The persistent and increasing outbreaks of violence against members of the gay community in Africa are jeopardising efforts undertaken to combat HIV, both within this group and across the population as a whole, AIDS activists warned at a recent meeting in Limbé, Cameroon.
The extreme vulnerability of members of the gay community to HIV on the continent was highlighted during the meeting, initiated by the French non-governmental organisation, AIDES, and its partners, which took place at the beginning of July in the south west of Cameroon and brought together many AIDS activists from Francophone African countries.
On average it is estimated that HIV infection rates amongst MSM (men who have sex with men) are four to five times higher than the population overall, with highs in certain areas.
In Bamako, the capital of Mali, screening tests carried out on a few hundred MSMs revealed that the infection rate was around 37 per cent, according to ARCAD-SIDA, an organisation in Mali that supports people living with HIV/AIDS. Official statistics set the national infection rate of the population at 1.3 per cent.
In Senegal, a survey carried out in 2005 showed that 21.5 per cent of MSMs in the capital, Dakar, were infected with HIV, compared to a national prevalence rate estimated by the authorities at 0.7 per cent.
The 2007 “Off the map” report, which was produced by the International Gay and Lesbian Human Rights Commission (IGLHRC), an American organisation that defends the rights of homosexuals, highlighted that “the vulnerability of same-sex practicing men and women is not due to any biological predisposition, but is the result of an interlocking set of human rights violations and social inequalities that heighten HIV risk”.
Criminalisation of homosexuality
According to IGLHRC, 38 of the 53 countries in Africa still consider homosexuality as an offence punishable by sentences ranging in severity up to imprisonment.
This is the case in Cameroon, where 11 people were put in prison in 2007 for homosexual activity, according to the 2008 report of the human rights organisation Amnesty international. Due to lack of care, one of the men imprisoned died of an HIV/AIDS related infection a few days after his release.
Dr Steave Nemande, a doctor and the president of the human rights organisation Alternatives Cameroun, believes that by criminalising homosexuality “social homophobia is legitimised and it increases fear amongst MSM, who take further risks to live their sexual life in secret”.
In Senegal, homosexuality remains illegal, although in 2005 MSM were integrated into AIDS programmes. Here, the ‘manhunt’ and arrests that have taken place over the last few months, following photos of a gay festival being published in the local news, forced certain members of the MSM community to go into exile, and others, including those infected with HIV, to hide – therefore, giving up their treatment.
Even in countries with no legislation on homosexuality, such as the Côte d’Ivoire, MSM are far from able to claim their rights, noted Hervé Beuté, a member of Arc-en-Ciel+, an HIV/AIDS prevention association for MSM. “We are still fighting for [MSMs to have] access to health centres”.
Members of the community died from HIV/AIDS without receiving healthcare, after they were turned away by certain health facilities, he stated. He added that he had himself been “a victim of violence a few times” during prevention campaigns for MSMs.
“On the continent, more and more MSMs are organising prevention campaigns, however, they will never be effective whilst they are being hunted down and/or imprisoned, or even excluded from official strategies to combat the pandemic”, said David Monvoisin, a member of Africa Gay – a group fighting against AIDS within homosexual communities – also working with the French NGO, AIDES.
Philippe (last name withheld) is being monitored by a centre providing free information and care for MSM, which was opened very recently by Alternatives Cameroun in Douala, the large city port.
He decided to risk revealing his sexual orientation and his HIV positive status to give others something to hold on to, “in the hope that this will serve as an example for others so that there is more discussion about the illness between [MSMs] and health professionals”.
Such initiatives are indispensable, because many MSM “are not educated and ignore all or nearly all prevention methods”, said Aboubakar Dabo, a member of ARCAD-SIDA, in Mali. According to a survey carried out in 2006 by this organisation, 77 per cent of the MSMs questioned had had unprotected intimate relations.
“Many MSM told us they were sure that there was no risk of infection with anal penetration”, said Yves Jong, coordinator of Alternatives Cameroun’s sexual health and prevention unit.
Dangerous clandestine existence
Even when MSM are aware, their exclusion from the majority of health policies on the continent means that it is difficult for them to obtain what they need to protect themselves from infection. The most frequent problem is access to lubricating gel, explained Monvoisin. “Many [MSM] use butter or oil, but unfortunately this damages condoms.”
The clandestine existence that gay communities are forced to hide away in exposes them not just to the risk of HIV, but the rest of the population too: because they are unable to live openly as gay men, many MSMs also have sexual relations with women, or are even married, activists have highlighted.
In Mali, “the majority of homosexuals – 88 per cent according to a study – are bisexual, which increases the spread of the disease”, said Dabo.
African governments must, therefore, act as quickly as possible and protect these vulnerable groups in the interest of the population as a whole, urged participants at the meeting in Cameroon.
“As long as [MSMs] are ignored, all efforts undertaken in the world to combat AIDS will be destined to fail”, concluded Joël Nana, from IGLHRC’s African office.