AIDS status & challenges of the epidemic

4. Are human rights and vulnerable populations sufficiently protected?

• 4.1 Is AIDS sufficiently grounded in human rights?
• 4.2 What has been done to reduce vulnerability to HIV infection?

4.1 Is AIDS sufficiently grounded in human rights?

Despite some improvements between 2003 and 2005, the fight against AIDS in many countries is still insufficiently based on human rights. This relates for instance to the rights of all population groups to prevention and treatment as well as the non-discrimination of people living with HIV and vulnerable communities.

• Eighteen out of 21 countries reported improved policies, laws and regulations to promote and protect human rights.
• Sixty percent of countries surveyed have laws and regulations to protect people living with HIV from discrimination. However, in many cases these laws are not fully enforced, often because there is no money set aside for it.
• Half of the countries studied acknowledge the existence of policies that make HIV prevention and care measures less accessible and effective, for instance, making consensual sex between males illegal, prohibiting condom and needle access for prisoners, or not providing prevention and treatment services to non-residents.

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4.2 What has been done to reduce vulnerability to HIV infection?

In recent years, more money has been available for HIV prevention. However, many countries have mainly spent this money on prevention programmes which focused on the general public rather than on high risk population groups, which would be more cost-effective and more likely to have an impact on the epidemic. Vulnerable population groups include for instance, sex workers, men who have sex with men, injecting drug users, and prisoners.

Studies in Uganda show that children who drop out of school are three times more likely to be HIV-positive in their twenties than children who complete basic education. Many countries in sub-Saharan Africa have lowered or cancelled school fees for vulnerable children but not all countries have set aside money to help children stay in school.

To make injecting drug users less vulnerable, some countries offer syringe exchange programmes and drug substitution treatment. Iran, for instance, ordered that illegal drug users no longer be treated as criminals but as patients. However, overall, fewer than 20% of people who inject drugs receive HIV prevention services.

Only ten out of the 24 countries that reported information on sex workers managed to offer prevention services to at least half of this population group.

Although in many countries the prevalence of HIV is rising among men who have sex with men, public health authorities are not spending enough money on preventing HIV in this population group.

Wars and disasters often force large numbers of people from their homes, disrupt health-care services and expose people to severe health risks, including the risk of HIV infection. Countries are increasingly including HIV into their action plans for emergency situations and all UN-sanctioned peacekeeping operations have full- or part-time HIV advisers. More...