Uganda’s anti-LGBT+ laws: putting lives and efforts to eliminate HIV at risk

Uganda’s Anti-Homosexuality Act (AHA) signed by President Museveni in May 2023 has been upheld by the Constitutional Court. The court rejected appeals against the AHA despite acknowledging that sections of the act were incompatible with universally recognised human rights, including the right to health.

The act imposes the death sentence for “aggravated homosexuality” and the consequences of the anti-LGBT+ law are already being felt in HIV services across the country. At Mbarara regional referral hospital, a government facility serving over 4 million people including key populations from western Uganda, there are evident cases of discrimination and other threats against LGBT+ people seeking HIV services. This district has the second highest HIV prevalence rate in Uganda.

Scared of accessing life-saving HIV services

Adjacent to the hospital is the AID Support Organization-TASO western Uganda centre, where authorities have confirmed that the passage of the AHA has caused a decline in the number of LGBT+ people seeking HIV services with the number of LGBT+ clients having more than halved since the passage of the bill was passed.

“The AHA has caused decline in LGBT+ clients. Some were scared, became lost [to follow-up] and started missing their drugs. When it comes to service delivery at facilities, hospitals or private clinics, it should stay neutral. We are not here to judge as health workers; our work is to give services. Whoever you are when you come in to the facility; equal services, equal rights for every person – whether you are transgender, LGBT+…equal services. That’s what we are supposed to do,” explained Dr. Rosemary Ayebazibwe, the AIDS Support Organization-TASO Mbarara regional facility medical services technical lead.

Dr. Justus Ampaire who runs the St. Augustine Community Health Centre in Mbarara city has seen a similar trend with LGBT+ clients no longer coming to the centre.

“They used to come before this law was passed, but now no one knows where they are. The fact is that they are dying. Even the medical workers who are offering services to some groups are being harassed.” Dr. Justus explains.

Under threat

Ivan who describes himself as LGBT+ and is living with HIV describes the discrimination he experienced at a health facility in Mbarara city.

“The situation is very bad and actually it is worse to the extent that even when you go to the hospital, I think they look at you like a rebel. Even you yourself start feeling left out of the community, and the situation is really worse. We are under threat… recently they attacked me and broke my leg…I am just there, I can’t help myself,”

“There are many challenges hindering the fight against HIV/AIDS in Uganda including policy gaps… We all see that it [AHA] targets the LGBT+ group,” explains Kamanzi Edbert, of the Justice Forum – JEEMA. Youth activists from JEEMA have launched a campaign dubbed “Don’t care? You should” which aims to tackle the prevalence of HIV and other sexually transmitted infections. They emphasise that to succeed prevention efforts should focus on LGBT+ communities and that the AHA is hindering this.

The Health Ministry in Uganda, through Dr. Henry Mwebesa, the Director General of Health Services has been warning all health care providers nationwide to offer services to all people without discrimination. But the implementation of this directive is hindered by ongoing stigma and discrimination against LGBT+ people which has been fueled by the Anti-Homosexuality Act.

According to the Sharon Lewin, president of the International AIDS Society (IAS):

“The ruling is completely at odds with Uganda’s stated commitment to ending HIV as a threat to public health by 2030. The consequences for the HIV response, not just in Uganda, but in other African countries grappling with anti-gay sentiment, are severe.” 

A regional challenge

Indeed, Uganda is not the only country in the region to move towards harsh anti-LGBT+ laws. In February Ghana passed a new tough bill imposing a prison sentence of up to three years for anyone convicted of identifying as LGBT+, and a maximum five-year jail term for forming or funding LGBT+ groups. The bill proposes a jail term of up to 10 years for anyone involved in LGBT+ advocacy campaigns aimed at children.

The UNAIDS Executive Director, Winnie Byanyima has said that this would “obstruct access to life-saving services” and “jeopardize Ghana’s development success.”

“If Human Sexual Rights and Ghanaian Family Values Bill becomes a law, it will exacerbate fear and hatred, could incite violence against fellow Ghanaian citizens, and will negatively impact on free speech, freedom of movement and freedom of association,’’ she added.

Kenya is also considering legislation which could lead to 50-year prison sentence for non-consensual same-sex acts. Meanwhile Burundi’s President Evariste Ndayishimiye, has claimed that homosexuality is imported from the west, and gay people should be stoned to death.

The growing list of countries enacting anti-LGBT+ laws in the region has led some experts to predict that international health targets may not be achieved.

“Evidence shows that criminalizing populations most at risk of HIV, such as the LGBTQ+ communities, obstructs access to life-saving health and HIV services, which undermines public health and the overall HIV response in the country,” said Anne Githuku-Shongwe, UNAIDS Regional Director for Eastern and Southern Africa. “To achieve the goal of ending the AIDS pandemic by 2030, it is vital to ensure that everyone has equal access to health services without fear."

Some names have been changed to protect identities.

HIV in focus
This news story has been published as part of our HIV in focus news network. This is a network of writers and journalists from our focus countries, dedicated to delivering news on HIV and sexual health. The network aims to amplify the voices of communities most affected by HIV and share the stories that matter to them.

About the writer
Aaron Ainomugisha is an award-winning freelance journalist based in Uganda. He is the team leader of Rise News Uganda, a media network focusing on in-depth storytelling tackling unreported and underreported issues in the community.