People Most at Risk Driven Underground by Discrimination, Violence
(Dar es Salaam) – Tanzanians who are most at risk of HIV face widespread police abuse and often can't get help when they are victims of crime, Human Rights Watch and the Wake Up and Step Forward Coalition (WASO) said in a report released today.
The 98-page report, "'Treat Us Like Human Beings:' Discrimination against Sex Workers, Sexual and Gender Minorities, and People Who Use Drugs in Tanzania,"documents abuses including torture, rape, assault, arbitrary arrest, and extortion. The organizations found that the fear of abuse is driving sex workers, people who use drugs, and lesbian, gay, bisexual, transgender, and intersex (LGBTI) people away from prevention and treatment services. The groups conducted their research from May 2012 to April 2013, and interviewed 121 members of high risk groups, along with Tanzanian government officials, service providers, and academics.
"The Tanzanian  government has committed on paper to reduce the stigma for at-risk groups, but that commitment is meaningless if the police regularly rape, assault, and arrest them," said Neela Ghoshal , Lesbian, Gay, Bisexual, and Transgender (LGBT) Rights  researcher at Human Rights Watch. "The government's HIV policy can't succeed if police are driving away the very people the public health programs most need to reach."
The two organizations also documented a wide range of abuses against at-risk groups in the health sector, including denial of services, verbal harassment and abuse, and violations of confidentiality. Tanzanian HIV/AIDS policy calls for efforts to reduce stigma against marginalized groups, and authorities have taken some measures to do so. But Human Rights Watch and WASO identified dozens of cases in which health workers turned away sex workers, LGBTI people, and drug users from health facilities without offering services, or publicly humiliated them.
The groups also documented the commercial sexual exploitation of children. It is prohibited for children to engage in sex work, but instead of protecting these children and offering them assistance, the groups found that police rape, sexually assault, and beat them with impunity. In one case, a 12-year-old girl engaged in sex work in Mbeya was gang-raped by police officers. Police who abuse these children should be investigated and prosecuted.
The groups found that semiofficial security forces, most notably the Sungu Sungu, a vigilante group, are also implicated in violence against at-risk populations, "policing" their behavior, often through force.
These human rights violations contribute to an environment in which men who have sex with men, transgender people, sex workers, and people who inject drugs have become increasingly distrustful of the state. Their fears undermine public health initiatives that depend on cooperation and partnership between the government and key populations that are most at risk of HIV infection.
Tanzania's HIV policy commits, among other strategies, to increase access to HIV prevention and services for key populations; to build partnerships with nongovernmental organizations representing these marginalized groups; and to work toward decriminalization of sex work and same-sex conduct. However, these strategies have been carried out halfheartedly at best, Human Rights Watch and WASO found.
Members of most at-risk populations are also denied access to information about HIV. Public awareness campaigns on HIV almost exclusively target heterosexual couples. Many community-based organizations believe they cannot offer services to criminalized groups, fearing that working with these groups is, in itself, illegal. LGBTI people and sex workers say that they cannot form legally recognized membership groups and register with the government. In 2011, police arrested and beat one gay man in Dar es Salaam simply because he tried to organize a workshop for other men who have sex with men.
Tanzanian law punishes consensual sexual conduct between adult males with 30 years to life in prison, one of the harshest sentences for same-sex intimacy in the world. In semiautonomous Zanzibar, the law prohibits consensual same-sex sexual relations between men, with a penalty of up to 14 years in prison, and between women, with up to 5 years in prison. No one has been prosecuted for same-sex conduct in recent years, but the law contributes to the isolation and marginalization of LGBTI people. Sex work is criminalized in both mainland Tanzania and Zanzibar, as is the personal possession and consumption of even small amounts of narcotic drugs.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) says that criminalization of key populations drives them underground and away from HIV services, resulting in further marginalization, discrimination, and violence. The Global Commission on HIV and the Law, a commission of experts established by the United Nations Development Programme (UNDP), also calls for decriminalizing sex work and same-sex conduct involving consenting adults.
The criminalization of consensual sexual relations among adults is incompatible with a number of internationally recognized human rights, including the rights to privacy and non-discrimination. Criminalization of the voluntary, commercial exchange of sexual services among adults, as in the case of consensual sex work by adults, is also incompatible with the right to privacy, including personal autonomy.
President Jakaya Kikwete should publicly condemn police abuse, discrimination in health care, and all other forms of discrimination against sex workers, people who use drugs, and LGBTI people, Human Rights Watch and WASO said. The police and the Health and Social Welfare Ministry should provide services for all who require them.
The parliaments of Tanzania and Zanzibar should decriminalize same-sex conduct and sex work involving consenting adults, and review drug laws to ensure that they are consistent with human rights.
Donors should ensure that funding directed to HIV/AIDS prevention and treatment in Tanzania includes funds specifically aimed at these key populations' health needs, and should support the development of civil society organizations representing them.
"If Tanzania is truly committed to addressing HIV/AIDS among key populations, it needs a coordinated, rights-based approach," Ghoshal said. "The police and health care workers should provide protection and treatment to at-risk groups, rather than setting an example of hatred and bigotry."