Treatment of Homosexual Men and Women in the Developing World

Lord Rea Excerpts

Thursday 25th October 2012 Lords Chamber

[Lord Rea]

My Lords, many people in the developing world will be grateful to the noble Lord, Lord Lexden, for raising so cogently this important and disturbing issue. Although we may condemn the draconian laws and practices he has described, we should not forget that it is only quite recently in historical terms that this country and other industrialised democracies have repealed laws which prohibited same-sex relationships. Although the law has been liberalised in the UK and other countries in the north, and many prominent people, including MPs and Ministers, are now able openly to declare their sexual orientation, powerful prejudice is still there among a substantial minority of the population. A well-known example of that is the problem that the most reverend Primate has had with some of his bishops both here and abroad. The noble Lord, Lord Lexden, has pointed out that the intolerant and puritanical attitudes to gay sex that prevail in many developing countries may be a relic of colonialism, and that before the colonial era there was a much more permissive attitude.

How does this social and legal condemnation of homosexual people affect their health, particularly in terms of HIV infection? I was privileged to serve last year on the House of Lords Select Committee that looked into HIV and AIDS in the UK, which was chaired very ably by the noble Lord, Lord Fowler. Although sexual orientation and HIV infection are different entities, there are parallels, particularly regarding stigma and social rejection. To quote from the Select Committee’s report, we found that:

“Stigma and lack of understanding can undermine HIV prevention efforts … and can also impact upon adherence to treatment”.

The double prejudice that gay people with HIV suffer from makes it even more difficult for them to get access to treatment and the follow-up which is necessary. In many countries they are thwarted in obtaining treatment by laws and attitudes that criminalise or shun them.

HIV infection was of course first discovered 30 years ago among gay men, so the disease is associated with gay sexual behaviour. However, heterosexual transmission in Africans is now more common than homosexual transmission both at home and among the diaspora. HIV infection itself is nevertheless still much more common in gay men than heterosexuals both here and in Africa; 19 times more common, in one study quoted in the recent excellent report of the Global Commission on HIV and the Law. Stigma and discrimination play a significant role in causing and maintaining these high rates. In Caribbean countries where homosexuality is criminalised, such as Jamaica and Guyana, which are both Commonwealth countries, the prevalence of HIV is around one in four gay men, while in countries that do not criminalise same-sex sexual activity, such as Cuba and the Bahamas, it is only around one in 15. Can the Minister who is to reply outline the response of DfID to this unacceptable situation? I am aware that the Government are concerned about the issue and that they have played an important role in bringing it on to the international stage.

However, there is still a long way to go, with discriminatory legislation being passed or debated in Uganda and several other countries in the Commonwealth and elsewhere; I mention particularly eastern Europe. A fundamental step should be to encourage and support citizens and civil society who oppose these outdated and misguided laws in those countries. We should encourage them to put pressure on their Governments to repeal them as soon as possible.

This is not an impossible task. For example, the UN Secretary-General, Ban Ki-Moon, the Independent Commission on AIDS in Asia and the UN special rapporteur on the right to health, as well as a meeting of Commonwealth Foreign Affairs Ministers, have all recommended repealing laws that prohibit sex between consenting adults of the same sex, as have courts in Hong Kong and Fiji, as was mentioned by the noble Lord, Lord Lexden.

However, action on the ground is less evident than declarations of intent. The clear evidence that punitive discriminatory laws encourage the spread of HIV infection should act as a stimulus to repeal them. I hope that the noble Baroness can outline the moves the Government are taking to encourage international action as well as words.

A further line of attack should surely be to encourage treatment centres for HIV and AIDS to be freely open to people of any sexual orientation. DfID devotes a substantial proportion of its budget to the prevention and treatment of HIV. I hope the noble Baroness can assure the House that the special problems encountered by gay and other sexual minority groups in getting access to medical help are taken fully into account.