Heterosexual 'situationships' and HIV exposure for sexual and gender minority persons assigned female at birth in the Western Kenyan context

Cult Health Sex. 2025 Jun 20:1-12. doi: 10.1080/13691058.2025.2515199. Online ahead of print.

Abstract

Sexual and gender minority persons assigned female at birth (hereafter referred to as lesbian, bisexual, queer, transgender, intersex, gender non-conforming, non-binary and other sexual and gender minority persons, or LBQT+ persons) experience extreme vulnerabilities to negative sexual health outcomes due to intersectional stigma in the Western Kenyan context. To navigate the structural violence created by this intersectional stigma, many LBQT+ persons manoeuvre heterosexual 'situationships', or relationships with cis-gender men. While such relationships help them to navigate economic inequalities and gendered expectations, they create vulnerability to intimate partner violence, and negative sexual and reproductive health outcomes, as well as the risk of acquiring HIV. Reflecting on the findings from a three month long feminist ethnographic study in Kisumu, Kenya, this paper explores the lived realities of LBQT+ persons, including those within heterosexual 'situationships', and the need to navigate compulsory heterosexual norms. The paper aims to challenge any conception that members of this group may not be vulnerable to HIV, highlighting the need to include the group and its specific needs in HIV and sexual and reproductive health interventions, research and programming, and calling for greater attention to the structural stigma its members experience as a barrier to health.

Keywords: HIV; LBQTI; intersectional stigma; sexual and gender based violence; sexual and reproductive health and rights.