With Nigeria’s anti-gay law, HIV care drops 10%-70%

Nigerian President Goodluck Jonathan signed  the so-called "Jail the Gays Bill" on Jan. 7, 2014. (Photo by Ricardo Stuckert via Wikimedia Commons)

Nigerian President Goodluck Jonathan signed the so-called “Jail the Gays Bill” on Jan. 7, 2014. (Photo by Ricardo Stuckert via Wikimedia Commons)

The extent of the devastation that Nigeria’s anti-gay law is wreaking on Nigerian anti-AIDS efforts is coming into view.

Among Nigerian men who have sex with men, the number of people reached for HIV prevention has dropped drastically since the signing of the anti-gay “Same-Sex Marriage Prohibition Bill” in January. According to a survey of five anti-AIDS organizations in five Nigerian states,  HIV prevention contacts (using UNAIDS’s Comprehensive Minimum Prevention Package Intervention) are:

  • Down 40 percent in Lagos state
  • Down 30 percent in Rivers state.
  • Down 10 percent in Cross River state.
  • Down 30 percent in Abuja (Federal Capital Territory).
  • Down 70 percent in Kano state.

Survey results were mixed with regard to contacts with HIV-positive people — a range of minus 50% to plus 30% contacts in those same five locations for the Positive Health, Dignity and Prevention program endorsed by UNAIDS (the Joint United Nations Programme on HIV/AIDS).

A key reason for the drop in HIV prevention services is health-care professionals’ fear of prosecution under the anti-gay law, which provides 10-year prison sentences for people at meetings with gay men.

The Nigerian government maintained that health-care for LGBT people will not be affected by the new law, but that has not proven to be true. As The Economist reported:

“Browbeaten by foreign aid donors, the government promised that gays with HIV would not be denied access to health care. Yet doctors are afraid of the consequences if they provide it, citing the law as a reason not to help.

“Gay Nigerians say they are routinely turned away from hospitals. Many more are afraid to seek medical help in the first place. Local advocacy organisations such as The Initiative for Equal Rights have stopped issuing referrals to public-health institutions, lest people are ‘outed’ by unsympathetic medics.”

Nigeria has the world’s second-highest number of new HIV infections per year, a pace that has boosted the nation’s total number of HIV-positive people to 3.4 million as of 2011, or 3.1 percent of the general population. Among men who have sex with men, the estimated infection rate is 17.2 percent.

Logo of Men's Health Network -- Nigeria

Logo of Men’s Health Network — Nigeria

The crisis caused by the new anti-gay law was already evident in the spring, when Antigone Barton in Science Speaks described the problems encountered by the Men’s Health Network Nigeria, which was formed by the Population Council and local partners in Nigeria. Barton described the situation before and after Nigeria’s bill prohibiting gatherings of gay people was signed into law on Jan. 7:

“The network reached [gay men, other men who have sex with men,] the clients of sex workers and men who inject drugs as well, making services accessible to some of the least served and hardest hit by Nigeria’s HIV epidemic, and the numbers of men reached grew quickly.

” ‘We thought everything was fine,’ the spokeswoman [for the network] added, ‘until January 7, 2014.’ …

“In the wake of the Nigeria law, gains vanished overnight, said the spokeswoman (whose name the Population Council requested not be used for her protection). From reaching 1,700 men in three months, she said, programs saw numbers of new clients halve, and drop to zero, she said, as threats of extortion, arrests and mob violence drove patients into hiding. ‘Among health care providers there was a lot of panic, there was a lot of frustration, and a lot of fear,’ she added.

“As reaching people in groups became impossible, she said, programs had to change their strategies to reach individuals. The government, in turn had to release a statement saying it was okay to seek health services.”

But the latest statistics show that those strategies did not prevent the Nigerian anti-gay law from having a disastrous effect on anti-AIDS efforts.

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