HIV, law, human rights and gender equality
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Key populations are at higher risk of HIV
Vulnerable and key populations in the HIV response include:
- Gay and bisexual men and other men who have sex with men
- Transgender people
- Sex workers
- People who inject drugs
- Women and girls, and
- Young people.
Their marginalized, unequal and even criminalized positions in society make key populations least able to protect themselves from HIV infection and to access appropriate treatment, prevention, care and support.
Sex work, or aspects of sex work is criminalized in many countries across the world. Sex workers report experiences of stigma, discrimination and violence from health care workers and law enforcement officers.
They experience denial of health care, discrimination and humiliation, as well as violence, rape, harassment, extortion and detention by police. This deters them from accessing and being able to use HIV prevention services effectively, increasing their vulnerability to HIV.
Rights-based health programmes that seek to, for example a) strengthen the protection of sex workers’ rights in law and policy b) train health care workers to treat sex workers with dignity and respect, and c) sensitize law enforcement officials to the human rights and health rights of sex workers, will support access to HIV-related health care for sex workers.
Once affected by HIV, key populations experience further rights violations
In addition, due to the ongoing stigma and prejudice surrounding HIV, people living with HIV experience discrimination and violations of their rights. These human rights challenges are exacerbated when people living with and affected by HIV become ill, lose their jobs and are impoverished by costs of health care. They become increasingly vulnerable, with less agency to protect their rights and limited ability to cope with the impact of HIV.
The Global Commission on HIV and the Law
The Global Commission on HIV and the Law, a global commission of HIV and human rights leaders, experts and activists, led by the United Nations Development Programme and convened on behalf of the Joint United Nations Programme on HIV/AIDS (UNAIDS) undertook consultations and deliberations in seven regions of the world during 2010-2012.
This was accompanied by extensive research and analysis to examine the relationship between laws, policies, practices and HIV in six focus areas:
- HIV-related stigma and discrimination
- Criminalization of HIV transmission, exposure and non-disclosure of HIV status
- Risk and stigma experienced by key populations
- Gender-based violence and the disempowerment of women
- Children and youth, and
- Intellectual property law and access to treatment.
The Commission’s comprehensive report, Risks, Rights & Health found evidence of how bad laws, policies and practices were fuelling the spread of HIV, resulting in human rights violations for affected populations and limiting the efficacy and efficiency of HIV and health programmes. They also noted that protective laws and practices to promote human rights and gender equality strengthened the response.
The report called on countries to outlaw discrimination, repeal punitive laws and enact protective laws to promote public health and human rights for effective HIV responses. Today, more than 89 countries have taken action to repeal or reform laws. The GCHL Fact Sheet and UNDP’s Issue Brief: Advancing Human Rights, Equality and Inclusive Governance to End AIDS provide information and examples of across the globe of UNDP’s work with country stakeholders.
A 2018 Supplement to the report highlights developments since 2012 in science, technology, law, geopolitics and funding that affect people living with or at risk from HIV and its co-infections. The recommendations add to and amplify those of the Commission’s 2012 report, which remain as relevant as they were 6 years ago.
Discrimination against people living with HIV
The People Living with HIV Stigma Index studies document the experiences of stigma and discrimination faced by people living with HIV across the globe, including verbal and physical harassment and abuse within their homes and communities; denial of sexual and reproductive health care services and discrimination within their working environments
The UNAIDS Reference Group on HIV and Human Rights
The UNAIDS Reference Group on HIV and Human Rights, which is co-managed by UNDP, advises UNAIDS on matters relating to HIV and human rights.
The Reference Group has discussed and examined critical human rights and gender equality issues and produced leading guidance on protecting human rights in various aspects of effective responses to HIV.
The Reference Group furthermore provides advice on the implementation of the human rights elements of the UNAIDS 2016-2021 Strategy. The Strategy highlights structural interventions required to address human rights and gender-related barriers for key populations with specific targets linked to the Sustainable Development Goals. The strategy has a specific focus on prevention, treatment and support services, social protection programmes and gender equality. The strategy also has a specific result area focused on ensuring that punitive laws, policies, practices, stigma and discrimination that block effective responses to HIV are removed.