An Open Letter to the HIV and Public Health Community in Uganda
March 5, 2010
The Global Forum on MSM & HIV (MSMGF) applauds efforts by people living with HIV in Uganda to
stand up against the proposed “Anti-Homosexuality Bill, 2009”, and urges HIV service providers in
the country to join them by making a clear, collective public statement condemning the proposed
legislation and calling for its immediate dissolution. If enacted, this legislation will have a profoundly
detrimental impact upon the effort to address HIV in Uganda. Implementing organizations dedicated
to delivering HIV & AIDS prevention, treatment and care services in Uganda have contributed
enormously to fighting the epidemic on the ground, and as such are uniquely positioned to speak out
against the bill - especially those implementers receiving significant funding from large global donors
like PEPFAR and the Global Fund. Moreover, implementers have an obligation to the health and
safety of all people in the communities they serve, including gay men and other men who have sex
with men (MSM), their families, their loved ones, and agencies who work to provide them essential
health services. Protecting and promoting public health includes weighing in on any debate that
threatens to undermine HIV service implementers’ ability to deliver effective public health programs.
The Global Forum on MSM & HIV is deeply concerned about the ways in which the proposed anti-
homosexuality bill will undermine the nation’s efforts in addressing the HIV epidemic:
First, the bill is very clear with regards to people living with HIV: anyone charged with the offense of
aggravated homosexuality will undergo HIV testing, and all those found to be HIV positive are subject
to the death penalty. Simply put, one’s HIV status is grounds for execution. This proposal not only
reinforces stigma, discrimination and violence against people living with HIV, it is an outrageous
violation of human rights and should be roundly condemned by all committed to the effort to end
HIV.
Second, the extreme criminal penalties proposed in the bill further marginalize men who have sex
with men (MSM), a community that is already criminalized in Uganda, as well as highly stigmatized and
vulnerable to HIV infection. In low and middle-income countries, MSM are 19 times more likely to be
infected with HIV than the general populationi. The gold standard public health principle for
addressing HIV – “know your epidemic, know your response” – necessitates targeting HIV-related
services at most-at-risk communities. The harsh penalties in this bill drive MSM underground, fueling
HIV risk and transmission in a context of silence and fear, and making it difficult to (a) assess the HIV
burden among MSM, and (b) subsequently reach out to high-risk individuals with essential information
and services. Uganda’s own AIDS Commission has specifically called for a review of legal
impediments to the inclusion of most-at-risk populations – including MSM – in the national AIDS
responseii.
Third, conditions in the bill against the “promotion of homosexuality” are vague, raising serious
concerns that AIDS service providers’ work to provide critical HIV-related information and services
tailored to the needs of MSM may be considered illegal. Without clear guidance on what specifically
constitutes “promotion of homosexuality”, the materials necessary for HIV prevention among MSM
would be classified as homosexual “promotional materials”, even though such products and
information are integral to save lives and prevent transmission of HIV. The 2009 AIDS Epidemic
Update (UNAIDS) explicitly highlights the need to implement prevention programs for MSM and
other key populations of higher risk as an important part of all national AIDS responsesiii. Given the
severe nature of the proposed sentencing - convicted organizations are liable to having their
registration cancelled and their executive director imprisoned for seven years - it is reasonable to
expect most AIDS service organizations to halt vital HIV-related outreach to key affected populations
for fear of possible broad interpretation of the law that would invoke criminal penalties.
Finally, the bill would jeopardize the critical relationship between healthcare providers and patients
seeking HIV-related services by mandating that any person, including doctors, report suspected
homosexuality to the authorities. In such an environment, people who may be at risk for HIV will
delay seeking information and services, or may not present to healthcare facilities at all. Early
identification of people living with HIV is a critical public health imperative in the prevention of
onward transmission, and these provisions would seriously undermine the ability of the National
AIDS Response to do so effectively.
In sum, the Anti-Homosexuality Bill will fundamentally compromise the effectiveness of the HIV
response in Uganda. We urge HIV service providers, including international non-
governmental organizations, committed to halting and reversing the spread of HIV in
Uganda to stand with us in calling on legislators to withdraw the bill under question
immediately. We share a collective responsibility to speak out in the interests of the communities
we serve, and every voice is paramount in our work to challenge discriminatory public policy
practices that undermine our efforts to end AIDS.
Sincerely,
The Global Forum on MSM & HIV (MSMGF) applauds efforts by people living with HIV in Uganda to
stand up against the proposed “Anti-Homosexuality Bill, 2009”, and urges HIV service providers in
the country to join them by making a clear, collective public statement condemning the proposed
legislation and calling for its immediate dissolution. If enacted, this legislation will have a profoundly
detrimental impact upon the effort to address HIV in Uganda. Implementing organizations dedicated
to delivering HIV & AIDS prevention, treatment and care services in Uganda have contributed
enormously to fighting the epidemic on the ground, and as such are uniquely positioned to speak out
against the bill - especially those implementers receiving significant funding from large global donors
like PEPFAR and the Global Fund. Moreover, implementers have an obligation to the health and
safety of all people in the communities they serve, including gay men and other men who have sex
with men (MSM), their families, their loved ones, and agencies who work to provide them essential
health services. Protecting and promoting public health includes weighing in on any debate that
threatens to undermine HIV service implementers’ ability to deliver effective public health programs.
The Global Forum on MSM & HIV is deeply concerned about the ways in which the proposed anti-
homosexuality bill will undermine the nation’s efforts in addressing the HIV epidemic:
First, the bill is very clear with regards to people living with HIV: anyone charged with the offense of
aggravated homosexuality will undergo HIV testing, and all those found to be HIV positive are subject
to the death penalty. Simply put, one’s HIV status is grounds for execution. This proposal not only
reinforces stigma, discrimination and violence against people living with HIV, it is an outrageous
violation of human rights and should be roundly condemned by all committed to the effort to end
HIV.
Second, the extreme criminal penalties proposed in the bill further marginalize men who have sex
with men (MSM), a community that is already criminalized in Uganda, as well as highly stigmatized and
vulnerable to HIV infection. In low and middle-income countries, MSM are 19 times more likely to be
infected with HIV than the general populationi. The gold standard public health principle for
addressing HIV – “know your epidemic, know your response” – necessitates targeting HIV-related
services at most-at-risk communities. The harsh penalties in this bill drive MSM underground, fueling
HIV risk and transmission in a context of silence and fear, and making it difficult to (a) assess the HIV
burden among MSM, and (b) subsequently reach out to high-risk individuals with essential information
and services. Uganda’s own AIDS Commission has specifically called for a review of legal
impediments to the inclusion of most-at-risk populations – including MSM – in the national AIDS
responseii.
Third, conditions in the bill against the “promotion of homosexuality” are vague, raising serious
concerns that AIDS service providers’ work to provide critical HIV-related information and services
tailored to the needs of MSM may be considered illegal. Without clear guidance on what specifically
constitutes “promotion of homosexuality”, the materials necessary for HIV prevention among MSM
would be classified as homosexual “promotional materials”, even though such products and
information are integral to save lives and prevent transmission of HIV. The 2009 AIDS Epidemic
Update (UNAIDS) explicitly highlights the need to implement prevention programs for MSM and
other key populations of higher risk as an important part of all national AIDS responsesiii. Given the
severe nature of the proposed sentencing - convicted organizations are liable to having their
registration cancelled and their executive director imprisoned for seven years - it is reasonable to
expect most AIDS service organizations to halt vital HIV-related outreach to key affected populations
for fear of possible broad interpretation of the law that would invoke criminal penalties.
Finally, the bill would jeopardize the critical relationship between healthcare providers and patients
seeking HIV-related services by mandating that any person, including doctors, report suspected
homosexuality to the authorities. In such an environment, people who may be at risk for HIV will
delay seeking information and services, or may not present to healthcare facilities at all. Early
identification of people living with HIV is a critical public health imperative in the prevention of
onward transmission, and these provisions would seriously undermine the ability of the National
AIDS Response to do so effectively.
In sum, the Anti-Homosexuality Bill will fundamentally compromise the effectiveness of the HIV
response in Uganda. We urge HIV service providers, including international non-
governmental organizations, committed to halting and reversing the spread of HIV in
Uganda to stand with us in calling on legislators to withdraw the bill under question
immediately. We share a collective responsibility to speak out in the interests of the communities
we serve, and every voice is paramount in our work to challenge discriminatory public policy
practices that undermine our efforts to end AIDS.
Sincerely,
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