amfAR, The Foundation for AIDS Research

GRASSROOTS: The GMT Initiative Blog

amfAR's GMT Initiative supports grassroots organizations that respond to the devastating impact of HIV/AIDS among gay men, other men who have sex with men, and transgender individuals (collectively, GMT).

Delivering Results on LGBT Research in Kenya

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Posted by Kent Klindera March 31, 2014

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Kenyan LGBT activists discuss their community research priorities.

Last week in Nairobi, Kenya, amfAR hosted a meeting of lesbian, gay, bisexual and trans (LGBT) community activists, in partnership with the Gay and Lesbian Coalition of Kenya (GALCK) and the International AIDS Vaccine Initiative (IAVI). For a day and a half, we debated past, current, and future research being conducted on LGBT issues and HIV in Kenya, with the aim of developing a strategic LGBT research agenda for the future.  Although it was quite a successful meeting, what was most troubling to me was hearing about past experiences the activists had working with outside researchers.

Repeatedly, the community activists talked about academics “coming in” to work with the communities and then “going out” with their data to analyze, publish, and disseminate with little regard for the community they had investigated. One activist talked about how so many research studies had been conducted in his community, each assessing the needs or sexual behavior of the LGBT community, yet so little impact had actually come from the data. The activists said that community members were tired of talking to researchers about their needs, when no new programming to actually meet those needs arises.

At the meeting we discussed how to change that troubling paradigm by involving the community in study design and implementation. At the end, a core group of LGBT community activists formed a plan to help GALCK, IAVI, and amfAR both engage researchers in a research agenda focusing on the issues the community thinks are the most pressing, and also raise support for programming that addresses the real needs documented by that research.  Some of the questions comprising that new agenda include:

  • What is the relationship between homophobia/transphobia, anti-homosexuality laws, and the spread of HIV?

  • How can we best promote antiretroviral (ARV) adherence among LGBT living with HIV?  What factors inhibit adherence?

  • How does gender-based violence in LGBT communities link to HIV infection?

  • What are the health and human rights needs of lesbian, bi, and trans individuals? (All studies to date have focused on gay men and other men who have sex with men, with none looking at the rest of the community.)

  • Is it easier to “come out” now in society? If so, what are the factors that made it easier to do so?

  • After 10 years of activism in Kenya, what are the milestones in LGBT rights, what has been successful, and what is lacking?

  • What is the impact of new media, including social media, on LGBT Rights? 

For the first time, the discussions at this meeting were putting the activists in the driver’s seat to define their own research agenda, and what was interesting to me was how real and honest the discussion was They talked frankly about their communities’ needs, which primarily revolved around the pervasive homophobia and transphobia in society that inhibit their lives. Many recognized how internalized homophobia —the internalized shame associated with same sex attraction— helped fuel the external homophobia witnessed by all participants because when one is ashamed of oneself, it is very difficult to see the need to assist others. 

In June, we will be hosting another meeting in Kenya.  This time, researchers, community colleagues, and donors will meet to take this new research agenda forward and to develop strategies to link funding and programs for the LGBT community in Kenya to this agenda. 

The Impact of the Nigerian and Ugandan Anti-Gay Laws on Public Health

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Posted by John Power on March 18, 2014

Protestors in front of the of the Nigerian Consulate in New York during the March 7 Global Day of Action against the Nigerian anti-gay law. 
Protestors in front of the of the Nigerian Consulate in New York during the March 7 Global Day of Action against the Nigerian anti-gay law.

Studies have clearly shown that criminalizing same-sex sexual behavior poses an immense structural barrier to HIV prevention. It “drives men away from services, reduces the likelihood of disclosure of risks to providers and partners, and makes men vulnerable to blackmail,” Dr. Chris Beyrer, the current president-elect of the International AIDS Society, wrote in 2010. Indeed, Nigeria and Uganda’s new anti-gay laws are already proving that they will be extremely destructive to efforts to combat HIV. In both countries, same-sex behavior was already illegal, but the new laws increase the severity of the prison sentences faced by LGBT and criminalize organizations that serve them.

Reports indicate numerous LGBT Nigerians have been assaulted and arrested since its “Same-Sex Marriage Prohibition” law was signed in January. On February 25, days after a similar bill was signed into law, a major Ugandan tabloid published a list of “Uganda’s 200 Top Homos,” prompting fears of attacks and arrests among Ugandan LGBT. As a result, healthcare centers serving GMT have closed their doors in both countries amidst fears of mob attacks, leaving GMT without HIV treatment and prevention services. Furthermore, many GMT have gone into hiding and are afraid that they will be targeted at health centers.

Since these laws also criminalize LGBT organizations, activists and healthcare providers are uncertain how they will affect the organizations that continue to provide GMT with HIV services. Will the ten-year prison sentence for Nigerians who “make public show of same sex amorous relationships” apply to patients who disclose their identity as GMT to their doctor? Will Ugandan healthcare workers report HIV-positive GMT to the police, leading to life sentences? Will Ugandans who distribute condoms to GMT or the healthcare workers who treat them be punished with a seven-year prison term for “aiding or abetting of homosexuality”?

Although HIV is diminishing in other parts of the world, the epidemic is a growing problem in these two countries. The latest data show that Nigerian MSM have an HIV prevalence of 17.2%, compared to the nationwide prevalence of 4.1%. An estimated 13.7% of Ugandan MSM are HIV positive, compared to a 7% prevalence nationwide. Without reform, the new laws will only cause these rates to rise. This is especially devastating in light of the recent progress that both countries had made in addressing HIV among GMT. Nigeria, for example, had one of the few African governments that had developed robust MSM-specific HIV goals. These included reducing HIV prevalence among MSM from 17.2% to 8.5%, increasing MSM condom use from 52.8% to 80%, and increasing the percentage of MSM who have been tested for HIV in the past year from 31.5% to 50%. Unlike most other African governments, the Nigerian government even designed a package of HIV services for MSM, which it aimed to deliver to 80% of them by 2015.

However, new reports indicate that the Nigerian government will no longer monitor HIV among GMT, a sign that its GMT programs will also be brought to a halt. We should not allow ourselves to be fooled by Nigerian and Ugandan government officials who proclaim that anti-gay laws won’t set back the HIV response or cause GMT to be discriminated against in the healthcare setting. The new wave of discrimination has already begun.

Developments over the past three weeks have also shown that the laws’ effect extends beyond national borders. For example, activists in Kenya have been threatened by mob justice, and Kenya, the Democratic Republic of the Congo, Malawi, and other countries have all seen a reinvigorated flurry of movement toward similar anti-gay legislation. Since these are countries where GMT are also disproportionately affected by HIV, this type of legislation will only impose further barriers to the HIV response.

If governments across Africa don’t reverse their course and commit to delivering equitable healthcare to GMT, the consequences could be disastrous. The gravity of the moment requires immediate steps to protect the rights of GMT, a sharp push to monitor GMT health, and a concerted effort to repeal the anti-gay laws or overturn them in the courts.

Global Day of Action: A Nigerian Asylee’s Story about the Effects of the Anti-Same Sex Marriage Law

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Posted by Lucile Scott March 6, 2014

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The Solidarity Alliance, a coalition of Nigerian LGBT-focused human rights and HIV/AIDS organizations and individuals, has organized a March 7 Global Day of Action “for the world to stand in solidarity with LGBTI Nigerians” and speak out against the Anti-Same Sex Marriage bill that Nigerian President Goodluck Jonathan signed into law in January. Scroll down to find out how you can participate.

The law punishes those who enter into a same-sex marriage or union with 14 years in prison and those who participate in LGBT organizations, societies, or relationships with 10 years—a category that could include HIV service providers targeting GMT, potentially gutting the national HIV response. Another draconian anti-LGBT law was enacted in Uganda in February, and Kenya and Malawi are beginning to consider similar draft laws. amfAR talked to Alex (not his real name), 37, a gay man from Nigeria, who has been granted asylum in the U.S., about the on- the-ground situation in Nigeria, where anti-LGBT violence is increasing and HIV services are shutting down. The following is excerpted from that interview.

I left Nigeria and sought asylum in the U.S. in July of 2012. At the time I was working as a referral officer for an organization funded by the Global Fund. I worked mostly with MSM throughout the north-central zone. I held meetings and provided guys with peer education, taught them to use condoms correctly, got them tested, and if they tested positive, got them to go to a clinic that was safe for GMT. Before, even though it was frowned upon to be gay and people would cuss at you or tease you and sometimes beat you, lives weren’t in danger.

“Before, even though it was frowned upon to be gay and people would cuss at you or tease you and sometimes beat you, lives weren’t in danger.”After this bill passed the Senate in 2011, people started to notice that it was only men in our meeting, and they figured it out. I was beaten almost to the point of death when I was walking home from a meeting. They were beating me, kicking me all over. I got to a time I couldn’t even cry out anymore. There were also calls and threats. After I was beaten a second time, I knew it was time to leave. And now that the bill is law, the violence is even worse. People have died and a lot more are going to die.

This law is going to cause the HIV rate in Nigeria to double. It’s only been in the past few years that the government has worked with us or targeted GMT with HIV services, but now the HIV services for GMT are being shut down. Many MSM in Nigeria have wives. And more are now going into hiding and they will secretly sleep with men and fear seeking out HIV services and they will infect their wives, their girlfriends, and the other men.

The Nigerian government is corrupt and this bill is a distraction. Passing it is the only successful thing the government has done in a decade. The country doesn’t have lights, or enough food, or good education, and the only thing they’ve done is to pass a law to kill people. People say being gay is against our religion, it is against our tradition. Being gay is as old as man and there are accounts in history that imply it was accepted in Africa before colonialism and Christianity. And if you say you are trying to serve God, he said, “Love thy neighbor as thyself.” He didn’t say, “Love everybody, hate gay people.” I look at the videos on the internet from Nigeria that are sent to us and I see the way my people are treated, and my whole day is messed up at work, I cry through the night, because there is nothing I can do. I have a video where the police stand by and watch while a mob beats two guys to death, like animals. I knew one of the guys. But the government says, “Oh, that never happened.”

When I got here, before I had asylum, I had a visa but no social security number or way to get work. An AIDS organization in New York took me and my friend in. I am HIV positive and they helped me find health insurance so I could get medication and gave us housing and a job. My friend and I were the first LGBT people seeking asylum that the organization helped. Now they have nearly a dozen. And with this law, there will be more and more who need help. But most people cannot leave Nigeria. This Global Day of Action we need to show that people and the international community disapprove, because the voice of the international community is very strong.

And I am very grateful for everything the American government and people have done. I hope to go back to Nigeria one day to see my family, but my first allegiance is to the American people now. I am still part of them [the Nigerian people], but I’ve given up my citizenship. This is my home now.

What you can do on the March 7 Global Day of Action—and every day until the Nigerian law is overturned:

Post a message of support on Twitter, Facebook, Instagram, and other social media using: #IStandWith9jaLGBT

For these posts you can say this, or something like it:
“I stand with the LGBTI community in Nigeria. The anti-gay law is unconstitutional and violates Nigerian and international human rights law.”

Attend a rally in New York, Washington, D.C., or London.

All three events are coordinated and scheduled to take place from 11:00a.m. to 1:00 p.m. Eastern Standard Time.

New York City, 11:00 a.m., The Nigerian Consulate, 828 2nd Ave., New York, NY 10017 (corner of E 44th Street)

Washington, D.C., 11:00 a.m., The Nigerian Embassy, 3519 International Ct. NW

London, 4:00 p.m., The Nigeria High Commission, 9 Northumberland Ave.

Or organize your own in a different city. If you do, please contact Michael Ighodaro at alliance.ighodaro@gmail.com in North America or Adebisi Alimi at bisialimi@gmail.com in the U.K. and let them know.

Sign a petition.

You can also call your elected officials and ask what they are doing to fight the bill and protect the safety of LGBT living in Nigeria and Uganda, or wear a t-shirt or badge stating your support.