Political homophobia and the effect on GBMSM programmes in Kenya: The significance of a community-led rapid agency assessment

ABSTRACT

A recent Supreme Court ruling that permitted LGBTQ + rights organisations to officially register as non-governmental organisations has led to rises in political homophobia in Kenya. Community leaders initiated and led a rapid agency assessment to examine the effects of this rising political homophobia on sexual health services access for gay, bisexual and other men who have sex with men (GBMSM). This survey assessment engaged directors and programme managers running 20 community-based organisations (CBOs) representing 19 Kenyan counties, serving the sexual health needs of more than >25,000 GBMSM. In addition to prevalent shutdowns of health services, respondents reported growing religious tensions, fears and threats of attack, withdrawal of local county government support, and rising religious tensions. At a moment when highly oppressive anti-LGBTQ + legislation has been drafted and debated in parliament, in the name of ‘family protection’, this commentary makes an appeal to allied health officials and global funding partners to make more explicit statements that call attention to the negative consequences of political homophobia on the grounds of public health and human rights.

KEYWORDS:

• Homophobia
• GBMSM
• community-led
• CBO
• HIV
• STBBI
• Kenya

Since January 2023, LGBTQ + Kenyans have endured vilifying political rhetoric at the hands of government leaders and religious fundamentalists across the country. For instance, former Governor of Nairobi County, Mike Sonko, via social media, offered up to 50,000 KES to anyone who sends him a video of themself physically attacking an LGBTQ + person (Mike Sonko, 2023); while Homa Bay Member of Parliament, Peter Kaluma, drafted the bill known as the Family Protection Bill, 2023 that not only criminalised homosexuality but framed it as a criminal violation between a victim and a perpetrator, deploying language such as ‘attempted’, ‘promoting’, ‘recruiting’ and ‘funding’ in relation to homosexuality (Family Protection Bill, 2023). This political homophobia feeds into tensions surrounding a series of events, including the high-profile murder of well-known activist and fashion designer, Edwin Chiloba (Tandon et al., 2023; Zane, 2023) and the Supreme Court ruling that permitted the National Gay and Lesbian Human Rights Commission (NGLHRC) and LGBTQ + rights organisations to officially register as non-governmental organisations (Lavers, 2023). While the ruling was a victory for LGBTQ + organisations, the event stirred up political dissent among religious leaders (Gathara, 2023), leading Christian and Muslim clerics to hold public demonstrations against homosexuality in April 2023, especially in the Coastal region of Kenya.

This recent wave of political homophobia certainly is not confined to Kenya (Kisika, 2023). In Uganda, the passing of oppressive anti-homosexuality laws in February 2023 formed the basis for Kenya’s Family Protection Bill. As proposed in the Kenyan Family Protection Bill, criminalisation of homosexuality in Uganda extended beyond the sexual act between people of the same sex to include an array of social and economic circumstances in which homosexuality was deemed to take place (see for example: Jerving, 2023). In Tanzania, the government recently passed legislation to ban the display of rainbow flags or colours within organisations or public spaces (Rédaction Africanews with AFP, 2022). The legislation continued the prohibitive legal climate that the late President John Magufuli precipitated during his reign, which led to the suspension of HIV programmes for gay, bisexual and other men who have sex with men (GBMSM) and the arrest and coerced anal exams of men suspected of ‘committing’ homosexuality (Sieff, 2016).

Although these recent events have longer historical roots in the East African region (Kuloba, 2016; Njoroge, 2019), political homophobia in Kenya has taken on an especially virulent quality in a post-COVID-19 moment. Political homophobia is now used by politicians to distract from the economic crisis the country currently faces, in which the cost of living continues to soar. While anti-poverty protests have erupted against President William Ruto’s newly formed government because of increasingly rising costs of living (Reuters, 2023), the government’s employment of anti-homosexual rhetoric distracts from Kenya’s economic crisis while shoring up their political base. While the Family Protection Bill has not yet been written into law, its violent impact has already been felt (Gathara, 2023). In March 2023, members of the NGLHRC received 367 calls reporting incidences of abuse, including assaults, threats, and discrimination, compared to 78 cases in January and 117 in February (Mersie, 2023).

This negative socio-political climate and its related discriminations has dramatically affected sexual health programming in Kenya. On 12 April 2023, the Kenyan parliament unanimously passed a motion to ban any discussion, publication, or dissemination of information related to same-sex sexuality in the country (NextGen Lawyers Kenya, 2023). This ban greatly undermines sexual health promotion and service delivery efforts to communities of GBMSM while also inhibiting the development of HIV/STI policies for this population. However, although the Kenya AIDS Strategic Framework (National AIDS Control Council, 2014) emphasises the importance of working with key populations such as GBMSM, health officials have yet to present any public criticism of the bill’s negative impact on the HIV programme. Despite 12 written requests made by the national GBMSM HIV Prevention Network (GHPN) and Key Populations Consortium to funding partners and allied health officials working in Kenya’s Ministry of Health – no written response has been received, at the time of writing. During a meeting in May 2023, where community leaders were invited to discuss how to address the recent spur of community clinic closures due to growing safety concerns, LGBTQ + and sex worker community members confronted representatives from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, the National AIDS and STIs Control Programme (NASCOP), and the National AIDS Control Council (NACC) on their inaction. Yet these policy makers insisted that they have been doing ‘silent advocacy work’ on behalf of the community, in line with a long history of squarely focusing on HIV programming rather than the criminalised contexts causing harms (Česnulytė, 2017; Moyer & Igonya, 2018; Woensdregt & Nencel, 2022; Woensdregt & Nencel, 2023). When activists stressed the need for immediate action given programme setbacks and ongoing violations they were encountering, these policy makers dismissed their concerns on the grounds that they required ‘the numbers’ to prove their claims.

Anticipating this need for ‘evidence’, community leaders had already initiated a community-led rapid agency assessment of organisations serving and led by GBMSM throughout Kenya. A mixed methods assessment engaged directors and programme managers running 20 community-based organisations (N = 20) representing 19 counties, serving more than >25,000 GBMSM. Under the initiative of the galck + (formerly the Gay and Lesbian Coalition of Kenya), community leaders led the rapid agency assessment to examine the effects of rising political homophobia on sexual health services access for GBMSM. A SurveyMonkey link with closed and open-ended questions was circulated throughout Kenya to member organisations, through a shared Whatsapp group and was active from 12 April to 15 May 2023.

When asked if their organisation was forced to shut down since the Supreme Court ruling that permitted LGBTQ + organisations to officially register, 65% (n = 13) of organisations responded that they were forced to close for at least some period of time. Furthermore, 95% (n = 19) of respondents stated that their outreach programmes have faced numerous challenges since January 2023. When asked to select challenges faced, programme leaders reported: that peers and outreach workers feared mobilising their networks (90%, n = 18); that they feared clients coming to the drop-in centre (75%, n = 15); increases of violence within the community (80%, n = 16); and attacks from families (75%, n = 15). Sixty-five percent (n = 13) of participants felt that the response from partners, donors, and funders was inadequate to support the needs of the organisation. Expanding on the fear, threats, and attacks experienced by their members, programme leaders described disruptions to their programming, as well as adaptations they made to their services. As one respondent stated, ‘We had our team chased away when they went for outreach in some locations, especially in the rural areas and warned never to come back and [were accused] of recruiting gay men in the community’. Another respondent described how ‘[o]ur outreach workers and team were attacked while contacting an outreach hence we suspended all outreaches that were remaining after the attack’. The high prevalence of these disruptions and attacks speaks, ironically, to the negative fallout that came from a positive Supreme Court ruling regarding the right of LGBTQ + organisations to officially be registered.

Currently key population leaders in Kenya are engaged in the process of writing the proposal for the next round of the Global Fund (GC7) and the PEPFAR Country Operational Plan (COP 23). However, many leaders express feeling a shift in the partnerships with government and funders – from being closely collaborative to antagonistic, paternalistic, and undemocratic. The reiteration that state partners are engaging is ‘silent advocacy’ is worrying given that communities are left in the dark on issues that directly pertain to them. The negative consequences on HIV programming for GBMSM following progressive legislation based on the Supreme Court of Kenya ruling underscore the important implications of the Kenyan Ministry of Health and our global funding partners in making a strong statement against the proposed Family Protection Bill. In short, the Family Protection Bill should be a matter of urgent concern to PEPFAR and other HIV stakeholders. In our view, the bill not only criminalises the existence of LGBTQ + persons in Kenya, but it also criminalises the availability and accessibility of services to LGBTQ + persons. The bill criminalises those who ‘fund/sponsor’ programmes and services and those who provide direct services to persons who are perceived or identify as LGBTQ + . The bill contains many other draconian provisions, such as criminalising the provision of gender affirming care and the ‘promotion of homosexuality’, a phrasing that could potentially encompass any health promotion work in these communities. Moreover, this bill contravenes the right to health as enshrined in the Kenyan Constitution (Republic of Kenya, 2010), as well as other fundamental rights and freedoms including the freedom of association, freedom of assembly, the right to privacy, dignity, and freedom from discrimination.

This bill spells devastating consequences to the HIV response in Kenya if it were to pass and becomes law. Kenya, among many other countries in Africa and beyond, is not new to legislation that criminalises and harms those who identify as LGBTQ + . HIV public health science has shown that criminalisation, stigma and discrimination, violence, and other human rights violations enacted towards key populations negatively impact health seeking behaviour and are key ingredients in HIV vulnerability and poor health outcomes (Csete et al., 2023). Whereas Kenya has considerably advanced its efforts towards HIV epidemic control, this escalating series of events will only compromise the milestones achieved. We insist that our partners not only make more explicit statements to challenge the potential hazardous effects of the bill on the ground of public health and human rights, but we also insist on the need for greater community inclusion in these conversations given well established global standards and wisdom around the greater and more meaningful involvement of those who have the most at stake in the outcome of this bill. Urgently, key populations leaders have called for their own community-led technical support unit to have an equal voice at the table, to ensure that the needs of LGBTQ + communities are integrated into policy and programme decisions, beyond HIV. Furthermore, in an era of integrating health services, community-based organisations remain critically necessary in creating safety nets for their communities during crises and heightened periods of criminalisation.

Ethics

This study was approved by the University of Manitoba Health Research Ethics Board (HS 24029 (H2020:292)) and the AMREF Health Africa Research Ethics Board (AMREF-ESRC P1079/2021).

Acknowledgement

We would like to thank the members of the GMT HIV Prevention Network (GHPN) for taking time to complete the surveys and share their experiences.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

As the datasets involve sensitive data from criminalised and stigmatised groups, data will not be made publicly available. Some data may be made available from the corresponding author on reasonable request and approval from the community organisations and study teams.

Additional information

Funding

This was a community-led initiative and funded by the Community Research and Technical Support Hub. The project was also support by a larger sexual health project funded by the Canadian Institutes for Health Research (179790). Robert Lorway is supported by a Tier 2 Canada Research Chair in Global Intervention Politics and Social Transformation.