The Steam Room is broadcast on GaySA Radio every Wednesday from 19:00 to 21:00, and is brought to you by the National Department of Health’s Phila programme.

The Phila programme encourages all South Africans to be inspired to live, and is about keeping fit, knowing about your health and body, eating well and taking action about your health in general.

Episode 1 of The Steam Room focuses on MSM, or men who have sex with men.

GaySA Radio spoke to Johan Meyer, the Health Manager at OUT in Pretoria, a professional service organisation focusing on direct health and mental health services, research, mainstreaming and advocacy for Lesbian/Gay/Bisexual and Transgender (LGBT) people.

What is MSM?

The term MSM is an acronym for “men who have sex with men”. These men do not necessarily identify as gay, bisexual or transgender, but do occasionally “bat for the other team”, or have sex with men. They self-identify as heterosexual, and many are happily married to women and have children. MSM prefer being in a relationship with a woman, but sometimes feel the urge to have sex with other men.

How prevalent is MSM?

According to Meyer, it is difficult to get exact statistics about men who have sex with men, as this is a very hidden group. While gay men are out and proud and bisexual men are also gaining more visibility, men who have sex with men are already struggling with questions regarding their sexuality, and have great difficulty in coming out.

In addition to this, the community struggles to understand the concept, as it doesn’t clearly fit into any of the boxes regarding sexuality that society has gotten used to. According to OUT’s estimates, there are roughly 40 000 men who have sex with men in Pretoria alone, and Meyer believes that they add to the existing 11% of men who identify as gay.

What issues do MSM face?

Due to issues like the community’s disregard for this group of people, men who have sex with men often face stigmatisation, discrimination, and are also quite marginalised – in addition to the existing instances of internalised homophobia that are characteristic of many people who face psychological difficulties regarding their gender and sexuality. All of these factors make men who have sex with men an especially difficult group to reach, both for research and statistical purposes and for health services.

According to research done by OUT in 2015 to gauge levels of empowerment and to determine the instances of discrimination and stigmatisation in South Africa on a health and justice level, 49% of the just over 2000 respondents who took part in the survey said that they do experience discriminisation and even hate crimes. As men who have sex with men are sometimes even more marginalised than other groups within the LGBT community, one can assume that these people face the same issues.

In addition to societal and psychological issues, men who have sex with men may also be at risk of sexually transmitted infections and HIV, as well as general sexual health issues. Because members of this group are often fearful of coming out, they may avoid visiting their family GP or other public health facilities when they experience issues relating to their sexual health.

What measures should MSM take?

Like gay men in general, men who have sex with men should take special care when engaging in sexual activity with other men.

• Use condoms

In conjunction with a water-based lubricant, high-quality condoms dramatically reduce the risk of transmitting STIs. Be careful not to use oil-based lubricants, which could dissolve the condom, rendering it ineffective.

• Get tested

Men who have sex with men are at a higher risk of contracting STIs than MSW (men who have sex with women) and WSW (women who have sex with women), which is why it is highly advisable to get tested for HIV and other STIs every six months, even if you use protection.

• Be ready in the moment

A sexually active MSM should always have lubricants and condoms at hand, on the off chance that they might have a sexual encounter.

• Pay attention

Having an open and honest discussion with your partner about your status not only keeps things comfortable, it is also the responsible thing to do. Use enough lube and make sure that the condoms you are using are not damaged in any way. Certain minor things – like not brushing your teeth directly before oral sex (this can cause tiny abrasions which could be passageways for STIs) and paying attention to not aggravate any sore spots in the anal area – will also do a lot to ensure your peace of mind throughout your encounters.

• Keep track of your health

After engaging in any act of MSM, pay particular attention to your body. In the hours and days following a sexual encounter with another man, keep an eye out for any burning in the genital or anal area, or anything abnormal like rashes or fever. Should anything seem out of sorts, consult with a medical professional immediately, as it’s always better to catch things that are out of the ordinary early.

Click on the player below to listen to our full discussion about MSM on Episode 1 of the Steam Room, brought to you by the National Department of Health’s Phila programme.