A Matter of Life & Death: Homophobia Threatens HIV/AIDS Work in Africa

The threat of homophobia has recently become a growing obstacle for HIV and AIDS prevention efforts in African countries. Read more about how one organization, amfAR, The Foundation for AIDS Research, and gay communities throughout Africa are making strides despite living in a climate of fear.

In February, peer educators at an HIV clinic in Kenya that serves men who have sex with men (MSM) were savagely beaten by an anti-gay mob that doused some of the men with kerosene and tried to set them on fire. In Malawi, a leader of a grassroots group working to stop HIV/AIDS among MSM went to his local police station to file a report after a break-in at his office—and was arrested for distributing HIV prevention materials the police deemed "pornographic." And in Uganda, the country's legislature is seriously considering anti-gay laws that would make consensual sex among HIV-positive adults punishable by death.


Homophobia, of course, is present in every country. But a wave of homophobic rhetoric and violence in some African countries is undermining efforts to combat high rates of HIV/AIDS among MSM. Human-rights activists, AIDS advocates and grassroots MSM organizations—including a number of groups funded by amfAR's MSM Initiative—say that the progress that had been made over the past several years in reaching African MSM is being threatened by a new climate of fear and repression that is sweeping parts of the continent.

Uganda: 'We'll Be Forced Underground'

Same-sex sexual behavior has long been outlawed in Uganda, but the country's war on homosexuality began to escalate in the spring of 2009, when several evangelical clergymen from the United States visited to give a series of talks opposing the "gay agenda." Amidst the ensuing anti-gay fervor, in October Member of Parliament (MP) David Bahati introduced new anti-homosexuality legislation in Parliament.

The proposed law would impose the death penalty for "aggravated homosexuality," which includes any same-sex sexual activity by HIV-positive people. It mandates up to life in prison for anyone convicted of homosexuality or attempted homosexuality. It would also imprison anyone who knows of homosexual conduct and fails to report it—effectively criminalizing the efforts of anyone providing HIV/AIDS services to members of the LGBT community.

Click here to read Attorney Raymond Brown's comments at DiversityInc's event on Uganda's anti-gay legislation.

Pepe Julian Onziema is the HIV/AIDS program coordinator at Sexual Minorities Uganda (SMUG), which received a community award from amfAR's MSM Initiative for advocacy and outreach aimed at curbing the spread of HIV among MSM. Over the past several months, Onziema explains, SMUG's vocal opposition to the bill has made it the target of sensational media coverage and has raised fears that anyone associated with the organization will be subject to violence or arrest.

Providing HIV services has become nearly impossible. "We were referring our clients to doctors who had agreed to help us, but they're finding it difficult to continue because they are afraid something will happen to their jobs," Onziema explains. "One doctor still manages to get us condoms, which we are able to distribute to MSM through our men's organization. But we are limited in the number of people we are able to reach."

If the bill passes, Onziema acknowledges, SMUG will be unable to continue working openly with members of the LGBT community. "We'll be forced underground, and that will only increase cases of abuse and HIV infection," he says.

Malawi: 'You Can Run But You Cannot Hide'

"POLICE HUNT FOR PROMINENT GAYS." The headline in the Feb. 28 edition of a Malawian newspaper appeared in inch-high block letters above a photo of two men whose arrest in late December for holding a traditional engagement ceremony set off a wave of anti-gay hostility in Malawi. The first line of the story conveys a chilling message from police to the "high-profile homosexuals" they claim are providing encouragement to the engaged men and distributing pornography: "You can run but you cannot hide."

The "prominent people" described in the article are, in fact, members of an amfAR-supported grassroots group, the Center for the Development of People (CEDEP), which provides HIV testing, counseling and outreach to MSM and other vulnerable groups. The "gay pornography" in question? Informational DVDs and pamphlets on HIV prevention.

By the time this inflammatory article appeared, CEDEP's staff had already been forced to close their office in Blantyre and relocate to the capital, Lilongwe, after two health workers from the organization were arrested. In Lilongwe, CEDEP has found it impossible to continue its HIV/AIDS activities. "We were supposed to conduct a big study to determine the size of the MSM population in Malawi. But we can't do that now because people will not agree to be interviewed," explains CEDEP's director, Gift Trapence. "The MSM community can't access testing because they've been driven underground. They are afraid of the police—and the media reports are increasing the threat. They have been publishing statements by the police saying that they have a list of gay people, and that they will arrest all of them."

In short, he said, "HIV/AIDS–related programs have stopped. We are only doing advocacy, to see if this situation can be improved."

As for the two men who were arrested in December, they face up to 14 years in prison if convicted.

Kenya: 'There Are No Prevention Activities Going On Now'

In Kenya, a Feb. 12 attack on an HIV/AIDS clinic in the coastal town of Mtwapa, near Mombasa, followed a rumor that two local men were planning a wedding ceremony there. Incited by local radio reports about the alleged wedding and by religious leaders who discussed the issue during Friday prayers, a mob of several hundred attacked the clinic at the Kenya Medical Research Institute (KEMRI), which runs an HIV program for MSM. The violence spread as angry mobs attacked the homes of men known or suspected to be MSM.

Police were able to quell the violence—by arresting six of the men who had been attacked by the mob. Peter Njane, director of the amfAR-funded group Ishtar MSM, was involved in efforts to free the men from custody and is now working with other advocates to keep them safe.

HIV/AIDS services in the area of the attacks have since grinded to a halt. "People used to get their antiretrovirals at KEMRI," Njane says. "While it's been closed, there is no provision of condoms and lubricant, no medical services for this community. Some of these things, like lubricant, aren't available anywhere else. There are no prevention activities going on now."

Even when the clinic is able to resume HIV/AIDS services, the lingering fear will not be easily dissipated, making it even harder to reach an already vulnerable population. "Some of the men who were attacked are not sure they will be able to go back to work as peer educators," Njane says. "And we are hearing from other AIDS organizations in the area that people are afraid to come to their office for meetings."

A Shifting Tide?

Despite the fear and discrimination—even the violence and the threat of prosecution—those working on the front lines in the fight for HIV services for MSM remain determined to continue their struggle. Some can even see the tide shifting—slowly, but surely—in their favor.

"Five years ago, people did not talk about homosexuality, but now I have dialogues about it," says Kenya's Njane. Increased media attention, he explains, has given Ishtar MSM an unexpected platform for reaching MSM with prevention messages. "More people know about our initiative. After we were mentioned in the media, our web site kept jamming. People who need information are coming to us."

In Malawi, Trapence and his colleagues remain outspoken advocates for MSM and other minorities, speaking to leaders and activists at home and abroad, and risking their own safety by talking to the media. He has reason to hope that at least some in Malawi's government will be receptive to their message. Thanks to CEDEP's advocacy efforts, in 2009 MSM were included for the first time in Malawi's national strategic plan on HIV/AIDS.

In Uganda, SMUG is at the forefront of efforts to defeat the anti-homosexuality bill. In early March, SMUG leaders were part of a delegation, including AIDS service providers, human-rights activists and clergy members, who presented a petition signed by more than 450,000 people to the speaker of Uganda's Parliament.

Faced with intense pressure from around the world, Uganda may remove some of the bill's harshest provisions, including the death penalty. But opponents point out that passing the legislation in any form will cripple efforts to combat HIV/AIDS among Uganda's MSM. By driving them underground and denying them access to lifesaving prevention and treatment, Uganda will—no matter what the law says—be handing these men a death sentence.

Reprinted with permission from amfAR, the foundation for AIDS research.

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