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Investigating the impact of human rights violations on access to HIV prevention and treatment services for men who have sex with men in Africa

Stoner, Jerone (2017) Investigating the impact of human rights violations on access to HIV prevention and treatment services for men who have sex with men in Africa. Master Essay, University of Pittsburgh.

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Background: Currently, there are 76 countries worldwide with laws criminalizing homosexuality, and nearly half of these countries are located in Africa. These laws are of particular public health significance because they incite stigma, discrimination, overt acts of violence, and a variety of other human rights violations towards men who have sex with men (MSM). This review contextualizes the extent to which criminalization of homosexuality and human rights violations impact access to HIV-related healthcare and risk for HIV infection among MSM in African countries and compares these findings within and between the various regions of Africa. Methods: One hundred twenty-two relevant research articles and reviews were identified through PubMed using four major concepts: 1) African countries & regions, 2) sexual identity & same-sex practices (specifically gay, bisexual, and other MSM), 3) HIV prevalence and behavioral risks, and 4) human rights violations and laws criminalizing homosexuality. Results: Reports of human rights violations experienced by MSM due to sexuality and same-sex practices in North, West, East, and Southern Africa vary by country, region, and occasionally presence of laws criminalizing homosexuality. Collectively, this literature reveals a trend towards MSM experiencing human rights violations and being unable or afraid to access HIV/STI prevention and treatment services, which may account for generally low knowledge and risk perceptions, numerous behavioral risks, and elevated bacteremia and viremia among communities of MSM in each region of Africa. Laws criminalizing homosexuality also hinder health professionals and LGBT-serving organizations from providing HIV-related services to MSM. Most importantly, this review reveals a growing body of evidence that suggests a strong correlation between experiencing human rights violations and HIV infection among MSM. Conclusions: Laws criminalizing homosexuality in Africa promote stigma, discrimination, overt acts of violence, and other human rights violations, which ultimately deter MSM from accessing HIV prevention and treatment services and put them at greater risk for HIV infection. However, decriminalizing homosexuality is not enough to increase access to HIV-related healthcare. A combination of social and legal reforms in addition to scale-up of MSM-specific biobehavioral interventions are needed to effectively change the course of HIV epidemics disproportionately burdening MSM in Africa.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Stoner, Jeronejts88@pitt.eduJTS88
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFriedman, Mackeymrf9@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberEgan, Jamesjee48@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 2017
Date Type: Submission
Number of Pages: 163
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 17 Jul 2018 16:58
Last Modified: 01 Jan 2019 06:15


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