The Anti-Gay Bill, 2023, If Assented To By The President Of The Republic of Uganda, Will Reverse The Good HIV/TB/Malaria-related Public Health Outcomes: Lessons Informing Bio-behavioural Risks for HIV/TB/Malaria, April 2023

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The Anti-Gay Bill, 2023 was tabled on the 21st/March 2023. Among many of its blows, is criminalising any form of Public Health service targeting the LGBTIQ+ including the right to associate.

This report was produced to highlight the Public Health and Legal Services that may be inaccessible if the law comes into force. 

The Anti-Gay Bill, will violate the rights to liberty, freedom from fear of one’s life, freedom of pursuance of happiness, freedom of expression and association, liberty, privacy, equality, freedom from discrimination, inhumane and degrading treatment, and a fair hearing – all of which are guaranteed under Ugandan and international law – for all Ugandans and persons in Uganda.

From a Strategic Public Health view point CBOs/CSOs, whether led by cis-persons, Sex-workers, Persons who use drugs, or LGBTIQ+, are expert peer networks that demonstrate superior public health benefits and outcomes for HIV, TB and Malaria prevention in cisgender males, persons who use drugs, people with disabilities, cisgender females, MSM, transgender women who have sex with men and gender non-conforming persons. In the event of signing the Anti-gay bill, 2023 in Uganda, we point out how such a legislation which is a creator and pathway for social determinants of health if passed will reverse the Public Health gains in Uganda.

We previously analysed 18 infections between March-April (4 within support networks and 14 in non-networked individuals). Further analysis of new infections was linked to urban, peri-urban and rural residence. 3 among the 4 are based in rural settings; and among the 14 non-network subscribing members 9 were in rural setting. There is an inequity of home-visiting, outreach and testing services in rural settings; a higher likelihood of finding more support subscribing/seeking individuals or adherence promoting associations in the urban setting than peri-urban or rural setting. The  health benefits included: regular check-ups (to assess HIV prevalence, addressing gender-dysphoria, trauma and related mental distress, TB diagnosis, testing for malaria, drug resistance, to characterise identity and age, identify candidates for VMMC, provide Syphilis and HPV testing, screening for substance use), integrated services (such as psychosocial support, addressing gender-based violence, RMNCAH care, SRH-related services, or TB Preventive Therapy (TPT)), Harm-Reduction, joining and maintenance of livelihood projects, companionship visitation, exchange visits between CBOs/CSOs to share knowledge and skills, continued HIV testing, viral load testing, participation in studies, quantification of study drug concentrations, life stage/span counselling/guidance, drug resistance testing,  treating opportunistic infections,  administration of drugs on-time and evaluation of medication  resistance.

This report lists the Public Health gains, further characterizes the range of health (physical and mental) seeking practices, bulk of care, Public Health benefits of attending clinic days, HIV/TB infections and Malaria in persons getting prophylaxis and helps define the impact of CSOs/CBOs and associations on the detection of infection and the reduction of risks and vulnerabilities contributing to HIV, TB or Malaria disease progression.

Further studies should look into: delineation of and the intersectionality between Public Health and Legal needs; and Public Health-harming legislations. 




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