Human rights

The relationship between HIV and human rights stems from the right to health, which includes the right to sexual and reproductive health (SRH), and is also connected to the right to education, the right to live a life free from violence and coercion, and the right to equality and non-discrimination.

Millions of people are denied their rights when they are forced into risky sexual or injecting behaviours, when they are prevented from accessing the information and services that would protect them from HIV, and when they are unable to receive the HIV treatment, care and support services they need.

Rings Photovoice MyanmarThe Independence Monument in Myanmar represents freedom, but lesbian couples can’t get married. So they’re holding the rings and asking for marriage. ©Sue Chol / International HIV/AIDS Alliance / PhotoVoice

People who are criminalised, stigmatised and discriminated against – such as people who are lesbian, gay, bisexual or transgender (LGBT), men who have sex with men, sex workers and people who use drugs – face multiple human rights violations that make them more vulnerable to HIV for many reasons. For example, they may be denied the agency to decide who to have sex with and how to have sex, face gender-based or intimate partner violence or lack the resources to access clean needles and condoms or information about how HIV is transmitted.

People from these groups are often forced to become ‘invisible’ in society, which means they are less likely to access effective HIV testing, care and treatment. These factors fuel the HIV epidemic among these groups, all of whom experience considerably higher HIV prevalence than the general population.

When accessing health care, those who are most affected by and living with HIV are more likely to face breaches of confidentiality and stigma and discrimination from health workers. They are often denied access to SRHR services such as family planning, and experience mandatory HIV testing. They may be pressured not to have children or not to have sex, and even forced to undergo sterilisation and abortion. In some countries, they may be prohibited from getting appropriate HIV information and education and denied the right to organise and form support organisations.

Our approach

Our human rights-based approach not only promotes the right to health, it also addresses a range of other civil, political, economic, social and cultural rights linked to health and wellbeing in the context of HIV. As a result, our programmes recognise and respond to whatever underlying inequalities, prejudices and power relationships increase vulnerability and risk of exposure to HIV in a specific context.

This approach has three main pillars: the enforcement of human rights norms (the legal human rights standards set out in international, regional and national human rights instruments, which are translated into laws by countries); the implementation of commitments to HIV response based on human rights (political declarations signed by governments that are not legally binding but represent strong political commitments to the HIV response based on human rights), and the application of human rights principles in relation to HIV programming, which recognise the need to put human rights at the centre of HIV programming through all stages of the programme cycle, from design through to implementation, monitoring and evaluation.

Contained within our human-rights approach is a commitment to put individuals and the communities that represent them at the centre of all our programmes. This means building people’s awareness, knowledge and skills to understand what HIV services are available, what their rights are to access them, how to access them, and what they can do when their rights are denied.

It also means respecting the right of communities to participate in bringing about change in their own lives and supporting them to identify the skills and capacity they need to both develop human rights-based HIV programmes and exercise their voice in decision-making and policy spaces.

In order to create environments that enable people most affected by HIV to effectively respond to HIV we work advocate for the reform of all legislation criminalising and discriminating people most affected by and living with HIV, and for countries to repeal legislation that specifically criminalises HIV transmission, HIV exposure or failure to disclose HIV status; punishes people who use drugs solely on the grounds of such use; punishes consenting adults involved in sex work; and/or criminalises consenting adults involved in same-sex sexual activity or transgender people for expressing their gender identity

Our experience

  • REAct (Rights –Evidence – ACTion) is the Alliance’s secure IT-based system for monitoring and responding to human rights-related barriers in accessing HIV and health services, which is owned and managed by community-based organisations. The system helps respond to these barriers by collecting relevant evidence in order to identify and provide, or refer to, individual emergency support and human rights-based HIV programmes. It is also used to generate evidence for advocacy and future programming.
  • The Rapid Response Fund, launched in October 2016 and financed by the Elton John Aids Foundation and the United States President’s Emergency Plan for AIDS Relief, provides grants to support organisations providing HIV services for men who have sex with men and LGBT people, whose work is endangered by stigma, discrimination and violence.

Our results

  • In 2016, 17 Linking Organisations in 14 countries provided data on cases of violence and discrimination and provided emergency responses, and 621 community based organisations and networks reported to Linking Organisations on human rights-related barriers to accessing to HIV and health services.
  • Also in 2016, Linking Organisations reached 380,000 people with programmes addressing stigma, discrimination and social exclusion in countries with high levels of stigma as rated by the People Living with HIV stigma index. In almost half of the countries where Linking Organisations work, programmes to address gender and intimate partner violence were run, and in 19 countries Linking Organisations provided services to victims of violence and discrimination.
  • In 2016, Alliance Linking Organisations supported human rights advocacy in 28 countries, holding governments to account on enabling universal access to services, increasing domestic financing of the national HIV response or upholding human rights.
  • In addition, the Alliance was instrumental in engaging in global policy spaces such as the United Nations High Level Meetings on HIV, UNGASS on Drugs and the Commission on Narcotic Drugs. Many Linking Organisations and partners helped protect and sustain important spaces and policy priorities such as advocating for human right-led approaches to drug policy, ensuring recognition for measures such as harm reduction.

Key resources

Good practice guide:  HIV and human rights

A practical tool to help HIV programmers respond to human rights within HIV and broader health programmes. Published in partnership with the AIDS and Rights Alliance for Southern Africa (ARASA), the guide brings together international guidance, expertise from the Alliance global community, as well as ARASA’s experience of strengthening the capacity of its partners and the communities they serve.

REAct guide and factsheet

The guide provides an introduction to REAct, including information on its founding principles, the steps needed to set it up and how to adapt the system to different contexts. The factsheet outlines REAct’s progress so far.

Quantifying the impact of human rights and gender programmes

This technical brief explores some of the main challenges in measuring and quantifying the impact of both the human rights context (such as laws, policies, social norms and practices) and human rights-based programmes on the effectiveness of the HIV response. It mostly focuses on the quantification of the positive impact of human rights and gender programmes and interventions on the response.

Policy Position on Decriminalisation and HIV

A declaration of the principles relating to the decriminalisation of sex workers, men who have sex with men, people who are LGBTI, people who inject drugs and people living with HIV, which Linking Organisations and the Alliance Secretariat subscribe to as members of the Alliance.

Challenging criminalisation of LGBT people

It is a crime to be gay in over 70 countries, with punishments including life imprisonment, flogging and the death penalty. This policy briefing provides recommendations for governments, multilaterals, companies and NGOs in forming a long-term strategy to tackle homophobia.