Uganda’s Anti-Gay Law Threatens Progress in Fighting HIV

Uganda's Anti-Gay Law Threatens Progress in Fighting HIV
The atmosphere of fear and mistrust has eroded healthcare services and could have far-reaching consequences for public health in the country.
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  • Impact of Uganda’s Anti-Gay Law on HIV Progress
  • HIV Progress at Risk in Uganda Due to Anti-Gay Legislation
  • The Struggle Against HIV in Uganda Amidst Controversial Anti-Gay Law

In a mostly empty clinic that serves people with HIV, staff are worried about spies, showing how scared Ugandan health workers are since a new law was passed.

“Patients need to trust their doctors, and doctors need to trust their patients, but now everyone is afraid,” said Brian, the clinic’s founder.

Efforts to Fight HIV: During the three hours we spent at the clinic, no patients came in. Brian, who didn’t want to share his last name for safety reasons, said this is a troubling sign of how the law is affecting the fight against HIV in Uganda.

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The law, passed in May, makes “aggravated homosexuality” a crime punishable by death and can imprison people for life for consensual same-sex relationships.

It has also raised fears that patients or healthcare workers could be reported to the police. Anyone caught “promoting homosexuality” can face up to 20 years in prison, and organizations supporting LGBTQ+ activities could be banned for ten years.

When Parliament started discussing the law in March, filled with homophobic slurs, Brian said they received many calls asking to delete patient records. Since then, fewer people have been coming to the clinic.

Around 35% of people who used to get HIV prevention services have stopped coming to his clinic. Another 10% of those who need antiretroviral medication have also cut off contact. Three health workers have left because they felt unsafe, reducing staff by over a quarter.

Moreover, when patients stop taking their medication, their viral load increases, making it more likely they will pass HIV to others.

“Fear and Paranoia”: The health ministry in Uganda told healthcare providers to ensure no one is discriminated against or denied medical services, but this hasn’t reassured those working in the field.

“People have been arrested for having lubricants or condoms,” said Richard Lusimbo, director general of Uganda Key Populations Consortium, which advocates for healthcare.

During the law’s debate, police arrested six men in March in Jinja, finding 192 sachets of lubricants, a rainbow flag, LGBTQ+ community pamphlets, and T-shirts. All six were released on bail after more than three months in jail, facing charges of “recruiting male adults into gay practices.”

Lusimbo said, “The law has created a lot of fear and paranoia. There’s no clarity on how you can talk about HIV prevention without being seen as promoting LGBTQ+ activities.”

“If the law isn’t annulled, we’ll see more HIV infections.”

Warnings from International Organizations: UNAIDS, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and the US President’s Emergency Plan for AIDS Relief (PEPFAR) have all warned that Uganda’s progress in fighting HIV is in danger due to the anti-gay law.

But Uganda’s director general of health services, Henry Mwebesa, disagrees, saying that the country is still on track to end AIDS as a public health challenge by 2030. He insists that services are provided without discrimination.

“Expect the Worst”: Back at the clinic, Brian and his staff are trying to find ways to reach patients safely. Telemedicine and discreet delivery services have helped, but anxiety still lingers.

“We’ve introduced a WhatsApp line and used social media to reach clients directly without revealing their identities,” Brian said. They make sure packages are discreetly labeled to avoid identification and targeting.

Yet these temporary measures do little to alleviate the anxiety felt by Brian and his colleagues.

“When we come to work, we expect the worst,” he said.

The consequences for their patients are even more devastating. “Even if this law is struck down, our people have been radicalized,” he said, adding that the legislation has heightened homophobia.

“It will take us many years to undo the damage because people who have been lost to healthcare won’t just come back. Rebuilding trust will take a lot of time.”

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