Fewer patients are visiting some HIV treatment centres 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 prison term for same-sex sexual acts to 10 years and criminalized what it described as any efforts to promote it. The country also increased the maximum fine to 10 million CFA francs ($24,450).
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-2SLGBTQ+ law in parliament.
That includes 18 arrested in a single raid on April 19 in Linguere, about 300 kilometres 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 stigmatization 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 reprisal.
“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-2SLGBTQ+ 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 per cent.
Followup 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 per cent in Senegal, far lower than the continent’s worst hit countries, many in southern Africa. But new infections increased by 36 per cent 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 per cent, 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 Feb. 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 followup care in hospitals because they think, ‘As soon as I go to a hospital to pick up my medication, I’ll be labelled 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 health care, for creating an organization that works for the well-being of LGBTQ people … and simply because I’m gay.”
