Uganda's gay community is now being pushed underground, being branded as abnormal, which could be a setback for the fight against AIDS, the activists claim.
Last week Uganda's President Yoweri Museveni refused to approve a controversial bill that would have seen homosexuals jailed for life even after lawmakers removed an extremely controversial death penalty clause. The president's decision was greeted with measured relief among gays.
But far from approving of homosexuality, the president merely conceded that they have a right to exist, and branded them "sick" genetic freaks. He also said lesbians were victims of "sexual starvation" because of their failure to find a man.
For Frank Mugisha, one of Uganda's most prominent gay activists, homosexuals are being driven into leading dangerous double lives and therefore indulging in risky sexual practices.
"The ones who wanted to come out will not dare to come out anymore," Mugisha said.
"African culture dictates that you have to marry in a heterosexual relationship and have children. And gay people are not going to stop having sex," he said. "HIV is going to be on the increase (and) people will start dying."
Uganda was once heralded as a success story in the fight against HIV. Museveni, one of the first African leaders to speak openly about AIDS, mounted a highly successful public awareness campaign in the late 1980s and 1990s, slashing the HIV infection rate from more than 20 percent to single digits.
Gays are far from being the main vector for HIV transmission in the country, health workers say, adding that heterosexual contact, in particular sex workers, continue to be the main cause.
But they say the ongoing debate in Uganda surrounding the anti-gay bill, which has had the backing of influential evangelical Christian and other religious groups, would damage their efforts to reach out to the gay community.
"We are going one step forward and then ten steps back," said Milly Katana, a public health specialist and AIDS activist who is herself living with HIV. "As far as HIV prevention is concerned, we are heading for a total disaster. It's a crisis."
Even if the law has been blocked, for the time being at least, health workers were alarmed by parliament's insistence that it be mandatory to denounce anyone known to be homosexual.
The provision was a reflection of what is already a reality in Uganda, where tabloid newspapers frequently expose alleged gays.
In 2011, prominent Ugandan gay rights activist David Kato was bludgeoned to death at his home after a newspaper splashed photos, names and addresses of gays in Uganda on its front page along with a yellow banner reading "Hang Them".
"We have communities that are at risk of contracting HIV and we put punitive measures in place against them and also against people who work with them. They will not be able to talk to people who are able to advise them on how to protect themselves," Katana said.
"We public health workers cannot do our job," she added.
Bildard Baguma, deputy secretary general at the Uganda Red Cross, agreed that there were consequences to the wave of homophobia.
"The issue of access becomes a problem," he said. "If these people go underground and can't access services, then it is likely to have a negative effect on the epidemic."
At the AIDS Information Centre in Kampala, staff have also been deeply worried over the impact on access to public health facilities for those most at risk -- notably sex workers where HIV prevalence is 33 percent, and male homosexuals where prevalence is 12 percent.
"When these communities blend with the population, they tend to cause transmission of HIV," said Raymond Byaruhanga, a doctor who runs the centre.
"Therefore, it results in an increase of HIV prevalence in the wider community," he added, saying the general climate of repression against homosexuals was among several reasons that HIV rates in Uganda are creeping up again for the first time in two decades.
Other problems include complacency -- the sentiment that HIV infection is not that bad given the availability of anti-retroviral medication -- and misconceptions about the benefits of male circumcision.
According to the most recent figures, from 2011, the national prevalence rate rose to 7.3 percent from 6.4 percent in 2004-05 -- and this prompted the Ugandan health ministry to announce earlier this year that it would open special clinics aimed at the communities most at risk of infection.
"If you don?t target them... they will get infected and spread it," said Alex Ario, the doctor in charge of the healthy ministry's AIDS control programme.
"It will make our work more complicated," Ario said of the push for tough legislation, "because we won't be able to talk about the issues."