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June 2014
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President's Message: ID Specialists Should Take a Stand
By Joel Gallant, MD, MPH, Chair, HIV Medicine Association

In the wake of President Yoweri Museveni’s signing of Uganda’s Anti-Homosexuality Act, which introduced a sentence of life in prison for “aggravated homosexuality” and criminalized support of gay individuals, including by health care providers, I worked with members of HIVMA to write President Obama requesting that he respond to the legislation with meaningful action. The letter was signed by nearly 1,000 HIV health care providers, and well received among infectious disease colleagues except for one. The exception was a physician member of both the IDSA and HIVMA who wrote to defend Museveni’s right to sign the legislation, considering it an appropriate response to Uganda’s HIV epidemic. 

In fact, criminalization of homosexuality has been shown to be a barrier to effective HIV prevention for gay men. As infectious disease and HIV physicians, we have a responsibility to respond to measures that violate human rights and medical ethics and that endanger public health, and I submitted an editorial to Infectious Diseases News to share my views.

The Uganda parliament has since passed the even more objectionable HIV and AIDS Prevention and Control Act, which is awaiting president Museveni’s signature. This bill would criminalize HIV transmission and attempted transmission and would mandate HIV testing and treatment in pregnant women, at the risk imprisonment. While the Anti-Homosexuality law has already impeded the access of gay and lesbian Ugandans to critical health care services, the signing of the HIV criminalization bill by the President would even further impair efforts to address Uganda’s growing HIV epidemic. Many countries already have anti-gay or anti-HIV laws, and other sub-Saharan countries are now attempting to follow Uganda’s lead. In Nigeria, a similar law is already affecting health care access, and other African leaders are lining up to enact similar legislation.

Sadly, the U.S. is not a role model for Uganda or other counties. We also criminalize risk behavior at the expense of public health and the rights of U.S. citizens. Thirty-two states have HIV criminalization laws, and people with HIV are serving time in U.S. prisons for the crime of consensual sex with disclosure of HIV status in which no transmission occurred.

It is our duty to advocate ethical and scientifically sound public health policy here at home and abroad. HIVMA and IDSA’s Center for Global Health Policy recently wrote to President Obama expressing our concern regarding the law, and Ken Mayer, MD, FIDSA, co-chair of the Center, published an editorial in The Hill supporting the International Human Rights Defense Act of 2014 that was recently introduced by Sen. Edward Markey (D-MA) to combat homophobia globally.

Please urge your senator to support the bill by becoming a co-sponsor and look for other opportunities from HIVMA and IDSA to take a stand against these laws that undercut basic human rights and threaten our ability to turn the tide on the global HIV pandemic.

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