Today, a new report from the HIV Policy Lab shows remarkable progress in decriminalization of consensual same-sex globally amid dangerous regression in some places - an impressive reversal given that at the start of the AIDS epidemic most countries in the world criminalized same-sex sex. The report is anchored by Georgetown Law's O'Neill Institute, the United Nations Development Programme (UNDP), and the Global Network of People Living with HIV (GNP+).
According to the report, "Progress and the Peril: HIV and the Global Decriminalization of Same-sex Sex," law reform has accelerated as thirteen countries, including Barbados, Botswana, and India, have recently repealed criminalizing laws, including some of the world's major economies and those with the highest HIV rates.
As of this year, 129 out of the 194 countries tracked by the HIV Policy Lab - two thirds of states - do not criminalize same-sex sex. This is a near exact reversal from the start of the AIDS epidemic and important progress on "10-10-10" goals agreed by UN member states to remove harmful laws. The fastest progress was in the Caribbean - moving from 71% criminalization in 2017 to 43% in 2023- followed by Eastern and Southern Africa.
"The progress in addressing discriminatory laws and criminalization is made possible by the leadership of people living with HIV and other key populations," said Mandeep Dhaliwal, director of the HIV and Health Group at UNDP. "Evidence clearly demonstrates that laws grounded in human rights and equity lead to better health outcomes. If we want to end HIV and counter the pushback on gender and human rights, we must continue bolstering the efforts and leadership of key populations and scale what we know works."
This report also documents a dangerous counter trend of rising homophobia and anti-LGBTQ+ laws, prosecution, and persecution in some countries, which the authors say are increasingly out-of-step with progress toward more humane legal systems and frameworks. Some countries have become even more punitive, imposing long prison sentences or even the death penalty.
An estimated 34% of the world and 37% of all people living with HIV reside in countries that still criminalize same-sex sex. In countries that actively enforce criminalization, there is a decreased uptake of HIV care and treatment services, undermining the AIDS response at a population level.
"Law is one of the most important public health interventions governments have at their disposal-it can enable or undermine effective pandemic response," said Dr. Matthew Kavanagh, director of Georgetown University's Center for Global Health Policy & Politics at the O'Neill Institute. "This report challenges the notion that legal change is too hard or too long term-showing how countries are taking different legal and political pathways to decriminalization and reaping the health benefits."
The authors show multiple models of progress through case studies of decriminalization from Africa, Asia, and the Caribbean that show how countries can remove structural barriers and promote health equity.
"The battle for our rights, dignity, and quality of life has reached a fervent urgency," said Florence Riako Anam, co-executive director at GNP+. "Repressive legislation looms, institutionalizing discrimination, prejudice, and violence against our communities, particularly those based on sexual orientation and gender identity. Yet, hope prevails through the growing movement for decriminalization, tearing down walls of discrimination and injustice."
The report discusses how lessons learned for the AIDS response include the importance of greater investment in community services and advocacy. The authors emphasize that decriminalization on its own is not sufficient, and countries can advance an effective multi-sectoral AIDS response through aligned engagement from government, the judiciary, and civil society.
Read the report here.
