"There's a huge amount of ignorance about issues of sexuality throughout Africa, whether its men or women, straight or gay," the medical director of South Africa's Innovir Institute, Dr Steven Miller, told Australia's Sydney Star Observer recently.
Miller was on a speaking tour of Australia to discuss the plight of men who have sex with men in Africa and to talk about cultural factors in African societies, which hinder people's access to good HIV care.
"There are social taboos around talking about [sexuality]...so people grow up in a state of ignorance about this very important aspect of their lives," Miller said.
The end result is a lot of SDTs, poor monitoring of physical and sexual health and a lack of perception that something may be wrong, or knowing where to go to get the problem sorted out.
"But men who have sex with men are the most under-reached, under-recognised and most discriminated against people in Africa.
"With the exception of South Africa the rest of Africa is still very strongly against the notion that men having sex with men is a normal behaviour and its certainly not seen to be part of African culture - though of course there are many studies and simple experience shows that this is not the case."
Miller said that homosexual men had become the new victims of the HIV epidemic because African communities were scapegoating them as spreaders of HIV and a range of social ills.
"If we extrapolate from what we know is happening in South Africa and assume the same rates of infection exist in other African countries, that would be between 5 and 8 percent of gay men being infected with HIV.
"That is in fact much, much lower than the seroprevalence rates we see in the heterosexual population in Africa, where in some countries up to 40 percent of people are infected."
Miller said this was because the repression directed at gays had driven them so far underground that options for sexual expression was extremely limited and different groups of men who have sex with men rarely had contact with each other. Andrew M. Potts