We have recently launched a new program
to purchase medicines and healthcare visits for
these especially marginalized communities. In addition to funding
the cost of medical care, we connect patients to a network of caring
and judgement-free healthcare providers. Moreoever, no one is refused
treatment based on their ability to pay.
Maintaining our committment is difficult without
continued assistance from you. Please consider
helping us reach out
to the sexual minority community in Africa.
Ghana is serving as the test site for this pilot
program. Because on the ground issues prevent openly promoting the
program, great care must be taken to get the word out to those who
need it, but not endganger them either. HEP staffers have recently
returned from spending 4 months in Ghana and have established a small
network of healthcare providers who have demonstrated a committment
to serving GLBT and sex worker populations without discrimination.
In addition, key contacts within the gay and lesbian community are
given small cards that they can then present to the healthcare provider
which identifies them as part of the program.
As the program undergoes testing, we plan to expand
it to other areas in sub-Saharan Africa as resources allow. In the
meantime, we have also established partnerships with groups in Uganda
and South Africa to distribute condoms, lubricants, sponges, and
other materials to prevent infection from STDs, HIV/AIDS, etc.
Josef, who lives in Ghana,
was turned away by his church and family after discovering his
sexual orientation. He was later fired by his employer. When
Josef was infected with a severe case of malaria, he was able to
receive assistance through the Health Equity Project. Josef was treated
for malaria and is now attending school where is studying computer
science.
I was
really going though a real tough time before, I lost my job at
the watchtower house of Jehovahs witnesses branch office in Ghana
because of my sexual orientation, and my family also
deserted me at the time when I needed them most.
I wanted to
continue my education to help myself but I did not know how
because I had no resources and I was very sick. There was no one
to help me out. God answered my prayers by finding you, who encouraged
me to pursue my dreams all the way, helping me get medicine and
started at school.
At the moment school is moving on very
well.
As a way of giving back, I am helping at the clinic as a volunteer.
After one year of school, I will able to get a job in computer technology
with the help of the school.
You are also aware that i love helping
people who are also in need beacause I know how it feels like to
have nobody. My project work for this Semester
would be a Website on poor and needy kids.
Once again i would like thank you for all that you have done for
me and continue doing on my behalf.
HEP has partnered with Gay
Uganda, 
assisting
gays, lesbians, bisexuals, transgenders, and sex workers. In our
initial phase, we are sending and distributing condoms and lubricants
for preventative health measures among these communities.
We are also actively seeking partnerships with
organizations in Uganda that serve GLBT and sex worker communities.
Please email us if you are, or know of one.
HIV and Homosexuals in Uganda, written by Dr. Paul Semugoma
The Patient
He was young: mid twenties, medium height and unremarkable. He
had recently been diagnosed HIV positive. We talked, did tests
and discussed the results, and then he dropped the bombshell. He
was homosexual- a gay man. For doctor and patient issues are clear-cut.
The issue was not homosexuality: it was HIV.
But he was a healthy young man. How would he stop his lovers from
getting HIV? I did not know.
Facts…
The link between HIV and gay sex is well known outside Uganda.
First cases of the new disease in 1983 were identified in gay men.
Gay men are a ‘Key Population’ in HIV because they
have high rates of infection, high transmission rates, and high
rates of STDs. In countries with young epidemics, gay sex contributes
most cases of infection. Gay women can also get HIV from each other.
The spread of the disease can be prevented in both populations.
Most Ugandans know HIV prevention in sex between a man and a woman.
We don’t know how to prevent infection in sex between men,
or between women.
Questions…
Are there gay people in Uganda? Do they know how to prevent HIV
transmission? Do the HIV Service organizations know the importance
of gay sex? I (Paul Semugoma, who is working with HEP), conducted
research in Kampala with the assistance of the Ford Foundation.
I approached many people, and interviewed a few who agreed. I
chose them for their knowledge and particular aspects of the lifestyle.
They included a prominent professional, students, male commercial
sex workers, gay women (lesbians), former prisoners, and gay men
living with HIV.
We talked about their concerns and problems, HIV and STDs prevention
and care. I then talked to Service organizations.
Results.
We have many myths about homosexuals.
- One is that there are no gay people in Uganda. Yet there are
all around us. They are our brothers, sisters, friends and mates.
They fear telling us they are gay, because we can kill them with
our hate.
- Gay men are a key population in HIV. Yet some gay men believe
that a man cannot get HIV from sex with another man. They hear
from the media all about HIV gotten from sex with a woman, and
about prevention when having sex with a woman. They see nothing
about HIV gotten through sex between men, or between women. They
assume that if one gets HIV then one must have had sex with the
opposite sex!
- Gay women believed one can’t get HIV from another woman.
- Gay men talked about condoms, but many admitted not using them.
- Lubricants used for sex included: pre-cum (the fluid when sexually
excited before ejaculation), saliva, and Vaseline, Blue Band®,
Movit® and baby oil. All these are not good. Pre-cum contains
HIV. Saliva is too thin and the others are oil-based lubricants
that destroy rubber condoms, leading to tears.
- Some believed one couldn’t get STDs of the anus: only
of the vagina. And most did not think they could tell a doctor
that they had an STD of the anus.
Service Providers
Many service organizations do not know much about this issue.
Those who knew were scared; because there was a persistent rumor
that one prominent person lost his job because of HIV prevention
amongst gay people. They are justifiably worried for their jobs,
reputations, and livelihoods.
The draft National HIV Prevention Policy dodges the question.
If one applies Uganda’s ABC for HIV prevention;
- Abstinence must have an endpoint. For a man and a woman,
that is marriage, which is not possible for gays in Uganda.
- Being faithful to one partner would expose the person
as homosexual. ‘Hit and run’ affairs seem to be the
rule.
- Condoms and barriers are not used. Cheap water based
lubricant is not available for gay men. There are no dental dams
for gay women.
Community implications
All this is important because gay Ugandans are part of the larger
community. Gay men have sex with women, and gay women have sex
with men (Sunday Vision 15/05/05). A study in Ghana came up with
46% gay men having sex with women. In order to hide their sexuality,
gay men have girlfriends and wives. Gay women are under the pressure
to get married or have children. Also most prisoners rejoin the
general population.
Recommendations
These communities are marginalized in the fight against HIV. Yet
we cannot forget them in this war because they are part of us.
We need to know their HIV prevention needs and constraints. They
lack information, and basic prevention materials like lubricant
and dental dams. There is a need to correct these deficits, a need
to devise innovative programs for them, because they interact with
all society.
The issue is HIV prevention, and targeted efforts here will benefit
all Ugandans.
Dr. Paul Semugoma
semugoma@hotmail.com
Unfortunately,
many gays, lesbians, bisexuals, transgendered persons and sex workers
are often refused treatment for STDs
and other health issues. In regions such as sub Saharan Africa this
can result in a tragic double setback. Health Equity Project is committed
to assisting LGBT and sexual minorities who are among the most marginalized.
Josef writes: