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Preface n 1982, in Oxford, Dr Harold Jaffe, a senior investigator from the Centers for Disease Control (CDC) in Atlanta presented a cluster of cases of homosexual men who were engaged in risky sexual behaviour, who had all the features of Acquired Immune Deficiency Syndrome (AIDS). At this stage the Human Immunodeficiency Virus (HIV) had not been isolated or identified yet but AIDS, as a syndrome, had been described a year earlier by the CDC. At this meeting I remarked that" This syndrome may be more common in Africa than it is appreciated". I made this premature, but predictive, remark for the following reasons: as a medical student at King Edward Hospital in the years 1973 to 1976 I had seen several young, male patients with Kaposi's Sarcoma and I knew homosexual behaviour was being practised within African communities but always denied or suppressed. In rural Sekhukhune, for example, we always heard of the practice of'matanyola'(sexual practice between men) and we also heard of men who engaged in this practice, particularly in prisons. In KwaZulu-Natal I also came to know of'isitabane', a Zulu word for homosexual practice.

However, when AIDS was first wrongly linked to homosexual practice many Africans promoted the notion that homosexual practices were'unAfrican', thus sowing the seeds for denial to justify why AIDS would not be prevalent in their communities. This denial predictably became the first African public response to AIDS and swept across the continent as country after country became engulfed in the HIV/AIDS epidemic. Today, despite many documented cases of homosexual practice in Africa, this denial …