Kelly Sans Culotte

MSM and HIV in Ghana

Influencing Factors
For love and money.
Related Sections
Gay Mundo

A. Overview
1. Background
2. Literature Review
3. Findings —
3.1 Background of Respondents
3.2 Areas of Operation / Known MSM Sites
3.3 Factors Influencing MSM in Ghana
3.5 Health Problems Associated with MSM
3.6 Bridging from Bisexual Men to Women
4. Conclusions and Recommendations
5. Appendix: Terms, Survey, References
6. Acknowledgements
7. Abbreviations and Acronyms

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



Total (for money)

Economic Reasons




Not stated





80 (53.3%)





60 (40.0%)

Not stated




10 (6.7%)

Total (for pleasure)

137 (91.3%)

10 (6.7%)

3 (2.0%)

150 (100%)

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





Older or superior person



Parent or a relative






Born this way



Not stated






"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




Receptive intercourse only



Oral sex (felatio)




Insertive intercourse only



Anal sex




Both receptive & insertive




No anal intercourse




Not stated







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)



Number of daily customers

No. of Respondents (n=80)






<6 a week







1 daily



5 and above




2-4 daily



Not stated




5 and above daily







Not stated







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)














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)


Practice in secret















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 donąt 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.

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