Health centers treating HIV patients across Senegal are experiencing a significant decline in visits as widespread arrests of LGBTQ individuals create fear among those seeking care, according to health officials and government records obtained by Reuters.
The West African nation recently strengthened its anti-LGBTQ legislation, extending maximum prison sentences for same-sex relationships from five to 10 years. Officials also established penalties of up to 10 million CFA francs ($18,000) for promoting such activities, despite homosexuality already being prohibited in the country.
Since early February, when President Bassirou Diomaye Faye’s administration began preparing the enhanced legislation, human rights advocates and news organizations report that 86 individuals have been detained. A particularly large operation on April 19 resulted in 18 arrests in Linguere, located 186 miles northeast of the capital Dakar.
Two people have already been convicted under the strengthened legislation.
Authorities have charged those detained with “acts against nature,” with some facing additional accusations of intentionally transmitting HIV to others. Government officials have not confirmed the total number of people arrested.
Information from Senegal’s National Council for the Fight Against AIDS (CNLS) indicates that patients are avoiding essential antiretroviral medications that both treat HIV and prevent transmission, driven by concerns about potential arrest or mistreatment.
Government representatives, police officials, and lawmakers who supported the legislation did not respond to requests for comment.
Dr Safiatou Thiam, who previously served as health minister and currently leads CNLS, noted that some Senegalese news organizations have taken the unprecedented step of publishing complete names and HIV status information of arrested individuals, potentially exposing them to additional discrimination and harm.
“We certainly fear, and this has been confirmed, that this wave of arrests will have repercussions for our work,” she stated, emphasizing that healthcare providers remain dedicated to protecting patient privacy and encouraging law enforcement to follow similar practices.
According to UNAIDS data, Senegal stands among only four nations in West and Central Africa where new HIV cases have increased in recent years.
A community health worker who previously distributed HIV testing materials and prevention resources in Dakar now remains confined to their home out of fear.
“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,” the worker said, requesting anonymity due to safety concerns.
“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 previously reported that Senegalese supporters of the anti-LGBTQ legislation coordinated with a U.S.-based “pro-family” organization that characterizes homosexuality as a public health risk.
CNLS surveyed 22 HIV treatment facilities over three days in late February, following concerns that the arrests would reduce HIV testing and disrupt ongoing treatment programs.
Survey results revealed that 1,803 patients received care in February, compared to 2,425 in January – representing a 25.6% decrease.
Additional interviews conducted by CNLS with more than 50 men who have sex with men revealed they were staying away from treatment sites due to fears of being reported, arrested, or experiencing verbal and physical abuse.
Dr. Cheikh Bamba Dieye, who heads the research division at CNLS, confirmed that the unpublished findings clearly demonstrate a connection between the arrests and reduced patient numbers.
While Senegal’s overall HIV rate of 0.3% remains much lower than the most affected countries in southern Africa, new infections have risen by 36% from 2010 to 2024, according to UNAIDS statistics.
When patients discontinue treatment, the virus becomes more easily transmissible to others.
HIV cases in Senegal are primarily concentrated among key populations, particularly men who have sex with men, where government data shows a prevalence rate of 27.6%.
The World Health Organization has recently cautioned about emerging HIV outbreaks among men who have sex with men and has called on governments to eliminate punitive legislation, decrease discrimination, and combat anti-LGBTQ violence.
Responding to Senegal’s new law, UNAIDS stated: “Evidence shows that criminalization causes people to turn away from health services.”
While the HIV treatment centers surveyed by CNLS provide care to all HIV patients, certain groups appear more likely to experience treatment interruptions.
The National Alliance Against AIDS (ANCS), an organization serving key populations, sent a February 23 email to partners announcing it was “suspending interventions aimed at the groups most exposed to HIV/AIDS, in particular MSM and transgender people.”
The message, reviewed by Reuters, cited “the difficult working environment” created by the arrests as the reason for this decision.
The new legislation includes language stating that health organization activities will not be considered illegal.
While some men who have sex with men have relocated to neighboring countries including Mauritania, Gambia, and Ivory Coast, others who remain in Senegal have adopted a low-visibility approach.
“We’ve seen a lot of people lost to follow-up care in hospitals because they think, ‘as soon as I go to a hospital to pick up my medication, I’ll be labeled a homosexual’,” explained 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 healthcare, for creating an organization that works for the well-being of LGBTQ people… and simply because I’m gay.”
