India applauded for taking 'big step' in AIDS fight with gay sex ruling

No longer shamed as criminals, millions of LGBT+ people in India will be less at risk from HIV/AIDS following the legalisation of gay sex, the head of a global health fund said on Thursday (7).

Many gay and transgender people say they encounter discrimination and stigma during health check ups, leading some to avoid doctors' visits altogether, in the largely conservative society where homosexuality has long been taboo.

India has the world's third largest population living with HIV - 2.1 million people - and prevalence rates among gay men - at 2.7 percent - are 10 times that of the total adult population, according to the United Nations agency UNAIDS.

"Criminalisation of communities ... demonstrably increases their vulnerability to diseases like HIV because it creates barriers to accessing health services," said Peter Sands, head of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"On the other hand, decriminalisation is big step forward, it breaks down those barriers," he told the Thomson Reuters Foundation ahead of meetings in New Delhi to drum up support to raise some $14 billion to fight the three diseases.

In its landmark September ruling, the Supreme Court said the 157-year-old Penal Code violated the right to health.

"It forces consensual sex between adults into a realm of fear and shame, as persons who engage in anal and oral intercourse risk criminal sanctions if they seek health advice," it said.

About three in 10 gay men and four in 10 transgender people in India living with HIV do not know their status, UNAIDS says.

Religious groups had protested the decriminalisation of gay sex, arguing that it would lead to a surge in HIV cases.

"The opposite is true," said Sands, a former banker from Britain who was appointed to the role last year.

The Global Fund, launched in 2002, is a group of governments, civil society and private sector partners which invests about $4 billion a year to fight infectious diseases.

It has since helped slash the number of people dying from AIDS, TB and malaria by about a third.

Sands said failure to raise sufficient money for the Global Fund's next three-year cycle could lead to "very real risks" such as a resurgence of infections and deaths.

"We would surrender many of the hard-won gains that have been made thus far," he said, pointing to India's impressive achievement in reducing malaria cases by 24 percent in 2017 compared to 2016.

But India continues to have the world's highest burden of tuberculosis, with 27 percent of all global cases, he said.

"These three diseases are formidable adversaries," Sands said. "If we don't step up the fight, we will be losing. And that loss is measured in lives and in large number of lives."