Criminalization, Punitive Laws, and HIV-related service Utilization among MSM and Transgender Populations in Sub-Saharan Africa: A Scoping Review

This scoping review aims to examine the association between criminalisation, discrimination and punitive laws affecting key populations and the accessibility and equitable health service utilisation (HSU) of HIV/AIDS-related services in sub-Saharan Africa. The review will critically assess whether recent increases in punitive legislation and homophobia and transphobia in sub-Saharan Africa are associated with a shift in HSU. Specifically, we try to identify the determinants causing the variations in HSU among key populations in sub-Saharan Africa and understand whether the rising phobia, proposed by discriminatory bills such as the recently proposed Anti-LGBTQIA+ Bill in Ghana, further exacerbates the limited access of key populations to the HIV care continuum and increases adverse health effects and inequities. Further, we try to identify service and policy approaches (e.g. community-based or integrated care models) that may mitigate the adverse effects of criminalization and stigma, helping to overcome prevailing gaps in the provision of a holistic HIV-related service continuum and address the large sociodemographic discrepancy in the burden of HIV/AIDS throughout the continent by promoting health and well-being, especially for disadvantaged communities.