Global Backlash Against LGBT Rights Impairs HIV/AIDS Advances

Yuli Rustinawati
Yuli Rustinawati, co-founder of the Indonesian LGBT rights group Arus Pelangi
Lucile Scott

The past year has brought an outpouring of victories in the fight for global LGBTIQ rights that just a couple of years ago seemed all but impossible -- landmark legislation and court decisions in countries from the United States to Columbia, the UN Security Council's very first discussion of LGBTIQ rights, and more.

But as with so many journeys towards justice, often every two steps forward in the fight are followed by a devastating one back. In this case, a growing list of countries, from Nigeria to Indonesia, have responded to their LGBTIQ communities' standing up to demand their rights by passing repressive legislation that increases the discrimination and legal repercussions they face.

And in addition to sanctioning discrimination -- and, implicitly, violence -- against those perceived to be queer, these laws have also proven deadly by deterring HIV testing and outreach and setting back the 35-year-long fight to end AIDS, just as leaders around the world are proclaiming that the end may finally be in sight.

"My workers are now being criminalized for giving out condoms," says Yuli Rustinawati, co-founder of the Indonesian LGBTIQ rights group Arus Pelangi, of the effects of a recent legislative backlash to the LGBTIQ rights movement in Indonesia. "[The police] find condoms and say it is proof you are gay."

The wave of backlash in Indonesia began last year, when the Indonesian Ulema Council issued a fatwa against same-sex sexual activity, and intensified in January, after a cabinet minister called for banning LGBTIQ organizations in universities. It has spiraled from there, with over 30 new national and provincial anti-gay laws, ubiquitous harassment and the minister of defense calling the LGBTIQ community more dangerous than nuclear war.

But while it's too soon to gauge the impact of this so-called moral panic on HIV testing and treatment in Indonesia, data on the effect of such developments in other countries' are emerging.

In 2013 and 2014, the legislatures in Russia and Nigeria, respectively, passed bills that for the first time criminalized the "promotion" of homosexuality. In both countries, this vague prohibition could be interpreted as criminalizing everything from LGBTIQ group meetings to HIV outreach targeting members of the community.

In Nigeria, mob violence against LGBTIQ erupted in the wake of the law's passage, resulting in several deaths and forcing numerous prominent advocates to flee the country. This left LGBTIQ individuals living in constant fear and worrying that they might be outed by their doctors -- who in turn might fear being persecuted if they work with homosexuals without reporting them -- for seeking HIV testing or treatment. And research published in Lancet HIV confirms that after the law went into effect, significantly more men who have sex with men (MSM) reported that they feared seeking health care and, as a result, actively avoided it.

In Russia, after President Vladimir Putin signed the law, masked men stormed an LGBTIQ community center that was a hub for HIV services; health outreach workers known to work with the community were told to cease and desist or risk arrest; and the national conversation about HIV dwindled to almost nothing. As a result, new HIV infections in Russia have increased by 10% since the law's passage and the number of AIDS-related deaths by 15%.

Globally, MSM remain 19 times more likely to have HIV than members of the general population, and trans women 49 times more than other adults. Nations cannot effectively respond to HIV without responding to it among these -- and other -- key populations, but 73 countries do not currently report national data on HIV among MSM (and very few count trans women as a distinct category) and 78 countries criminalize homosexuality, making MSM and trans women hard to reach.

Beginning in 2009, the U.S. State Department has made the protection of the human rights of LGBTIQ individuals an increasingly integral part of U.S. foreign policy, and the UN has been publicly and privately advocating that member states stop criminalizing homosexuality since 2010; however, intervention from the U.S. and other international actors can have unintended consequences.

In Indonesia, Russia and Nigeria, as in many other places, the backlash to LGBTIQ rights includes rhetoric condemning the entire movement, and homosexuality itself, as the product of a Western agenda. This means international intervention and pressure, if not handled carefully, can intensify the discrimination and in fact make the situation worse for those on the ground.

So how should the international community respond?

"The best way that international political actors can support LGBTI communities is by coordinating closely with grassroots communities themselves," says Jessica Stern, executive director of OutRight Action International (formerly IGLHRC). "The broader argument that homosexuality and transgenderism are the products of Western intervention is incredibly dangerous. Obviously it's not true. But the facts are being ignored. If the truth were all that mattered, every HIV outreach strategy would prioritize sexual rights and stigma prevention."

In some cases, more direct intervention can yield results, such as in Uganda, where the withholding of aid has been cited as a factor contributing to the 2014 overturning of a draconian anti-gay bill. In other situations, it's better for international actors to play a more behind-the-scenes role. In all situations, international stakeholders seem to agree that they should follow the lead and guidance of communities on the ground, who understand the risks and nuances.

"The question [UN organizations] always have to ask is, will they have more impact if they speak up and make a big noise about what is happening and bring in international criticism, or will it be better to hold back and use internal contacts to try to get allies in the government to move away from this," says Charles Radcliffe, chief of Global Issues at the UN Human Rights Office.

In Indonesia, activists have called for international businesses working in the country to write letters supporting LGBTIQ rights and for advocates and allies around the world to condemn the wave of hate and repression, and to urge moderate voices in the government to publicly speak out against it.

"It's all part of a bigger process," added Radcliffe. "We are seeing more and more countries behind the cause and more and more discussion at the UN with the activists. There is a moment now for this movement."

And last week, Indonesia's Rustinawati travelled to New York City to accept an award for her work at an OutRight International gala, the first LGBTIQ gala ever to be held at the UN.

And as she stood at a podium overlooking the sunset-dappled terrace of the UN Delegates' Lounge, a room often occupied by ambassadors and heads of state from countries around the world, including her own, Rustinawati said, "There is nothing more beautiful than looking out into the world and seeing nothing but support and generosity from our community of brothers. And I can tell you one thing, we are not tired, and we are not going to give up."

Lucile Scott is a writer living in Brooklyn, New York, who has written extensively about the global and domestic AIDS epidemics for POZ magazine and organizations including amfAR and Housing Works.