The social stigma that comes with being in a same sex relationship makes it difficult to cultivate a sustained relationship that is psychologically and physically healthy in many ways – the most well-docmented of which is its impact on HIV.


In August 2009 a paper published in the Lancet, a leading medical journal, suggested that rates of HIV among men who have sex with men (MSM) in the sub-Saharan African region are up to ten times the rates in the overall male population.


This is largely the result of social barriers that generate fear of stigma or legal prosecutionif one is open about his or her involvement in a same-sex relationship, which have a potent impact of discouraging people from seeking access to the education, prevention, testing, treatment and care services that all form part of an essential package for HIV and other sexually transmitted infections.


The authors of the Lancet paper warned that “The HIV/AIDS community now has considerable challenges in clarifying and addressing the needs of MSM in sub-Saharan Africa; homosexuality is illegal in most countries, and political and social hostility are endemics. An effective response to HIV/AIDS requires improved strategic information about all risk groups, including MSM. The belated response to MSM with HIV infection needs rapid and sustained national and international commitment...”


In addition to generating barriers to accessing health services, homophobia has also fuelled acts of “correctional rape” against women, which is perpetrated in some countries by men who supposedly intend, by forcing a lesbian woman to have sex with them, to “cure” her of her attraction to women. “Correctional rape” makes women who are engaged in same sex relationships particularly vulnerable to sexual violence and the range of health problems that comes with this.


The United Nations has issued calls for action to ensure the protection of sexual minorities in law and to thus increase their access to health services, with Secretary General Ban Ki-Moon stating:


Not only is it unethical not to protect these groups [sexual minorities]; it makes no sense from a health perspective. It hurts all of us.”