Human Rights Watch (HRW) released a report on Monday documenting how Tanzania’s health policies deny adequate services to lesbian, gay, bisexual and transgender (LGBT) people and other people who are at risk of contracting HIV. The report details the escalating attacks against LGBT individuals and how the anti-LGBT crackdown has disabled many of the community organizations that serve them.

The report further details many of the discriminatory health policies in place, including a “ban on distribution of lubricant and the prohibition on HIV and public health outreach and operation of drop-in centers by community-based organizations serving LGBT people and key populations.” The closure of drop-in centers has led to lower levels of HIV awareness and testing in communities that are at high risk of contracting HIV.

In addition to the inadequate health services, “police continue to conduct arbitrary arrests based on sexual orientation or gender identity. In some cases, police enlist health care providers to carry out forced anal examinations in attempts to find proof of homosexual conduct.”

HRW recommends that Tanzania end arrests based on sexual orientation, gender identity and gender expression, and to take a “rights-respecting, evidence-based approach to HIV prevention and treatment.”