HIV patients in Senegal skip treatment, fear arrest amid anti-2SLGBTQ+ campaign

Fewer patients are visiting HIV treatment centers in Senegal amid a wave of arrests targeting 2SLGBTQ+ 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 sentence for same-sex acts to 10 years and made what it described as efforts to promote it. The country also increased the maximum fine to 10 million CFA francs ($24,450).

According to reports from local human rights activists and media reports, 86 people were arrested in the campaign that began in early February, when President Bassirou Diomaye Faye’s government was preparing to introduce a new anti-2SLGBTQ+ law in parliament.

That includes 18 arrested in a single raid on April 19 in Linguere, about 300 kilometers northeast of Dakar. There were two sentences under the new law.

Those arrested have been accused of “unnatural acts” and, in some cases, knowingly giving HIV to others. The government did not give the number of those arrested.

Data from the Senegalese government’s National Council Against AIDS (CNLS), obtained by Reuters, suggests that patients are forgoing essential drugs, which treat and suppress HIV, for fear of arrest or exploitation.

A government spokesman, a police spokesman and a lawyer supporting the law did not respond to requests for comment.

First, some Senegalese media have put detainees at risk of discrimination and harassment by publishing their full names and HIV status, said Dr. Safiatou Thiam, former health minister and executive director of CNLS.

“Of course we are afraid – and this has been confirmed – that this wave of arrests will have an impact on our work,” he said, adding that health workers are committed to maintaining patient confidentiality and encouraging law enforcement to do the same.

Senegal is one of only four countries in West and Central Africa that have experienced an increase in new HIV infections in recent years, according to UNAIDS.

‘I don’t want to leave the house’

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

“I never leave the house anymore, so I’m locked inside. I double-lock all the doors and windows to avoid being discovered,” they said, speaking on condition of anonymity for fear of reprisals.

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

Reuters reported last month that Senegalese supporters of an anti-2SLGBTQ+ bill had discussed the strategy with a US-based “pro-family” group that calls homosexuality a public health threat.

Patients mention fear of arrest, torture

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

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

Follow-up CNLS interviews with more than 50 men who have sex with men (MSM) indicated that they avoided the sites for fear of being accused, arrested or verbally and physically abused.

The findings, which have not yet been published, indicate that the drop in patients is related to arrests, said Dr. Cheikh Bamba Dieye, head of the research unit at CNLS.

The national HIV infection rate is 0.3 percent in Senegal, which is much lower than the most affected countries in the continent, most of which are in southern Africa. But new infections increased by 36 percent between 2010 and 2024, according to UNAIDS.

If the patient stops receiving treatment, the virus is highly contagious.

HIV in Senegal is concentrated in so-called key populations such as MSM, where the prevalence is 27.6 percent, according to government statistics.

The World Health Organization has warned in recent years about the resurgence and new epidemic of HIV among MSM and has urged governments to remove punitive laws, reduce discrimination and tackle homophobic violence.

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

CNLS-tested HIV/AIDS treatment sites help all HIV patients, but there are indications that some will be hit hard by treatment interruptions.

In an email dated February 23, the National Alliance Against AIDS (ANCS), a grassroots NGO, informed its partners that it “is setting up interventions aimed at groups most vulnerable to HIV/AIDS, particularly MSM and transgender people.”

The email, seen by Reuters, said the move was due to a “difficult work environment” created by the arrest.

This new law includes a provision that states that the activities carried out by health organizations will not be considered illegal.

While some MSM have fled to other countries including Mauritania, Gambia and the Ivory Coast, others who remain in Senegal feel inferior.

“We have seen many people lose follow-up at hospitals because they think, ‘If I just go to the hospital to get my medication, I will be called gay,'” said the public health worker.

“I’m exhausted, emotionally and physically. It’s draining me, and I expect to be arrested at any time – for helping my community access health care, for creating an organization that works for the welfare of LGBTQ people … and because I’m gay.”