"I'm alone in this world," sobs the woman, tears smudging her black eyeliner as she clutches a handbag with medicine inside — antiretroviral pills for HIV.
Wearing a hijab that covers her long hair, a traditional Arabic dress with roses and wedge heels, she sits in the office of a community group that offers support to LGBT sex workers, trying to regain her composure. "Princess Shadya," as she is known to friends, is transgender and identifies as a woman. And she lives in Tanzania, where LGBT people are increasingly coming under attack from the government.
"I'm getting worried if they know I'm transgender they will refuse to give me medicine," says Shadya, who asked that her real name not be used because of the government's crackdown.
Last August, the justice minister suspended HIV prevention programs, funded by the U.S., that were aimed at gay men — and warned that any nonprofit that supports homosexuality would be suspended. Since then, there has been a continued effort to wind back or stop such programs.
In February, the government banned 40 private drop-in health centers from providing services for HIV/AIDS to "key populations" — a category that includes gay men, transgender people and sex workers. The reason: Health minister Ummy Mwalimu stated at a press conference that "it was established that the centers were promoting homosexuality, which is against Tanzania's laws."
And on March 5, deputy health minister Dr. Hamisi Kigwangalla tweeted: "The war against promotion and normalization of homosexuality in Tanzania is real. I commend recent efforts by the police force on our cause." Kigwangalla, who is a medical doctor, has also ordered three men to turn themselves into the police for "spreading" homosexuality.
Among his other Twitter remarks:
This kind of anti-gay attitude is part of Tanzania's history. From 1885 until World War I, Tanzania was a Germany colony and the German anti-sodomy law was in force. Then the British took over; their laws against "gross indecency" — basically sexual acts between men — were in place until 1945. That year, the colony passed its own criminal code that prescribed 30 years to life in jail for male sex. Lesbian sex, however, is not criminalized.
Despite the legal prohibitions, the country had a reputation for accepting its LGBT community — until John Magufuli was elected president in late 2015.
Nicknamed the "Bulldozer" for his pragmatic attitude, Magufuli has stepped up efforts to penalize homosexual behavior, part of a wider crackdown during which journalists have also been targeted, Paul Makonda, the regional commissioner for Dar es Salaam, the largest city in Tanzania, said in 2016 he personally would look for gay people on Facebook and Instagram and arrest them. He publicly said that those who follow gays are "just as guilty as the homosexual."
Even when programs for people with HIV are in place, patients may be afraid to come for help. At one clinic that works with the LGBT population, around 30 people would come in each month for free testing for HIV and sexually transmitted diseases, medication, condoms and lubricants. Now, no one shows up, says Wenty, a a staff member who asked to be identified only by his first name because of the fear of government persecution.
"People have stopped [coming in for] their HIV medication, they don't go for HIV testing and counseling," he adds.
The clinic would also pay for community health educators to escort patients to private clinics for treatment of sexually transmitted infections. They'd make sure the patient got to the right departments. This service was discontinued last year out of fear.
The clinic directors decided to paint over the words "HIV testing and counseling and psychological support" on the inside walls. And they're planning to take down the outdoor sign with the clinic's name. "I think people have never feared like this before," says Wenty.
Tanzania currently receives approximately $380 million a year from PEPFAR, the U.S. program that supports programs to prevent HIV and AIDS and provides medications for people who are HIV positive. "We have been consistent in expressing concern on the statements and actions taken by certain Tanzanian officials targeting health care providers and civil society organizations that provide services to key populations at risk of HIV/AIDS," a USAID spokesman wrote in an email to NPR. "We urge Tanzania to maintain its prior commitments to combat the HIV/AIDS epidemic and to serve all of its people and populations equally without bias or discrimination."
In a statement posted to its Facebook page on February 17 after the government announced the ban on drop-in centers, the U.S, embassy in Tanzania said it anticipated the decision will "result in fewer Tanzanians receiving lifesaving services and expand the epidemic among those most in need of viral suppression."
Neela Ghoshal, a researcher in the LGBT rights division of Human Rights Watch, said the Tanzanian government "ought to know better — if you begin shutting down health services dedicated to key populations, including men who have sex with men, it's quite likely that you'll see an uptake in HIV prevalence among these groups," she says.
"You'll also see people stop adhering to their drugs because it can even become unsafe for them in some cases to go out and get ARVs."
For Princess Shadya, who's 23, the new atmosphere is the latest in a series of obstacles. Once she worried that she didn't have tap water in her home so it was hard to down her pills. Now she's afraid to go to the hospital to pick up her medications because police officers are patients there, she says, and she worries she could be arrested.
Rama, a gay 30-year-old man, sits next to Princess Shadya, trying to comfort his friend.
"Here in Africa when you're gay there's a big problem," he says, crossing two fingers to make an "x," underlining his point that homosexuality is taboo in Tanzania. "Gays here live in fear."
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