HIV counseling and testing among men who have sex with men (MSM) in Uganda: the AIC-Uganda perspective
AIDS Information Centre-Uganda, Executive Director, Kampala, Uganda
Issues: In Uganda, homosexuality is illegal and taboo. Consequently, MSM are rarely addressed by HIV prevention programs despite their elevated risk of infection. It is estimated that there are 4,000 MSM in Uganda and they contributed 559 new infections. Considerably little is known about the role of sex between men in the AIDS epidemics in Uganda. The lack of information is related to denial, intense stigmatization and criminalization of same sex relations.
Description: AIC is at the fore front of providing free HIV Counseling and testing (HCT) to couples. During this campaign the counselors at AIC counseled and tested gay MSM & lesbians. The counselors lacked guidelines for provision of HCT and related support that is sensitive to issues unique to gay couples.
Lessons learned: AIC has created and maintained an environment of confidentiality, which has attracted the high-risk MSM who had never been tested and had no access to preventive HIV information. The bill on homosexuals in Uganda has driven this group underground. More people are presenting as bisexuals, which has created an additional risk of spreading the infection to their female counterparts. Furthermore, funding for institutions involved in provision of HIV prevention services to gay couples hangs in the balance.
Next steps: Resistance and denials mean that a great deal remains to be done to reach gay couples. Lack of information, in itself compounded by a lack of harmonization of legal and public health policies and practice, are serious constraints. More research needs to be done on the socio-economic heterogeneity of such groups, their geographically varying composition, and overlaps with other risk groups.