Religious practices, cultural beliefs and stigmatisation by the general population hamper access to health care and HIV/Aids prevention for Malian Men who have Sex with other Men (MSM) and force them into bisexuality or underground sexual practices that put them at high risk of Sexually Transmitted and HIV infections, says Dr Dembelé Bintou Keita, Director of ARCAD/SIDA, an HIV/Aids organisation that also provides health care for MSM in Mali.