UN HLM on AIDS: IPPF Key Message 02

Mention the ‘unmentionables’

Create enabling environments to reduce stigma and discrimination and protect human rights through the removal of punitive laws that criminalize key populations that are particularly vulnerable to HIV, such as sex workers, men who have sex with men, transgender people and people who use drugs. Without specifically mentioning the groups of people that are particularly vulnerable to HIV infection, they are all too often ignored or sidelined in HIV responses.

Rationale: All too often human rights is seen as a ‘soft option’ that is difficult to measure. However, experience shows that human rights need to underpin a response to HIV. Stigma and discrimination continues to limit access to essential services for people living with HIV and individuals particularly vulnerable to infection — young women and girls, men who have sex with men, transgender people, people who use drugs and sex workers. Multiple legal and socio-cultural barriers continue to prevent or discourage these groups from accessing and using healthcare services. Being among the most marginalized and discriminated against populations in society, they are often ‘hidden’ and are rarely involved in the formation and implementation of HIV policies, programmes and services to meet their specific needs. Any sustainable response to HIV must remove these punitive laws and address the other social drivers of the epidemic.

Current gaps to address:

• Increase access to services for MSM: Globally, MSM are often denied access to basic health services due to the criminalization of sex between men, homophobia amongst healthcare workers and isolation due to stigma and discrimination. Recent studies have found high levels of HIV prevalence among men who have sex with men in Africa, ranging from 10 per cent to 43 per cent. It is imperative that restrictive laws and policies are repealed and healthcare workers are sensitized so access to vital SRH and HIV information and services for MSM can be improved.
• Repeal punitive discriminatory laws and policies: Nearly three decades after the epidemic was first identified, stigma, discrimination, and punitive laws and policies continue to undermine efforts to prevent new infections. Key populations are reluctant to seek services in contexts where their behaviour is against the law. Such punitive and coercive policies are both counterproductive from a public health perspective and antithetical to the human rights basis of effective prevention.
• Scale up gender transformative programmes: Gender transformative programmes aim to change gender norms and promote relationships between men and women that are fair and just. A ‘gender argument’ has often been used to establish and enhance women’s participation and rights but some groups of women, such as women who use drugs and female sex workers, are often overlooked. Programmes to support these women and girls who are particularly vulnerable to HIV also need to also be scaled up. 

Read all of IPPF's key messages for the 2011 UN High Level Meeting on AIDS in the June issue of the HIV Update newsletter: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+26.htm