Criminalisation, stigma and HIV transmission
Anti-gay legislation, globally, is leading to higher rates of transmission for HIV. The countries with the highest populations of HIV positive people all criminalise gay men, or have a recent history of doing so. 77 countries still criminalise being gay. These countries do not allow LGBT people to openly express their identities, thereby preventing the development of LGBT rights movements and exacerbating HIV transmission rates.
Many LGBT people living with HIV face a dual stigma, that of being LGBT and that of being HIV positive. There is a clear link between criminalisation, stigma and HIV transmission. As we move out of the European Union, we must ensure that global LGBT equality remains a priority for UK legislators.
In Africa being gay remains illegal in 36 out of 54 countries. Africa has the highest prevalence of HIV in the world. Gay men in Africa are twice as likely to be HIV positive as their straight counterparts. Most African countries have European colonial era anti-LGBT legislation. Criminalisation entrenches homophobia. The African LGBT community is largely underground. Underground communities are harder to reach and are less informed about HIV or safe sex. LGBT people are less likely to use HIV testing services and are prohibited from accessing antiviral medication. Health professionals often discriminate against LGBT people and there are few government-led LGBT inclusive HIV initiatives.
Uganda and Senegal are among the worst on anti-LGBT legislation and its implementation. In Uganda the legislative situation is actually getting worse for LGBT people. In 2014, the Ugandan government attempted to bring in the Anti-Homosexuality Act, which was only overturned on a technicality. In Uganda, LGBT people are reluctant to discuss their sexual identities with health workers who, technically, are obligated to report them to the authorities for same-sex practices.
Senegal has had a number of arrests and convictions for LGBT activity in recent years. In Senegal homosexuality is punishable by up to five years in prison and it is also one of the few jurisdictions to have criminalised female homosexuality. Last year, in one raid, seven men were arrested and sentenced to six months in prison. Such raids are thankfully uncommon, and their sentencing caused international outrage, but this case is indicative of the hostile atmosphere LGBT people have to deal with in Senegal. Amongst the items found in their possession were condoms. The Senegalese government was effectively punishing these men for practising safe sex, the condoms evidence of their criminality. Ugandan and Senegalese health workers are reluctant to engage with LGBT people, as they may be perceived as encouraging illegal activity.
Moving out of the EU, we must not be shy of using our position as the world’s fifth largest economy to demand concessions for LGBT people.
In Mozambique, unlike in Uganda and Senegal, the existing colonial era anti-LGBT legislation, a legacy of Portuguese colonialism, has been repealed. Although legally there has been an improvement in their status, LGBT people face continued discrimination from government organisations. The government remains reluctant to encourage LGBT inclusive training for sexual health workers, or even register the country’s one LGBT organisation, which is called Lambda. Some LGBT people have been refused treatment for sexually transmitted infections, while trans people have been made to change their clothing before health workers will treat them.
In Caribbean countries where same-sex relationships are criminalised, the rate of incidence for HIV is a one in four, while in Caribbean countries where there is no anti-gay legislation it is one in 15. Approximately thirty per cent of Jamaican men who have sex with men are HIV positive, compared to a rate of 1.6 % in the general population. In Jamaica homophobia is rife. Anti-LGBT legislation creates the perception that violence against LGBT people may be tolerated. LGBT people cannot discuss their sexual identities. Men who are diagnosed as HIV positive are often “accused” of being gay. Here, the dual stigma, of being gay and that of being HIV positive, is at its most apparent. LGBT people who are HIV positive are the most likely to be victimised and face violence.
The LGBT community have been at the forefront of the fight against HIV in the UK. Over the last thirty years, we have pulled together at a time of crisis to save our neighbours, friends and lovers. We ensured our community knew about the HIV virus. We cared for those living with HIV. We confronted the stigma associated with HIV. It was the LGBT rights movement in the UK and the USA which first responded in an empathetic and effective way to the HIV epidemic. Anti-LGBT legislation prevents LGBT people coming together to confront HIV.
To fight HIV effectively we must insist upon the removal of anti-LGBT legislation globally. Where criminalisation exists and homophobia has been institutionalised, access to HIV services is difficult and violence against LGBT people is rife. Moving out of the EU, we must not be shy of using our position as the world’s fifth largest economy to demand concessions for LGBT people. The UK can pride itself on being one of the world’s most tolerant countries on LGBT issues and we should not be afraid of advancing the rights of LGBT people globally. We should not allow our work to promote LGBT rights globally to be diminished by leaving the EU, but instead embrace our freedom to promote LGBT rights more assiduously. Let us embrace this opportunity to increase our global influence on LGBT rights. We are a core part of the global LGBT rights movement.
Follow Phillip on Twitter @philipcbaldwin