Many African MSM are surprised to discover that the sex they have with other men puts them at risk for acquiring the virus. The media and most prevention programming in the region consistently describe HIV vulnerability in terms of heterosexual risk, and many African MSM do not realize that they too are vulnerable. The few programs that do target this population face significant challenges in reaching MSM with the information and services they need. Ghana, which like its neighboring states condemns homosexuality, is distinguished from most countries in sub-Saharan Africa by the level of activity addressing HIV among MSM. With the support of the President's Emergency Plan for AIDS Relief (PEPFAR), groundbreaking HIV programming for MSM has been developed in the country. Although the Ghanaian government has not publicly embraced these efforts, officials have also not prevented the development of these interventions despite the legal prohibition of homosexual behavior.
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