Criminalization of Sexual and Gender Minorities and Its Consequences for the HIV Epidemic in Zambia: A Critical Review and Recommendations

Valerie Yelverton; Shan Qiao; J Anitha Menon; Levy Ngosa; McLean Kabwe; Sayward Harrison; Sharon Weissman; Xiaoming Li; Gary W Harper

doi:10.1097/JNC.0000000000000281

Criminalization of Sexual and Gender Minorities and Its Consequences for the HIV Epidemic in Zambia: A Critical Review and Recommendations

J Assoc Nurses AIDS Care. 2021 Jul-Aug;32(4):423-441. doi: 10.1097/JNC.0000000000000281.

Authors

Valerie Yelverton¹, Shan Qiao, J Anitha Menon, Levy Ngosa, McLean Kabwe, Sayward Harrison, Sharon Weissman, Xiaoming Li, Gary W Harper

Affiliation

¹ Valerie Yelverton, MSc, is a Doctoral Candidate, Department of Health Services Policy and Management, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA. Shan Qiao, PhD, is an Assistant Professor, Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA. J. Anitha Menon, PhD, is a Professor, Department of Psychology, University of Zambia, Lusaka, Zambia. Levy Ngosa, is a Board Member, Dignitate Zambia, Lusaka, Zambia. McLean Kabwe, is a Director, The Lotus Identity, Lusaka, Zambia. Sayward Harrison, PhD, is an Assistant Professor, Department of Psychology, University of South Carolina, Columbia, South Carolina, USA. Sharon Weissman, MD, is a Professor, Department of Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA. Xiaoming Li, PhD, is a Professor, Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA. Gary W. Harper, PhD, MPH, is a Professor, Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

PMID: 34115722
DOI: 10.1097/JNC.0000000000000281

Abstract

To elaborate the negative impacts of sexual and gender minority (SGM)-related legislation for the HIV epidemic in Zambia, we reviewed Zambian legislation that restricts the rights of SGM people and synthesized its consequences. We retrieved legal documents through the National Assembly of Zambia and the Zambia Legal Information Institute and conducted a critical review based on four academic databases following thematic synthesis methodology. Eighteen literature records and six Zambian laws were included in the review. Existing laws criminalize same-sex sexual behavior and restrict same-sex marriage and the adoption of children. Anti-SGM legislation has limited legal protections for SGM people and increased vulnerability of criminal prosecution and HIV exposure, persistent stigma/discrimination, insufficient public health resources, and lessened access to HIV-related services. We recommend enacting legal protections for SGM people, decriminalizing anti-SGM laws, rectifying misinformation to destigmatize SGM people, targeting health care for SGM people, and including SGM people in the national HIV strategy.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Child
Epidemics*
HIV Infections* / epidemiology
Humans
Sexual Behavior
Sexual and Gender Minorities*
Zambia / epidemiology

Grants and funding

R21 TW011064/TW/FIC NIH HHS/United States