Anti-homosexual legislation and HIV-related stigma in African nations: what has been the role of PEPFAR?
Anti-homosexual legislation and HIV-related stigma in African nations: what has been the role of PEPFAR?
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DOI：
10.1080/16549716.2017.1306391
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发表时间：
2017
影响因子：
2.6
通讯作者：
Barnhart S
中科院分区：
文献类型：
--
作者：
Hagopian A;Rao D;Katz A;Sanford S;Barnhart S
背景：男同性恋者和其他男男性行为者感染艾滋病毒的负担不成比例。惩罚同性性交的法律助长了污名、同性恋和歧视的循环。在许多非洲国家，将同性恋定为犯罪的法律可能会助长这种流行病，因为它们劝阻了关键人群寻求治疗，并阻止了医疗保健提供者提供这种治疗。目标：我们分析了美国总统艾滋病紧急救援计划(PEPFAR)的政策和实践如何应对非洲各地普遍存在的严厉的反同性恋法律。鉴于美国PEPFAR计划的目标是减少围绕艾滋病毒的耻辱，我们探索了PEPFAR可能如何利用其影响力在其开展业务的国家减少对同性恋的刑事化。方法：我们评估了21个非洲国家的同性恋法律，在这些国家，PEPFAR的资金试图减少艾滋病毒的流行。我们研究了与这些国家相关的PEPFAR政策框架协议和其他PEPFAR文件，以寻找试图通过将同性恋合法化来减少耻辱的证据。结果：我们发现，在非洲21个由PEPFAR资助的国家中，有16个国家在同性恋方面的法律被定性为严厉。在由PEPFAR资助的非洲前八个国家中，有七个国家有严厉的反同性恋法律。非洲政府和美国国务院之间的16个非洲伙伴关系框架(PEPFAR)政策协议中的大多数(14)呼吁减少耻辱；然而，没有一个协议呼吁减轻对从事同性恋行为的个人的处罚。结论：我们的结论是，尽管PEPFAR承认污名在助长艾滋病毒流行方面的负面作用，但到目前为止，它错过了明确解决同性恋刑事化在助长污名化态度方面的作用的机会。我们的分析表明，像PEPFAR伙伴关系框架协议这样的机制可能是呼吁废除反同性恋立法的理想工具。
Background: Gay men and other men who have sex with men are disproportionately burdened by HIV infection. Laws that penalize same-sex intercourse contribute to a cycle of stigma, homonegativity and discrimination. In many African nations, laws criminalizing homosexuality may be fueling the epidemic, as they dissuade key populations from seeking treatment and health care providers from offering it. Objectives: We analyzed the ways in which policies and practices of the US President’s Emergency Plan for AIDS Relief (PEPFAR) program addressed pervasively harsh anti-homosexuality laws across Africa. Given the aim of the US PEPFAR program to reduce stigma surrounding HIV, we explored how PEPFAR may have used its influence to reduce the criminalization of homosexuality in the countries where it operated. Methods: We assessed homosexuality laws in 21 African countries where PEPFAR funding sought to reduce the HIV epidemic. We examined PEPFAR Policy Framework agreements associated with those countries, and other PEPFAR documents, for evidence of attempts to reduce stigma by decriminalizing homosexuality. Results: We found 16 of Africa’s 21 PEPFAR-funded countries had laws characterized as harsh in relation to homosexuality. Among the top eight PEPFAR-funded countries in Africa, seven had harsh anti-homosexuality laws. Most (14) of the 16 African ‘Partnership Framework’ (PEPFAR) policy agreements between African governments and the US State Department call for stigma reduction; however, none call for reducing penalties on individuals who engage in homosexual behavior. Conclusions: We conclude that while PEPFAR has acknowledged the negative role of stigma in fueling the HIV epidemic, it has, so far, missed opportunities to explicitly address the role of the criminalization of homosexuality in feeding stigmatizing attitudes. Our analysis suggests mechanisms like PEPFAR Partnership Framework agreements could be ideal vehicles to call for removal of anti-homosexuality legislation.