Gay Nigerian Actor Puts His Sexuality in the Spotlight

Below is a National Public Radio interview with activist Adebisi “Bisi” Alimi speaking (from a safe distance) to the double hardship of being gay and living with HIV in Nigeria. Bisi currently resides in London where he is a lead advocate on gay rights within the LGBT migrant African community. He is an original member of AVAC’s PxROAR Europe program, bringing HIV biomedical prevention advocacy and education to affected communities such as the African MSM diaspora. You can access his recent article Prepping Gay Men for PrEP on Project Syndicate here.

Adebisi Alimi is the first person ever to come out as gay on Nigerian television. But that wasn’t what the 29-year-old wanted to be known for back in 2004.

Alimi’s acting career was just starting to take off when his sexuality stole the spotlight. The student newspaper at University of Lagos, where he was studying theater, threatened to publish a photo of him with his then-boyfriend. So Alimi beat them to the punch. He went on “New Dawn with Funmi,” one of the most popular talk shows in Nigeria, and challenged a long-held belief that homosexuality was brought to Africa by white colonizers. That was also the year Alimi was diagnosed with HIV.

Suddenly, his home country no longer saw him as a rising star. Alimi lost his roles on TV and on stage, many of his friends shunned him and the police even arrested him on unexplained charges. In 2007, things got worse. He was detained at the airport on his way back from the United Kingdom, where he gave an interview to BBC Network Africa, and was released two days later. Then a group of men entered his home and attempted to kill him. Alimi fled to the UK and hasn’t been back to Nigeria since.

But Alimi says, “My story is not a story of a victim; it’s a human story.” Without it, he says, he wouldn’t be the outspoken activist he is today.

Now 40, Alimi shares his story when he speaks out for the rights of gay black and African men. He’s the founder of Bisi Consultancy, an organization that develops social policy recommendations based on HIV research on the lesbian, gay, bisexual and transgender community. For his birthday on Jan. 17, Alimi has also started a campaign called 40four40 to raise 40,000 pounds — or about $62,000 USD — for four LGBT charities.

Previously, he founded the Independent Project For Equal Rights-Nigeria, a nonprofit for LGBT youth, and helped set up the UK’s first international LGBT organization, Kaleidoscope Diversity Trust.

And while he’s no longer living in Nigeria, Alimi is deeply affected by the country’s anti-gay law passed in January. The law mandates a 14-year prison sentence for those who marry someone of the same sex and 10 years for anyone who, directly or indirectly, supports LGBT organizations.

Alimi was in Washington, DC last month for the 2015 Aspen New Voices Fellowship. Asked about his thoughts on the law, he says that, in a way, “I’m happy about it.”

Why are you happy about Nigeria’s harsh anti-gay law?

I see the law as a catalyst for change for good in Nigeria. You don’t understand what it is like to fight a beast that you cannot see. Before the signing of that law, between 95 and 98 percent of Nigerians were in support of it. The latest poll says 88 percent of Nigerians now support the law. That’s a 10 percent drop. Some people who are not LGBT are now saying, “Did we just support a law that criminalizes people… for falling in love?” [When] you see that your uncle or cousin is gay, it kind of changes the conversation.

Speaking of family, how does your family feel about your identity?

I’m in a relationship that I can’t talk to my parents about — it’s like a big elephant in the room. But [the fact that] they want to accept me [as gay] is a form of support.

I was diagnosed [with HIV] in 2004, and I’ve never discussed it with my parents. This is my personal life, and I don’t want them to get involved with it. Many times when I struggle with the challenges of being gay and being [HIV] positive, even living in diaspora and so many other things, I just really want to have somebody I can cry to who has blood lineage but I just said no.

So who is in your support network?

Mostly close friends. Many times it’s people I don’t know. I remember one incident when I was at my university. I was going back to my room at night and I was stopped by two guys. They were making very derogatory statements and becoming really aggressive. There was a [student] coming. So I raised my voice: “What did I do to you, why are you guys so frustrated with me?” [The student] stopped and said, “What’s going on?” I told her these guys were attacking me, and they said, “Oh he’s gay, he’s a faggot.” She just looked at them and said, “What if he’s a faggot? What’s your problem?” She stood up to them. These are the unsung heroes of my existence because anything could have happened that night.

Back in 2007, a group of guys tried to kill you and that’s when you fled the country. But did you ever want to leave Nigeria before then?

I was lucky enough to go through a 2-hour ordeal of being beaten and almost being shot in the head and escaping. If those guys are still alive, they might have read one or two of my interviews. I wonder how they feel that they almost killed me. But I felt that leaving was never a choice until my mother said, “Do you still have reason [to stay]? I think you should leave.”

How did you react when when you were diagnosed with HIV?

By 2001 I started working in HIV prevention because I lost my best friend [to the disease]. So I was kind of aware. That was why my diagnosis was a shock to me. I broke down and started crying and thought like this is the end of my life because I have seen my friends die. It’s such a big thing that even within the gay community, if you’re positive, that’s the end of it. Nobody wants to talk to you or date you, but you become the story everyone wants to talk about. So I didn’t tell anybody. I carried it for three years before leaving Nigeria. I didn’t start medication until 2009.

If you had known about the treatments and support for HIV then, would you have reacted differently?

No, because then I might still be in Nigeria. And I still wouldn’t want to talk about it because it would still be a death sentence. Treatment is a big challenge and people [in Nigeria] still don’t have access to it. And the support system is still not there because of the stigma against gay men — it’s a belief that [HIV] is a punishment from God. So it’s very difficult to exist with that system.

How would you assess the progress across Africa in providing HIV treatment?

We are still betraying generations when it comes to HIV prevention and treatment. Many people still need access to this treatment and we still have children being born with the virus when we know we can prevent it. We’re lacking political willpower and funding to HIV projects. It has become a political game.

Being an advocate gives you a different kind of stage than acting does. If you had a choice, would you go back in to acting?

I think I studied theater because I was pretty much a drama queen [laughs]. Acting is my biggest passion. The unfortunate thing is that it’s something I would never touch again because it left a big scar in my life. Even when I did try to go back to acting, I kept thinking, “If you keep doing this, you’re going to bring up media interest again.” I have media interest now but it’s very humane. It’s not about who I kissed last night or who I’m hanging out with.

So you’re done with theater?

If there’s anything I want to go back to, it’s acting. I want to be back on stage dancing and acting, but I’m also very scared of it.

Looking Back and Moving Forward

We often refer to AVAC as a translation organization—translating complex scientific concepts to a range of lay audiences and translating complex community perspectives into the scientific process. As we reflect on 2014, it’s clear that this work is as essential and necessary today as it was when AVAC was founded nearly 20 years ago.

From public health programs introducing daily oral pre-exposure prophylaxis (PrEP), to clinical trials of passive immunization with broadly-neutralizing antibodies, biomedical HIV prevention is complex, dynamic and in motion. And in this fast-changing world, it remains our commitment and our daily work to partner with activists and advocates to ensure that we all keep up.

This means keeping up the pressure on normative agencies and donors to be specific, strategic and reality-based in target-setting and implementation. It means sitting down in small groups and large webinars to understand the ramifications of the latest trial results. It means keeping up the call for full funding for HIV research and implementation because we all know that the AIDS crisis isn’t over.

The generous support of our members and donors has been critical to build and mobilize a global network of partners to increase awareness and understanding of the current state—and the future—of HIV prevention research and implementation, and we hope you will continue to support us with your work, wisdom and resources in the coming year.

Next year will be as fast-paced as ever. In the first quarter of 2015, there will be detailed data from two oral PrEP studies in gay men and other MSM in Europe. The FACTS 001 trial of tenofovir gel is also preparing to release data. And several other key HIV prevention trials will be getting underway. All of this will happen in the context of ambitious treatment and prevention targets and diminished funding. With your support, AVAC can be there—to engage, communicate and advocate.

In 2014, your support and collaboration allowed us to:

Please consider making a contribution at www.avac.org/donate. You can also shop online at Amazon via smile.amazon.com and select “AVAC” and a portion of your purchase is donated to us—at no additional cost to you.

We are proud of the work to date—now entering our 20th year as an organization—and we are continually energized and inspired by the opportunities to work with so many remarkable individuals and organizations.

Many thanks in advance for your continued support!

For Women in South Africa, HIV Stigma Still Runs Strong

This article first appeared in the Global Post.

Yvette Raphael left the medical clinic in Midrand, Johannesburg with one thought running through her mind.

She wanted to be dead.

She couldn’t face her baby, she thought. She couldn’t face her sister. She couldn’t face her mother. Her startling HIV diagnosis haunting her every thought, Yvette stepped into the street at the bottom of a hill, right into oncoming traffic.

“At the time, AIDS deaths were described as very painful, very long suffering —everyone would know what’s wrong with you,” Yvette said. “I thought it would take three months for me to be dead.”

“I knew I needed to know, do I have recourse as a person living with HIV?”

In what she now counts as one of the luckiest moments of her life, the taxi coming down the hill slammed on its brakes, stopping right in front of her. The driver took her bag, found her diary with her address in it, and drove her home.

As Yvette, 39, recalls that day 15 years ago when she found out she was HIV positive, she looks healthy and bright like the yellow patterned dress she is wearing. She had come to Cape Town from her home of Johannesburg to take part in the first-ever HIV Research for Prevention Conference, convening researchers, academics and activists to discuss breakthroughs and challenges in the field of HIV prevention.

An HIV diagnosis is no longer a death sentence, thanks to advances in medicine and treatment in the last 30 years. But stigma against HIV/AIDS and fear of discrimination still run strong in South Africa, despite legal protections, as well as drastically improved treatment, prevention techniques and education. Today an estimated 19 percent of South African adults ages 15-49 are living with HIV.

And women, who represent about 60 percent of people living with HIV in South Africa, face a disproportionately large array of consequences, including physical violence and abuse.

“Upon disclosure of women’s HIV positive status,” reads a 2012 study by the AIDS Legal Network on gender violence and HIV, “women’s lives change, due to fear and the continuum of violence and abuse perpetrated against them.”

Although forced or involuntary disclosure of one’s HIV status — along with any discrimination that may result from that disclosure — was made illegal by South Africa’s post-apartheid constitution, experts and advocates say that public knowledge of these laws is limited and the legal system is not equipped to implement them.

Women and HIV

As of 2013, South Africa had the most people living with HIV in the world. Though new infections have been steadily declining in the country since 2000, there are still more than 6 million people living with the virus.

And HIV prevalence is much greater in women than in men, especially in younger populations. United Nations Population Fund (UNFPA) statistics show that for people ages 20-24, HIV prevalence is at 17.4 percent for women and 5.1 percent for men.

Not only are women disproportionately affected by HIV, but they are also more likely to know their status. More women get tested, said Rukia Cornelius, community education and mobilization manager at the NGO Sonke Gender Justice, based in Johannesburg and Cape Town, because unlike men, women need antenatal care.

And often, she said, clinics give women HIV tests when they come in for prenatal visits.

The way hospitals and clinics are set up also are not always conducive to protecting privacy, said Alexandra Muller, researcher at the School of Public Health and Family Medicine at the University of Cape Town.

“People who provide services in the public system, at the community level, are community members,” said Muller. “This is an important dynamic when we think about stigma and disclosure.”

Doctors and nurses can see 60 to 80 patients per day in an overcrowded facility with shared consultation rooms, Muller said.

“There’s not a lot of consideration for how is a clinic set up,” added Cornelius, so that “a health care worker who has done your test and knows your status doesn’t shout across the room to the other health care worker, ‘okay, this one’s HIV-positive, that file goes over there.’”

Once HIV-positive women disclose their status, willingly or not,they are disproportionately affected by stigma because of the direct link between HIV and gender violence.

The 2012 “Gender Violence & HIV” report links the two, explaining that high levels of violence against women lead to a higher risk of HIV for those women, and a woman’s positive HIV status leads to a higher risk of violence and rights violations.

“Women’s experiences of living with HIV are a clear illustration of multiple forms of abuse and violence in all spheres of their lives, perpetrated by partners, families, friends, communities and service providers alike,” the study said.

“It’s about, generally, how society relates to issues of when, and how, we talk about sex and sexuality and power and gender norms,” said Cornelius. “And often, all of those things play out in overt ways that leaves women vulnerable and compromised.”

* * *

Yvette was diagnosed in 2000, and she didn’t begin talking about her HIV status until a year later. She started by joining secret chat rooms because no one in her life knew that she was HIV positive.

Then, her boss at SASSETA — an organization that promotes training and development for South Africans in the safety and security sector — asked her to arrange for a speaker for a World AIDS Day event they were planning.

With 80 colleagues in the room, she said, she told them her secret. “I told them I’m HIV positive. They don’t need a speaker, because I’m going to tell them about my life.”

When Yvette disclosed her status at work, she had not yet told her family. But she had a cousin who worked with her and told her relatives at a family meeting before Yvette had a chance to do so herself.

“I walk into this family house, and there’s close to 20 people there, all who know me, and everyone’s talking behind my back. Everything that I wanted to avoid,” she said.

“Everybody was whispering, saying stuff that I did not understand,” she said. “The fact that she went and disclosed my status to other people did more harm than good.”

It was because of her positive HIV status that Yvette picked up the South African constitution for the first time.

“I knew I needed to have my human rights in check. I knew I needed to know, do I have recourse as a person living with HIV,” she said.

South Africa’s constitution is one of the most progressive in the world and ensures the right to privacy and equality. The Promotion of Equality and Prevention of Unfair Discrimination Act (PEPUDA), passed in 2000, gives effect to the equality clause of the constitution by outlawing forced disclosure of HIV status and discrimination based on one’s status, said Katy Hindle, an attorney and the policy development and advocacy research associate at Sonke Gender Justice.

Yvette said she didn’t want to pursue legal recourse against her cousin because it was close family.

“I knew I could report her, I knew I could sue her, I knew I could do anything. It was going to be such a long battle. Was it worth putting the family in that situation? No,” she said.

After three years without speaking to her cousin, Yvette said, she eventually forgave her, realizing that she hadn’t meant harm. Rather, Yvette said, her cousin just had not known what to do with the information she had been given.

Unlike Yvette, most South Africans do not pick up the constitution and do not know that they are protected. A 2013 Foundation for Human Rights Survey found that only 10 percent of those interviewed had read any part of the constitution or had any part read to them, and only 46 percent knew of the constitution’s existence.

Even when women do know that their rights are protected, reporting cases of forced or involuntary disclosure or discrimination based on HIV status can be challenging, and access to court systems can be difficult.

Section 27, a Johannesburg-based public interest law center, has tracked only 12 cases related to HIV, discrimination and confidentiality that have been brought to court since 1993.

“I’ve heard it referred to as ‘magic legalism,’ which is this idea that you enact something, and because it’s progressive and it’s the right kind of legislation, it will suddenly have a ripple effect of positive benefits,” said Hindle. “In practice, that isn’t the case, and that hasn’t been the case in South Africa.”

Police stations are often not set up to allow women to disclose their status to a police officer privately, said Cornelius. And even if a woman does report a rights violation, it takes a lot of time and money to go through with legal action — two things that many women don’t have.

“If a woman’s status if involuntarily disclosed and she decides to take legal action in that regard, she’d have to have a lot of financial resources,” Cornelius said. “If you don’t have the resources? Good luck.”

Access to court systems is further limited by the public’s perceptions of the legal system, which were heavily shaped during apartheid, said Hindle.

During apartheid, “the legislature and the parliament in South Africa would pass laws that weren’t based at all on the will of the majority and weren’t democratic or fair. I think because of that, most people don’t really come to realize courts as a place where you can access or protect your rights,” she said.

Improvements

Stigma related to HIV/AIDS has decreased in South Africa and views have shifted, stated an article published this year by BMC Public Health, which outlines the results of an exploratory survey to measure stigma in the country.

The report points to results from the National HIV and AIDS Household Survey: In 2002, over 80 percent of participants said they would not sleep in the same room as someone who is HIV positive. In 2005, about 47 percent said they were hesitant to marry someone who is HIV positive.

Improvements in treatment and scientific advances are an additional source of decreased stigma, said Hindle.

“A lot of people who are HIV positive … live healthily, they live for much longer, they live comfortably. And all of those things, I think, have positively impacted discrimination and stigma,” she said.

Still, the survey on stigma concludes, “the advances made by scientists in the diagnosis, prevention and treatment have unfortunately not been matched by advances in social acceptance of the disease.”

After disclosing her status, Yvette helped the safety and security sector conceptualize an HIV/AIDS policy, and she was appointed as the HIV/AIDS coordinator for SASSETA. Now a 2014 fellow at AVAC — a nonprofit organization dedicated to global advocacy for HIV prevention — Yvette counts herself as an activist.

Her real motivation is her children, she said. Her daughter is now 15 and her son is 7.

She has used milestones in her daughter’s life as markers — first she vowed to see her through daycare, then to five years old, then to ten. She said her kids are her yardsticks in life.

“When I was diagnosed, I was in a very bad space. I was in a space of almost being suicidal, and getting past that is taking it one step at a time,” Yvette said. “We all need to find that reason why we live, why we are alive.”

Undetectable: New resources from Doctors Without Borders on viral load testing

Viral load testing is commonly used in high-income countries but remains a relative rarity in many low and middle income settings. This test, which measures the amount of HIV in the blood, has historically been viewed as too costly for widespread use and as unnecessary for good clinical care of HIV. The past few years have seen momentum building towards adding viral load to HIV care in all settings, including resource-poor environments.

Doctors Without Borders, usually known by its French name, Médecins Sans Frontières, continues to produce invaluable resources for advocates seeking to understand why viral load is useful, feasible and worth demanding as part of a comprehensive HIV response. Their new report, Achieving Undetectable: What questions remain in scaling up HIV virologic treatment monitoring?, includes additional evidence from a five-country study of viral load implementation and MSF’s own operational experience in viral load scale-up. And in our database you can also find other, related MSF documents released over the past year.

Post-2015 Millennium Development Goals affirm a future free of AIDS—but is this enough?

Three days after World AIDS Day, UN Secretary General Ban Ki-moon released the report Road to Dignity by 2030: Ending Poverty, Transforming All Lives and Protecting the Planet. This Synthesis Report aims to provide a roadmap beyond 2015, when the 2000 Millennium Development Goals (MDGs) expire. Among the MDGs is the reversal of the spread of HIV and the achievement of universal access to antiretroviral treatment (ART) for all in need. The MDGs are widely considered to have accelerated the changes in the global epidemic since 2000: Over the last fifteen years, global access to ART increased to an estimated 13 million people and there was a 38 percent reduction in new HIV infections. The MDGs were the backdrop for the “3 by 5” initiative, launched by UNAIDS and WHO in 2003 to provide three million people with ART by the end of 2005.

So what is next? The Synthesis Report addresses the unfinished business of the MDGs as well as new health priorities and challenges, including non-communicable diseases and neglected tropical diseases, and universal coverage and equitable access to health care. The report clearly states this new agenda must “…realize the vision of a future free of AIDS…” This goal, however laudable, is the only reference to future work on HIV/AIDS in all of the report’s almost 50 pages.

Should HIV advocates be concerned about the lack of specific HIV goals? Is this retrenchment—a move away from the previous global commitment? Even if it isn’t, will it be perceived as such by governments or civil society? The short answer: probably not. The AIDS advocacy and activist movement(s) do not need to spend time concerned about lack of detail in the post-MDG goals. There are other frameworks, such as the UNAIDS “90-90-90” campaign, that stakeholders need to put into action to achieve the end of the AIDS epidemic by 2030. Within this work, there’s a need to guarantee that ART reaches everyone who needs it—particularly, women, sex workers, men who have sex with men, transgender people, injection drug users and prisoners. And we need to be sure that care and treatment services and medications are high quality, leading to virologic suppression. That’s a hefty task that will only be achieved with concerted, re-invigorated partnership between civil society, policy makers and program implementers—a level of collective strategizing and collaboration that we haven’t seen before. That’s where the real work is needed.

Worrying about the post-2015 MDG agenda could overstate the role they played in the progress we, the global HIV community, have made, which likely also came from leadership, advocacy and trends independent of the MDGs. The rapid reduction in the price of antiretroviral drugs was key to expanded treatment access. Changes in political leadership were also critical in places such as South Africa. Some bilateral programs such as PEPFAR were not MDG driven. Finally the domestic health response has escalated with low- and middle-income countries investing US$ 9.65 billion in 2013.

The new post-2015 development goals laid out in the UN’s Synthesis Report do not deprive the HIV/AIDS field of a rallying call. Three years ago, people already began talking about ending AIDS—a goal beyond the imagination of the MDG architects. The call to end AIDS, UNAIDS’ 2014 90/90/90 target, and now realizing ” …the vision of a future free of AIDS …” in the Synthesis Report, should carry us forward to 2030.

Human Rights Day: LGBT activists discuss barriers to rights and HIV services with UN agencies and member states

Last week, The International Gay and Lesbian Human Rights Commission (IGLHRC) brought together more than 50 LGBT activists from around the world in New York City to mark this year’s International Human Rights Day. The delegation included 10 activists from Zambia, Egypt, Cameroon, Nigeria, Zimbabwe and South Africa, as well as other activist from Asia, South America and the Caribbean. The group attended several UN agency meetings and met with member states to raise their voices about the issues most important to them.

AVAC Policy and Program assistant Micheal Ighodaro was part of the delegation and facilitated the HIV/AIDS discussions during the activist planning sessions and was part of the delegation that visited UNICEF, UNDP and UNAIDS.  In these sessions the activists shared their lack of full understanding of the different UNAIDS targets and lack of African LGBT representation during development of these targets. Below is Micheal’s account of more advocacy discussions throughout the day.

Despite gains in controlling the spread of HIV in Africa, the disease has continued to spread at an alarming rate among its LGBT communities. This, the activists say, is becoming even more severe. They report that HIV programs targeting gay men are only available in big cities and do not reach the many men living in rural areas.

Many of the activists argued that a majority of the funding their organizations receives for HIV-related programs cannot be used for human rights or security advocacy. Conversely, rights-focused funding usually does not allow for provision of HIV prevention and treatment services. They noted that this has greatly increased the division of rights and HIV.  They agreed that it is important for both rights and HIV to be linked as one. Funding for HIV needs to include security and human rights advocacy and also, most importantly, there shouldn’t be a division of rights advocates and HIV advocates as we are all promoters for the good of our communities.   

The need for inclusion of transgender HIV programming in Africa was raised. The representative from a transgender advocacy organization stated that they are left behind in service provision and research. Little to nothing is known about HIV transmission among trans communities in Africa. What is known, however, is that transgender women are 49 times (yes, 49!) more likely to have HIV compared to their general population counterparts. They asked for specific attention to the trans community in all approaches.

The need for research on gay men living with HIV in Africa was raised by an MSM group. Little to nothing is known about this population except that their HIV risks are 19 times higher than those in the general population. The double stigma has limited many of them from accessing health care services. One culprit they cite is the lack of engagement by the national and international communities of people living with HIV.

Many of the delegates were specifically concerned about the new Global Fund and PEPFAR funding models. They agreed there are new opportunities but there are also many challenges around national governments implementing HIV services for gay and transgender communities in the context of criminalization of these very communities. There is need for proper monitoring by Global Fund and PEPFAR to ensure money earmarked for LGBT HIV services is actually funding such programs.  This will be a tall order as delegates emphasized the lack of meaningful engagement from their national governments. This support is key to ensuring seamless and quality services for key populations.

Many of the LGBT delegates’ concerns are not different from what many activists from Africa have been asking for in the last decade:  Meaningful engagement by national governments and international agencies; LGBT adolescent research and programing; specific transgender programs that do not count them as MSM; unified funding that addresses both rights and HIV; and research on HIV among lesbians in Africa.

As an advocate who has been involved in HIV and rights advocacy in Africa for many years, I have experienced and witnessed heightened HIV vulnerability among LGBTs in all its ugly manifestations.  Only when we activists succeed in uniting our struggle for sexual minorities with access to HIV treatment and prevention will we succeed in either. 

Prepping Gay Men for PrEP

Adebisi Alimi is an LGBT advocate, former AVAC PxROAR Europe member and a 2014 Aspen New Voices Fellow. This article first appeared in Project Syndicate.

In October, two groups researching the effectiveness of a potential breakthrough drug in the fight against HIV did something unusual. They announced that the therapy they were testing, an antiretroviral drug called Truvada, had proved effective enough to end the randomized phases of the trials, and that they were offering the pill to all of the studies’ participants.

The researchers found that gay men who take Truvada, in addition to using condoms when they have sex, were significantly less likely to contract HIV. This is further evidence of the effectiveness of pre-exposure prophylaxis (PrEP), a technique by which people who are HIV-negative use antiretroviral drugs to protect themselves from infection. In 2011, a trial funded by the Gates Foundation found that straight couples using Truvada reduced the risk of transmitting HIV by 73 percent.

Those fighting to prevent the spread of HIV/AIDS thus have a new tool in their arsenal. The question now is how best to deliver it to those who need it most: gay men in developing countries.

This summer, the World Health Organization took an important step to that end, recommending PrEP for all gay men and men who have sex with men, making it the first major international health organization to do so. The WHO estimates that increased use of PrEP could reduce HIV infections by up to 25 percent over the next decade among men who have sex with men (this category includes anyone with elevated risk, not just those who identify as gay).

But an important obstacle remains: the legal predicament of gay men in much of the developing world. In countries like Nigeria, where anti-homosexuality legislation has recently been approved, those following the WHO’s new PrEP guidelines could find themselves subject to imprisonment.

The climate of officially sanctioned homophobia in Nigeria has already set back the fight against AIDS. In 2006, a study found that 13 percent of men who have sex with men in Nigeria were HIV-positive, compared to 4.5 percent of all Nigerians. By 2012, the HIV rate among men who have sex with men had jumped to 17 percent. Meanwhile, an increasing number of men reported encountering homophobia at healthcare centers, making them less likely to seek help.

The consequences could not be more serious. Two years ago, a young HIV-positive Nigerian man contacted me on Facebook to tell me about his monthly ordeal at the clinic. The nurse at the hospital spent more time lecturing him on the evils of homosexuality than telling him about the drugs he was taking and their possible side effects. The man, a third-year medical student, told me that he had decided to stop going to the clinic. When I asked how he would continue treatment, he said that he had a friend abroad who could get him the drugs. Less than two years later, I saw a Facebook update announcing his death.

My Facebook friend is not the only one who has paid the price for Nigeria’s homophobia. A preliminary report from the Solidarity Alliance Nigeria, a coalition of gay, lesbian, bisexual, and transgender (LGBT) organizations, details a huge decrease in the use of HIV services by men who have sex with men in the six months following the enactment of the anti-gay legislation. The decrease ranges from 40 percent in Lagos – Nigeria’s most cosmopolitan city – to 70 percent in Kano, a predominantly Muslim state.

Nigerians living with HIV must do more than just fight the infection; they also must brave social stigma, weather discrimination by secular and religious institutions, and now, potentially, face threats from the legal system. In this environment, the promise of PrEP begins to dim, as the risks of seeking treatment outweigh the potentially life-saving benefits.

The story is similar in Uganda. Last spring, as legal persecution of gays there mounted, the government raided an HIV clinic and withheld its operating license for providing care and support to HIV-positive men who have sex with men.

As an African activist with more than ten years of experience in the fight against HIV, I hope that the WHO will build on its important first step of advising the use of PrEP. That means initiating a public conversation with countries like Nigeria, Uganda, Gambia, and Russia on the importance of inclusion in the battle against HIV.

The WHO should make it clear that while it may not be advocating for LGBT political rights, it is determined to ensure that all those who can benefit from PrEP are able to access the necessary drugs, without fear of legal consequences. Researchers, drug companies, and human-rights campaigners must take up the fight to ensure that PrEP is made available – without risk – to those who need it most.

Ugandan Advocates Emphasize Prevention Based in Evidence, Not Opinion

At this year’s World AIDS Day commemoration in Uganda, President Yoweri Museveni’s remarks were reported to question some of the scientifically proven HIV prevention interventions including voluntary medical male circumcision and condoms.

Political leadership is critical for an effective HIV/AIDS response. Over the past twelve months, Ugandan civil society has worked tirelessly to address national challenges including the anti-homosexuality law and enforcement of a law criminalizing HIV transmission. They have also responded to these recent developments.

Here is an op-ed written by Regional Policy and Advocacy Manager at the East/West Africa Bureau of the AIDS Healthcare Foundation and former AVAC Fellow Alice Kayongo-Mutebi.

Nigerians Call for Protection of the Rights of All Nigerians Including LGBT Persons

As the world marks this year’s International Human Rights Day on December 10th, a coalition of Nigerian human rights defenders have launched a campaign calling on the international community to raise awareness about the ongoing violations against LGBTI individuals across the country. 

According to UNAIDS Nigeria has the second largest HIV epidemic globally—in 2012, there were an estimated 3.4 million people living with HIV in Nigeria. In 2010, national HIV prevalence in Nigeria was estimated at 4% among the general population and 17% among men who have sex with men.  

AVAC will continue to work with civil society organizations and activists in Nigeria and all countries where criminalization of HIV status, homosexuality and other practices or identities undermines the right to health and life. To learn more about what we are doing, visit our “Strategic Initiatives” page and to receive updates in your inbox, please join our Advocates’ Network. Stay tuned—and stay in touch.

The press release for this effort is below. 

 #FREEANDEQUALNAIJA CAMPAIGN 

LAUNCHED TO PROTECT THE RIGHTS OF ALL NIGERIANS, INCLUDING LGBTI INDIVIDUALS.

A group of Nigerian human rights defenders have united in the #FreeAndEqualNaija media drive aimed at giving prominence to the protection of the rights of all Nigerians including lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals. 

Across the country this year, thousands of Nigerians have been victims of a wide range of human rights violations. Among them many have experienced violence, due to perceived or real difference in their sexual orientation or gender identity. Recorded violations included mob justice, arrests, sexual assaults, unlawful detention, eviction from homes, discrimination in health care and education settings, blackmail, extortion, public humiliation and even killings. In most cases, access to justice for victims was often impossible, and compounded by negative media reporting and lack of assistance from public authorities. Through the 

#FreeAndEqualNaija campaign, human rights defenders aim to create more awareness of the need to include sexual orientation and gender identity in the broader spectrum of human rights advocacy in Nigeria. 

The harm caused by gender-based violence (as highlighted in Nigeria last month) and barriers in accessing justice for victims of sexual assault is particularly crucial for sexual minorities. And like millions of their Nigerian counterparts, poverty, youth unemployment, HIV/AIDS and exclusion from public education further compound the plight of sexual minorities. Campaigners therefore wish to forge more partnerships with the mainstream human rights movement, as well as religious and opinion leaders. 

This year, two new resolutions of the African Commission on Human and People’s Rights (ACHPR) have called on member states to combat violence and discrimination related to sexual orientation and gender identity. The ACPHR has also expressed concern for the welfare of Nigerian human rights defenders following the passing of the Same Sex Marriage Prohibition Act 2013. #FreeandEqualNaija campaigners appeal Nigerian authorities to update its legal and policy apparatus regarding LGBTI individuals to be in line with standards recommended by the ACPHR and the United Nations Human Rights Council. 

According to Jake Okechukwu Effoduh (campaign member), “Much work is needed to highlight the negative impact of deeply held prejudices towards minorities, who are victimized simply because of who they are or who they love. This sad situation should concern all of us”. 

#FreeandEqualNaija campaigners are inviting members of the public to join the human rights movement on December 10, and show their support for a more tolerant Nigeria. According to Cheikh Traore (campaign member); “The public can help raise awareness through social media and conventional media with stories which reflect the harmful impact of prejudice on families and ordinary people’s lives”. 

The public is invited to share their experience relating to the harmful impact of prejudice towards sexual minorities. The public is also encouraged to use Facebook, Instagram and other social media platforms to promote the freedom and equality of all Nigerians. Tweet with the hashtag #FreeAndEqualNaija as well as follow @FreeEqualNaija on twitter to share stories relating to the hurtful impact of discrimination towards sexual minorities.

According to Dorothy Aken’Ova (campaign member) “All forms of violence experienced in Nigeria are interlinked. We will eliminate all forms of violence when we have the political commitment to protect the human rights of ALL”.

New publication: Journal of Virus Eradication

SOURCE: US Military HIV Research Program (MHRP)