Senegal: Arrests threaten Senegal’s HIV response as patients avoid clinics

HIV patients in Senegal skip treatment, fearing arrest amid anti-LGBTQ crackdown

DAKAR, April 29 (Reuters) – Fewer patients are visiting some HIV treatment centres in Senegal amid a wave of arrests targeting LGBTQ people, according to health officials and government data seen by Reuters, threatening the country’s fight against the virus.

Last month, Senegal, where homosexuality is illegal, doubled the maximum prison term for same-sex sexual acts to 10 years and criminalised what it described as any efforts to promote it. The country also ‌increased the maximum fine to 10 million CFA francs ($18,000).

According to local human rights activists and media reports, 86 people have been arrested in a crackdown that began in early February, when President Bassirou Diomaye Faye’s government was preparing to introduce the new anti-LGBTQ law in parliament. That includes 18 arrested in a single raid on April 19 in Linguere, 300 km (186 miles) northeast of Dakar.

There have been two convictions under the new law.

Those arrested have been accused of “acts against nature” and, in some cases, deliberately giving HIV to others. The government did not provide the number of arrests.

Data from the Senegalese government’s National Council for the Fight Against AIDS (CNLS), made available to Reuters, suggests that patients are forgoing vital antiretroviral drugs, which both treat and suppress HIV, for fear of arrest or abuse.

A government spokesperson, police spokesperson and a lawmaker who backed the law did not respond ⁠to requests for comment.

In a first, some Senegalese media outlets have put arrested individuals at risk of stigmatisation and abuse by publishing their full names and HIV statuses, said Dr Safiatou Thiam, a former health minister and CNLS executive director.

“We certainly fear, and this has been confirmed, that this wave of arrests will have repercussions for our work,” she said, adding health workers are committed to upholding patient confidentiality and encouraging law enforcement to do the same.

Senegal is one of just four countries in West and Central Africa that has experienced a rise in new HIV infections in recent years, according to UNAIDS.

‘I DON’T DARE LEAVE THE HOUSE’

One queer Senegalese community health worker who previously distributed tests and HIV prevention tools in Dakar is now afraid to go outside.

“I don’t dare leave the house anymore, so I’m literally holed up inside. I double-lock all the doors and windows just to avoid being found,” they said, speaking on condition of anonymity for fear of reprisals.

“I’m afraid there will be more deaths related to HIV… people will be afraid to show or keep their medication. Some won’t even want to continue their treatment for fear of being seen or associated with it.”

Reuters reported last month that Senegalese proponents of the anti-LGBTQ bill discussed strategy with a U.S.-based “pro-family” group that calls homosexuality a public health threat.

PATIENTS CITE FEAR OF ARRESTS, HARASSMENT

CNLS conducted a survey of 22 HIV/AIDS treatment centres over three ‌days at the ⁠end of February, after warning the arrests could lead to a drop in HIV testing and treatment disruptions.

The responses showed that 1,803 patients visited in February, down from 2,425 in January – a drop of 25.6%.

Follow-up interviews by CNLS with more than 50 men who have sex with men (MSM) showed they were avoiding the sites because they feared being denounced, arrested or subject to verbal and physical harassment.

The findings, which have not been published, make clear the drop in patients is linked to the arrests, said Dr. Cheikh Bamba Dieye, head of the research unit at CNLS.

National HIV prevalence is 0.3% in Senegal, far lower than the continent’s worst hit countries, many in southern Africa. But new infections increased by 36% between 2010 and 2024, according to UNAIDS.

If a patient stops ⁠receiving treatment, the virus is more transmissible.

HIV in Senegal is concentrated in so-called key populations like MSM, where the prevalence is 27.6% according to government figures.

The World Health Organization has warned in recent years about re-emerging and new HIV epidemics among MSM and has urged governments to remove punitive laws, reduce discrimination and address homophobic violence.

UNAIDS said in response to Senegal’s new law: “Evidence shows that criminalization causes people to turn away from health services.”

The HIV/AIDS treatment sites surveyed by CNLS serve all HIV patients, but there are indications ⁠that some will be hit harder by treatment disruptions.

In an email dated February 23, the National Alliance Against AIDS (ANCS), an NGO working with key populations, informed partners it was “suspending interventions aimed at the groups most exposed to HIV/AIDS, in particular MSM and transgender people.”

The email, seen by Reuters, attributed the move to “the difficult working environment” created by the arrests.

The new law includes a provision stating that activities carried out by health organizations will not be considered illegal.

While some MSM ⁠have fled to other countries including Mauritania, Gambia and Ivory Coast, others remaining in Senegal have assumed a low profile.

“We’ve seen a lot of people lost to follow-up care in hospitals because they think, ‘as soon as I go to a hospital to pick up my medication, I’ll be labeled a homosexual’,” said the community health worker.

“I’m exhausted, emotionally and physically. It’s draining me, and I expect to be arrested at any moment – for helping my community access healthcare, for creating an organization that works for the well-being of LGBTQ people… and simply because I’m gay.”

Reporting by Robbie Corey-Boulet and Ngouda Dione; Writing by Robbie Corey-Boulet; Editing by Alexandra Hudson

Canada: A new podcast series from the HIV Legal Network on HIV criminalisation and indigenous realities

Not a Crime: Indigenous perspectives on HIV criminalization

Over the coming weeks, the HIV Legal Network will be sharing a series of conversations with people from Indigenous communities on the impact of HIV criminalisation.

In Canada, Indigenous peoples — particularly women and youth — are disproportionately affected by HIV. Although they represent just 5% of the population, they accounted for over 18% of new HIV transmissions in 2020 and 10% of all people living with HIV. At the same time, criminalisation continues to shape lives and outcomes: at least 224 people have been charged for alleged HIV non-disclosure, most often with aggravated sexual assault — one of the most serious offences in Canadian law. Among them are at least 15 Indigenous people, including Indigenous women who are significantly overrepresented among those prosecuted.

In this episode, the HIV Legal Network speaks with Margaret Kisikaw Piyesis, Okimâw (Chief Executive Officer) of CAAN Communities, Alliances & Networks. A leading voice in Indigenous health advocacy, she brings decades of experience working to improve outcomes for Indigenous peoples affected by HIV, combining Cree knowledge systems with community-led health approaches.

🎧 Listen to the conversation and explore how criminalisation intersects with Indigenous health, rights and lived realities.

Learn more about CAAN and the Canadian Coalition to Reform HIV Criminalization.

New Zealand: New research reveals how HIV criminalisation is experienced in Aotearoa

HIV decriminalisation in Aotearoa: Survey findings

For the first time in Aotearoa New Zealand, we have national evidence on how HIV criminalisation is experienced by people living with HIV.

This research captures the voices of 247 people from diverse communities across the country. It documents how criminal law, public health processes, stigma, and modern HIV science intersect in real life. The project was undertaken collaboratively by Positive Women Inc, Burnett Foundation Aotearoa, Body Positive, and Toitū te Ao, reflecting the shared commitment of all four organisations to amplifying community experiences and informing meaningful change.

The findings highlight the need for greater clarity, alignment with contemporary science, and thoughtful public conversation.

About the research

This study explores:

Awareness and understanding of criminal and public health law
Attitudes toward HIV criminalisation
The lived impact of legal uncertainty
The role of stigma in shaping legal and social outcomes
Recommendations informed by participant experience

Participants represented a wide range of ages, genders, sexualities, ethnicities, migration histories, and lengths of time living with HIV.

This research centers lived experience while grounding analysis in contemporary HIV science, including the evidence behind U=U (Undetectable = Untransmittable).

Key findings

1. Preference for public health management

Most participants would prefer public health manage their HIV transmission rather than the police – because HIV is a health issue, not a crime.

2. Attitudes are nuanced

Participants held diverse and layered views about criminalisation. Support was often linked to cases of intentional harm, while broader criminalisation raised concerns about fairness, stigma, and unintended consequences.

3. Impact extends beyond prosecutions

Even where prosecutions are rare, the possibility of criminalisation shapes behaviour, disclosure practices, relationships, and wellbeing.

4. Stigma remains central

Legal frameworks do not exist in isolation. Participants described how stigma around HIV influences both public perception and perceived legal risk.

Why this matters

Effective HIV responses must reflect:

Modern treatment science
Public health best practice
Human rights principles
The lived experience of people living with HIV

Clear, evidence-informed discussion is essential to ensuring legal and policy settings support – rather than undermine – public health outcomes.

Recommendations

The report identifies areas for consideration, including:

Clearer, accessible legal guidance
Greater alignment between law and contemporary HIV science
Stigma reduction through public education
Meaningful involvement of people living with HIV in future policy conversations

What happens next

Positive Women Inc, Burnett Foundation Aotearoa, Body Positive, and Toitū te Ao will:

Share these findings across health, legal, and policy sectors
Engage stakeholders in informed discussion
Continue centering lived experience in advocacy and education
Support accurate public understanding of HIV and the law

This report is a foundation for evidence-based dialogue in Aotearoa.

For media enquiries, contact Kirk Serpes at kirk.serpes@burnettfoundation.org.nz

Read the full report here

Senegal: Rising homophobia drives patients away from HIV care and prevention services

Senegal’s LGBTQ+ community lives in fear as fight against AIDS faces setback

The country has regularly seen homophobic protest fueling assaults and public denunciations. Within this climate, organizations working to fight HIV worry that individuals will turn away from vital care and prevention services.

On February 20, Ousmane gathered a few belongings and fled his home. “Since then,” the Senegalese man said, speaking under a pseudonym, “I’ve been living in hiding, in a city I can’t name. I’m petrified. People in my neighborhood found out things about my life. They know I’m gay.” If word spreads, the man in his 30s went on, “I risk being beaten and arrested, or arrested and then beaten. I don’t see any solution other than leaving for another country as soon as I can.”

Denunciations, extortion and assaults: Over the past several weeks, people who are gay or who are suspected of being gay have faced a surge of hostility across Senegal, a country that has already been marked by regular homophobic mobilizations over the past decade.

Violence against LGBTQ+ people has escalated dramatically following the arrests in February of 14 suspected members of a pedocriminal ring targeting young boys; two days earlier, 12 men, including local media figures, were accused of homosexuality. The two cases are entirely unrelated.

Several media outlets, relying on evidence gathered by police, published the HIV status of some defendants in both cases, fueling “the conflation, already present at times in Senegal, between homosexuality and pedophilia, homosexuality and HIV positivity,” said Marane Kane, a French-Senegalese consultant and a specialist in gender issues based in France. “Since then, there has been a surge in reports of assaults, and people are living in hiding,” she stressed.

Calls for hatred

According to Free Sénégal, a support network for LGBTQ+ people, about 30 arrests have taken place since then in Dakar, Touba and Saint-Louis. “I’m afraid of everyone’s gaze. I feel like I could be denounced at any moment. I don’t eat, I don’t sleep,” explained a young man.

Prime Minister Ousmane Sonko responded to the media frenzy and, reiterating a promise made three years ago, announced on Tuesday, February 24, that he had submitted a bill to toughen sentences targeting “acts against nature” – a term that includes same-sex relations – raising the penalty to five to 10 years in prison, up from the current one to five years. The move was hailed by Mame Mactar Gueye, the influential leader of the Islamic NGO Jamra, which campaigns for the criminalization of homosexuality; his supporters, meanwhile, are demanding even harsher repression.

On TikTok and on Facebook, in videos viewed hundreds of thousands of times, influencers, including some based in Europe, have hurled condemnations at both ordinary citizens and public figures. The well-known actor Sanekh, star of the hit series Bété Bété, has been targeted. And Elimane Ndao, the Senegal correspondent for the French television channel France 24, has filed a complaint for similar reasons. To avoid being singled out, some people have even started posting proof of their HIV-negative status on social media.

Encouraged by these calls for hatred, assaults have multiplied, often taking the form of carefully planned ambushes. “He doesn’t want to talk to you, he’s too scared. I’ll tell his story for him,” said a Senegalese man living in France, describing a friend in Senegal. “He was chatting with a man on a dating app. They agreed to meet. It was a trap. He was threatened with a knife and had to hand over money to get away. Things like this happen all the time.”

The situation is alarming human rights advocates. “Gay people have become scapegoats for society. There’s the conflation with pedophilia, conspiracy theories painting them as Trojan horses for Western values, to the detriment of all local knowledge… Everything that goes wrong is blamed on them,” explained Kane. “Meanwhile, real issues like sexual violence against children are forgotten. People think they’ve done enough by cracking down on homosexuality.”

‘There’s nothing left to do but flee’

This pressure has organizations that work to fight AIDS worried that people will turn away from care and prevention services. Senegal has managed to keep HIV prevalence low (0.5% of the population in 2020). “We’re already seeing a drop in consultations. Many patients are skipping appointments, and the few who dare to come hide their identities,” said Safiatou Thiam, the executive secretary of the National Council for the Fight Against AIDS in Senegal.

After the disclosure of some citizens’ HIV status, panicked patients have asked health centers to erase their records. As for the network of community outreach workers serving at-risk populations, it has collapsed; outreach staff no longer dare ask about people’s health or try to promote prevention among a group facing such intense stigma.

In his address, Sonko insisted on the ban on sharing people’s health status. He also emphasized that the prison sentences in his bill for “promoting” so-called “acts against nature” – a provision targeting NGOs and advocacy groups that might defend the rights of gay people – should not prevent the health system from continuing its work on AIDS prevention. According to health professionals, they discreetly reached out to the government as soon as rumors emerged of a possible bill imposing harsher penalties for homosexuality.

“We can’t live in our country anymore. It’s too dangerous, there’s nothing left to do but flee,” said a young man in his 30s, his voice breaking with sobs, who spent all his savings to escape Senegal for Europe five months ago. “I can’t imagine a gay person seeking medical care in this climate.”

As for Gueye, he is showing no sign of ending his campaign. After thanking “all the TikTokers, valiant defenders of our cause,” he recently announced his intention to “tackle the scourge of lesbianism.”

Kyrgyzstan: Proposal to introduce mandatory HIV testing for people getting married

Deputy of the Jogorku Kenesh Nurzhamal Torobekova proposed to introduce a mandatory medical examination for those getting married due to the increase in cases of HIV infection in Kyrgyzstan, the publication “Azattyk” reports.

According to the Republican Center for the Control of Viral Hepatitis and HIV, more than 15 thousand people with a positive status are officially registered in the country. In five years, the number of identified cases has increased 1.5 times – from 10 thousand in 2020, notes edition.

Most of the infected – 60% – are people of working age. Experts record a change in the ways of transmission of the virus: at the moment the sexual route dominates, while in the past decades the main factor was injecting drug use.

Particular attention is paid to migration processes. According to the department, as of mid-2025, about 31% of all new cases of infection occur in citizens returning from work from abroad. The main flow of migration from Kyrgyzstan is directed to the Russian Federation, where, according to various estimates, from 1 to 1.2 million people with HIV live. According to the Ministry of Social Development of the Kyrgyz Republic, there are officially more than 341 thousand Kyrgyz in Russia. Often, the infection is detected after the creation of a family, when a labor migrant, not knowing about his status or hiding it, infects his partner.

Torobekova’s initiative is based on the practice of neighboring countries – Uzbekistan and Tajikistan, where future spouses are obliged to be tested for HIV, syphilis and liver disease. In these states, which are also major suppliers of labor to the foreign market, inspections for newlyweds are carried out free of charge.

Senegal: Arrests and breach of medical confidentiality trigger drop in HIV testing and treatment attendance

“Violation of medical confidentiality”: in Senegal, caregivers worried about allegations against homosexuals with HIV

In Senegal, people have been incriminated for their homosexuality and accused of HIV transmission. These arrests follow the announcement by Prime Minister Ousmane Sonko of the tightening of the law penalizing “unnatural acts”. Since these arrests, the actors in the fight against AIDS have seen a decrease in attendance at screening centers.

“Arrest for homosexuality: serious cases of unnatural acts with voluntary transmission of HIV/AIDS,” headlined the Senegalese daily Les Échos, on February 9. About thirty people have been accused of transmitting HIV and incriminated for their homosexuality, which is prohibited by law. The Senegalese government has just toughened this legislation on February 24. These arrests frighten patients with the virus, who no longer go to the Dakar screening center.

“Patients are afraid of being arrested and stigmatized,” explains Dr. Rassoul Diouf, at Fane Hospital, one of Senegal’s main health centers. Usually, this facility welcomes dozens of patients daily for HIV testing and monitoring. But in recent weeks, Dr. Rassoul Diouf has seen a significant drop in consultations.”The convocations for appointments are difficult to happen. We call them but there is reluctance,” he explains to TV5MONDE.

Breach of medical confidentiality

For the actors in the fight against AIDS, this disclosure constitutes a “violation of medical confidentiality“. The National AIDS Council recalls that a law in Senegal protects the identity of people with HIV.

“On an ethical level, this is not normal, but even less on a legal level,” says Dr. Safiatou Thiam, executive secretary of the National Council for the fight against AIDS. “HIV has the particularity of being framed by a law that prohibits the disclosure of people’s status. We do not know how or by what process medical results ended up in the public square,” she explains to TV5MONDE.

Misinformation and confusion about HIV transmission

Actors in the fight against AIDS also deplore confusion about the modes of transmission of the virus. However, Senegal has long been cited as an example for the means put in place to fight HIV. Since the end of the 1990s, the country made treatments accessible. “At the beginning of the epidemic [of HIV, ed.], many countries refused to recognize its existence. But Senegal said: not only does HIV exist, but I will treat it,” explains Dr. Khoudia Sow, doctor and anthropologist.

“When a person follows his treatment properly, he becomes undetectable and can no longer transmit the virus. On the other hand, if these people interrupt their treatment for fear of stigmatization, the risk is that in the short term new transmissions will appear,” she confides. Currently, the HIV prevalence rate in Senegal is estimated at 0.3%, one of the lowest in the region. However, if patients stop taking their treatment, for fear of stigma, this rate could increase in Senegal.

Senegal: CNLS issues guidelines on medical confidentiality and HIV care in prisons

Medical records and HIV: The CNLS imposes a strict ban targeting the prison administration

Health management in places of deprivation of liberty in Senegal is undergoing a major overhaul. In response to human rights issues, the National Council for the Fight against AIDS (CNLS) has issued a strategic guidance note detailing care protocols. According to information reported by the newspaper Le Quotidien, this approach aims to establish clear rules regarding the monitoring of people living with the virus in prisons.

The central point of this directive concerns medical confidentiality. The Executive Secretariat of the CNLS prohibits the disclosure of prisoners’ HIV status. In practical terms, the medical records of prisoners living with HIV (Pvvih) must be kept separate from the records managed by the prison administration. These documents remain the sole responsibility of the medical staff assigned to the infirmary.

The CNLS text also includes a scientific clarification intended for the day-to-day management of detention. The document specifies that an inmate carrying the virus can live in the community and share the same cell as other inmates without any risk of transmission.

From a medical standpoint, the protocol applied is in line with international standards, guaranteeing inmates the same care as the general population. Consultations are carried out in health centres or specialised hospital services, under the supervision of the prison medical service. Our editorial team also notes that HIV testing in prison is not compulsory; it is offered with the prisoner’s free consent, after psychosocial support.

The system provides for a full medical assessment upon incarceration. If the new arrival is already undergoing antiretroviral treatment, contact is established with their treating physician to prevent any interruption in treatment, a known factor in virus resistance. This initial examination also makes it possible to identify other comorbidities such as diabetes, hypertension or substance use disorders.

To support the implementation of these guidelines, the CNLS is rolling out training and advocacy sessions in the field. These meetings are aimed directly at professionals working in prisons, including senior nurses, warders and directors of detention and correctional centres (MACs).

Medical records and HIV: The CNLS fixe une interdiction stricte ciblant l’administration pénitentiaire

La gestion de la santé dans les lieux de privation de liberté au Sénégal fait l’objet d’un recadrage précis. Face aux enjeux liés aux droits humains, le Conseil National de Lutte contre le Sida (Cnls) a diffusé une note d’orientation stratégique détaillant les protocoles de prise en charge. Selon les informations rapportées par le journal Le Quotidien, cette démarche vise à instaurer des règles claires concernant le suivi des personnes vivant avec le virus au sein des prisons.

Le point central de cette directive concerne le secret médical. Le Secrétariat exécutif du Cnls pose l’interdiction de divulguer le statut sérologique des détenus. Concrètement, le dossier médical d’un détenu vivant avec le VIH (Pvvih) doit être impérativement séparé des dossiers gérés par l’Administration pénitentiaire. Ce document reste sous la responsabilité exclusive du personnel soignant affecté à l’infirmerie.

Le texte du Cnls intègre également une mise au point scientifique destinée à la gestion quotidienne de la détention. Le document précise qu’un détenu porteur du virus peut vivre en communauté et partager la même cellule que les autres pensionnaires sans aucun risque de transmission.

Sur le plan médical, le protocole appliqué s’aligne sur les normes internationales, garantissant aux détenus les mêmes soins qu’à la population générale. Les consultations s’effectuent dans des centres de santé ou des services hospitaliers spécialisés, sous la supervision du service médical carcéral. Notre rédaction note également que le dépistage du VIH au sein de la prison n’est soumis à aucune obligation ; il est proposé avec le libre consentement du détenu, après un accompagnement psychosocial.

Le dispositif prévoit une évaluation médicale complète dès l’incarcération. Si le nouvel arrivant suit déjà un traitement antirétroviral, une liaison avec son médecin traitant est établie pour prévenir toute rupture thérapeutique, un facteur connu de résistance au virus. Cet examen initial permet dans le même temps d’identifier d’autres comorbidités telles que le diabète, l’hypertension ou les troubles liés à l’usage de substances.

Pour accompagner l’application de ces directives, le Cnls déploie des sessions de formation et de plaidoyer sur le terrain. Ces rencontres ciblent directement les professionnels intervenant en milieu carcéral, notamment les infirmiers major, les surveillants et les directeurs des Maisons d’arrêt et de correction (Mac).

New Zealand: Undetectable yet prosecutable, study highlights the need for law reform

Momentum for change on HIV criminalisation

A study of people living with HIV has revealed that despite advances in HIV treatment, criminalisation continues to create uncertainty and distress, with 60% of people living with HIV fearing legal consequences and many avoiding relationships altogether.

The full study and its findings will be released at a public event on 27 February at 3 pm at the Ellen Melville Centre in Auckland, by Positive Women, Body Positive, Toitū te Ao and Burnett Foundation Aotearoa.

The study surveying 247 people living with HIV in New Zealand, highlights the urgent need for rules and practice to align with modern HIV science. Over half of participants reported anxiety about legal consequences, particularly around disclosing HIV or discussing sexual practices with healthcare service providers.

“This shows that people living with HIV want to see HIV transmission managed by Public Health authorities, and not the Police. We have one of the highest rates of HIV criminalisation per capita globally, with at least 14 prosecutions since 1993,” says Liz Gibbs CEO of Burnett Foundation Aotearoa.

“The Government’s decision to sign the U=U Call to Action at Big Gay Out 2026 is a great first step in bringing New Zealand into line with overseas best practices on how to manage HIV.”

U = U stands for Undetectable = Untransmittable (U=U). It means that a person living with HIV who is on effective treatment and maintains an undetectable viral load cannot transmit HIV to sexual partner(s).

“Currently people living with HIV may face prosecution under the Crimes Act for HIV non-disclosure to their sexual partners (unless they are using a condom), even if they are on treatment with an undetectable viral load and therefore pose zero risk of transmission,” says Gibbs.

Senegal: Following recent arrests, the National AIDS council calls for an approach based on science and human rights

The CNLS warns against judicial and social excesses

The executive secretariat of the National Council for the fight against AIDS (CnLS) published yesterday a technical note warning of the health, legal and social consequences of recent arrests for “unnatural acts” and transmission of HIV.

The executive secretariat of the National Council for the Fight against AIDS (CNLS) published yesterday a technical note warning of the health, legal and social consequences of recent arrests for “unnatural acts” and transmission of HIV. The institution fears a decline in screening, a break in treatments and a rise in stigma, calling on the authorities to favour an approach based on science, public health and respect for human rights.

“Health, legal and social impact of the arrest of people for unnatural acts and voluntary transmission of HIV”. This is the title of the technical note published yesterday by the National Council for the Fight against AIDS (CNLS), which proposes an in-depth analysis of the potentially disastrous consequences of mismanagement of news related to HIV transmission.

According to the CNLS, the country has a concentrated HIV epidemic, characterized by a low prevalence in the general population (0.3%) and a high prevalence within some key groups: 27% in men having sex with men, 6.4% in women sex workers, 5.2% in drug users and 2% in detainees. Faced with this situation, they maintain that the national response is based on equitable access to screening, prevention means and universal antiretroviral treatment.

According to them, these approaches have reduced new infections, improved the quality of life of people living with HIV and limited transmission in the general population. However, the CNLS believes that the high media coverage of the arrests of twelve (12) people has aroused a strong reaction from public opinion and rekindled tensions around sexuality, HIV and human rights, raising major health, legal and social issues.

Blow for early screening and continuity of care

First, in terms of health, the CNLS fears that legal proceedings or the disclosure of serological status will dissuade some people, especially from the most vulnerable groups, from voluntarily using screening. “This reluctance limits the early detection of people living with HIV and their rapid access to treatment, which is essential to interrupt transmission. Nearly 90% of people with HIV are tested to date and under treatment and 92% of them no longer transmit the disease,” reads the technical note published by the CNLS.

Worse, it says, the continuity of care is also threatened. Indeed, it is noted, for fear of stigma or public exposure, some people living with HIV can discontinue their antiretroviral treatment. “These ruptures increase the risk of medical complications, resistance to treatments and transmission of the virus, with a direct impact on national health indicators,” says the CNLS. It is also established that when the possession of condoms, the use of screening or adherence to treatment are perceived as burdens in legal proceedings, it constitutes a major risk to public health.

The CNLS thus draws attention to the fact that this situation discourages prevention behaviour and promotes silent circulation of the virus, increasing the number of people unaware of their serological status and the risks of transmission among the general population.

“Unauthorised disclosure of serological status is penalised by the HIV law of 2010…”

With regard to the legal issues of arrests for unnatural acts and transmission of HIV, the CNLS recalls at first glance that the voluntary transmission of HIV is a crime under the law. However, he says, its legal qualification, as provided for by the 2010 HIV Act, presupposes the meeting of several constituent elements: proven harm, a direct causal link and a deliberate intention to harm. In practice, he says, the establishment of these elements remains complex. The demonstration of intentionality is particularly difficult and cannot be based on serological status alone. It requires proof that the person knew his status, that he voluntarily exposed others to risk without prior information and that he had the obvious will to transmit the virus,” informs the CNLS, which adds that proof of the causal link and the anteriority of the infection requires specialized medical and biological expertise, rarely available in the context of ordinary judicial proceedings, thus exposing to a risk of judicial errors.

The CNLS also reports that scientific data establish that a person living with HIV on effective antiretroviral treatment, with an undetectable viral load, does not transmit the virus. And that ignorance of these evidences can lead to misinterpretations of the facts. As a result, he argues that excessive or imprecise criminalisation of HIV transmission can produce counterproductive effects by discouraging voluntary screening, as ignorance of status is sometimes perceived as legal protection. The CNLS argues that respect for the presumption of innocence, privacy and confidentiality of medical data remains a fundamental requirement. “The unauthorised disclosure of serological status is penalised by the 2010 HIV law and can engage the responsibility of the State, with regard to Senegal’s international commitments,” he said.

Plea for a circular for judicial actors integrating current scientific data on HIV
Still in the technical note of the CNLS, it is established that on the social level, the arrests and communication that accompany them may increase the stigma and discrimination against people living with HIV. “The amalgam between sexual orientations and serological status reinforces prejudices and further marginalizes already vulnerable groups,” the document points out.

Moreover, the CNLS fears that the people concerned will be subject to social and family exclusion, and will be victims of attacks on their dignity as well as verbal, psychological or even physical violence, weakening social cohesion. Another concern for the CNLS is that community organisations and civil society actors, essential to prevention and awareness, can reduce their activities for fear of stigmatisation or reprisals, leading to a decrease in social mobilisation and a weakening of prevention mechanisms. Faced with this situation, the CNLS believes that a balanced approach, based on public health, respect for human rights and the rule of law, is essential. They also ask the Prime Minister to instruct the Keeper of the Seals to disseminate a circular to judicial actors integrating current scientific data on HIV.

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Le CNLS met en garde contre des dérives judiciaires et sociales

Le secrétariat exécutif du Conseil national de lutte contre le sida (CnLS) a publié hier une note technique alertant sur les conséquences sanitaires, juridiques et sociales des récentes arrestations pour “actes contre nature” et transmission du VIH.

Le secrétariat exécutif du Conseil national de lutte contre le sida (CNLS) a publié hier une note technique alertant sur les conséquences sanitaires, juridiques et sociales des récentes arrestations pour “actes contre nature” et transmission du VIH. L’institution redoute un recul du dépistage, une rupture des traitements et une montée de la stigmatisation, appelant les autorités à privilégier une approche fondée sur la science, la santé publique et le respect des droits humains.

«Impact sanitaire, juridique et social de l’arrestation de personnes pour actes contre nature et transmission volontaire du VIH». Tel est l’intitulé de la note technique publiée hier par le Conseil national de lutte contre le sida (CNLS), qui propose une analyse approfondie des conséquences potentiellement désastreuses d’une mauvaise gestion de l’actualité liée à la transmission du VIH.

Selon le CNLS, le pays présente une épidémie de VIH de type concentrée, caractérisée par une faible prévalence dans la population générale (0,3 %) et une prévalence élevée au sein de certains groupes clés : 27% chez les hommes ayant des relations sexuelles avec des hommes, 6,4% chez les femmes travailleuses du sexe, 5,2% chez les consommateurs de drogues et 2%chez les personnes détenues. Face à cette situation, il soutient que la riposte nationale repose sur l’accès équitable au dépistage, aux moyens de prévention et au traitement antirétroviral universel.

A l’en croire, ces approches ont permis de réduire les nouvelles infections, d’améliorer la qualité de vie des personnes vivant avec le VIH et de limiter la transmission dans la population générale. Cependant, le CNLS estime que la forte médiatisation des arrestations de douze (12) personnes a suscité une vive réaction de l’opinion publique et ravivé les tensions autour de la sexualité, du VIH et des droits humains, soulevant des enjeux sanitaires, juridiques et sociaux majeurs.

Coup porté au dépistage précoce et à la continuité des soins

D’abord, sur le plan sanitaire, le CNLS craint que les poursuites judiciaires ou la divulgation du statut sérologique dissuade certaines personnes, notamment issues des groupes les plus vulnérables, de recourir volontairement au dépistage. “Cette réticence limite le dépistage précoce des personnes vivant avec le VIH et leur accès rapide au traitement, pourtant essentiel pour interrompre la transmission. Près de 90% des personnes atteintes de VIH sont dépistées à ce jour et sous traitement et 92% d’entre elles ne transmettent plus la maladie”, lit-on dans la note technique publiée par le CNLS.

Pis, dit-il, la continuité des soins est également menacée. En effet, note-t-on, par peur de stigmatisation ou d’exposition publique, certaines personnes vivant avec le VIH peuvent interrompre leur traitement antirétroviral. “Ces ruptures augmententles risques de complications médicales, de résistance aux traitements et de transmission du virus, avec un impact direct sur les indicateurs nationaux de santé”, confie le CNLS. Il est également établi que lorsque la possession de préservatifs, le recours au dépistage ou l’adhésion au traitement sont perçus comme des éléments à charge dans des procédures judiciaires, cela constitue un risque majeur pour la santé publique.

Le CNLS attire ainsi l’attention sur le fait que cette situation décourage les comportements de prévention et favorise une circulation silencieuse du virus, augmentant le nombre de personnes ignorant leur statut sérologique et les risques de transmission au sein de la population générale.

«La divulgation non autorisée du statut sérologique est pénalisée par la loi VIH de 2010…»

En ce qui concerne les enjeux juridiques des arrestations pour actes contre nature et transmission du VIH, le CNLS rappelle de prime abord que la transmission volontaire du VIH constitue un délit au regard de la loi. Toutefois, fait-il savoir, sa qualification juridique, telle que prévue par la loi VIH de 2010, suppose la réunion de plusieurs éléments constitutifs : un préjudice avéré, un lien de causalité direct et une intention délibérée de nuire. Dans la pratique, précise-t-il, l’établissement de ces éléments demeure complexe.“La démonstration de l’intentionnalité est particulièrement difficile et ne saurait reposer sur le seul statut sérologique. Elle nécessite la preuve que la personne connaissait son statut, qu’elle a volontairement exposé autrui au risque sans information préalable et qu’elle avaitla volonté manifeste de transmettre le virus”, renseigne le CNLS qui ajoute que la preuve du lien de causalité et de l’antériorité de l’infection requiert des expertises médicales et biologiques spécialisées, rarement disponibles dans le cadre des procédures judiciaires ordinaires, exposant ainsi à un risque d’erreurs judiciaires.

Le CNLS informe également que les données scientifiques établissent qu’une personne vivant avec le VIH sous traitement antirétroviral efficace, avec une charge virale indétectable, ne transmet pas le virus. Et que la méconnaissance de ces évidences peut conduire à des interprétations erronées des faits. De ce fait, il soutient qu’une criminalisation excessive ou imprécise de la transmission du VIH peut produire des effets contreproductifs en décourageant le dépistage volontaire, l’ignorance du statut étant parfois perçue comme une protection juridique. Le CNLS soutient dans la foulée que le respect de la présomption d’innocence, de la vie privée et de la confidentialité des données médicales demeure une exigence fondamentale. “La divulgation non autorisée du statut sérologique est pénalisée par la loi VIH de 2010 et peut engager la responsabilité de l’État, au regard des engagements internationaux du Sénégal”, a-t-il fait entendre.

Plaidoyer pour une circulaire à l’attention des acteurs judiciaires intégrant les données scientifiques actuelles sur le VIH

Toujours dans la note technique du CNLS, il est établi que sur le plan social, les arrestations et la communication qui les accompagnent, risquent d’accentuer la stigmatisation et la discrimination à l’encontre des personnes vivant avec le VIH. “L’amalgame entre orientations sexuelles et statut sérologique renforce les préjugés et marginalise davantage des groupes déjà vulnérables”, souligne le document.

D’ailleurs, le CNLS craint que les personnes concernées fassent l’objet d’exclusions sociales et familiales, et soient victimes d’atteintes à leur dignité ainsi qu’à des violences verbales, psychologiques, voire physiques, fragilisant la cohésion sociale. Autre préoccupation pour le CNLS, les organisations communautaires et les acteurs de la société civile, essentiels à la prévention et à la sensibilisation, peuvent réduire leurs activités par crainte de stigmatisation ou de représailles, entraînant une baisse de la mobilisation sociale et un affaiblissement des mécanismes de prévention. Face à cette situation, le CNLS pense qu’une approche équilibrée, fondée sur la santé publique, le respect des droits humains et l’État de droit, est indispensable. Il sollicite d’ailleurs le Premier Ministre afin qu’il instruise le Garde des Sceaux de diffuser une circulaire à l’attention des acteurs judiciaires intégrant les données scientifiques actuelles sur le VIH.

US: New Williams Institute analysis shows HIV criminalization disproportionately targets Black communities

Black Americans are disproportionately criminalized for living with HIV.

Through “heightened surveillance, arrest, and conviction,” Black Americans are more likely to be criminalized for their HIV.

Black people in the U.S. aren’t just more likely to have HIV — they’re more likely to be criminalized for it.

Black Americans accounted for about 38 percent of new HIV diagnoses and 39 percent of people living with HIV in 2023, according to a report from the Williams Institute, despite making up around 12 percent of the population.

Black women had the highest HIV diagnosis rate at 19.6 per 100,000, which is about 11 times the rate for white women at 1.8 per 100,000. Black boys and men ages 13 to 24 accounted for 47 percent of all new diagnoses among youth, while white boys and men made up just three percent.

Even with higher rates of infection, Black Americans are less likely to be on medications that treat HIV, with just 64 percent receiving care and 53 percent virally suppressed. They are also less likely to have health insurance, as 12.3 percent of Black adults ages 19 to 64 did not have health insurance in 2024, compared to 6.8 percent of white adults.

Black Americans are more likely to be criminalized for their HIV as well, as they are often subjected to “heightened surveillance, arrest, and conviction within the criminal legal system,” according to the report. In 64 percent of states analyzed, they faced higher rates of arrest than their share of people living with HIV. For example, Black people in California were 6 percent of the state population and 18 percent of people living with HIV, but 39 percent of HIV-related arrests.

They’re also more likely to face harsh post-conviction penalties like sex offender registration. In Tennessee, Black people were 17 percent of the state’s population and 55 percent of people living with HIV, but 74 percent of people on the sex offender registry with an HIV-related conviction.

“Most HIV criminal laws were enacted before effective HIV treatment and prevention tools became widely available,” said Nathan Cisneros, director of the HIV Criminalization Project at the Williams Institute. “In recent years, there has been a push to reform or repeal these laws as policymakers and the public increasingly recognize that these laws can discourage testing, increase stigma, and deepen disparities — especially for Black Americans.”