Executive Summary:
This report provides a comprehensive socio-legal analysis of the systemic challenges confronting HIV Key Populations (KPs)—including sex workers, LGBTQ+ individuals, people living with HIV (PLHIV), and people who use drugs—in Egypt under the post-2013 authoritarian regime. It argues that the persecution of these groups is not an incidental byproduct of conservative social norms but a deliberate state strategy. By instrumentalizing “public morality,” the regime seeks to legitimize its rule, particularly against narratives from political Islam, and to deflect public attention from a protracted economic crisis and the mismanagement of state resources. This strategy has led to the active criminalization and marginalization of KPs, whose human rights are systematically violated to serve the state’s political objectives.
The analysis deconstructs the legal architecture of this persecution, which is built upon a web of vaguely worded and broadly interpreted legislation. The colonial-era Law 10/1961 on the Combating of Prostitution, with its gendered terms of “prostitution” and “debauchery,” serves as the cornerstone for prosecuting sex workers and for the de facto criminalization of LGBTQ+ individuals. Critically, the judiciary has actively expanded the law’s scope, with the Court of Cassation removing the need for financial proof in sex work cases, thereby transforming the law into a tool for policing any non-normative sexuality. The recent Cybercrime Law 175/2018 has shifted this persecution into the digital sphere, enabling mass surveillance and entrapment under ambiguous pretexts like protecting “family values.” Recent judicial interpretations have further escalated this trend, moving from de facto to explicit, de jure criminalization of homosexuality.
Beyond direct criminalization, the report details a system of state-sponsored discrimination and public health failures. LGBTQ+ individuals are barred from public employment, pathologized as mentally ill to avoid military service, and subjected to deportation under discriminatory migration laws. Transgender and intersex individuals face a particularly dire situation, governed by a rigid, religiously influenced health policy that distinguishes between “permissible sex correction” for intersex people and “impermissible sex change” for transgender people, effectively denying the latter access to essential gender-affirming healthcare and creating a dangerous underground market. This prioritization of “public morality” over public health is starkly evident in the state’s HIV response. Despite a rising infection rate, HIV is treated as a “non-issue,” with policy focusing on treatment over prevention and failing to address stigma. This neglect stands in sharp contrast to the state’s highly successful campaign against Hepatitis C, demonstrating that the lack of an effective HIV response is a political choice, not a lack of capacity. Similarly, drug policy has taken a punitive turn with Law No. 73/2021, which mandates the termination of public employees for drug use, officially abandoning a rehabilitative model for one of pure punishment.
In this highly constrained civic space, civil society has been forced to adopt an “advocacy inversion” strategy, shifting from direct lobbying of the state to engaging international bodies, pursuing strategic litigation, and integrating data collection into service provision. Concluding with a set of pragmatic recommendations grounded in a “Harmonization and Expansion” strategy, the report outlines a path forward for the Egyptian government, international partners, and local civil society. It focuses on achievable, incremental changes—such as expanding STI services, clarifying drug laws, enhancing data transparency, and leveraging international mechanisms—to build a foundation for improving the human rights and health outcomes for all Key Populations in Egypt.
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