Trading sex and building capital: Sexual identity and the programmatic challenge of reaching young African MSM Copyright Colin Purrington (http://colinpurrington.com/tips/academic/posterdesign). S. Leclerc-Madlala1, U. Amanyeiwe1 & Y. Naidoo2 1USAID, Office of HIV/AIDS, Washington D.C., United States 2Human Science Research Council, Durban, South Africa Introduction While age-mixing in sexual relationships has been identified as a major risk factor for HIV among young women in sub-Saharan Africa, less is known about age-mixing among young men, including age-mixing in same-sex partnerships. This longitudinal study examined sexual identity and age-mixing patterns among a group of young men in South Africa who have sex with other men with the aim of assessing the adequacy of current public health categories and approaches for addressing the vulnerability of young African men who have sex with men. Global surveillance of HIV in MSM (2011) Conclusions There is a need to be better informed, more strategic and more culturally sensitive when programming for MSM in African contexts. Approaches that focus on behavior and overlook identity, are limiting the capacity of programmatic responses to reach and resonate with many young African men at heightened risk for HIV. Social science-based paradigms and approaches that go beyond narrow concepts of ‘key populations’ are needed to inform programming for MSM, particularly in generalized epidemic settings. Figure 2 . KwaZulu-Natal province in South Africa. Figure 1. Almost 50% of MSMs in the study did not identify as gay. Methods Focused ethnographic study among a community of 34 men aged 18-26 was conducted over a three-year period. Participants were all affiliated with an informal ‘safe-house’ for MSMs, either as semi-permanent, temporary or visiting members located in an urban suburb of KwaZulu-Natal. In depth interviews focused on life histories, sexual identity, future aspirations and the role of the ‘safe-house’ in the men’s lives. Literature cited C. Broqua. (2008, August). Is transactional sex among MSM in Mali a HIV risk factor? Presented at the XVII International AIDS Conference: Abstract no. WEPE0784 Hurt, C., Matthews D., et al.  (2010). Sex with older partners is associated with primary HIV infection among men who have sex with men in North Carolina. Jrnl. of Acquired Immune Deficiency Syndrome 54 (2): 185-190. Leclerc-Madlala, S. (2008). Age-disparate and intergenerational sex in southern Africa: the dynamics of hyper-vulnerability. AIDS 22 (Supp 4): 17-25. Scheibe, A., Brown, B., Batist E., and Kanyemba B. (2010). HIV prevention and men who have sex with men: A South African experience. EXCHANGE on HIV and AIDS sexuality and gender. Desmond Tutu Foundation. UNAIDS. (2012). World AIDS Day Report. Washington, DC: Government Printing Office. Retrieved from http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/g r2012/jc2434_worldaidsday_results_en.pdf Results A majority of study participants reported having compensated age-disparate sexual relations during the 3-year period. Almost 50% did not identify as gay, and many were eager to maintain and emphasize a heterosexual male identity. Concurrent partnerships with women were common, and sex with other men was often characterized as hyper-masculine performance. Relationships with older men were often seen as a type of stepping-stone towards life improvement, and beneficial in helping men to build the economic and social capital needed to achieve successful manhood, including sexual success with women. Acknowledgments We thank the young male participants in this study who generously shared their views and experiences regarding motivations for engaging in age disparate relationships. We hope these findings will be used to develop more culturally relevant and effective prevention strategies that account for local understandings of gender and sexuality. Presented at AIDS 2014 – Melbourne, Australia