Uganda faces a surge of HIV infections, local doctors have warned, as patients have been driven underground by the most draconian anti-gay laws on earth.
At one HIV clinic, antiretroviral drugs are piling up unused – suggesting many patients are foregoing life saving treatment for fear of being picked up by the authorities.
Another has seen a 60 per cent decrease in LGBT+ walk-in patients since March, meaning that far fewer people are being tested for HIV.
Across Uganda 1.4 million people live with the virus and 17,000 die of Aids each year because they do not receive the necessary retroviral treatment, according to the state-run Uganda Aids Commission.
Under the new bill, which President Yoweri Museveni signed into law last week, gay sex is punishable by life in prison while “aggravated homosexuality” – which includes transmitting HIV – is punishable by death.
Patients have become fearful of being identified and arrested at clinics, while others have been evicted and forced to move away from their local treatment centres.
The Telegraph spoke to two non-governmental organisations, which combined treat almost 100,000 HIV/Aids patients across Uganda. Identifying details have been removed to protect the safety of medical staff and patients.
“Since the bill was introduced we’ve seen a decrease in LGBT+ people going to the clinics for HIV screening and treatment. We’ve seen a 60 per cent decrease in the number of LGBT+ walk-ins,” said an executive director at one of the NGOs.
He said that since March, when the bill was introduced in parliament, 15 per cent of his patients have stopped receiving their antiretroviral therapy.
The drugs have transformed HIV treatment across the globe in recent decades and prevent those with HIV infections from developing Aids if taken regularly.
Antiretrovirals also reduce the risk of those living with HIV passing the virus to their sexual partners or to their unborn children.
The decline in testing and treatments in Uganda has led to “extreme concerns” about a new surge in HIV infections.
“In Uganda every week we already have 1,000 new HIV infections – now this is going to get worse, not just for key LGBT+ populations, but the general populations as well,” one doctor warned.
“Patients can’t come to the clinic because they are afraid. Our patients fear talking to the doctors. They have asked not to be contacted. People are already missing their medications. It makes me extremely concerned.”
Reuters news agency also reported on Thursday that at a clinic in Kampala the daily influx of 50 patients has “all but dried up.”
“The LGBT community in Uganda is on lockdown now,” the clinic’s resident medical officer said. “They don’t have preventive services. They cannot access condoms ... they cannot access ARTs.”
Those patients who do still attend do so out of absolute necessity, he added, with their HIV cases presenting as more severe after skipping treatment.
Some health providers now fear that offering medical services to LGBTQ patients could be classed as “promoting” homosexuality, an offence punishable by 20 years in prison under the new law.
Those interviewed by the Telegraph reported that some of their staff had already been arrested due to this law, while others have faced verbal and social media abuse.
“We are working like secret service people. We have to be very careful,” a doctor said. “We had to hide documentation of patients. We have to provide services in hiding.”
In one clinic, the 14 staff have been split into two groups to work on alternate days. “We send seven people in one day, and seven people the next. That way, if [the police] raid the clinics, not all of our workers will be arrested,” a source said.
Treatment has been further disrupted by landlords evicting LGBTQ+ tenants, themselves fearful of punishment. This prevents health providers from delivering medication safely to their patients’ homes.
“It’s more than a lockdown, [LGBTQ+ people] are in hiding, they have to find somewhere to live where nobody knows them,” one doctor said.
Uganda’s health minister disputed a suggestion from a US official that the law would reverse the country’s gains fighting HIV/Aids, saying last week that the government would ensure that prevention programmes would remain accessible to those that needed them.
The health ministry did not respond to requests for a comment.
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