"In the fell clutch of circumstance": HIV and men who have sex with men in sub-Saharan Africa.

Men who have sex with men (MSM) in sub-Saharan Africa (SSA) have been repeatedly found to have high risk of HIV infection, and in spite of the differing nature of the HIV epidemic in the general population between East and Southern Africa, and West and Central Africa, MSM are disproportionately affected by HIV across the entire region. Recent research has examined the drivers of HIV risk, and the dynamics of the MSM HIV epidemic in greater detail. However, this growing knowledge has generally not been translated into effective HIV prevention interventions. In part, this is due to the highly stigmatised and frequently criminalised nature of same-sex sexualities in much of the region. Without human-rights-based advocacy targeting governments and interventions aiming to decrease stigma and homophobia, translating research into effective HIV interventions for MSM in SSA at the scale needed to reduce HIV transmission in this population remains highly unlikely.