HTB October/November 2023

We lead this HTB with a special report on the dramatic increase in human rights abuses in Uganda against LGBTQI+ communities and individuals, or anyone who supports them, as a result of the Anti-Homosexual Act (AHA) legislation earlier this year.

The impact of this new law, passed in March 2023 and slightly modified in May, is much wider than HIV or other healthcare issues, but the impact on both HIV prevention and treatment certainly justifies the numerous statements issued against the AHA, including from UNAIDS, IAS, BHIVA and others.

Even before the law was passed, HIV clinics experienced a significant decrease in people falling out of care, for fear of attending services. We reported this in the summary of Track D studies at IAS 2023 in the September issue of HTB. (https://i-base.info/htb/46249)

As international global health goals are used as a structure for financial support, including the 95:95:95 cascade targets, the threat of losing funding is one of the few ways that international pressure could overturn the AHA. It is a significant achievement that in August the World Bank suspended international loans to Uganda, largely because activist pressure made this a global political issue.

Politics and healthcare overlap with issues of migration and the right to have freedom from persecution, which by definition includes the right to claim asylum.

As background, the strategy to marginalise and persecute LGBTQI+ communities in Uganda was to deflect attention away from issue of political corruption in Uganda. Funding for this policy has also been directly linked to religious extremists based in the US.

The particularly cruel speeches recent given by the UK Home Secretary Suella Braveman MP stating that she wants to deny LGBTQI+ persecution as a factor in claiming asylum in the UK, even faced with the death penalty in their own country, makes this a healthcare issue in the UK.

The persecution in Uganda is directly linked to human rights in the UK and internationally and we need to collectively engage in protecting these rights or we risk them being steadily eroded.

The rest of HTB continues with six further reports from IAS 2023 focused on new and pipeline ARVs (lenacapavir, bNAbs and CAB/RPV injections), viral resuppression in the ADVANCE study, and on the safety of tenofovir-based oral PrEP in pregnancy, and bictegravir use in pregnancy (more data needed).

We report recent peer-reviewed papers on ART-related weight gain, resistance to dapivirine rings and changes in renal function in women using alcohol and/or cannabis.

As an admin note for the sharp-eyed reader, even though the previous HTB was September/October we have dated this new issue October/November because we compiled enough reports over the last week or so.