In her seminal piece, Kimberlé Crenshaw (1989) provides various groups and individuals that can use an intersectional frame. Crenshaw (1989) argues that intersectionality is not a grand theory but is rather a prism
for understanding certain kinds of problems. Theoretically in this study it, Intersectionality Theory is used to illuminate the problem of accessibility to necessary preventative health methods. This is against a backdrop of social and structural vulnerability that BMSM experience and how these BMSM as a means of self- preserving or correcting attempt to address these problems with prevention implements such as PrEP and through dialogue. The main issue which is relevant to this study is marginalisation and how thesecauses of marginalisation function at various levels. To best understand how BMSM can be intersectionally analysed, this study draws on the famous quote of Gay, Anti-Apartheid and HIV activist Simon Nkoli. In the popular documentary, Simon and I by Bev Ditse and Nicky Newman Ditse and Newman (2002), Nkoli at the first-ever Gay Pride in 1990 delivers what went on to become known as a poster quotation on Intersectionality. Nkoli comments:
This is what I say to my comrades in the struggle when they ask why I waste time fighting for moffies.
This is what I say to White gay men and women who ask me why I spend so much time talking about Apartheid when I should be fighting for gay rights. I am Black, and I am Gay. I cannot separate the two parts of me into secondary and primary struggles. It will all be one struggle. In South Africa, I am oppressed because I am a Gay man. So, when I fight for freedom, I must fight against both oppressions… All those who believe in a democratic South Africa must fight against all oppression, all intolerance, all injustice.
Even in as early as 1990, Nkoli exhibits an understanding of the interrelated, interdependent struggles that converge to define his lived experience as a Black gay man in South Africa. From this statement, the intersectional struggles based on ethnicity and sexuality are apparent. Drawing associations between this statement and this study the attitudes and perceptions of BMSM cannot be understood individually, these need to be explored in a nuanced manner that takes into cognisance, the effects of race, gender, sexuality and class and how these define, sexual risk behaviours and preference of preventative methods.
As highlighted in earlier sections of this chapter, Intersectionality can be understood as a frame; What is the frame that black gay men are explored through?Black gay men can be explored through the intersections of race, gender and particularly sexual orientation. Although focused on the struggle of black women, Kimberlé Crenshaw (1989) is aware of the struggles of other sexual minorities, particularly the struggles experienced
by black sexual minorities. A prominent statement in her seminal work, argues against the proliferation of a focus on the privileged group against the marginalised group. An example that she makes is that of gayness and how within a critical paradigm, it has been associated with whiteness, maleness and privilege. This then mirages the marginalisation of black gay, men if we are to explore it from the vantage point of sexuality. This does not consider race as a determining factor of the lived experience of black gay men. Crenshaw (1989) further explicates this by arguing that BMSM sometimes experiences discrimination in ways that are like other MSM and their experiences are sometimes like with those of black heterosexual men. Yet overall, BMSM experience double discrimination which is the combined effect of the practices that discriminate them based on their gender, race and sexual orientation. Concluding that they sometimes experience discrimination just as BMSM, not the sum of race, gender or sexual orientation but as BMSM, Intersectionality offers a frame through which to explore this. So, this marginalisation all intersects at some certain points in the lived experiences of these BMSM.
Exemplifying the intersecting struggles within a South African context, the marginalisation that is inherent in BMSM cannot be understood outside the context of the current environment. If we are to explore these struggles from a health perspective, although South Africa has one of the world’s most comprehensive constitutions with an exhaustive bill of rights that protects the rights of all citizens against discrimination based on sexual orientation (Constitution of the Republic of South Africa, 1996), the lived experience of BMSM is not congruent with the laws enshrined in this constitution. Therefore, many BMSM who are out-identified experience harassment in communities, the workplace and health care facilities, resulting in a large number of BMSM opting not to disclose their same-sex desire for fear of this discrimination (Lane et al., 2008a;
Mantell et al., 2016).
An intersectional prism of analysis of the lived experience of these BMSM would firstly consider the construct of race, e.g. blackness in a post-apartheid South Africa is characterised by neo-marginalisation and subjugation, which hence marginalises these individuals based on their race. Their ethnic (race) and social (class) backgrounds dictate the level of education they can attain, the opportunities available to them as well as employment or more predominantly in South Africa, unemployment. This affects their financial capacity (class) and increases their dependency which then leaves them forced to use government facilities and being