Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services
Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services
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DOI：
10.1080/17290376.2012.744177
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发表时间：
2012-09-01
影响因子：
1.1
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
--
作者：
Semugoma, Paul;Beyrer, Chris;Baral, Stefan
乌干达对艾滋病毒流行病的应对措施因其稳健性和成就而受到称赞。然而，艾滋病毒预防方案规划的一个关键组成部分一直缺失，即针对男男性行为者。主要原因是将男性同性恋行为定为刑事犯罪。2009年，议会提出了《反同性恋法案》，以加强现有的反同性恋法律。一个多学科小组对拟议的AHB进行了健康影响评估。提交的法案将严重增加惩罚，增加封闭。男男性接触者的社会资本将被要求朋友、亲戚和熟人报告的条款侵蚀。卫生保健专业人员必须举报同性恋者。强制性艾滋病毒检测将是对方案拟订的一个打击。在公共场所（法院）披露艾滋病毒感染状况也是一种威慑。对那些检测呈阳性的人进行更严厉的惩罚会增加耻辱感，并阻碍随后的护理。AHB主张对艾滋病毒感染者和性少数群体进行排斥和更多的歧视。这将加剧现有立法对公共卫生的负面影响。乌干达政府应审查包括世界银行、世界卫生组织在内的权威机构发布的指导文件，以制定并推广确认人权的艾滋病毒预防、治疗和护理对策。
Uganda's response to the HIV epidemic has been lauded for its robustness and achievements. However, a key component of HIV prevention programming has been missing, for men who have sex with men (MSM). The main reason cited has been criminalization of male homosexual behavior. In 2009, the Anti-Homosexuality Bill (AHB) was introduced in the parliament to enhance existing anti-homosexuality law. A multi-disciplinary team made a Health Impact Assessment of the proposed AHB. The bill as tabled would severely increase punishments, increased closeting. Social capital of MSM would be eroded by clauses mandating reporting by friends, relatives, and acquaintances. Health-care professionals would have to inform on homosexuals. Mandatory HIV testing would be a blow to programming. Probable disclosure of HIV status in a public space (court) would also be a deterrent. Heftier punishments for those testing positive increases stigma and hobbles subsequent care. The AHB argues for exclusion, and more discrimination targeting persons living with HIV and sexual minorities. It will exacerbate the negative public health consequences of the existing legislation. The government of Uganda should review guidance documents published by authoritative bodies including the World Bank, World Health Organization to develop and bring to scale Human rights-affirming HIV prevention, treatment, and care responses.