Stigmatised as 'promoting' with a duty to report: public healthcare workers providing services to criminalised 'key populations for HIV' under Uganda's 2023 Anti-Homosexuality Act.

IF 1.8 3区 医学 Q2 FAMILY STUDIES
Austin Bryan
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Abstract

This paper analyses the experiences of public healthcare workers in Uganda under the Anti Homosexuality Act (AHA) 2023, who specialise in the provision of HIV prevention and treatment services to criminalised 'key populations' for HIV, including men who have sex with men, transgender women, and female sex workers. Utilising in-depth semi-structured interviews with 17 public healthcare workers and participant observation with LGBTQ+ and HIV activists, public health officials, and development workers, this ethnographic study explored the legal, social and ethical challenges that public healthcare providers faced. Public healthcare workers have experienced various types of stigma from their work, including socio-legal stigma from the criminalisation of 'promoting homosexuality', stigma by association with key populations, concealment stigma, and denial. Legal ambiguities stemming from the AHA 2023 have led to security incidents for some public healthcare workers. The study highlights the ethical dilemmas that have arisen from the 'duty to report' clause, which conflicts with professional healthcare ethics of confidentiality, and the role the Ministry of Health played in passing the AHA 2023, instilling confusion about its enforcement, and minimising and denying the risks the legislation has had on Uganda's HIV epidemic.

被污名化为有义务报告的 "宣传":根据乌干达 2023 年的《反同性恋法》,公共医疗工作者为被定罪的 "艾滋病关键人群 "提供服务。
本文分析了乌干达公共医疗工作者在《2023 年反同性恋法》(AHA)下的工作经历,他们专门为被定罪的艾滋病 "关键人群"(包括男男性行为者、变性女性和女性性工作者)提供艾滋病预防和治疗服务。这项人种学研究通过对 17 名公共医疗工作者进行深入的半结构式访谈,以及对 LGBTQ+ 和 HIV 活动家、公共卫生官员和发展工作者进行参与式观察,探讨了公共医疗服务提供者所面临的法律、社会和伦理挑战。公共医疗工作者在工作中经历了各种类型的污名化,包括因 "宣扬同性恋 "而被定罪所带来的社会法律污名化、与重点人群的关联所带来的污名化、隐瞒污名化以及否认污名化。AHA 2023》产生的法律模糊性导致一些公共医疗工作者遭遇安全事件。该研究强调了 "报告义务 "条款所带来的道德困境,该条款与医疗保健专业保密道德相冲突,并强调了卫生部在通过《2023 年艾滋病法案》、对其执行造成混淆以及尽量减少和否认该立法对乌干达艾滋病疫情造成的风险方面所扮演的角色。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
4.50%
发文量
80
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