Sexuality Disclosure Among Black South African MSM and Responses by Family.

Although South Africa protects sexual orientation in its Constitution, homosexuality is socioculturally contested and unaccepted. This lack of acceptance may impact the coming-out process of men who have sex with men (MSM). This study explored diverse factors that influenced whether Black South African MSM disclosed their sexual practices and identities to their families, how their families responded, and how family responses affected them. In-depth interviews were conducted with 81 Black MSM from four Tshwane townships about their sexual and gender identities, sexual practices, social networks, and familial relationships. Interview transcripts were analyzed with ATLAS.ti using a priori codes and inductive coding. Most participants disclosed their sexual identities to at least one person in their families or assumed their families knew despite no explicit disclosure about their sexual identity; a significant minority had not disclosed. Families of those who disclosed were either supportive, in denial, confused, or unsupportive in their responses. Whether or not family was supportive, silence around the participants' same-sex sexualities was prevalent within families. Family responses affected how participants perceived their sexuality and their confidence. Further studies are required to better understand the underlying processes of coming out for Black South African MSM and how these processes impact health outcomes and social well-being.