Two-thirds of countries no longer criminalise consensual same-sex sex, a “remarkable reversal” since the start of the AIDS pandemic that has enabled global progress against the spread of HIV.

This is a key finding of Progress and the Peril, a report on HIV and decriminalisation released this week by Georgetown University’s Global HIV Policy Lab.

While 129 out of the world’s 194 countries, a further 24 countries don’t enforce their criminalising laws, said Professor Matthew Kavanagh, Director of the Center for Global Health Policy & Politics at the university’s O’Neill Institute.

“The reason why we’re talking about the decriminalisation of LGBTQ people around the world is because it has a clear link to HIV outcomes,” Kavanagh said at the launch of the report.

The trend towards decriminalisation has accelerated since 2017, with 13 countries representing 7% of the world, removing criminalising laws. The most progress was made in  2022 when Singapore, Barbados, St. Kitts and Nevis, and Antigua and Barbudan decriminalised consensual same-sex acts. In 2023, the Cook Islands and Mauritius joined them, with Venezuela removing its criminalising military law. 

“Knowledge of HIV status and viral suppression among the whole population is significantly higher where decriminalisation has happened,” added Kavanagh.

Not a ‘Western agenda’

“This report shows how the world is increasingly rejecting the criminalisation of LGBTQ people,” said Winnie Byanyima, UNAIDS Executive Director. “Instead of sending a message of condemnation and fear, these governments are encouraging their people to come into the health system and get what they need for their well-being.”

Byanyima noted that progress had accelerated since the United Nations decision two and a half years ago to close the inequalities driving AIDS.

“That included creating enabling legal environments with a goal that, by 2025, less than 10% of countries in the world would have punitive laws standing in the way of ending the AIDS pandemic,” she added.

“There are some who say that this is a Western agenda. But no, look at this report – India, Botswana, Angola, Gabon, Barbados, Venezuela, and just a few weeks ago Mauritius. That is a South. The South is moving,” stressed Byanyima, who is Ugandan.

The Caribbean is the region that’s decriminalising at the fastest rate, she added.

Perils in some countries

But the report also warns of the perils, with recent prosecutions of LGBTQ people reported in 41 countries and “recent or pending legislation in several of these countries that make penalties more extreme”.

In May, Uganda passed an Anti-Homosexuality Act (AHA), which is one of the harshest anti-LGBTQ laws ever passed globally. Ghana passed a similar law in July.

“There is a concerted campaign [and] US organisations that are pushing the deepening of criminalisation,” warned Kavanagh, who described this as a well-financed, well-coordinated “neocolonial push”.

Florence Riako Anam, co-executive director of the Global Network of People Living with HIV (GNP+),  expressed deep concern that some countries are “continuing to deepen criminalisation and persecution against the LGBTQ communities”. 

“I’m speaking as a Kenyan and I can share how deeply worried I am about the coordinated efforts that are happening in East Africa to replicate the laws and condone violence and discrimination that we are seeing in Uganda,” said Anam. Kenya’s parliament is considering a Bill that is similar to Uganda’s AHA.

‘Step up and catch up’

Mandeep Dhaliwal, the United National Development Programme (UNDP) director for HIV and Health, said that homophobia and punitive laws cost the world more than $126 billion per year – largely calculated in lost productivity and increased health costs.

“People living with HIV in criminalising countries have 11% lower knowledge of their HIV status and 8% lower viral suppression rates,” said Dhaliwal.

Meanwhile, Byanyima called for the leaders of the one-third of countries that still criminalise to “step up and catch up”.  

“Those who are pushing in the opposite direction, sadly such as my own country, Uganda, towards direct criminalisation, are on the wrong side of public health, on the wrong side of economic growth, and on the wrong side of history,” she stressed.

“Politicians usually make this argument that [being LGBTQ] is unAfrican, really, with the purpose of disenfranchising LGBTQ people from society. Once they put them in the category of not citizens of Africa, then they are denied all their rights. I totally don’t respect it. I am a proud African and I support and promote and respect and cherish LGBTQ people.”

Anam said that programmes and interventions for people living with HIV would not work “if some of us are not able to come into the room and share what their needs are,” she added, noting that this was a human rights issue that should not be confined to HIV.

“The struggle for our rights and dignity and quality of life has reached fervent urgency now more than ever,” said Anam. “Repressive laws institutionalising the criminalisation, prejudice, and violence against our communities – particularly those based on sexual orientation and gender identities – do not serve us. 

“They cause harm. They lead to the death of friends or getting harmed. All of us people living with HIV must access treatment, get undetectable and achieve quality of life.”

Vivek Divan, head of the Centre for Health Equity, Law & Policy, said that the effort to decriminalise in India had taken two decades.

“The litigation that led to the decriminalisation of queer people in India was filed in 2001 to an HIV NGO. It had many ups and downs being dismissed on the grounds of local standby in 2004, reinstated in 2005 by the Supreme Court and finally heard in 2008 with a positive decision being adjudicated in 2009 – all by the Delhi High Court,” said Divan.

Dhaliwal noted that progress against criminalisation “is not an accident”. 

“It is the result of the courageous leadership of LGBTQI communities, people living with HIV and other key populations working together with enlightened institutions and allies towards decriminalisation and anti-discrimination. We need much more of this kind of solidarity in a world that is suffering from a solidarity deficit,” said Dhaliwal

Image Credits: Stavrialena Gontzou/ Unsplash.