THE EFFECTS OF A TWO YEAR SUSTAINED ANTI-GAY CAMPAIGN ON HEALTH SEEKING BEHAVIOUR OF THE SEXUAL MINORITIES IN UGANDA
BACKGROUND: Uganda criminalises same sex relations, the penalty is known as sodomy. A series of activities in 2008 saw a renewal of anti-homosexuality drives including a conference sponsored by Exodus (USA), the authorship of the Anti-Gay Bill 2009 which calls for death penalty as a revision to the existing Sodomy Law and a revision of the Equal Opportunities Act, 2006 to deny sexual minorities any consideration and social protection. This trend has created an environment of fear, evictions from homes of suspected homosexuals and other acts of impunity. Policy-makers have been made into reluctant actors when it comes to planning that targets same sex practicing persons. Criminalisation is strengthened by the Constitution of Uganda, Section 140. Section 140 of the constitution of the republic of Uganda criminalizes "carnal knowledge against the order of nature" with maximum penalty of life imprisonment. Also, Section 141 prohibits "attempts at Carnal knowledge" with maximum penalty of 7 years’ imprisonment. Section 143, punishes acts of procurement of or attempts to procure acts of gross indecency" between men in public or private with up to 5 years imprisonment.
FINDINGS: Most at risk populations’ Initiative-MARPI is a health service provider initiated in 2007 and using PEPFAR funds through a short term project that closed by March 2010 it reached out to Commercial sex-workers and Sexual Minorities. It was planned to reach over 250 LGBTI. However, by close of the project it had reached 500 LGBTI with targeted counselling, STI/STD/HIV testing and management services. A hotline was availed to LGBTI key leaders to share with LGBTI community and it benefitted 50 people by providing anonymous counselling and guidance (15 lesbians, 20TG and 15 gay men). Immediately after the Anti-Homosexuality Bill, 2009, MARPI recorded lesser attendances by LGBTI which dwindled continuously from 10 attendances on average from 2008 -2009 per week to 3 per week in 2010.
The legislation in form of the Equal Opportunities Act, 2006 was revised in 2009 and sections were added to not allow sexual minorities to express any form of need due to their orientation. The Act is now coached in such a way as to prohibit any form of service provision and it promotes denial of full expression and enjoyment by sexual minorities.
Sexual Minority groups on the other hand have increased a vigilance that promotes anti-HIV/STDs since 2008 up to 2010. In 2008, 5 organisations were at the forefront in organising around expression and demand for respect and dignity of sexual minorities. In 2009, 6 others joined the numbers and these ones were more focused on; empowerment, development, health, psychosocial support, dialogue and tolerance. These organisations have initiated safe spaces in which there was HIV/STD testing, Information, education and Communication on safer lifestyles among sexual minorities. 800 LGBTI have been reached through these spaces.
The following organisations have taken a leading role in LGBTI matters:
1. Sexual Minorities Uganda (SMUG) is increasingly involved in advocacy and driving conversation to reduce stigma and discrimination towards LGBTI.
2. Spectrum and GALA are involved in promoting income generating skills for LGBTI to reduce reliance on sex-work as a means of income. This has enabled them identify reproductive health needs and make referrals.
3. Eddoboozi Human Rights Defenders Network organises around fighting homophobia in Uganda.
4. SOGIAH-UGANDA promotes capacity building around sexuality, orientation, gender identity and Health as themes to explore in order to promote safer reproductive health. It is also packaged as an anti HIV strategy.
5. Empowered at dusk is an organisation that brings together members to lead productive lives in their community.
6. PAOTH is affirming transgender identity and health.
7. Stop abuse Kampala is promoting a reduction on reliance on drugs as stress management.
8. Makerere Health action group promotes health for members.
9. FARUG explores needs among lesbians and provides them with support.
10. Frank and Candy provides internet based health education/moderation of lgbti info link-list serve.
11. Youth on Rock Foundation (YRF) caters for improving income generating skills.
12. Queer Youth Uganda for promoting health seeking behaviour
13. Icebreakers Uganda for coming out counselling
LESSONS LEARNT: 24 outreach services that have been followed for 2 years were fully attended and these were opportunities for; meeting LGBTI leaders in Uganda, especially those who are from the areas nearer to Kampala; dialogue on LGBTI issues; testing of HIV; treatment for those who had ailments and; counselling/guidance. An average of 80 LGBTI persons attended in all 24 spaces. From morning up to late evening security precautions are taken not to attract un called for attention towards themselves and maintaining an HIV focused or Health focused space has enabled them to avoid being evicted. All groups provide earlier briefing meetings in which item is emphasized that conduct that does not draw animosity is to be maintained. LGBTI managed to attend medical, laboratory and counselling services. 2 medical doctors, 3 counsellors, 4 laboratory technicians were employed and they provided unconditional quality services. In some cases were halls were hired for dialogue sessions they were turned into HIV Dialogue safe space with IEC materials and posters with messages targeting LGBTI. All participants were provided lubricants, dental dams, condoms, literature that is sexual minority oriented and T-shirts. Refreshments were non-alcoholic and the days were filled with health improving activities.
CONCLUSION: These self help groups have demonstrated a sensitivity to what works in smaller marginalised communities and using their environment have managed to avoid attracting animosity while at the same time they have been able to carry out interventions.
RECOMMENDATION: Involving LGBTI in designing interventions has helped counter the back lash from the two year sustained anti-gay campaigns. It will help improve overall HIV campaigns in Uganda.