1. OWN, SCALE-UP & SUSTAIN
The 16th International Conference on AIDS & STIs in Africa
4 to 8 December 2011, Addis Ababa

2. Realities and Cultural Challenges in Africa
ICASA 2011
Addis Ababa - December 2011
Session: Key Population on HIV/AIDS: LGBT
Realities and Cultural Challenges in Africa
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Zoe Duby
Desmond Tutu HIV Foundation
& University of Cape Town, South Africa

3. Who are LGBTI?
L Lesbian
G Gay
B Bisexual
T Transgender
I Intersex

4. Contextualising
LGBTI refers to sexualities, sexual identities, sexual orientations, sexual lifestyles – NOT sexual behaviour
The terms MSM (men who have sex with men) and WSW (women who have sex with women) refer to sexual behaviour
LGBTI, MSM and WSW are all at increased HIV risk due to many factors

5. The history of homosexuality in Africa
LGBTI only recently recognised in context of HIV/AIDS in Africa
Homosexuality in Africa blamed on Western European influence, colonialism and technology
Evidence shows same-sex practices have always been present in African countries, and are often part of local cultures and traditions

6. Cultural practices
Examples of ‘traditional’ same sex practices in Africa: young-old partnerships, taking on different gender roles, cross dressing, initiation rituals (Wilson, 1951)
Situational same sex behaviours (for example prisoners, truck drivers, miners, armed forces etc)
Socially sanctioned Same-sex sexual experimentation before marriage, in adolescence (Murray & Roscoe, 2001)
Same sex behaviour plays a crucial role in certain rituals and traditional practices (Weiss, Quigley & Hayes, 2000)
There are words same-sex behaviours in many native African languages

7. Politics and State-Sponsored Homophobia
38 countries in Africa have laws criminalizing homosexuality
4 countries with death penalty
Africa is the continent with the harshest laws when it comes to homosexuality and other sexual minorities
partly rooted in colonial-era laws and political situations, religious autonomy, strong negative belief in cultural and family values, and a strong patriarchy
More than 50% of African governments have taken action and steps to formally criminalise same sex union
Political- and State-Sponsored Homophobia in Africa have been on the increase in the last decade
December 2008, United Nations Assembly in New York issued a declaration to decriminalize homosexuality, only 6 African countries signed (Ottoson, 2010)

8. Laws regarding same sex behaviour (2009)

9. Societal factors increasing HIV vulnerability of LGBTI

10. Societal factors increasing HIV vulnerability: Law and politics
Male same-sex behaviour is illegal in most African countries, 4 of which may impose death penalty (parts of Nigeria, Somalia, Sudan and Mauritania)
Protective legislation for LGBTI only exists in South Africa
Recent legal reforms in some African countries have aimed to strengthen anti-homosexual legislation, rather than make laws more inclusive
African LGBTI report harassment from state authorities, including police and public officials, in relation to their sexual orientation

11. Homophobia in Africa – Examples in recent news
Malawi: arrests for homosexuality and new law criminalising lesbians
Zimbabwe: gay people face persecution under the Sexual Offences Act
Uganda: “name and shame” media palaver & recent debate of the Anti-Homosexuality Bill
South Africa: “corrective rape” and hate killings of young lesbian women
And many more….

12. State sponsored homoprejuidice compounds existing situation of abuse, harassment, humiliation, extortion, arbitrary arrests, judicial violence, imprisonment, torture, hate crimes and honour killing on the grounds of sexual orientation and gender identity all over Africa

13. Societal factors increasing HIV vulnerability: Public Opinion
Irrespective of laws, public opinion toward homosexuality in African countries extremely hostile
African public opinion ranks most homophobic in the world in international opinions surveys – on average 85–99% of African people consider that homosexuality should not be accepted by society (Ottosson, 2009)
Roots of hostile public opinion may include:
opinion that homosexuality is ‘un-African’& misconception that homosexuality was introduced to Africa by foreigners
tendency of organised religion to brand homosexuality as immoral and sinful
family/cultural expectations to have partnerships that bear children

14. Societal factors increasing HIV vulnerability: Covertness
LGBTI fearful to disclose sexual behaviours or same-sex orientation to family members & health care staff
LGBTI feel unable to or fearful of coming forward to ask for help
Prevents access to knowledge, skills and services that would help meet HIV prevention and treatment needs

15. Societal factors increasing HIV vulnerability: Self esteem
Consequences of homophobic stigma from society, communities, religious groups, family and friends have direct impact on an individual’s sense of personal worth
Lack of self-esteem arising from stigma reduce a person’s motivation to protect themselves from high-risk behaviours

16. Consequences of multiple vulnerabilities
Combination of state sponsored homophobia, hostile public opinion, covertness and homoprejudice produce and add to:
Lack of knowledge & personal skills
Low self esteem and self efficacy belief
Inaccessibility & unavailability of prevention and treatment services
Hostile and stigmatising societal environment
All these factors combine to make LGBTI individually and collectively more vulnerable to engaging in high risk behaviour and HIV infection

17. African leaders in support of LGBTI

18. Religion and homosexuality
Archbishop Desmond Tutu has become a leading supporter of full LGBTI equality
"He has ... been an outspoken voice for freedom and justice in countries across the globe; a staunch defender of the rights of lesbian, gay, bisexual and transgender persons; and an advocate for treatment and prevention programs to stop the spread of HIV/AIDS… We will miss his insight and his activism, but will continue to learn from his example.”
President Obama

19. “We struggled against apartheid in South Africa, supported by people the world over, because black people were being blamed and made to suffer for something we could do nothing about; our very skins. It is the same with sexual orientation. It is a given.”
Archbishop Desmond Tutu in 2007, after the launch of a book by Amnesty International UK, "Sex, Love and Homophobia.”

20. “Hate has no place in the house of God
“Hate has no place in the house of God. No one should be excluded from our love, our compassion or our concern… because of their sexual orientation. Nor should anyone be excluded from health care…. Gay, lesbian, bisexual and transgendered people are… part of the human family… part of God's family… part of the African family. But a wave of hate is spreading across my beloved continent. People are again being denied their fundamental rights and freedoms…. Our lesbian and gay brothers and sisters across Africa are living in fear. And they are living in hiding -- away from care, away from the protection the state should offer to every citizen and away from health care in the AIDS era… ”
Archbishop Desmond Tutu, March 2010

21. “I know that some [gays and lesbians] are discouraged and even not going to church because they are being abused. Even today they are being abused. But please don’t be discouraged. God created you and God is on your side”
Bishop Christopher Senyonjo, Uganda
At the funeral of Ugandan gay rights activist David Kato – January 2011

22. Reverend Ijeoma Ajibade, Nigeria
“They (LGBT people) too are made in the image of God. They too are human and should be allowed to live without fear of death, harassment or discrimination… We want people in countries like Nigeria to see their fellow LGBT citizens for what they really are - normal Africans who would like nothing more than the freedom to live their own lives, unmolested and unthreatened by the criminal law or the condemnation of the church or state.”
Reverend Ijeoma Ajibade, Nigeria
Director of the Kaleidoscope Trust

23. "Jesus is saying if you said apartheid was unjust then you must say laws discriminating against homosexual people are unjust." 
Anglican priest Jo Mdhlela,
South Africa

24. “I did not come out in support of gay rights but I did come out in support of human rights… I can't understand why you say that homosexuality is un-African when there is evidence that it has always existed and exists today as it does elsewhere in the world. And therefore it appears to me that homosexuality whether we understand it or not or whether we like it or not, it is as African as it is European as it is Asian… homophobia is unjustified.”
Festus Mogae,
Former president of Botswana

25. "We are not only condemning African leaders who are criminalising same sex marriage, but we are urging them to start recognising these people, for the sake of HIV and AIDS.”
Kenneth Kaunda, former President of Zambia

26. In conclusion
Cultural, social & political context for LGBTI in Africa increases their vulnerability to HIV
Despite largely hostile environment, it is not universal – LGBTI are recognised and supported by a handful of African political and religious leaders
Countries that have decriminalised same sex behaviour and offered legal protections to LGBTI see more LGBTI coming forward for prevention, testing & treatment

27. Way forward…
In order to address the HIV epidemic in Africa, African LGBTI, as individuals and collectively, must be acknowledged and recognised
LGBTI must be afforded legal protection and access to health services, and ensured their fundamental human rights

28. Thank you Zoe Duby| DESMOND TUTU HIV FOUNDATION
Doctoral Research Fellow
Key Population and MSM Manual & Training Coordinator .
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