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Homophobia and HIV

  • Homophobia stops many lesbian, gay, bisexual, trans and intersex (LGBTI) people from accessing HIV and sexual health services.  
  • It can also lead to mental health issues and social isolation, which can increase the risks LGBTI people take with their health. 
  • Addressing homophobia needs a two-fold approach: tackling homophobic laws like the criminalisation of same-sex activity, and changing the way individuals and societies treat LGBTI people. 

  

What is homophobia?

Homophobia is the fear, hatred, mistrust of, or discomfort with, LGBTI people. 

It is expressed through negative comments, rejection from friends and family, bullying, violence, discrimination, and negative media representation. Some LGBTI people can internalise homophobic attitudes, which is called self-stigma.  

It is not only individuals who can be homophobic - governments and institutions can be too. For example, laws that criminalise homosexuality are homophobic laws.  

What links HIV and homophobia?

Blame and stigma

The HIV epidemic has always been linked with negative attitudes towards LGBTI people, especially gay men and other men who have sex with men. In many countries, gay men suffered violence and abuse when the HIV epidemic began. Homophobic reporting in the media fuelled the unfair view that gay people were to blame for HIV. 

Restrictions on access to services

The homophobia that LGBTI people face in their daily lives – plus the criminalisation of same-sex relationships, cross-dressing, sodomy and ‘gender impersonation’ – stops many LGBTI people from accessing HIV prevention, testing, treatment and care services. As a result, some LGBTI people with HIV do not know they have it, or they get diagnosed late when HIV is harder to treat. 

Mental health

Experiencing homophobia can lead to anxiety, depression and other mental health issues. This can lead people to misuse alcohol and drugs and increase the sexual risks they take, which makes people more likely to get HIV. 

Social isolation

Homophobic attitudes can stop LGBTI people from getting work or housing, and it can make young LGBTI people leave education. This can result in some LGBTI people selling sex, and it can also lead to mental health issues and substance misuse. All these things make someone more vulnerable to HIV. 

Poor quality services

There are very few specialised sexual and reproductive health (SRH) and HIV programmes for LGBTI people, even in comparison with other marginalised groups, such as sex workers. This is because many governments do not prioritise LGBTI communities. The programmes that do exist tend to focus on medical things like PrEP and condoms but ignore the effects of homophobia. There is also a lack of data on LGBTI people in many countries, which can make it hard to design effective programmes. 

Involve LGBTI people in service delivery and decision-making

LGBTI people should be at the heart of any programme that aims to reduce homophobia and increase LGBTI people’s access to HIV and SRH services. There is also a need for services that are designed and delivered by LGBTI people, including peer support. If it is safe, it is also important for LGBTI people to be able to take part in decision-making spaces. 

Tackle homophobic laws

If you are working to end HIV, it is important to support LGBTI-led advocacy to change the laws that criminalise same-sex activities and different gender identities.  

What can we do to tackle homophobia?

Evidence gathering

There is also a need for more data to show decision-makers the realities LGBTI people face in relation to HIV and SRH.  

Changing the way LGBTI people are treated

Public campaigns led by LGBTI people to challenge homophobic attitudes can reach large numbers of people. For example, Gay Pride events celebrate LGBTI people, and there have been successful anti-homophobia campaigns carried out in specific areas, such as sport. 

Social support

We can all help to tackle homophobia by challenging it when we see it – be that in our places of work, our communities or even at home.  

Education

Educating young people about LGBTI issues is key to overcoming prejudice. This can happen in or out of school. For example, by working with young LGBTI role models or running sessions about sexuality and gender identity in youth clubs and other places where young people socialise. 

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