Why HIV continues to Thrive in LGBT-Unfriendly States

18 Jan, 2019
According to 2014 UNAIDS data, 17.6% of men who engage in same-sex activities with other men in Tanzania are living with HIV -- a rate more than four times higher than the 4.5% in the nation's general adult population.

It is under President John Magufuli’s term, rights groups believe, that the situation has worsened, this is due to LGBT-friendly clinics closure and prohibiting community organizations that do HIV outreach from operating in the country — all because of their work on LGBT health and rights.

But the prospect of a civilian task force scouring the streets and giving civilians the power to report people brought a new level of terror.

After intense international pressure, the Tanzanian government tried to distance itself from the controversial governor’s plans, stating almost a week after the announcement that Makonda’s “views are not the view of the government.”
But the repercussions had begun.

Since the announcement, the International HIV/AIDS Alliance says, it has helped 30 people in Dar es Salaam through the Rapid Response Fund, which provides money to people in dire need within 72 hours. In Tanzania, the grants have provided basics like transport, medical help and shelter.

Many of the people supported this month reported suffering serious injuries as a result of violent attacks, the alliance said.

Those unable to flee are instead pushed underground and into hiding, kept from entering the outside world — which blocks their access to health services, such as those protecting against HIV/AIDS.

‘HIV is so much higher in those populations’

Being forced to be “invisible” due to “public antagonism” exposes people to sexual violence and abuse for which they are also not taken seriously by the police, said Christine Stegling, executive director of the International HIV/AIDS Alliance.
“All those things add to the reasons why HIV is so much higher in those populations,” she said, explaining that the organization’s response grants help get people out of situations where they might more easily become infected.

A gay man in Dar es Salaam, Tanzania, who for many years received condoms and medical attention from local outreach efforts, worries about what will happen now that those outreach programs have been suspended for the gay community.

Globally, according to UNAIDS, new HIV infections among gay men and other men who have sex with men are rising.

The region where “HIV rates are highest among men who have sex with men is sub-Saharan Africa, the second highest is the Caribbean, and these are both regions with high social intolerance for same-sex behavior,” Chris Beyrer, the Desmond Tutu Professor of Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health, previously told CNN.

“It’s impossible to say there is direct causality, but there certainly is a very strong correlation.”

Being forced into hiding also means people do not want to engage in any way with health services and will not test for infections or go to collect HIV treatment. People will avoid anything that will link them to being LGBT and subject to identification, Stegling said.

“You have a whole part of the community not engaging in conversations about sex, sexuality and conversations around HIV,” she said. “In the last couple of years, there’s a really heightened hijacking of rhetoric against gay people as part of local politics, making life very hard for communities … and to have HIV programs.”
Stegling believes that we’re far from meaningfully addressing HIV in marginalized communities.

We know what to do, but we can’t do it, she said. There needs to be more peer-led outreach and services, as government services will not reach vulnerable people in such political climates.

Tanzania’s Ministry of Health and a government spokesperson did not respond to requests for comment.

They are making us fear, like we are not human beings’

People involved in peer programs in Tanzania risk abuse but believe that in their work to help and educate people about the importance of HIV prevention as well as living with the condition, in addition to ensuring that they know their rights — keeping them out of prison and away from the risk of infection.

“People are not free,” said Fami, whose name has been changed to ensure his safety. The government is “making us fear, like we are not human beings.”