Sunday, November 29, 2009

Will Uganda's New Anti-Gay Law Sabotage Anti-AIDS Efforts?

(This post was written for my two-hour blogathon for A Dare to Remember. Please sponsor me!)

Stephen Harper has joined Gordon Brown and other Commonwealth leaders in condemning Uganda's proposed new anti-homosexuality law, which would proscribe the death penalty for anyone engaging in a homosexual act in which one person has AIDS, and would also give harsh prison sentences to anyone publicly defending homosexuality or failing to report known homosexuals to the police.

“I did raise it directly with the president of Uganda and indicated Canada’s deep concern and strong opposition,” Mr. Harper announced at the conclusion of the 53-country meeting in Port of Spain, Trinidad.

“We deplore these kinds of measures. We find them inconsistent with frankly I think any reasonable understanding of human rights,” the prime minister said.

“I was very clear on that with the president of Uganda.”

Sadly, the Commonwealth appears somewhat divided on the issue, with some African and Caribbean leaders either quietly supporting the measure or dismissing it as "an internal matter".

Uganda is already well known as a really bad place to be gay. Homosexuality has always been illegal there, as it is in most African nations, but the fear that Uganda's gay population lives under is extreme, as one aid worker discovered last year:

"Thanks for meeting me," I said at last, making a timid effort to break the ice. I told her a bit about myself (I am Jewish and gay) and what had brought me to Uganda. I was volunteering with American Jewish World Service at a grassroots human rights organization that focused on HIV/AIDS advocacy and was interested in learning about the country's lesbian, gay, bisexual and transgender (LGBT) community.

"What do you want to know?" she replied.

"I'm curious about your life; what it's like for you here."

"It's hard. Really hard. I got thrown out of school because of it. Thrown out of my home. You have to be careful if you want to survive. You have to be discreet. You learn to speak in ways that no one will understand. You know what I mean, yes?"

I did. Nothing could make a Ugandan more vulnerable than speaking frankly about homosexuality in a public space, especially with a white American. And so, we spoke in code—a reality that is all too familiar to the LGBT community in Uganda and in Africa at large.

The sad thing is, Uganda has been held up as a stellar example of an African nation successfully fighting AIDS. Their ABC program ("Abstinence, Be faithful, Condoms"), in combination with massive funding from the U.S. through their PEPFAR (President’s Emergency Plan for AIDS Relief) program, has dramatically lowered the incidence of AIDS there.

But while there has always been some controversy about some of the requirements for PEPFAR, a larger problem appears to be the refusal on the part of participating nations like Uganda to allow LGBT groups to play any role in their anti-AIDS strategy.

The perception, of course, is that AIDS in Africa is entirely a heterosexual problem, spread mainly by husbands having extra-marital sex with prostitutes or other women while away at work, then coming home and infecting their wives. But while this is certainly one of the predominant means of infection, it is certainly not the only one.

In Latin America, MSM [men who have sex with men] are the major affected population throughout, and in much of the Caribbean as well. In Asia, MSM are a significant part iof the epidemic in India, Thailand, Indonesia, Vietnam, Cambodia, and China.

In most Asian countries, MSM are the third part of the "triumvirate of concentrated epidemics," including commercial sex workers and injection drug users (and, of course, some MSM belong to all three groups).

Even in the continent of "generalized" (as distinct from concentrated) epidemics, emerging studies show that MSM play a surprisingly large role. In cities as diverse as Alexandria, Egypt; Khartoum, Sudan; Mombasa, Kenya; Dakar, Senegal; and Gabarone, Botswana, MSM contribute from 15-30% of the new HIV infections each year, and their incidence rate is much higher than other population groups.

Yet, very little effort has been devoted to exploring HIV and MSM in most countries, until very recently. Once the decision has been made somewhere to start looking, enormous barriers remain. Cultural terms of reference vary widely, as in the fact than in most non-Western countries, sexual orientation or diverse sexual practice is not usually a basis for identity, as in "I am a gay man."

Uganda's new law, if passed, will only further exclude this group and drive them so far underground that treating them will be all but impossible. And since the line between being a self-identified gay man and just a man who sometimes has sex with other men is so blurred in Uganda and many other countries, any progress against AIDS there could well be reversed when it starts transmitting back into the heterosexual community.

(cross-posted from Canada's World)

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