Uganda: Ministerier er uenige om hjælp til homoseksuelle med AIDS

Laurits Holdt

Sundhedsministeriet i Uganda har åbnet en AIDS-klinik for homoseksuelle og andre seksuelle minoriteter. Det kritiseres af ministeriet for etik og integritet, der ser det som en form for opfordring til homoseksualitet, der er ulovlig i landet.

KAMPALA, 9 December 2013 (IRIN): Eighteen months after slamming activists who opened a clinic for lesbian, gay, bisexual, transgender and intersex (LGBTI) people in Kampala, Uganda’s health ministry has decided it was a good idea after all and has begun setting up similar facilities, prompting outrage from the Ministry for Ethics and Integrity and scepticism from some in civil society.

Alex Ario, the acting programme manager of the Ministry of Health’s AIDS Control Programme (ACP), says they are rolling out four specialized clinics for the most at-risk populations (MARPs) in four division of Kampala and several others in major HIV/AIDS hot spots in upcountry towns. The clinics will target men who have sex with men (MSM) and female sex workers (FSW) with health services including HIV testing, counselling and treatment, and screening for other sexually transmitted infections (STIs).

“The clinics will not only be MSM clinics but MARPs clinics, though the focus will be on those MARPs that are most stigmatized, discriminated against and most likely to miss out on intervention services,” Ario told IRIN.

The initiative follows the success of a MARPs STD unit at Mulago National Referral Hospital, which has enrolled some 500 clients for comprehensive HIV treatment.

Turnaround

Gay rights activists opened Uganda’s first clinic for LGBTI people in the capital, Kampala, in May 2012 – an act fiercely criticized by the government.

Despite the high prevalence of HIV among MSM and FSW – 13.7 percent and 33 percent respectively, according to the 2008-2009 Crane Survey of high-risk groups in Uganda – the government has not included these groups in its national strategy to fight HIV because homosexual activity and prostitution are illegal.

There remains a strong stigma attached to the LGBTI community; the Anti-Homosexuality Bill, currently before the country’s parliament, seeks more stringent punishments for people engaging in homosexual acts and those perceived to be “promoting” homosexuality.

Even so, the health ministry is moving forward with its MARPs clinics, which are being implemented in phases in order to train healthcare providers, mobilize MARPs, and implement monitoring and evaluation mechanisms.

“They [clinics] will be part of the health delivery system, and I believe nobody will challenge delivery of interventions/services to people that are key in the HIV response,” Ario told IRIN.

“We do not promote what they do, but what they do is our concern because of its public health implications. Therefore, from the public health point of view, we must reach them. As far as health services are concerned, we are not bothered [by] their sexual orientation and the laws. For us, we don’t discriminate in our services. The other aspects of the law will come later.”

The US government, which provides support to Uganda’s fight against HIV, has welcomed the initiative.

“We strongly encourage them to ensure that these populations are not stigmatized and are respected under the Ugandan constitution, which guarantees equal rights for all minorities,” Daniel Travis, spokesperson for US Mission Uganda, told IRIN.

Objections

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