AIDS, gay men and Africa

Authorities in many African nations are deeply troubled by the prospect of having men who have sex with men in their midst. While living in South Africa a few years ago, I remember a heated debate in the letters to editor section of the Mail and Guardian about whether homosexuality was a purely imported phenomenon, something alien and originating from the fleshpots of (say) southern California, and dropped recently into Africa. The idea was that if it was something new and foreign, it could hopefully be returned to sender, like an unwanted package. But it eventually appeared that the phenomenon wasn't really new or entirely foreign to Africa. So what couldn't be denied would have to be repressed; while not unAfrican, the behavior was nevertheless an abomination. Many African churches have joined with political authorities over the years in their attempts to condemn and marginalize the sexual behavior of gay African men. In most African countries, homosexuality is still illegal.

Last week, the New York Times reported the sentencing of nine men in Senegal to eight years in prison for 'unnatural acts.' The men were arrested in the house of a leading gay HIV/AIDS activist in Dakar. The events in Senegal join a long list of repressive political actions against gay men in African countries, including Nigeria, Gambia, Burundi and Uganda. Now there is a lot that one could say, from a human rights or social justice perspective, about the political treatment of men who have sex with men in Africa. But there is also a public health ethics perspective: demonization of homosexuality is counterproductive in the fight against HIV/AIDS in Africa, just as it was in America during the early days of the epidemic. Condemnation and criminalization simply drives the behavior underground, away from prevention and treatment services, increasing risks of HIV transmission. The conclusion is hard to avoid: the HIV/AIDS epidemic has forced African countries to deal with homosexuality in their communities, but many have failed to develop responses that are justified from a public health point of view or even reflect basic human decency.