specifically against homosexuality in Ghana, but it is common for the police to use other laws against us, like one forbidding "unnatural sex."
I let the matter drop, but then I was afraid to leave the police station. My attackers would probably have been waiting for me outside. The police let me leave by a back door. I was too ashamed to tell to anyone for a year that I had been beaten and robbed. I even tried to have "normal" sex, but it didn't work.
Poverty and Violence
Every now and then, in a gay-friendly bar, I see the guy who arranged the bashing. I tried to talk to him, but he's never apologized, even though he is gay, and what he did to me could easily happen to him.
In Ghana, male homosexuality is lumped in with bestiality, and gay activity brings misdemeanor charges at minimum. The police have been known to arrest gay men, rape them, and let them go. Last year in August, four young men were convicted of "indecent exposure" and "unnatural carnal knowledge" and sentenced to two years each in prison.
Gay people in Ghana live in such a state of fear it is a form of violence. We are isolated, harassed, and beaten. Friends commit suicide from despair. Poverty is a big problem because a lot of us have been thrown out of our houses by our families. Many don't have any education past elementary school. Those few gay men who do have good jobs are deep in the closet and won't have anything to do with gay associations, though they still want gay sex.
Almost one third of the population in Ghana is below the poverty line. People come to the capital, Accra, hoping there will be more opportunities. When they don't find work they turn to prostitution. Some gay men become professional sex workers, but most do it to help ends meet.
HIV/AIDS
AIDS is blamed on foreigners, gay men, and the devil. Last year, school children staged a demonstration in the New Juaben Municipality in which they demanded that all tourists visiting the country be forced to get an HIV test. Homosexuality itself is also blamed on foreigners, though most gay Ghanaians, if you can find them, will tell you their first experiences were with local friends, and sometimes relatives.
When the devil is seen as the cause of AIDS, God is seen as the solution. A significant amount of gay men believe they are protected from HIV by a combination of spiritual practices and herbal medicine. Last November, Joseph Amponsah, Chairman of Hope Association of Nkoranza, an association of persons living with HIV/AIDS, went public to beg pastors to quit making HIV/AIDS patients fast for days on end because it was killing some of them.
Though a number of politicians and clergymen publicly blame gay men for AIDS, the only form of transmission the government mentions in official reports is heterosexual sex. There are few, if any, HIV prevention or awareness campaigns targeting the LGBT community, even though a substantial amount of work is directed to heterosexuals.
Because of the silence, a recent study found that while most gay men in Ghana knew HIV was sexually transmitted, many thought the risk was greatest with vaginal sex. As a result, they were more likely to use condoms with women than men, if they used them at all.
Young men are especially at risk. If they have an older partner, they will do anything the adult says. Respect for your elders is an important part of Ghanaian culture. Besides, young men prefer older partners because they think they will get more presents or will be paid more.
Shame
When they do get sick, gay men in Ghana don't go to the hospitals for health care, especially if they might have a sexually transmitted disease. One reason is that hospitals will not treat you unless you come in with your sex partner. Gay men who can't afford a private doctor rely on over the counter drugs, or go to herbalists. Some have died of treatable STD's because they were too embarrassed to see a doctor.
Talking about HIV is almost impossible here. Since we are considered criminals, where can we feel safe getting tested? Even if there were health services specifically for gay men, many say they would be afraid to use them.
To those of us that struggle with self-hate, HIV seems like one more blow. If you tell a sick person to get tested, they get very angry at you and call you names like the devil and Satan. AIDS in Ghana is terrible even before death. Besides despair and illness, it can bring terrible poverty. We lose our incomes when we become ill. Already ostracised by our families, the only people we can rely on are our friends.
