ADVANCING HUMAN RIGHTS PRINCIPLES: SERVICES AND BEYOND

MAKE THE CASE: GATHERING EVIDENCE one in five people living with HIV reported having avoided visiting a health facility for fear of stigma or discrimination related to their HIV status;   one in four people living with HIV reported experiencing some form of discrimination when using health-care services; and approximately one in three women living with HIV reported discrimination related to their sexual and reproductive health. HIV-related travel restrictions: many countries around the world restrict the entry, residence and stay of foreigners who are HIV positive. Criminal liability issues regarding non-disclosure of HIV status, exposure to and transmission of HIV: In many regions and countries, overly broad criminalisation of HIV exists, with 72 countries maintaining laws specifically for HIV criminalisation in 2016. Some laws are so far-reaching that they can be used to impose criminal liability on women living with HIV for becoming pregnant or for transmission of HIV to their newborns during pregnancy or breastfeeding. For example, Kenya’s high court in a 2015 landmark decision ruled a section of Kenya’s 2006 HIV and AIDS Prevention Act, which required HIV positive persons to disclose their status to sexual partners and criminalised “knowing and reckless” HIV exposure to others, to be unconstitutional. The provision could have been read to penalize pregnant women who exposed or transmitted HIV to their children.

INCLUSION GAPS In some countries more than 40% of transgender persons report avoiding health-care facilities because they fear stigma and discrimination. PLHIV who perceived high HIV stigma were 2.4 times more likely to present late for HIV care   Stigma or fear of stigma leading to non-disclosure undermine ART adherence PREVENTION All people TESTING Knowledge of status among people living with HIV HIV CARE People living with HIV receiving HIV care ART People living with HIV receiving ART VIRALLY SUPPRESSED People living with HIV who are virally suppressed One in 5 people living with HIV have experienced some form of discrimination in healthcare. One in 3 women living with HIV experienced discrimination related to their SRHR (Stigma Index surveys across 19 countries (2011-2016) Lack of confidentiality in undermined HIV testing uptake in SSA countries Fear of stigma a key barriers to initiating lifelong ART among pregnant women living with HIV in some settings

SUPPORT LITIGATION AND LEGISLATORS Sex workers Men who have sex with men People who inject drugs Coercive Sterilization Travel Restrictions Agency for International Development v. Alliance for Open Society International, Inc. was a 2013 United States Supreme Court decision in which the court ruled that conditions imposed on recipients of certain federal grants amounted to a restriction of freedom of speech and violated the First Amendment. Canada (AG) v Bedford 2013 is a ruling of the Supreme Court of Canada relating to Canada's laws relating to sex work. The applicants, Terri-Jean Bedford, Amy Lebovitch and Valerie Scott, argued that Canada's prostitution laws were unconstitutional. The Criminal Code includes a number of provisions, such as outlawing public communication for the purposes of prostitution, operating a bawdy house or living off of the avails of prostitution, even though prostitution itself is legal. The applicants argued that the laws deprive sex workers of their right to security by forcing them to work secretly. The Supreme Court of Canada ruled in a 9-0 decision on December 20, 2013 that all of these laws are unconstitutional. Also cases on: forced sterilisation of HIV-positive women (before the Inter-American Commission on Human Rights and before the Kenyan High Court) age of consent to sexual relations (before the Constitutional Tribunal of Peru) Travel restriction (in the case Vandom vs Republic of Korea before the UN Human Rights Committee)

MOBILIZE AND CATALYZE ACTION

SUPPORT COUNTRY ACTION Emergency responses: Malawi: comments on draft HIV law Tanzania (on arrest of civil society members and lawyers) China (on cases of deportation of a student living with HIV) Zambia (revised UNAIDS/WHO guidance on HIV)

MAKE HUMAN RIGHTS PROGRAMMATIC – TO IMPROVE LEGAL AND SOCIAL ENVIRONMENT FOR HIV AND BEYOND Reform and monitor laws Train police on non-discrimination, space for outreach, non-harassment, etc Train health care workers on non-discrimination, informed consent, confidentiality, duty to treat, infection control Legal services Legal literacy (know your rights and laws) Gender equality and reduce violence against women Reduce HIV-related stigma

FAST TRACK MUST BE GROUNDED IN HUMAN RIGHTS Key human rights principles that should inform the scale-up of HIV services are: Availability, accessibility, acceptability and good quality of services. Non-discrimination and equality. Privacy and confidentiality. Respect for personal dignity and autonomy. Meaningful participation and accountability • To support countries to integrate human rights principles in their HIV prevention, testing and treatment programmes, UNAIDS developed the Fast Track and human rights guidance to inform the development of Global Fund concept notes, national Fast-Track plans and other work to accelerate the response to HIV. • Human rights principles that are applicable in efforts to Fast-Track the response are described under three programmatic areas: HIV prevention, HIV testing and HIV treatment. • The checklists provide practical advice on how to implement and scale up the UNAIDS seven key programmes to reduce discrimination and increase access to justice in the context of HIV. • They also will help address potential human rights challenges and prevent abuses that may occur in the context of urgent efforts to FastTrack the achievement of HIV prevention, testing and treatment targets.

BUILDING AND CROSSING BIDGES Catalyze and support work with scientific community. Build bridges across movements challenging criminalization