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UNAIDS: Anti-LGBTQ laws in Africa could prompt spike in HIV cases 

Ugandan President Yoweri Museveni in May signed Anti-Homosexuality Act

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LGBTQ and intersex activists protested in front of the Ugandan Embassy in D.C. on April 25, 2023. (Washington Blade photos by Michael K. Lavers)

The U.N body on the HIV pandemic has raised concerns over a spike in the disease among gay and transgender people in eastern and southern Africa due to harsh anti-homosexuality laws.

The UNAIDS in its latest 2023 Global AIDS Update report released last month notes laws criminalizing consensual same-sex relations have remained a major obstacle in preventing and treating HIV among the LGBTQ community. These statutes have been enacted in the region the disease has impacted the most and in a part of Africa that has seen significant progress in reducing the number of new HIV infections. 

New HIV infections have dropped by 57 percent and AIDS-related deaths have decreased by 58 percent among heterosexual people since 2010. 

“HIV incidence has reduced substantially by 73 percent since 2010 among adult men aged 15–49 years, but it is not declining among gay men and other men who have sex with men,” reads the 196-page UNAIDS report. 

HIV prevalence in 2022 around the world was 11 times higher among gay men aged 15-49 years, compared to heterosexual men within the same age bracket and 14 times higher among trans people. 

The report reveals the HIV prevalence among gay men stands at 12.9 percent and 42.8 percent for trans persons in 21 of 24 surveyed countries in eastern and southern Africa where a total of 20.8 million people in live with the virus. 

The disease remains rife among gay men and trans people and efforts to combat it among the aforementioned population continues to lag because of stigma and discrimination in accessing equitable HIV care from anti-homosexuality laws in Uganda, Kenya, Tanzania and in other countries.   

A total of 67 countries in the world criminalize homosexuality, with nearly half of them being in Africa. Twenty countries criminalize trans people.

A recent survey in 10 sub-Saharan African countries showed HIV prevalence among gay men was five times higher in countries that criminalize consensual same-sex relationships compared Rwanda and South Africa and other nations that don’t. 

The survey also notes HIV prevalence was 12 times higher in countries that use anti-homosexuality laws to prosecute gay men, compared to nations without such prosecutions. It also notes HIV prevalence was more than nine times higher in countries that curtail the operations of pro-LGBTQ civil society organizations, compared to nations that do not obstruct them. 

UNAIDS Executive Director Winnie Byanyima noted HIV/AIDS killed one person every minute last year. She also called for stronger collaboration and equality to end the disease by 2030. 

“HIV responses succeed when they are anchored in strong political leadership to follow the evidence, tackle the inequalities holding back progress, enable communities and civil society organizations in their vital roles in the response and ensure sufficient and sustainable funding,” she said.    

The UNAIDS report points out gay men and trans people are left out of HIV treatment programs in eastern and southern Africa, where coverage among adult women stands at 86 percent and men at 78 percent. 

The neglect that punitive laws and police harassment exacerbates has, in turn, led to HIV prevention gaps that increase the risk of transmission and limit access to services and sabotages efforts to decrease the impact of the virus among the group. 

Uganda this year enacted the Anti-Homosexuality Act with a death penalty provision for “aggravated homosexuality” and severe punishment for organizations the government claims promote homosexuality. A similar punitive bill is set to be introduced in Kenya’s Parliament. 

Ugandan President Yoweri Museveni’s decision to sign the Anti-Homosexuality Act in May saw a U.S.-funded HIV treatment clinic in Kampala that normally sees dozens of patients a day almost deserted because clients, many of them gay, feared arrest.

“Removal or reform of these laws in line with public health evidence would boost the HIV response and the human rights of people from marginalized populations, particularly, key populations who continue to have much higher HIV prevalence than the general population,” the UNAIDS report states.

In 2022, a total of $9.8 billion meant for universal HIV financing in eastern and southern Africa was spent. Thirty-nine percent of this money was domestic funding, while the rest came from the Global Fund, UNAIDS, the U.S. Agency for International Development and other international donor organizations. Botswana, Kenya and South Africa contributed the largest share of donor funding. 

UNAIDS asks countries to use disaggregated data to effectively identify populations to ensure the LGBTQ community and other key groups are not left out of HIV care since many countries lack programs and size estimates. UNAIDS also requests stronger action against stigma and discrimination at healthcare facilities in order to increase access and use of HIV testing and treatment services by all people, regardless of their sexual orientation.

“Failure to protect people from key populations against HIV will prolong the pandemic indefinitely at great cost to the affected communities and societies,” warns UNAIDS. 

UNAIDS notes Singapore and other countries last year repealed laws that criminalize consensual same-sex sexual relations and trans people and introduced statutes that protect gender identity. UNAIDS, nevertheless, in its report raised concerns over an increase in homophobia and transphobia in countries that prompt the introduction of anti-homosexuality laws.

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South Africa

South African activists demand action to stop anti-LGBTQ violence

Country’s first gay imam murdered in February

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Mohsin Hendricks (courtesy photo)

Continued attacks of LGBTQ South Africans are raising serious concerns about the community’s safety and well-being.

President Cyril Ramaphosa in May 2024 signed the Preventing and Combating of Hate Crimes and Hate Speech Bill into law that, among other things, has legal protections for LGBTQ South Africans who suffer physical, verbal, and emotional violence. Statistics from the first and second quarters of 2025 have painted a grim picture.

Muhsin Hendricks, the country’s first openly gay imam, in February was shot dead in Gqeberha, in a suspected homophobic attack. Authorities in April found the body of Linten Jutzen, a gay crossdresser, in an open field between an elementary school and a tennis court in Cape Town.

A World Economic Forum survey on attitudes towards homosexuality and gender non-conformity in South Africa that Marchant Van Der Schyf conducted earlier this year found that even though 51 percent of South Africans believe gay people should have the same rights as their heterosexual counterparts, 72 percent of them feel same-sex sexual activity is morally wrong. The survey also notes 44 percent of LGBTQ respondents said they experienced bullying, verbal and sexual discrimination, and physical violence in their everyday lives because of their sexual orientation.

Van Der Schyf said many attacks occur in the country’s metropolitan areas, particularly Cape Town, Durban, and Johannesburg.

“Victims are often lured to either the perpetrator’s indicated residence or an out-of-home area under the appearance of a meet-up,” said Van Der Schyf. “The nature of the attacks range from strangulation and beatings to kidnapping and blackmail with some victims being filmed naked or held for ransom.”

The Youth Policy Committee’s Gender Working Group notes South Africa is the first country to constitutionally protect against discrimination based on sexual orientation and the fifth nation in the world to extend marriage rights to same-sex couples. A disparity, however, still exists between legal protections and LGBTQ people’s lived experiences.

“After more than 20 years of democracy, our communities continue to wake up to the stench of grief, mutilation, violation, and oppression,” said the Youth Policy Committee. “Like all human beings, queer individuals are members of schooling communities, church groups, and society at large, therefore, anything that affects them should affect everyone else within those communities.”

The Youth Policy Committee also said religious and cultural leaders should do more to combat anti-LGBTQ rhetoric.

“Religious institutions seem to perpetuate the hate crimes experienced by queer individuals,” said the group. “In extreme cases, religious leaders have advocated for killings and hateful crimes to be committed against those in the queer community. South Africa’s highly respected spiritual guides, sangomas, are also joining the fight against queer killings and acts of transphobia and homophobia.”

“The LGBTQIA+ community is raising their voice and they need to be supported because they add a unique color to our rainbow nation,” it added.

Steve Letsike, the government’s deputy minister for women, youth, and persons with disabilities, in marking the International Day Against Homophobia, Biphobia, and Transphobia on May 17 noted Ramaphosa’s administration has enacted legislative framework that protects the LGBTQ community. Letsike, however, stressed the government still needs to ensure its implementation.

“We have passed these policies and we need to make sure that they are implemented fully and with urgency, so that (LGBTQ) persons can self-determine and also have autonomy without any abusive requirements,” said Letsike. “We need families, faith leaders, traditional authorities, and communities to rise together against hate. Our constitution must remain respected.”

Siphokazi Dlamini, a social justice activist, said LGBTQ rights should be respected, as enshrined in the constitution.

“It is terrible to even imagine that they face discrimination despite the fact that this has been addressed numerous times,” said Dlamini. “How are they different from us? Is a question I frequently ask people or why should they live in fear just because we don’t like the way they are and their feelings? However, I would get no response.”

Dlamini added people still live in fear of being judged, raped, or killed simply because of who they are.

“What needs to be addressed to is what freedom means,” said Dlamini. “Freedom means to have the power to be able to do anything that you want but if it doesn’t hurt other people’s feelings while doing it. There is freedom of speech, freedom from discrimination, freedom of expression, of thought, of choice, of religion, of association, and these needs to be practiced. It is time to take such issues seriously in order to promote equality and peace among our people, and those who do not follow these rules should be taken into custody.”

Van Der Schyf also said LGBTQ South Africans should have a place, such as an inquiry commission, that allows them to talk about the trauma they have suffered and how it influences their distrust of the government.

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Uganda

Trans Ugandans build power through business

One organization backs economic projects that can reshape lives

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Trans Resilience and Economic Empowerment participants (Photo courtesy of Williams Apako)

Achen, not her real name, is a soft-spoken 26-year-old from northern Uganda. She never imagined she would run a business, let alone one that would allow her to earn enough to send her younger sister to school. For years, she moved from shelter to shelter, surviving day by day, evicted from rental rooms, beaten on the street, and regularly denied healthcare simply for being a transgender woman.

When Uganda passed the Anti-Homosexuality Act in 2023, along with other trans persons, Achen’s fragile life collapsed further. Fear intensified, support systems buckled, and donor-funded safe spaces that once offered her hope shuttered under a wave of foreign aid suspensions. Her voice, already timid, nearly disappeared altogether.

Achen is one of transgender and gender diverse persons who have found a lifeline through the Trans Resilience and Economic Empowerment (TREE) a bold initiative by Tranz Network Uganda that has been running since 2020. Designed as an integrated support economic empowerment platform in the face of both institutional hostility and global donor shifts, TREE is one of the few initiatives/ strategies still standing amid Uganda’s increasingly restrictive environment. 

At a time when the LGBTQ+ movement in Uganda is grappling with an unprecedented dual crisis — legal persecution at home and donor withdrawal abroad — this initiative is a timely intervention to restore agency and dignity through livelihoods. Funded modestly through a patchwork of partner organizations, TREE delivers skills training, seed capital, mentorship with health services linkage/referral to trans and gender diverse people navigating the harsh realities of criminalization and economic exclusion.

Since it began, TREE has supported trans-led businesses across Uganda’s towns and cities, from Kampala to Mbarara, Lugazi to Mbale. Groups have been trained in financial literacy and record-keeping, received smartphones to enable digital transactions, and built networks of savings and credit through Village Savings and Loan Associations while creating a safe space and linkage to health services like HIV test and counseling and gender violence services. Trans-led businesses in piggery, tailoring, catering, vending, and crafts have emerged not just as sources of income but as community hubs. 

Some beneficiaries have gone on to earn certificates in accounting and financial management. Others have used their new income to rent safe housing, restart school, or reenter HIV treatment. Emergency assistance has been extended to community members facing eviction or violence, including access to medical care, relocation support, and GBV counseling. These interventions have created a ripple effect that is difficult to quantify but undeniable to those living it. One project beneficiary described TREE as “not just money, but a second chance.”

Economic marginalization has long been wielded as a weapon of control against transgender communities. Trans and gender diverse persons in Uganda are systematically excluded from the formal labor market due to discriminatory hiring practices, lack of legal recognition on IDs, and pervasive social stigma. Many are pushed into unstable, informal sectors like sex work, which not only expose them to health risks but also legal vulnerability under vague morality clauses in the law. 

In rural areas, where surveillance and stigma are even more pronounced, trans and gender diverse persons report being blacklisted from community savings groups, denied land access, and forcibly outed when seeking credit or medical attention. With nowhere else to turn, many live in cycles of poverty, dependent on shrinking NGO safety nets that were already under strain even before U.S. foreign aid cuts triggered widespread closures.

The 2025 executive order(s) issued by President Donald Trump, which halted 83 percent of USAID programs, acted like a wrecking ball through Uganda’s LGBTQ+ support ecosystem. Despite waivers allowing continued funding for basic HIV and tuberculosis treatment, the cuts included a freeze on programs that offered diversity and inclusion services. Shelters closed, staff were laid off, mental health services evaporated, and peer-led HIV prevention programs vanished. As access points to HIV testing and treatment diminished, stigma deepened. Several community members who previously accessed PrEP, lubricants, and condoms through drop-in centers began reporting new infections or treatment interruptions. In these conditions, economic resilience isn’t just about income — it’s about survival.

Williams Apako, executive director of Tranz Network Uganda, says the TREE initiative is about putting power back into the hands of trans people by recognizing that economic agency is foundational to every other form of empowerment, including health. 

“You can’t ask someone to adhere to HIV treatment or avoid risky behavior when they’re hungry, homeless, or too afraid to walk to a clinic,” he says. “This strategy is about reframing resilience not as endurance but as self-determination. Each cycle has adapted to what our communities are facing. When people lose shelter, we help them find footing again. When businesses collapse due to legal attacks, we help them pivot. The ability to make money on your own terms means you can walk away from violence, from unsafe sex, from dependence.”

Afiya, not her real name, is a 22-year-old trans woman in Lugazi. She turned to TREE after being kicked out by her family and missing her antiretroviral medication for weeks. 

“They helped me get back into care quietly,” she says. “But also, I now braid hair from home and have customers who love my work. I have my own money now. It’s not much, but it’s mine.”

TREE-supported organizations, whose names have been withheld to protect participants, have trained dozens of trans persons in tailoring, hairdressing, catering, piggery, and crafts. Others are piloting mobile vending and delivery services in areas where visibility is dangerous. The project does more than provide capital. It helps beneficiaries establish business registration, form cooperatives, and, where possible, partner with sympathetic local leaders to create safer work environments while still accessing critical reproductive health services. In one region, a local health center has agreed to integrate HIV services with the TREE enterprise hub, providing discreet access to ARVs and counseling without requiring individuals to self-identify as LGBTQ+.

Hakim, not his real name, shares his journey with honesty and strength.

“As if life wasn’t already challenging enough as a trans person, I was also broke. I wanted to do something that would help me earn a living without having to depend on anyone. I’ve always had an entrepreneurial mindset, but back then, I didn’t know where to begin. I took a leap of faith and got a loan from the SACCO (Savings and Credit Cooperative Organization),, which I invested in a sisal sponge business. It took time, but it paid off. With my own hands, I’ve managed to repay the loan and sustain myself. That’s something I’m really proud of.” 

What makes the TREE project stand out is its decentralized design. Rather than imposing a single model, it tailors support to each organization’s strengths and the local risks they face. Some groups have chosen to stay low-profile, operating income-generating activities from private homes. Others have gone semi-public, advocating for inclusive budgeting from district councils. In either case, the project positions trans persons not as passive recipients of aid, but as innovators, workers, and citizens. Several beneficiaries reported, for the first time in their lives, being able to make a financial decision without external approval. One said simply, “I paid my rent without begging. That was new for me.”

Yet even as TREE offers a glimpse of hope, Apako is realistic about its scale and limits. 

“This is not a replacement for healthcare or human rights protections,” he says. “Economic empowerment can’t thrive in a vacuum. We need international solidarity, we need political pressure on the Ugandan government to respect human dignity, and we need donors, including private foundations, to rethink how they fund resilience in hostile contexts.” He notes that several TREE partners are already overwhelmed with requests for support that they cannot meet.

Uganda’s HIV strategy, guided by the Uganda AIDS Commission and supported in part by global actors like UNAIDS and the Global Fund, risks losing its effectiveness if it continues to marginalize or exclude key populations. The rollback of targeted, inclusive programs will not only lead to higher transmission rates but also undermine decades of progress in public health. TREE, though small and other supporting programming and strategies in solidarity with LGBTQI+ communities in Uganda, reminds us that solutions must center the people most affected. In a moment when rhetoric is high and funding is low, this project speaks the language of possibility.

For Achen and others, the transformation has been quiet but profound. She now runs a small catering stall with two other trans women. She no longer sleeps with one eye open, waiting for a landlord to bang on her door. When asked what she would tell other trans persons scared of being visible or starting over, she says, “Even in fear, we can plant something small. And from that, we live.”

Williams Apako is the executive officer of the Tranz Network Uganda and a board member of the Global Fund’s Uganda Country Coordinating Mechanism.

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Ghana

LGBTQ people, allies targeted in Ghanaian cities

Man attacked intersex, trans woman who refused his advances

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LGBTQ people and allies have been attacked in the Ghanaian cities of Tamale and Wa.

Yeliminga Naa Abayema, a journalist with Wa-based Tungsung Radio, last month while on the air said he was going to deal with the LGBTQ community and called on local law enforcement and officials to help him.

Rightify Ghana, a local LGBTQ organization, said Abayema’s remarks are in response to human rights activists who had helped two queer people evade anti-gay attacks.

The chief of Kpalsi Palace in the Sagnarigu municipal district tracked down one of the activists, beat him, fined him $300 and a sheep. The activist was also banished from the area.

The second activist had a written death threat attached to the front door of his apartment, warning him to stop protecting LGBTQ people. The threat forced him to flee the area.

Rightify Ghana on May 27 issued a statement that condemned the attacks.

“From physical attacks, eviction, and death threats to media-led defamation and economic sabotage, these defenders are being punished for standing up against hate,” reads the statement. “In Tamale, two defenders are now homeless, one was beaten, fined, and banished, the other received a death threat. In Wa, a journalist led a public campaign naming and shaming queer individuals, resulting in threats and business losses.”

Rightify Ghana also said the attacks are silencing voices and crippling community support. The group noted the two activists are in urgent need of protection, legal support, relocation assistance,  medical and psychological care.

Yaw Mensah, a Ghanaian LGBTQ activist, said some law enforcement officials were exacerbating the homophobic attacks through arbitrary arrests and supporting the perpetrators.

“The saddest thing in this, is that they can’t even rely on the police for protection because some of the police officers are part of the problem as they are helping persecute LGBT people and their supporters,” said Mensah.

Awo Dufiean, a Ghanaian intersex and transgender woman, in April said a man left her with bruises on her cheek and arms after she refused his advances.

“Why is there such an extreme push to enforce heteropatriachy and heteronormativity through laws and policies and who does it benefit? Why are we developing such an insatiable appetite to use culture to harm and disenfranchise so many people simply because they are different? I have argued and will argue that we need to critically start examining our position as West Africans on what we are doing to queer people,” said Dufiean.

Meanwhile, the Promotion of Proper Human Sexual Rights and Ghanaian Family Values Bill that would further criminalize LGBTQ people and outlaw allyship is back in parliament.

Parliament Speaker Alban Bagbin on May 27 said the anti-LGBTQ bill can now be tabled for its first reading after having completed all necessary processes.

The Ghanaian penal code criminalizes consensual same-sex sexual activity and carries a maximum penalty of three years in prison.

Anyone convicted of forming or funding LGBTQ groups under the Promotion of Proper Human Sexual Rights and Ghanaian Family Values Bill would face fines and up to five years in prison. Those convicted of participating in LGBTQ rights campaigns aimed at children would face up to 10 years in prison.

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