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Strategic Litigation, Public Health, and the Decriminalization of Same-Sex Sexual Intimacy: Lessons From Legal
Sara Wallach1, Jirair Ratevosian1, Tom Smith1
1Sara Wallach is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Jirair Ratevosian and Chris Beyrer are with the Duke Global Health Institute, Duke University, Durham, NC. Tom Smith and Katie Duval are with Hogan Lovells International LLP, London, UK. Stefan Baral is with the Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
None:
Consistent data have demonstrated the harms of punitive laws criminalizing same-sex sexual intimacy in the context of both public health and human rights. However, as of January 2025, 61 United Nations member states criminalize consensual same-sex sexual acts among adults, with varying degrees of enforcement and severity. We used 6 legal challenges across former British colonies in Africa, the Caribbean, and Asia to assess the role of strategic litigation in decriminalizing same-sex practices and where public health arguments, particularly regarding HIV, were central to these legal challenges. Successful decriminalization efforts in Belize and Dominica were contrasted by legal setbacks in Jamaica, Saint Vincent and the Grenadines, and Kenya. Our findings emphasize the importance of integrating health-related evidence, country-specific data, and local civil society input into legal strategies, highlighting the critical role of collaboration between public health experts, legal professionals, and local advocacy groups. Future litigation efforts must carefully consider local contexts, engaging with communities to ensure both legal success and long-term societal change for LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, and all subsects) individuals. (Am J Public Health. 2025;115(8):1254-1263. https://doi.org/10.2105/AJPH.2025.308072).
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