When the anti-gay laws passed in Uganda late last year, there was a worldwide outcry over what many were calling human rights violations. The laws made it illegal to be homosexual, or engage in homosexual sex, with a chance at a lifetime in prison. The people of Uganda overwhelmingly support the law even in the face of international censure. A Ugandan court has since invalidated the law, but Uganda was not the only country that has laws pertaining to homosexual relations.

37 African countries have laws that make homosexual sex illegal that vary in the severity of the sentence from fines to the death penalty. Most of the laws are holdovers from Western colonialism. Opinions on same-sex relations aside, anti-gay laws end up hurting everyone. LGBT individuals will be the most effected, but these laws will damage access to quality health care for the entire nation. 

Here are the 13 reasons anti-gay laws are a problem for everyone when it comes to health care:

1) It's not just about LGBT people: Men who have sex with men (MSM) are the most visible population who are being prosecuted by these laws. What might surprise you is that most MSM also have sex with women. Having sex with men doesn't mean that the person isn't also attracted to women. Even if a MSM is only attracted to men, he will often have heterosexual relationships to appear straight publicly, as well as secret same-sex relationships. This means that any laws that effect the STI rates for MSMs will effect the whole population.

Flickr: Doctors of the World UK

2) HIV/AIDS rates will increase: MSM have the highest prevalence of HIV and Uganda has one of the highest HIV positive populations in the world. With same sex relationships being forced underground, this vulnerable population can’t get the health interventions they need and everyone is at greater risk. Targeting health care on groups that are especially vulnerable to disease, such as MSM, can do wonders for disease rates. Health workers already treat sex workers as a vulnerable group for HIV with some success. Failing to do the same with the people who have the highest HIV prevalence will certainly increase HIV rates.

Flickr: beL0VED

3) Fewer people will get tested for HIV: Since HIV is known to disproportionally effect people who have homosexual sex, even people who don’t could fear that being found positive for HIV will put them under suspicion. This stigma has real consequences for health care. Fear of getting tested and fewer places to get tested for HIV means that fewer people are aware of their status. When people are unaware of whether or not they have HIV, people are less likely to take the precautions that protect their partners. This in turn means more people will be afflicted.

Flickr: USAID

4) Fewer people will get treated for HIV and AIDS: The same fears and obstacles that will keep people from getting tested will affect those who need to seek treatment. HIV and AIDS need to be managed by health workers to keep those infected as healthy as they can be. People who are HIV positive also rely on health care workers to educate them on practices that will keep their partners safe.

Flickr: Jon Rawlinson

5) But its not just about HIV: Although increased HIV rates are incredibly scary, and MSM are especially at risk, there are other ways the all citizens will be effected by anti-gay laws. The conversation about how anti-gay laws effect public health can't begin and end with HIV.

Flickr: Anne Cormier

6) Other STIs: The same factors that will likely increase HIV rates apply to other STIs. In developing countries STIs and their complications are in the top 5 disease categories that adults seek care, even after excluding HIV. The effects that come from contracting an STI can last a lifetime: effects include poor maternal health, ectopic pregnancy, infant death, cancer, and infertility. And not to harp on the HIV prevalence, having an STI puts people at greater risk for contracting HIV.

Flickr: Louis Kreusel

7) Overall confidence in healthcare will be eroded: After the anti-gay laws passed in Uganda, the health minister said that there would still be equal health care access for all citizens, LGBT or not. However, there is no way that he can guarantee that that is the case. If citizens can’t communicate openly with their doctors about any aspect of their health, especially sexual health, many people won’t get the treatment the need. Trust in doctors is important for effective healthcare, but there have been doctors taking bribes to protect a patient’s suspected sexual identity.

Flickr: hdptcar

8) Health workers can be prosecuted: Because of the ambiguity of the parts of the law that cover “aiding” homosexuals, which can carry a 7 year prison sentence, some health care workers will refuse to treat possible LGBT people at all. Since there is no way to tell if a patient is gay or not, health care workers will inevitably turn away non-LGBT citizens as well as LGBT citizens.

Flickr: Feed My Starving Children

9) Gay aid workers are at risk: The staff of aid organizations and international NGOs are subject to the laws of the country they are working in. This means that gay staff are at risk for prosecution, which is an added obstacle that needs to be considered when organizing aid.

Flickr: Ian Barbour

10) Aid has been cut: The World Bank pulled back $90 million in health funding it planned for Uganda after the law passed. Some countries, including the US, cut aid or transferred aid from government organizations to private NGO's. Whatever you may feel about this move, it is clear that the poorest people in Uganda will have less access to aid as a result.

Flickr: neajjean

11) HIV research has been targeted: On April 4, police raided Makerere University Walter Reed Project (MUWRP) a non-profit HIV research program that provides prevention, care and treatment. The police claimed that they were suspected of “recruiting” people into homosexuality. Currently, there is no cure for HIV and research is the only way to find a cure.

Flickr: See Li

12) Health care workers will have no idea what’s really going on: The White House announced that it would no longer be conducting surveys on high-risk HIV populations in Uganda after the law passed. Health workers and development strategists rely on accurate statistics to know what strategies are working and which areas need the most aid. If it is illegal to be gay, and there is an intense stigma around HIV status, no one will want to report their status, even when they are straight. Interventions that aim to improve health care are only as effective as the information in the hands of the workers. These statistics aren't only used by the people who are focused on HIV either. When aid workers are working without accurate information there is no way they can do their jobs.

Flickr: Adam Jones

13) Violence against LGBT, and suspected LGBT, has sky-rocketed: There has been a 750% to 1,000% increase on attacks aimed at LGBT individuals. There have been attempted lynching, kidnappings, and cases of torture of people who were suspected of being LGBT. The health care costs of these attacks need to be considered, along with the general effects of increased violence on the street, for all citizens.

flickr: Mike Blyth

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Michelle Kennedy