Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Commonwealth Health Ministers must tackle legal obstacles that undermine HIV responses


Punitive laws affect people's health (c) Nell Freeman for the Alliance

The Commonwealth HIV/AIDS Action Group (CHAAG) and the International HIV/AIDS Alliance are attending the Commonwealth Health Ministers meeting in Geneva this weekend to raise the important issue of dealing with the legal barriers that are undermining HIV responses.

As the Commonwealth Ministers meet to discuss the prevention of non-communicable diseases CHAAG and the Alliance will urge Ministers not to let the issue of communicable diseases such as HIV drop off the agenda.

Many Commonwealth states are failing to tackle their HIV epidemics because they are neglecting to address social, cultural and legal factors that influence people’s health.

The impact of the law

“The tendency for punitive legal responses to address HIV is undermining HIV prevention and can lead to more people being infected not less,” said Anton Kerr, Chair of CHAAG. “Health Ministers need to ensure that laws support people who are most at risk of HIV and those living with HIV, to access HIV services.”

Putting human rights protections in place means that people are more likely to access and participate in HIV prevention, care and support programmes.

“Applying criminal law to HIV transmission promotes fear and stigma and reinforces stereotypes that people living with HIV are immoral and dangerous,” said Christine Stegling, Senior Human Rights Advisor for the Alliance. “Where HIV exposure is a crime it can mean that pregnant women may avoid antenatal care for fear they will be tested, found positive and exposed to prosecution.”

Groups at high risk of HIV

For some groups where HIV prevalence is very high, such as among men who have sex with men it is vital that prevention services reach them. When sex between men is criminalised it becomes very hard to target men who have sex with men with appropriate health services because of the fear of prosecution and violence if they identify themselves.

There are places where enlightened steps are being taken. In India for example State AIDS Authorities encourage police to participate in HIV education programmes delivered to men who have sex with men.

Sex workers are another affected group. In Australia and New Zealand for example, where sex work is legal and brothels are regulated health officials can work with the sex worker communities to access HIV and health services without fear of discrimination.

Injecting drug users are also in need of particular support. Rather than injecting drug use being a criminal justice issue it should be considered primarily as a health issue. Drug dependency is a treatable illness. There is strong evidence that shows when drug use is decriminalised, HIV infections reduce. In Portugal where the government decriminalised drug use and possession the number of new HIV cases caused by using dirty needles dropped from nearly 1,400 in 2000 to about 400 in 2006.

Harm reduction services such as needle and syringe programmes and substitution therapy, should be provided in an environment where people are allowed to work without fear of arrest.

Action is needed

“CHAAG and the Alliance are calling for better dialogue and collaboration between Ministries of Justice and Law on HIV-related priorities. Specific guidance is needed to be given to the police and prisons on what is required to ensure law enforcement practices don’t create barriers to reach particularly at risk communities. We are asking governments to repeal laws that criminalise people living with HIV and most at risk groups,” said Kerr. “With Commonwealth countries having 60% of the world’s AIDS cases this issue needs urgently addressing.”

Find out more:

Enabling legal environments for effective HIV responses: A leadership challenge for the Commonwealth

Briefing: HIV, health and the law

View our photos on protecting human rights to tackle HIV