Homosexuality and HIV/AIDS in Uganda

Uganda, praised for its fight against HIV/AIDS, also makes homosexuality illegal. How, asks Victor Mukasa can any HIV/AIDS policy be successful if it excludes a sector of the population from its programmes.

HIV/AIDS is an epidemic and in order to control and eradicate it, all individuals no matter their sex, sexual orientation, religion, nationality, race, or any other status, must be included in all policies against the scourge. Uganda has been praised for her ‘excellent’ HIV/AIDS policy by the international community.

But the politics of pretence in Uganda is leading to the deaths of many Ugandans from HIV/AIDS. The main group that is suffering as a result of this pretence are homosexuals. The Ugandan government has previously asserted that homosexuals do not exist, yet it is clear that these people do exist. No wonder there are laws against homosexuality put in place. Even the few officials who openly admit that homosexuals exist in this country claim that they (homosexuals) do not deserve any kind of care when it comes to the AIDS scourge.

As a result, homosexuals in Uganda have been excluded from the National AIDS Policy. Simple logic is that once a particular group is not catered for in terms of HIV/AIDS then it cannot be claimed that the scourge is being effectively fought. If one chose to cater for only the male population, for example, that would be a waste of time and resources. Same with catering for, say, only southerners, and ignoring northerners, when there is the aspect of intermarriages. Likewise, once one caters for only heterosexuals, ignoring homosexuals, then one is wasting time. The uncatered (homosexuals) will still spread the disease to the catered (heterosexuals).

It is a fact that homosexuals exist in Uganda and that there are very harsh laws in place against their sexual activities. Among homosexuals are bisexuals. These will have sexual relationships with people of either sex. As if that is not enough, because of the harsh laws, homosexuals either engage in relationships with people of the opposite sex in order to disguise their criminalized nature or are forced into marriages with people of the opposite sex by family and/or friends.

The elimination of homosexuals from the Uganda AIDS Policy has therefore done more harm than good.

There is also the politics of intimidation. In conjunction with deliberately ignoring sexual minorities on matters of a deadly, worldwide health epidemic, the Ugandan government actively discourages agencies that may counsel and treat sexual minorities on HIV. In November of 2004, the government of Uganda warned UNAIDS not to assist sexual minorities in organizing a campaign that may reach out to members of its own group in an effort to stem HIV infections. The government defended its actions of exclusion by reminding UNAIDS that homosexuality is illegal.

Intimidating UNAIDS from assisting Ugandan sexual minorities had a domino effect on other NGOs: organizations who are otherwise willing to assist these minorities with HIV treatment and counseling do not dare to do so because they may lose their license as an NGO.

But why and how could an entire government comprised of individuals who claim to love their people come to this sort of decision? Even if they didn’t love their people, is it not the duty of the Ugandan government to protect Ugandans? Is not every Ugandan entitled to life?

In Uganda, public outreach and advertising campaigns address heterosexual HIV transmission only. This narrow-mindedness lethally deceives and disadvantages the entire sexual minority population. A qualified Ugandan physician who frequently treats patients for HIV complains that sexual minorities are an ignored key population: unprotected anal sex is – according to scientific research – the most risky behavior for spreading HIV. Yet, without government outreach, the key population of those who practice anal sex (often homosexual men, but heterosexuals too) is becoming infected unaware. Government advertising campaigns that depict HIV as a disease transmittable only through penal-vaginal contact put many couples – regardless of sexual orientation - unaware that HIV can be transmitted through anal sex.

It is important to note the size and importance of this anal sex “key population”: outside of intravenous drug users, anal sex (often associated with, but not exclusive to, male homosexual activity) is the most effective method of transmitting HIV. Yet, HIV/AIDS policies allow citizens to unknowingly contract HIV despite all of Uganda’s outreach efforts. This deletion, please note, is unlike any HIV/AIDS outreach program in America or Europe: other countries and regions protect their anal sex population specifically. The fact that the Ugandan government asserts that homosexuals do not exist within its territory and outlaws homosexual activity contributes to this deadly deletion in HIV/AIDS outreach.

Another government-influenced deletion concerning HIV/AIDS that affects Ugandan sexual minorities is a lack of available HIV prevention information suitable only for these minorities. That is, because sexual practices of homosexuals differ from those of heterosexuals, and Ugandan HIV/AIDS organizations are equipped by mandate to concern only penal-vaginal transmission, these minorities cannot receive HIV prevention counseling that may save their lives. Gay men will not receive needed advice about using lubricants that do not destroy condoms. Lesbians will not receive counseling on dental dams. In fact, if a lesbian seeks counseling at an HIV/AIDS outreach organization in Uganda, she will receive advice concerning her boyfriend. Any person can agree that mitigating the effects of a deadly, worldwide epidemic involves treating every patient and potential patient with relevant information, regardless of the circumstances under which he/she caught the disease. The Ugandan government clearly discriminates when it agrees with the preceding statement in regards to many criminals, yet not sexual minorities.

In this era the issue of whether homosexuality is immoral, un-African or a crime, etc, should be dropped when it comes to the control of HIV/AIDS. The fact is, homosexuals exist in Uganda and are a key population in the spread of the scourge. They should be catered for in the National AIDS Policy, be included in all prevention advertisements and in every activity designed to combat the epidemic. The Ugandan Government should give up on its politics of pretence and intimidation and embark on the protection of its population from the deadly epidemic.

* Victor Mukasa is the chairperson of a human rights organisation called Sexual Minorities Uganda (SMUG).

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