"Women and LGBT are the most important groups to have an effective response with" - AAI
NAIROBI (TrustLaw) – Telling a medic the details of your sexual history can be daunting.
"Should I tell her about that one night stand? What will he think of me if I say I didn't use a condom?" we wonder.
Imagine how much worse it would be if what you were doing was illegal.
This is the situation facing lesbians, gays, bisexuals and transgender people (LGBT) in Africa where widespread homophobia and laws criminalising same sex activities are preventing many from accessing health care services.
AIDS Accountability International (AAI) – a member of TrustLaw Connect, the free service connecting legal needs with pro bono expertise – argues that governments must be more responsive to the needs of such vulnerable groups if they are to halt the HIV/AIDS pandemic.
"Women and LGBT are the most important groups to have an effective response with," said AAI Executive Director Rodrigo Garay.
In sub-Saharan Africa, women account for six out of 10 people living with HIV, largely due to inequalities that leave many women poor, uneducated and without a voice.
'CORRECTIVE' RAPE
AAI has criticised the United Nations for failing to demand that governments provide data on knowledge about HIV transmission among lesbians, bisexuals and transsexuals in the 2001 Declaration of Commitment on HIV/AIDS.
In adopting the 2001 Declaration, U.N. member states are obliged to report on their progress to UNAIDS every two years. These reports are what AAI uses to compile its scorecards. Generally, the less data governments provide the lower they score.
While sex between women was thought to carry little risk of HIV transmission, many lesbian and bisexual women are married to men because of social pressures to conform.
They are also vulnerable to homophobic 'corrective' rape.
Similarly, many gay men are married to women. Studies show that at least two-thirds of men who have sex with men in Africa also have sex with women.
AAI argues that it necessary to decriminalise homosexuality and reduce stigma and discrimination against sexually diverse people if HIV/AIDS is to be tackled effectively.
"In some countries, it's even illegal to be a lesbian or homosexual," said Garay. "To make governments accountable on promises on universal access on HIV/AIDS, you need to have transparency about how these groups are being provided with treatment and prevention."
"It's difficult. It's politically sensitive. But if you want accountability you need to demand accountability."
LESBIANS, WOMEN NEGLECTED
Experts say that the first step in tackling the spread of the disease within groups that are at risk is to monitor their behaviour and role in the epidemic.
AAI has created scorecards to show how inadequate most government responses are to LGBT and women.
Its 2011 scorecard found that only 50 out of 192 countries provided data on knowledge about HIV transmission among men who have sex with men.
Africa scored very poorly, with only Tunisia, South Africa, Nigeria, Togo and Gabon providing any data on knowledge about HIV transmission among men who have sex with men (MSM). Some 70 percent of African countries criminalise homosexual sex, with sentences of up to 14 years.
AAI's 2009 scorecard focused on responses to HIV/AIDS in relation to the specific needs of women. It found that 75 percent of countries failed to report basic information to the United Nations about their domestic responses to the disproportionate impact of HIV/AIDS on women.
Developed countries were the worst performers, with the United States, Norway, Portugal, Ireland and Denmark among those submitting no data on women. More encouragingly, two-thirds of the high-burden countries, including all of southern Africa, qualified as "responsive".
(Editing by Katie Nguyen)
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