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HIV Criminalisation and the Cost of Stigma from the Africentric Lens

By Rita Babirye

Modern legal systems across Africa are dismantling centuries of communal solidarity by replacing restoration with retribution. HIV criminalisation in Africa is not simply regulation – it is a mechanism that fractures unity, compromises dignity, and undermines Africentric traditions of care _^(1-2). These laws frame HIV as a criminal matter instead of a public health concern by prioritizing blame, punishment, and arrest over prevention and support. HIV criminalisation rests on the assumption that contracting or transmitting the virus reflects a personal or moral failure deserving punishment ^(3-5). For instance, in Uganda, the HIV and AIDS Prevention and Control Act criminalises attempted and unintentional transmission, mandates compulsory testing, and permits disclosure without consent ⁽⁶⁾. This perspective diverges from traditional African beliefs of health and illness, where healing is a community concern grounded in care solidarity and collective responsibility ⁽⁷⁾.

Africentrism proposes that Africans should center their view and evaluation of the world within their own historical and ontological framework ⁽⁸⁾. It calls for reclaiming and affirming African values and practices. From this viewpoint, the criminalisation of HIV is not simply a public health measure; it reflects the continued imprint of colonial legal systems that disrupted and displaced indigenous frameworks of care, solidarity, and collective accountability.

How Traditional African Communities Understood Illness and Disease

In precolonial Africa, disease was perceived as holistic, relational, and communal. Health was understood as a balance between the body, community, ancestors, and the spiritual world. When illness occurred, it was not looked at as a moral or personal failure. Rather, questions were framed to determine what channels of healing would be used, and focus was placed on mending relationships ⁽⁹⁾.

How Traditional African Communities Understood Sex and Sexuality

On the African continent, HIV is primarily transmitted through sexual conduct. Consequently, understanding how sexuality was holistically framed in traditional African societies is essential to challenging contemporary narratives of blame and moral failure.

Among Indigenous African communities, sex and sexuality were not morally condemned. Instead, sex was understood as part of social harmony. In South African communities, children learned about sex through games and freely sought guidance from their relatives, with sexual exploration considered to be natural and healthy, free from moral judgment ⁽¹⁰⁾. Social norms, taboos, and customs shaped the regulation of sexual and reproductive conduct in African communities. Individuals did not suffer neglect or isolation, and women participated in decision-making to shape their health outcomes ⁽¹¹⁾.

In precolonial contexts, diseases, including sexually transmitted disease was treated communally, which reduced stigma and the moral condemnation of people living with sexually transmitted diseases. Baganda family councils in Uganda used diviners and spirit mediums to guide healing rituals that brought families to uncover spiritual or moral causes of illness fostering compassion rather than blame ⁽¹²⁾; Among the Yoruba of Nigeria, it was perceived that the individual and the lineage were mutually bound therefore, diviners and herbalists worked closely with families to perform divinations and sacrifices intended to heal both, emphasising shared accountability rather than shame ⁽¹³⁾; The Akan of Ghana understood that harmony was lost when an individual fell ill, and restoration required priests and family elders to conduct purification and reconciliation rituals that reaffirmed belonging and restored harmony ⁽¹⁴⁾. Across these traditions, illness was never a moral indictment but a disruption of balance requiring collective care.

Colonialism altered the African understanding of illness, disease, and sexuality at every level. It was not just influence, but rather, a radical restructuring in the social, communal, and customary systems of African communities. Illness became linked to sin and a moral failure that demanded punishment and invoked shame from family and the wider community. Western medicine separated illness from community life by turning health into an instrument of governance ⁽¹⁵⁾.

Contemporary HIV legislations function as instruments of moral regulation rather than public health tools. These laws reframe a medical condition as a “disease of choice,” effectively shifting the focus from communal support to individual punishment ⁽¹⁶⁾. This transition displaces indigenous African models of social healing with a modern culture of surveillance and exclusion. Ultimately, the threat of imprisonment erodes the foundational trust required for effective healthcare access. This legal approach abandons the Africentric principle that health is a collective, dignified journey, opting instead for state-sanctioned shame.

Conclusion

Laws that criminalise HIV do not protect communities but instead, fracture them by isolating responsibility, deepening stigma, and deterring access to care. Meaningful reforms demand moving away from criminalisation and investing in shared prevention and mitigation approaches that are grounded in care rather than punishment.

References:

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