a. Arbitrary Deprivation of Life and Other Unlawful or Politically Motivated Killings

There were at least two reports the government or its agents committed arbitrary or unlawful killings.

On March 11, authorities charged three police officers in the death of a motorcycle driver in Fatick. The man was allegedly carrying illegal drugs when he was stopped by police. Following his arrest, the police officers allegedly took the man to the beach where they beat him to death.

On May 2, a prisoner at Diourbel prison died from severe injuries. Three police officers and a security and community outreach officer from the Mbacke police station reportedly beat him. Authorities charged the alleged perpetrators for his death.

b. Disappearance

There were no reports of disappearances by or on behalf of government authorities.

c. Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment

The constitution and law prohibit such practices. Human rights organizations noted examples of physical abuse committed by authorities, including excessive use of force as well as cruel and degrading treatment in prisons and detention facilities. In particular they criticized strip search and interrogation methods. Police reportedly forced detainees to sleep on bare floors, directed bright lights at them, beat them with batons, and kept them in cells with minimal access to fresh air. Investigations, however, often were unduly prolonged and rarely resulted in charges or indictments.

Impunity for such acts was a significant problem. Offices charged with investigating abuses included the Ministry of Justice and the National Observer of Places of Deprivation of Liberty.

On March 24, during the first night of a nationwide curfew related to COVID-19, videos showed police swinging nightsticks at fleeing persons. Police in a statement apologized for “excessive interventions” and promised to punish officers involved.

According to the Conduct in UN Field Missions online portal, there was one allegation submitted in February of sexual exploitation and abuse by Senegalese peacekeepers deployed to United Nations Stabilization Mission in Haiti, allegedly involving an exploitative relationship with an adult. As of September the Senegalese government and the United Nations were investigating the allegation.

Some prison and detention center conditions were harsh and life threatening due to food shortages, overcrowding, poor sanitation, and inadequate medical care.

Physical Conditions: Overcrowding was endemic. For example, Dakar’s main prison facility, Rebeuss, held more than twice the number of inmates for which it was designed. Female detainees generally had better conditions than male detainees. Pretrial detainees were not always separated from convicted prisoners. Juvenile detainees were often held with men or permitted to move freely with men during the day. Girls were held together with women. Infants and newborns were often kept in prison with their mothers until age one, with no special cells, additional medical provisions, or extra food rations.

In addition to overcrowding, the National Organization for Human Rights, a nongovernmental organization (NGO), identified lack of adequate sanitation as a major problem. Poor and insufficient food, limited access to medical care, stifling heat, poor drainage, and insect infestations also were problems throughout the prison system. On February 20, an inmate passed away at Mbour Prison. According to official reports, he suffered an acute asthma attack due to being held in an overcrowded cell holding 87 other inmates.

According to the most recent available government statistics, 31 inmates died in prisons and detention centers in 2019, six more than perished in 2018. Government statistics did not provide the cause of death. While perpetrators, which included prison staff and other prisoners, may have been subject to internal disciplinary sanctions, no prosecutions or other public actions were taken against them.

Administration: Authorities did not always conduct credible investigations into allegations of mistreatment. Ombudsmen were available to respond to complaints, but prisoners did not know how to access them or file reports. Authorities permitted prisoners and detainees to submit complaints to judicial authorities without censorship and to request investigation of credible allegations of inhuman conditions, but there was no evidence that officials conducted any follow-up investigations.

Independent Monitoring: The government permitted prison visits by local human rights groups, all of which operated independently, and by international observers. The National Observer of Detention Facilities had full and unfettered access to all civilian prison and detention facilities, but not to military and intelligence facilities. The national observer was unable to monitor prisons throughout the country. It previously published an annual report, but reports for 2015-19 had not been published by year’s end.

Members of the International Committee of the Red Cross visited prisons in Dakar and the Casamance.

Improvements: In April, President Sall pardoned 2,036 detainees as a measure to control the spread of COVID-19 within the prison system.

The constitution and law prohibit arbitrary arrest and detention; however, the government did not always observe these prohibitions. Detainees are legally permitted to challenge in court the legal basis or arbitrary nature of their detention and obtain prompt release and compensation if found to have been unlawfully detained; however, this rarely occurred due to lack of adequate legal counsel. In a January 2019 policy directive, the minister of justice instructed prosecutors to visit detention facilities on a regular basis to identify detainees with pending criminal dossiers to minimize use of detention for unofficial, extrajudicial purposes.

The government did not have effective mechanisms to punish abuse and corruption. The Criminal Investigation Department (DIC) is in charge of investigating police abuses but was ineffective in addressing impunity or corruption (see section 4, Corruption). An amnesty law covers police and other security personnel involved in “political crimes” committed between 1983 and 2004, except for killings in “cold blood.” The Regional Court of Dakar includes a military tribunal that has jurisdiction over crimes committed by military personnel. A tribunal is composed of a civilian judge, a civilian prosecutor, and two military assistants to advise the judge, one of whom must be of equal rank to the defendant. A tribunal may try civilians only if they were involved with military personnel who violated military law. A military tribunal provides the same rights as a civilian criminal court.

Unless a crime is “flagrant” (just committed or discovered shortly after being committed), police must obtain a warrant from a court to arrest or detain a suspect. Police treat most cases as “flagrant” offenses and make arrests without warrants, invoking pretrial detention powers. The DIC may hold persons up to 24 hours before releasing or charging them. Authorities did not promptly inform many detainees of the charges against them. Police officers, including DIC officials, may double the detention period from 24 to 48 hours without charge if they demonstrate substantial grounds for a future indictment and if a prosecutor so authorizes. If such extended detention is authorized, the detainee must be brought in front of the prosecutor within 48 hours of detention. For particularly serious offenses, investigators may request a prosecutor double this period to 96 hours. Authorities have the power to detain terrorist suspects for an initial 96 hours, and with renewals for a maximum of 12 days. The detention period does not formally begin until authorities officially declare an individual is being detained, a practice Amnesty International noted results in lengthy detentions.

Bail was rarely available, and officials generally did not allow family access. By law defense attorneys may have access to suspects from the moment of arrest and may be present during interrogation; this provision, however, was not regularly observed. The law provides for legal representation at public expense in felony cases to all criminal defendants who cannot afford one after the initial period of detention. In many cases, however, the appointed counsel rarely shows up, especially outside of Dakar. Indigent defendants did not always have attorneys in misdemeanor cases. A number of NGOs provided legal assistance or counseling to those charged with crimes. The Ministry of Justice published a policy directive in 2018 mandating counsel for defendants when questioning begins.

Arbitrary Arrest: On June 21, the Gendarmerie arrested a former civil servant after he published an open letter to President Sall in the press denouncing Sall’s alleged mismanagement of the country. Authorities released him the following day.

Pretrial Detention: According to 2018 UN statistics, 45 percent of the prison population consisted of pretrial detainees. In late 2019 the country’s authorities reported the percentage to be 42 percent. A majority of defendants awaiting trial are held in detention. The law states an accused person may not be held in pretrial detention for more than six months for minor crimes; however, authorities routinely held persons in custody until a court ordered their release. Judicial backlogs and absenteeism of judges resulted in an average delay of two years between the filing of charges and the beginning of a trial. In cases involving murder charges, threats to state security, and embezzlement of public funds, there were no limits on the length of pretrial detention. In many cases pretrial detainees were held longer than the length of sentence later imposed.

On June 30, the legislature passed two laws authorizing Electronic Monitoring (EM) as an alternative to incarceration. Once operational the EM system is designed to allow criminal courts to release certain defendants awaiting trial and other first-time offenders convicted of low-risk crimes to home detention, where electronic bracelets would monitor their movements. The bracelet system is intended to relieve chronic overreliance on pretrial detention and thereby reduce the prison population.

Although the constitution and law provide for an independent judiciary, the judiciary was subject to corruption and government influence. Magistrates noted overwhelming caseloads, lack of adequate space and office equipment, and inadequate transportation, and they openly questioned the government’s commitment to judicial independence. The judiciary is formally independent, but the president controls appointments to the Constitutional Council, the Court of Appeal, and the Council of State. Judges are prone to pressure from the government on corruption cases and other matters involving high-level officials.

On several occasions the Union of Senegalese Judges and Prosecutors complained of executive influence over the judiciary, in particular the presence of the president and the minister of justice in the High Council of Magistrates, which manages the careers of judges and prosecutors. Members of the High Council of Magistrates previously resigned in protest, stating that the executive branch should not have the ability to interfere in judicial affairs. In August judicial authorities summarily demoted a district court president, prompting speculation he was punished for detaining a religious leader in a criminal case. The Union of Senegalese Judges and Prosecutors published an open letter condemning the demotion and hired counsel to defend the judge on appeal. On September 2, a Dakar daily published a list of 20 magistrates it claimed had been demoted during the past decade in retaliation for unpopular court decisions. The August demotion of the district court president prompted harsh criticism of the minister of justice in media and legal circles and renewed calls for justice reform, including reconstitution of the High Council of Magistrates. Authorities respected and enforced court orders.

The constitution provides for all defendants to have the right to a fair and public trial, and for an independent judiciary to enforce this right. Defendants enjoy a presumption of innocence and have the right to be informed promptly and in detail of the charges against them. They have the right to a timely trial, to be present in court during their trial and to have an attorney at public expense if needed in felony cases (although legal commentators note provision of attorneys is inconsistent) and they have the right to appeal. They also have the right to sufficient time and facilities to prepare their defense, and to receive free interpretation as necessary from the moment they are charged through all appeals. Defendants enjoy the right to confront and present witnesses and to present their own witnesses and evidence.

While defendants may not be compelled to testify against themselves or confess guilt, the country’s long-standing practice is for defendants to provide information to investigators and testify during trials. In addition case backlogs, lack of legal counsel (especially in regions outside of Dakar), judicial inefficiency and corruption, and lengthy pretrial detention undermined many of the rights of defendants.

Evidentiary hearings may be closed to the public and press. Although a defendant and counsel may introduce evidence before an investigating judge who decides whether to refer a case for trial, police or prosecutors may limit their access to evidence against the defendant prior to trial. A panel of judges presides over ordinary courts in civil and criminal cases.

The right of appeal exists in all courts, except for the High Court of Justice, the final court of appeal. These rights extend to all citizens. On June 15, the country’s largest union of court clerks declared a strike, causing major disruption of court proceedings, including delayed trials and inaccessible court decisions and administrative paperwork. On September 1, the union suspended the strike after the Ministry of Justice agreed to negotiate.

There were no reports of political prisoners or detainees.

Citizens may seek cessation of and reparation for human rights violations in regular administrative or judicial courts. Citizens may also seek administrative remedies by filing a complaint with the ombudsman, an independent authority. Corruption and lack of independence hampered judicial and administrative handling of these cases. In matters related to human rights, individuals and organizations may appeal adverse decisions to the Economic Community of West African States Court of Justice.

The constitution and law prohibit such actions, and there was at least one report the government failed to respect these prohibitions.

On June 1, police arrested activist Assane Diouf after breaking down the gate of his house. Diouf broadcasted live on his Facebook page a video in which he insulted authorities, including President Macky Sall, and denounced an ongoing water shortage in the Dakar suburbs. Diouf remained in pretrial detention at year’s end.

The de facto ceasefire in the Casamance has been in effect since 2012, and President Sall continued efforts to resolve the 38-year-old conflict between separatists and government security forces. Both the government and various factions of the Movement of Democratic Forces of the Casamance (MFDC) separatist movement accepted mediation efforts led by neutral parties. Progress toward a political resolution of the conflict remained incremental. On June 30, the army began a campaign to bombard MFDC rebel bases in the Mbissine forest after armed MFDC rebels had reportedly attacked villages in that area. Two soldiers died from landmines during the month-long campaign and several soldiers were injured. Since July the conflict dissipated, and no further military action took place.

Killings: There were no reported killings by or on behalf of government authorities.

Abductions: There were several incidents related to acts of banditry attributed to MFDC rebels in which they detained or otherwise harmed civilians.

The law provides criminal penalties for official corruption, but the government often did not enforce the law effectively. Officials frequently engaged in corrupt practices with impunity. During the year there were reports of government corruption.

Corruption: The National Anticorruption Commission (OFNAC) in 2016 concluded that bribery, misappropriation, abuse of authority, and fraud remained widespread within government institutions, particularly in the health and education ministries, postal services, and the Transport Ministry. In January, OFNAC released long overdue reports on its activities for 2017 and 2018 and swore in six new executive-level officials, bringing its managing board to a full complement for the first time in several years. Reports of corruption ranged from rent seeking by bureaucrats involved in public approvals, to opaque public procurement, to corruption in the judiciary and police. Some high-level officials in President Sall’s administration were allegedly involved in corrupt dealings. The government made some progress in its anticorruption efforts, mounting corruption investigations against several public officials (primarily the president’s political rivals) and secured several convictions (see section 1.d.).

Financial Disclosure: The law requires the president, cabinet ministers, the speaker and chief financial officer of the National Assembly, and managers of public funds in excess of one billion CFA francs ($1.8 million) to disclose their assets to OFNAC. Failure to comply may result in a penalty amounting to one-quarter of an individual’s monthly salary until forms are filed. The president may dismiss appointees who do not comply. With the exception of disclosures made by the president, disclosures made under the law are confidential and unauthorized release of asset disclosures is a criminal offense. On July 13, President Macky Sall gave a one-month ultimatum to government ministers to follow OFNAC guidelines related to the declaration of assets. All except one complied by the deadline.

A wide variety of domestic and international human rights groups generally operated without government restriction, investigating and publishing their findings on human rights cases. Government officials were somewhat cooperative but rarely took action to address their concerns.

Government Human Rights Bodies: The government’s National Committee on Human Rights included government representatives, civil society groups, and independent human rights organizations. The committee had authority to investigate abuses but lacked credibility, did not conduct investigations, and last released an annual report in 2001.

Rape and Domestic Violence: The law prohibits rape but does not address the gender of victims. The law also does not address spousal rape. An amendment to the penal code passed in December 2019 increased the penalties for rape, child abuse, and pedophilia. It received widespread grassroots support from women’s and civil society groups outraged by egregious incidents of rape. Offenders that previously received five to 10-year sentences faced 10 to 20 years in prison, with possible life sentences in aggravated situations. Experts noted the government should train more gynecologists and psychologists to assist victims and raise awareness of the law among key actors in society, including police, judges, religious leaders, and media.

The government did not fully enforce existing laws, particularly when violence occurred within families. Although domestic violence that causes lasting injuries is punishable with a prison sentence of 10 to 20 years, and life imprisonment for murder, police usually did not intervene in domestic disputes. Several women’s groups and the Committee to Combat Violence against Women and Children (CLVF) reported a rise in violence against women.

NGOs, including the CLVF, noted the failure of some judges to apply domestic violence laws, citing cases in which judges claimed lack of adequate evidence as a reason to issue lenient sentences. NGOs also noted the government’s failure to permit associations to bring suits on behalf of victims and the lack of shield laws for rape.

The number of incidents of domestic violence, which many citizens considered a normal part of life, were much higher than the number of cases reported. The Ministry of Justice is responsible for combating domestic violence, but it did not undertake any programs to address rape and domestic violence. The government-run Ginddi Center in Dakar provided shelter to women and girls who were survivors of rape or child, early, and forced marriage as well as to street children.

On February 20, a judge placed a Quranic teacher in custody for the alleged rape of minors younger than 13 years, following accusations that he abused a number of young students attending his religious school.

Female Genital Mutilation/Cutting (FGM/C): The law provides criminal penalties for the perpetration of FGM/C on women and girls, but authorities prosecuted no cases. FGM/C was practiced in the country with an average prevalence of 25 percent, with dramatic variation across regions and ethnic groups, including rates as high as 80 percent in some regions, according to UNICEF and local surveys.

Sexual Harassment: The law mandates prison terms of five months to three years and modest to substantial fines for sexual harassment, but the problem was widespread. The government did not effectively enforce the law.

Reproductive Rights: The law provides that all couples and individuals have the right to decide the number, spacing, and timing of their children, and to have access to the means to do so, free from discrimination, coercion, or violence.

In 2019 qualified providers attended 75 percent of deliveries. According to government statistics, 53 percent of women of reproductive age had their need for family planning satisfied with modern methods.

The government provided access to sexual and reproductive health services for survivors of sexual violence.

According to 2017 data from the Ministry of Health and Social Action, the maternal mortality ratio was 236 deaths per 100,000 live births. The ministry estimated most maternal deaths in childbirth were preventable, caused by the lack of medical equipment and qualified providers, particularly in rural areas. FGM/C exposed women to increased obstetrical complications during labor and childbirth.

Coercion in Population Control: There were no reports of coerced abortion or involuntary sterilization on the part of government authorities.

Discrimination: The law provides for the same legal status and rights for women as for men, although there are legal restrictions on women in employment, including limitations on occupations and tasks but not on working hours. Nevertheless, women faced pervasive discrimination, especially in rural areas where traditional customs and discriminatory rules of inheritance were strongest.

The law’s definition of paternal rights also remained an obstacle to equality between men and women. The law considers men to be heads of household, preventing women from taking legal responsibility for their children. Additionally, any childhood benefits are paid to the father. Women may become the legal head of household only if the husband formally renounces his authority before authorities or if he is unable to act as head of household.

While women legally have equal access to land, traditional practices made it difficult for women to purchase property in rural areas. Many women had access to land only through their husbands, and the security of their rights depended on maintaining their relationships with their husbands. Discriminatory laws and policies also limited women’s access to and control over capital.

The Ministry for Women’s Affairs, Family Affairs, and Gender has a directorate for gender equality that implemented programs to combat discrimination.

Birth Registration: Citizenship is acquired by birth on national territory or naturalization. The law provides for equal rights for mothers and fathers automatically to transmit citizenship to their children. The law does not make birth declaration mandatory. Registering births required payment of a small fee and travel to a registration center, which was difficult for many residents of rural areas.

Education: The law provides for tuition-free and compulsory education for children between ages six and 16, although approximately one-third of these children did not attend school. Some did not attend for religious reasons. While children generally could attend primary school without a birth certificate, they needed one to take national exams. Students often had to pay for their own books, uniforms, and other school supplies.

Girls encountered greater difficulties in continuing in school beyond the elementary level. A lack of running water, poor sanitation, early pregnancy, long travel distances, and sexual harassment by school staff contributed to girls leaving school. Where school directors were aware of sexual harassment or exploitation, they generally tried to resolve the situation on their own without reporting it to higher authorities or police and often stigmatized and faulted the behavior of the girls rather than the teacher. Girls were generally unsure of what constituted consent and harassment and did not know where to report exploitation. If girls became pregnant, they dropped out of school and were often shunned by their families.

Many parents opted to keep their middle- and high-school-aged daughters home to work or to marry rather than sending them to school. In recent years, however, gender disparity at the middle- and high-school level significantly lessened.

Child Abuse: Child abuse remained common, particularly of boys sent to Dakar and other cities to beg under threat of punishment. Parents sent many of these boys to study in daaras (Quranic religious schools). At some daaras, Quranic instructors exploited, physically abused, and forced children to beg on the street. According to Human Rights Watch in 2019, more than 100,000 students lived in daaras across the country.

On February 18, an age 13 Quranic school student in Louga died after being severely beaten by his Quranic teacher. Authorities neither investigated nor brought charges against the teacher.

Child, Early, and Forced Marriage: By law women have the right to choose when and whom they marry, but traditional practices often restricted a woman’s choice. The law prohibits the marriage of girls younger than 16, but this law generally was not enforced in most communities where marriages were arranged. Under certain conditions a judge may grant a special dispensation to a man to marry a girl below the age of consent.

According to women’s rights groups and officials from the Ministry of Women, Family, and Gender, child, early, and forced marriage was a significant problem, particularly in the more rural areas in the south, east, and northeast. The ministry conducted educational campaigns to address the problem. According to UN Population Fund statistics, 33 percent of women were married before age 18, and 12 percent before age 15.

Sexual Exploitation of Children: The law prohibits the commercial sexual exploitation, sale, and offering or procuring of children for prostitution and practices related to pornography. Sexual abusers convicted of trafficking of children receive five to 10 years’ imprisonment and a fine. If the offender is a family member, the maximum is applied. Procuring a minor for prostitution is punishable by imprisonment for two to five years and modest to substantial fines. If the crime involves a victim younger than 13, the maximum penalty is applied. The law was not effectively enforced, but when cases were referred to authorities, they conducted follow-up investigations. The minimum age of consensual sex is 18.

Pornography involving children younger than age 16 is considered pedophilia and punishable by up to two years’ imprisonment and a fine.

Exploitation of women and girls in prostitution and sex trafficking was a problem, particularly in the southeast gold-mining region of Kedougou. Although there were no reports of child sex tourism, the country was considered a destination for child sex tourism for tourists from France, Belgium, and Germany, among other countries.

Infanticide or Infanticide of Children with Disabilities: Infanticide continued to be a problem, usually due to poverty or embarrassment. In some cases women’s families shamed them into killing their babies. Domestic workers and rural women working in cities sometimes killed their newborns if they could not care for them. According to the African Assembly for the Defense of Human Rights, infanticide also occurred when a woman became pregnant with the child of a man from a prohibited occupational caste. If police discovered the identity of the mother, she faced arrest and prosecution for infanticide.

Displaced Children: Many children displaced by the Casamance conflict lived with extended family members, neighbors, in children’s homes, or on the streets. According to NGOs in the Casamance, displaced children suffered from the psychological effects of conflict, malnutrition, and poor health. In May the Ministry of Women, Family, Gender, Children, and Social Protection launched a third phase of its “Zero Enfants Dans La Rue” (No Children in the Street) project. It sought to remove 10,000 street children in Dakar by returning them to their families. The one billion CFA francs ($1.8 million) program also sought to remove an additional 10,000 from other regions.

International Child Abductions: The country is not a party to the 1980 Hague Convention on the Civil Aspects of International Child Abduction. See the Department of State’s Annual Report on International Parental Child Abduction at https://travel.state.gov/content/travel/en/International-Parental-Child-Abduction/for-providers/legal-reports-and-data.html.

There were approximately 100 Jewish residents in the country; there were no reports of anti-Semitic acts.

See the Department of State’s Trafficking in Persons Report at https://www.state.gov/trafficking-in-persons-report/.

The law prohibits discrimination against persons with disabilities, but the government did not enforce these provisions adequately. The law also mandates accessibility for persons with disabilities, but the government did not effectively enforce the law.

The government provided grants, managed vocational training in regional centers, and offered funding for persons with disabilities to establish businesses. Due to a lack of special education training for teachers and facilities accessible to children with disabilities, authorities enrolled only 40 percent of such children in primary school. Support for persons with mental disabilities was not generally available, and incidents of abuse of persons with mental disabilities were common.

Persons with disabilities experienced difficulty registering to vote as well as accessing voting sites, due to physical barriers such as stairs as well as the lack of provisions such as Braille ballots or sign language interpreters for persons who were visually or hearing impaired, or unable to speak. The law reserves 15 percent of new civil service positions for persons with disabilities, but this quota has never been enforced. In regions outside Dakar, in particular, persons with disabilities were still effectively excluded from access to these positions.

The Ministry for Health and Social Action is responsible for protecting the rights of persons with disabilities.

Ethnic groups generally coexisted peacefully.

Discrimination against individuals of lower castes continued, and intellectuals or businesspersons from lower castes often tried to conceal their caste identity.

Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation and Gender Identity

Consensual same-sex sexual activity between adults, referred to in law as an “unnatural act,” is a criminal offense, and penalties range from one to five years’ imprisonment and fines; however, the law was rarely enforced. No laws prevent discrimination based on sexual orientation or gender identity, nor are there hate crime laws that could be used to prosecute crimes motivated by bias against LGBTI persons.

LGBTI persons faced widespread discrimination, social intolerance, and acts of violence. LGBTI individuals were subject to frequent threats, mob attacks, robberies, expulsions, blackmail, and rape; authorities sometimes condoned or tolerated these abuses. LGBTI activists also complained of discrimination in access to social services. The government and cultural attitudes remained heavily biased against LGBTI individuals.

In October 2019 cemetery authorities in Touba refused to authorize the burial of a man in the Bakhia cemetery based on a report of the deceased’s LGBTI status.

In November 2019 a prominent anti-LGBTI organization published a list of LGBTI associations and their leadership who had received nongovernmental organization status from the government. Publication of the list created widespread public backlash against those organizations, resulting in authorities closing them.

The law prohibits all forms of discrimination against persons with HIV/AIDS, and the government and NGOs conducted HIV/AIDS awareness campaigns to increase social acceptance of persons with HIV or AIDS and increase HIV testing and counseling nationwide. Nevertheless, human rights activists reported HIV-positive individuals and those with AIDS-related illnesses suffered from social stigma due to the widespread belief that such status indicated homosexuality. HIV-positive men sometimes refrained from taking antiretroviral drugs due to fear their families would discover their sexual orientation.