The Rwanda Biomedical Centre (RBC) has revealed that the number of men who have sex with men (MSM) in Rwanda has increased from 18,000 to 29,000 over the past three years. The institution noted that one of the major health challenges affecting this group is HIV, which continues to have a significantly higher prevalence among them compared to the general population. The figures are drawn from an RBC study conducted during the 2024/2025 period.
Higher HIV Prevalence Among MSM
Zephanie Nzeyimana, an RBC official responsible for HIV prevention services targeting key populations at higher risk of acquiring and transmitting the virus, told IGIHE that people who engage in same-sex relations include both men who have sex with men and women who have sex with women.
He explained that the latest RBC research found that women who have sex with women are not at a higher risk of HIV infection than the general population. However, men who have sex with men face elevated risks, primarily because of receptive and insertive anal intercourse.
According to Nzeyimana, HIV prevalence among men who have sex with men in Rwanda stands at 5.8%, compared with 3.0% in the general population.
he said: “Anal sex places anyone who engages in it at a higher risk of HIV infection, whether it is between two men or between a man and a woman, because of the biological nature of the tissues involved,”.
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He added that the risk of HIV transmission is highest for the receptive partner during anal intercourse, followed by the insertive partner, while vaginal intercourse generally carries a lower risk of transmission.
Nzeyimana noted that Rwanda does not have official estimates for the number of women who have sex with women because they are considered to be at relatively low risk of transmitting HIV to one another.
Other Health Risks Linked to Unprotected Anal Sex
Nzeyimana warned that unprotected anal sex can lead not only to HIV transmission but also to the spread of hepatitis B, hepatitis C, syphilis, gonorrhea, and other sexually transmitted infections.
He said HIV prevalence among men who have sex with men declined from 6.9% in 2021 to 5.8% in 2024, but emphasized that the rate remains considerably higher than that of the general population.
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Stigma Continues to Limit Access to Healthcare
Although healthcare services are widely accessible across Rwanda, research indicates that many men who have sex with men avoid visiting health facilities unless they become seriously ill. This is largely due to fear of disclosing their sexual practices to healthcare providers.
A man who has sex with men and lives in Rugarama Cell, Nyamirambo Sector, told IGIHE that stigma and discrimination remain widespread, discouraging many individuals from seeking medical care even when they are sick.
Another respondent from Nyagatovu Cell in Kimironko Sector said he once contracted a sexually transmitted infection after having sex. When he sought treatment, he claimed the healthcare provider focused more on advising him against same-sex relations than on addressing his medical condition.
Expanding Access to HIV Prevention Services
Nzeyimana stated that men who have sex with men can now access healthcare services at public health centres across Rwanda.
He said the services they most frequently require include counselling, health education, condoms, and water-based lubricants.
he said: “We have made these services available in as many locations as possible to ensure they can easily access them,”
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Addressing Stigma to Strengthen HIV Prevention
Suleyman Muhirwa, an official at HDI working with populations vulnerable to HIV and other infectious diseases, told IGIHE that eliminating stigma is essential to controlling the spread of HIV.
he said: “When people are stigmatized, they eventually internalize that stigma. If they become infected, they are less likely to seek testing and treatment, increasing the risk of transmitting the virus to others,”
Muhirwa added that some members of the MSM community are trained as peer educators to provide support and guidance to others who may encounter similar challenges, as they are often more approachable and trusted.
RBC Emphasizes Public Health Approach
RBC stressed that providing healthcare services to people who engage in same-sex relations should not be interpreted as promoting homosexuality. Rather, it is a public health intervention aimed at protecting the health of the wider population.
Under Rwanda’s national HIV response, men who have sex with men are recognized as a key population requiring targeted prevention and healthcare services as part of the country’s broader strategy to reduce HIV transmission among the general population.
