Govt’s dilemma in dealing with HIV, same sex

Thursday December 1 2016

An HIV rapid blood test shows two red strips of

An HIV rapid blood test shows two red strips of a positive result in an improvised mini-laboratory. PHOTO I FILE 

By Deonatus Mafuru

Since the HIV/Aids pandemic hit Tanzania more than 30 years ago, the government and donor agencies have made great strides in fighting against it.

There was constructive criticism levelled at various ways of addressing the disease, not until the last three months, when things began to fall apart between government officials and some donor agencies—in some aspects though. The government took a different stance on some of the issues that some donor agencies were supporting and implementing.

It banned the supply of water contained lubricants, condoms and drugs to homosexuals or rather, men who have sex with other men (MSM) as it was seen as tantamount to blessing homosexual practices – acts that contravene the laws of the land and are believed by leaders to be against morals.

This situation has raised some questions. Why did some donor agencies choose to supply those things to homosexuals under the umbrella of preventing disease transmission in the first place?

Well! Perhaps they saw some tangible results. Despite the fact that the number of people dying from Aids-related illnesses dropped by 44 per cent between 2005 and 2013 and that the HIV/Aids prevalence fell from 7 to 5.1 per cent from 2003/4 to 2011/12, things were not looking good in certain aspects.

That in certain groups, there was still a high risk of contracting HIV/Aids due to the nature of their activities, the environment they are living in, their behaviour and sexual practices. In that regard, reducing the rate of HIV/Aids transmission to zero means that intervention had to be made directly to these groups so that the circle of transmission could be broken.


The groups were identified as key populations, which include people who have sex with those with unknown status (sex workers), people in the transport sector, prisoners, police officers, military, bar tenders and injecting drug users.

Great efforts have to be made in education, supplying condoms and drugs for pre-exposure prophylaxis—all being done in the name of helping these groups to remain safe.

Despite these efforts, it was found out that transmission still persisted at higher rates, especially in groups, whose practices exposed them to more than 10 times risk of contracting HIV/Aids and other sexually transmitted infections (STIs).

The demographic data of MSM in the country is not well documented, but according to World Health Organisation estimates, there are 3-19 per cent MSM globally, which brings a picture that MSM practices are a worldwide issue.

However, 95 per cent of Tanzanians are not in agreement and are categorically denying homosexuality. The same stance is held by the government, and this makes Tanzania to be among the 76 countries worldwide that consider homosexuality illegal.

Although there is no capital punishment for homosexuality in Tanzania, this situation puts the country in a crisis of choice—between fighting HIV/Aids and dealing with an immoral practice—homosexuality. The two seem not to go together.

Lack of studies on the effects of HIV/Aids in infected MSM compared to the ‘moral population’ in Tanzania does not mean that the matter is not significant.

By considering a study conducted in Mombasa, Kenya, that showed 43 per cent of exclusive MSM are HIV/Aids seroconverted and 12 per cent of MSM, who also had sex with women were living with HIV/Aids. This study more or less relates to our population and brings in a picture of the extent HIV/Aids positive MSMs. Another study conducted in Zanzibar based on the relationship between MSM and injection drug use (IDUs), showed that there was an overlap between MSM risk behaviour and IDUs on the Isles.

As we all understand, HIV/Aids kills. It has been killing since it was reported in 1983. It has affected our communities in all aspects socially, politically and economically.

The author is a medical doctor based in Dar es Salaam.