Uganda: Valorized Heterosexuality fueling HIV Infections

In Uganda, like in other African countries grappling with HIV, the gay population is disproportionately burdened by HIV. The situation is made worse by contexts of valorized Heterosexuality, pathologized homoerotic experiences, little studied LGBT diversities and country based HIV Prevention impacted upon by laws penalizing same-sex eroticism. 

When asked how this is so, Tom Muyunga-Mukasa, the Chief Executive Officer of Most At Risk Populations’ Society (MARPS in Uganda), one of the oldest Health rights organizations in Uganda, said the following:

“Strengthened, more focused, and innovative efforts to address HIV-care disparities in LGBT demographies (minorities) is still an uphill task . However, Most At Risk Populations’ Society in Uganda (MARPS in Uganda) has attempted to understand how each subgroup engages in day-to-day life long activities. It is our hope that this will then inform health seeking practices as well as provide a broad sweep of life-span stories.”

One way of tackling the HIV-related disparities experienced by minorities is through HIV Prevention practices disaggregated according to gender and sexuality. We cannot reach national goals without further improving HIV-related results for minorities. 

In a 2016 report shared by MARPS in Uganda , Transgender population had reported more HIV incidences suggesting that the prevalence is reportedly rising among this particular population.

The HIV-related disparities for a study cohort of 320 LGBT of whom 75 HIV+ve.  L(30: 17 below 22 years (4 bisexual)/13 above 22 years (3 bisexuals) (5 HIV+ve)); G (120: 80 below 25 years (15 bisexuals/ 45 bottom role solely/25 top role solely/10 versatile) (15 HIV+ve)/35 above 25 years (25 bottom role solely/15 top role solely/10 versatile (10 HIV+ve)/5 versatile (2 HIV+ve)); T(200: 100 below 20 years/50 were 20-24 years (FTM:MTF 10/40)/50 are 25 years and above FTM:MTF 12/38 (75 had Bisexual orientation too) (43 HIV+ve: FTM 10: MTF 33).

In Uganda, and Africa at large save for Republic of South Africa HIV Programmes targeting Key populations have been leaning more on strategic civil rights/litigation and less on strategic public health rights. At MARPS in Uganda this call is treated seriously and they decided to approach HIV using the Public/Mental health approach. They use the life-span models to generate data which is used to inform  interventions. The idea is to start doing impacting work and infuse meaning in the deficit narrative parlayed by media.

 “There has been so much talk about stigma, stigma this, discrimination, discrimination this and that without actually unpacking the contexts that bring these about,” said the CEO MARPS in Uganda.  

“LGBTIQQ, MSM, WSW, Gender non-conforming face more substantive stigma and discrimination from within that without,” he continued. He talked of tendencies to promote wrong messaging for instance when pressed to explain. In Uganda three LGBT-led organizations were promoting a PrEP message where it was claimed that one can have unprotected sex indiscriminately and not get HIV! This in Uganda has entrenched a “vicarious liability on the part of leaders who promote this messaging and precarious prevention practices on the part of those who believe in such messaging,” said the CEO MARPS in Uganda. 

There are many issues to address in order to promote dignity of people. But, on the issue of HIV, it is required that messaging is standard and geared at preserving lives.