The AIDS Accountability Scorecard on Sexual Diversity presents an analysis of the degree to which countries are fulfilling their commitments to respond to the needs of sexually diverse people in the context of HIV and AIDS.

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What is meant by sexual diversity?

Many civil organisations currently use sexual orientation and gender identity (SOGI) as a term to collectively identify the following individuals: bisexuals, gays, lesbians, intersex people, men who have sex with men (MSM), transgender, transsexual and gender variant people, queers, and women who have sex with women (WSW).

Sexual diversity, as a term, doesn’t position some “groups” as “normal” or “majority” and others as “abnormal” or a “minority”, but rather reflects the reality that people have a variety of different kinds of sex, thus challenging the idea of heteronormativity and a world of binary genders. It also includes pomosexual people (those who refuse to be given an identity or a gender), and non-self identifying people such as Hijras, Metis, Warias and Kathoeys.

Why focus on sexual diversity?

Lesbians, gay men, bisexuals, transgender, intersex and queer people have been and continue to be marginalized in many areas (social, economic, access to justice, access to healthcare) and although the role of these people in the HIV epidemic is not fully understood, there remains insufficient research and hence a lack of useful statistics. In many research projects sexual orientation and gender identity have been pushed aside or lost under the ambit of gender and/or most at risk populations (MARPs) and combined with injecting drug users (IDUs), and sex workers (SW).

Sex between men has been identified, in some countries, as one of the drivers of the epidemic and thus obviously a necessary behavior to understand yet there remains inadequate work on these matters in many parts of the globe, for example the problems being faced by MSMs in Africa in terms of universal access (UA).

Sex between women carries an exceptionally low possibility of HIV transmission yet their vulnerability comes from inadequate health care, lack of information, violence and homophobic rape. These factors are increasingly being recognized as possible factors that place WSW at greater risk than previously acknowledged.

Various studies have provided evidence that lesbians and WSW engage in sex with men. In a study of British women it was ‘found that 4.9% of the women reported same-sex partner(s) ever; 2.8% reported sex with women in the past 5 years (n=178); 85.0% of these women also reported male partner(s) in this time. Compared with women who reported sex exclusively with men, women who reported sex with women and men reported significantly greater male partner numbers, unsafe sex, smoking, alcohol consumption, and intravenous drug use (…) and sexually transmitted infection diagnoses.”[1]

Similarly, in a study of nearly 7000 self-identified lesbians in the USA, “77.3% had 1 or more lifetime male sexual partners, 70.5% had a lifetime history of vaginal intercourse, 17.2% had a lifetime history of anal intercourse, and 17.2% had a lifetime history of a sexually transmitted disease. Exactly 5.7% reported having had a male sexual partner during the past year.”[2]

Indeed, it is not useful to assume that lesbians, bisexual women and women who have sex with women engage in sexual activity solely with women and not men. Evidence suggests that these women are also likely to engage in sex with gay and bisexual men or men who have sex with men. The same erroneous assumption is made with respect to gay men, bisexual men and men who have sex with men.

Our research is intended to be a tool for activists, government officials, civil society including community based organisations, health care workers and many others who work in the HIV arena, to use to reduce the transmission of HIV.

Contact Details

For further inquiries please contact: Phillipa Tucker, Senior Researcher, by phone at: +27 (0) 21 466 80 74 or by email at:phillipa@aidsaccountability.org