Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services

Abstract

Uganda's response to the HIV epidemic has been lauded for its robustness and achievements. However, a key component of HIV prevention programming has been missing, for men who have sex with men (MSM). The main reason cited has been criminalization of male homosexual behavior. In 2009, the Anti-Homosexuality Bill (AHB) was introduced in the parliament to enhance existing anti-homosexuality law. A multi-disciplinary team made a Health Impact Assessment of the proposed AHB. The bill as tabled would severely increase punishments, increased closeting. Social capital of MSM would be eroded by clauses mandating reporting by friends, relatives, and acquaintances. Health-care professionals would have to inform on homosexuals. Mandatory HIV testing would be a blow to programming. Probable disclosure of HIV status in a public space (court) would also be a deterrent. Heftier punishments for those testing positive increases stigma and hobbles subsequent care. The AHB argues for exclusion, and more discrimination targeting persons living with HIV and sexual minorities. It will exacerbate the negative public health consequences of the existing legislation. The government of Uganda should review guidance documents published by authoritative bodies including the World Bank, World Health Organization to develop and bring to scale Human rightsaffirming HIV prevention, treatment, and care responses.Keywords: HIV, homosexuality, MSM, Uganda, anti-homosexuality law, criminalization RésuméLa réponse Ougandaise sur l'épidémie de VIH a été salué par sa robustesse et ses réalisations. Mais, l' élément clé du programme de la prévention du VIH demeure manquant, pour les hommes ayant des rapports sexuels avec des hommes (HSH). La principale raison invoquée a été la criminalisation du comportement homosexuel masculin. En 2009, le projet de loi anti-homosexualité (AHB) a été présenté au parlement pour renforcer la législation contre la loi sur l'homosexualité. Une équipe multidisciplinaire a été composée pour évaluer l'impact de la santé sur la dite loi (AHB) proposée. Le projet de loi tel que deposé avait sévèrement augmenter de punitions, ce qui augmente closeting. Le capital social de MSM serait érodée par des clauses rendant obligatoire de rapports par des amis, parents et connaissances. Les professionnels de la santé seraient tenus d'informer sur les homosexuels. Le dépistage obligatoire du VIH serait un coup dur pour la programmation. Probable, divulgation du séropositivité statut dans un espace public (tribunal) serait aussi un moyen de dissuasion. Lourdes peines pour ceux qui augmenteraient la stigmatisation en testant positifs et entraveraient les soins ultérieurs. L'AHB plaide pour l'exclusion et la discrimination des personnes ciblées vivant avec plus le VIH et les minorités sexuelles. Il va exacerber les conséquences négatives de la santé publique sur la législation existante. Le gouvernement Ougandais doit examiner les documents d'orientation publiés par des organismes faisant autorité, y compris la Banque mondiale, l'Org...

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