STI medical services and sexual minorities

FOR ALL … the commemoration of World Health Day, under the theme: ‘Health for all’ on 7 april coincides with the World Health organisation observing its 75th birthday. Photo: WHO

WORLD Health Day on 7 April is to be commemorated under the theme of ‘ Health for All’. Nowhere is this more important than in the case of sexually transmitted diseases (STIs), such as chlamydia, gonorrhoea and syphilis.

How available are STI services in Namibia and are they inclusive of the needs of sexual minorities?
Data on STIs in Namibia is scarce, with no published report since a 2007 study in Windhoek and Oshakati (Tobias S and co-workers, Surveillance for Sexually Transmitted Infections in Windhoek and Oshakati, Namibia, Sexually Transmitted Infections, Vol 87, 2011).

Hence, I employed an auto-ethnographic study to gain insight into one facet of access – my own. Based on personal experience, this qualitative methodology allows an individual who seeks to understand the risk of STIs in Namibia and the mitigation thereof.

I here present my autoethnography from the vantage point of the sexual networks of gay, bisexual, and other men who have sex with men (MSM), including transgender persons.

Digital age and access

Living in London, I was accustomed to an overwhelming number of men seeking partners on mobile apps. Arriving in Windhoek, in 2023, I was stunned to see the number of users was remarkably high, almost as phantasmagorical as London.
Known as Grindr, the app facilitates sexual encounters by finding other users near oneself. I remarked that the app in Namibia did not disclose the location of users – due to the fact that sex between men is still criminalised.

Nevertheless, individuals could infer the location of other users through the position of other users on a grid of profile images – the further I scrolled, the more images of the coastal towns I saw. Hence, the app allows users some degree of location services – the key feature that popularised this app in developed countries over the past two decades.

Namibia, therefore, is in a grey area, locations are not completely obscured, as may be the case in Uganda, but I cannot see whether the person standing next to me is online, as in the UK.

Risk factors for STIs

In my use, numerous users questioned where I was from. I also noted that gay, bisexual and other MSM who are tourists in Namibia employed the app to find local partners.

This means Namibia is part of world-wide sexual networks, where tourists may be participating in sex-tourism, as they do as world destinations where sexual tourism is commonplace.

This may be in part due to lack of enforcement of the sodomy law in Namibia, relative to most African countries. Moreover, Namibia and the MSM community are now in sharp relief in the world, as the recent landmark court cases between same-sex couples and the Namibian state attest.

Lastly, there are visual markers of Namibia as part of the privileged group of countries where sexual minorities are part of society, notably the Pride rainbow flag outside a popular establishment in Windhoek. Importantly, individuals of both previously advantaged and previously disadvantaged – white and black – Namibian men on the app sought out partners who could give them material or monetary rewards for sex.

The main risk of sex tourism for those in Namibia acquiring an STI that is resistant to existing antibiotics from partners who unwittingly carry these infections.

The 2007 survey in Windhoek and Oshakati found approximately 24% of 118 patients with gonorrhoea were resistant to the first-line antibiotic ciprofloxacin. The possibility of introducing other strains of gonorrhoea from overseas, for which treatment options are extremely limited, is a considerable threat to our public health.

Room for intervention

Consequently, the Ministry of Health and Social Services and other stakeholders have the potential of launching STI prevention and treatment interventions on the app, such as having users who are peer educators.

However, for this to be effective, the government needs to take concerted steps to destigmatise same-sex relations in Namibia; users will be unlikely to engage with any government agency on the app if they perceive those same actors as admonishing their behaviour.

As a user, I would be more likely to trust the Ministry of Health and Social Services on the app I use to find partners, if I knew that same ministry was advocating the decriminalisation of same-sex activity in Namibia.

Clinical Competency

I was surprised that few users reported having had a recent test for STIs, with one person stating he did not even know where to access testing. Though a clinic focused on rendering services to sexual and gender minorities does exist, this is a single facility dependent on donor funding.

Investment in training of health-care workers to be empathetic towards MSM so that more individuals come forward for testing is necessary. In this way, we can avert the negative consequences of STIs, including infertility, cancer and perhaps most disquieting, loss of sexual function.

  • Pancho Mulongeni holds a masters in public health from the University of Cape Town.

Stay informed with The Namibian – your source for credible journalism. Get in-depth reporting and opinions for only N$85 a month. Invest in journalism, invest in democracy –
Subscribe Now!

Latest News