Strategic Litigation, Public Health, and the Decriminalization of Same-Sex Sexual Intimacy: Lessons From Legal Challenges Across Former British Colonies.

Consistent data have demonstrated the harms of punitive laws criminalizing same-sex sexual intimacy in the context of both public health and human rights. However, as of January 2025, 61 United Nations member states criminalize consensual same-sex sexual acts among adults, with varying degrees of enforcement and severity. We used 6 legal challenges across former British colonies in Africa, the Caribbean, and Asia to assess the role of strategic litigation in decriminalizing same-sex practices and where public health arguments, particularly regarding HIV, were central to these legal challenges. Successful decriminalization efforts in Belize and Dominica were contrasted by legal setbacks in Jamaica, Saint Vincent and the Grenadines, and Kenya. Our findings emphasize the importance of integrating health-related evidence, country-specific data, and local civil society input into legal strategies, highlighting the critical role of collaboration between public health experts, legal professionals, and local advocacy groups. Future litigation efforts must carefully consider local contexts, engaging with communities to ensure both legal success and long-term societal change for LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, and all subsects) individuals. (Am J Public Health. Published online ahead of print April 24, 2025:e1-e10. https://doi.org/10.2105/AJPH.2025.308072).