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Religious tradition and religiosity affect attitudes toward LGBT people, their rights, and their position within religious communities. There is significant variability within the American context concerning how religious traditions approach issues related to sexuality and gender identity, with monotheistic religions holding more conservative positions. These positions and the elites who hold them often influence the attitudes of their congregants, but not always, as some congregations diverge from the official positions of their denominations in terms of attitudes toward LGBT rights, religious leadership, and congregational membership. As the religious landscape is consistently changing in terms of attitudes toward sexual minorities, understanding the special role of religion in LGBT-related attitudes remains important and an area ripe for future scholarship.

Eastern Europe and Central Asia (EECA) is the only region in the world where annual HIV infection rates continue to grow. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), in 2019 approximately 1.4 million people in the region were living with HIV. The main factors that have contributed to the spread of the epidemic over the past two decades include injecting drug use, the stigmatization and marginalization of vulnerable groups, the increasing spread of HIV into the general population, and the lack of evidence-based prevention and treatment programs necessary for controlling the epidemic. Limited access to life-saving antiretroviral treatment has intensified the impact of the epidemic in EECA and increased mortality rates among people living with HIV (PLWH). In the post-Soviet space, Russia is experiencing by far the biggest HIV/AIDS epidemic. This can be attributed largely to the government’s failure to introduce evidence-based prevention measures for vulnerable groups, e.g., harm reduction programs, which are recommended by international health organizations. Other countries in the region have been more pragmatic in their approach and introduced harm reductions programs on a broader scale. In Ukraine, the efforts to combat HIV, which led to an initial stabilization of the epidemic in 2012, have been endangered by the military conflict in the eastern part of the country and subsequent internal displacement, which has increased HIV vulnerability. In comparison with Russia and Ukraine, the countries of the South Caucasus and Central Asia are less affected by HIV. However, labor migration to Russia constitutes a persistent risk factor for HIV transmission from higher-prevalence Russia to lower-prevalence South Caucasus and Central Asia. Although initially the HIV/AIDS epidemic has been mainly driven by injecting drug use, it is also clearly linked to lesbian, gay, bisexual, and transgender (LGBT) politics and policies in EECA. Because of widespread stigmatization and marginalization, the spread of HIV within LGBT communities remains underreported and is barely visible in official HIV statistics. This makes it difficult for prevention programs to reach out to vulnerable groups. In all countries in the region, prevention efforts among LGBT communities remain inadequate and largely depend on local civil society organizations (CSOs), which lack the capacities to provide nationwide information campaigns and other prevention programs for the LGBT community. In addition, the work of CSOs that advocate for HIV prevention among LGBT groups is further undermined by repressive laws, e.g., the 2013 “gay propaganda law” in Russia, which has increased the stigmatization of LGBT people and has made prevention outreach more difficult. Research has contributed to our understanding of HIV vulnerability and its impact in EECA. Further research is needed, however, into the social and political factors that explain the persistent failure of regional decisionmakers to adequately address the growing HIV epidemic.

Marriage equality movements have been successful in achieving policy change in an increasing number of states. Hence, a growing body of scholarship has explored institutional and cultural factors that influence activists’ tactics and messaging and, in turn, contribute to marriage equality policy diffusion. Democracies with parliamentary, presidential, and semi-presidential systems, federal and unitary states with varying levels of centralization, and the presence or absence of constitutional anti-discrimination protections provide social movements with divergent political opportunity structures, contributing to dynamics in their tactical choices. In addition, the type of electoral system and party system, the presence of political parties that are movement allies, the use of conscience votes, the level of party discipline, the presence of out LGBT elected officials and straight political allies, and the degree of political will to enact policy change also impact activists’ strategic calculations. Finally, the use of personalized narratives in advocates’ messaging, the framing of marriage equality and LGBT rights as human rights norms, the adoption of family values frames to coopt opponents’ messaging, and the use of homonationalist versus homophobic discourses to justify policymaking decisions regarding same-sex marriage are explored. This article provides a comprehensive review of state-of-the-art research concerning all of the states that have legalized same-sex marriage as well as a detailed analysis of the mechanisms used to achieve policy change. After examining how different explanatory factors perform in accounting for the dynamics in marriage equality activism and policy convergence across a broad range of national contexts, new directions for future scholarship are suggested.