New report from UNAIDS: Protecting human rights is key to ending AIDS

This World AIDS Day, UNAIDS has released a report that shows the importance of upholding human rights for an effective HIV response. 

What is this story about? 

As well as presenting the latest evidence on HIV and rights, UNAIDS’ World AIDS Day report includes essays from global HIV response leaders. This includes Jeanne Gapiya-Niyonzima, ANSS founder and the first person in Burundi to publicly announce they had HIV. She says: “We know the pathway to building a society in which we all thrive. If the world wants to end AIDS as a public health threat, it needs to protect the rights of every person.” 

Why is this important? 

We have the tools and knowledge to end AIDS by 2030. But if the people most affected by HIV are still criminalised and discriminated against, if millions of people (particularly women and girls) are denied their sexual and reproductive rights and experience gender-based violence, and if countries continue to be denied access to effective treatment and prevention tools, the HIV epidemic will continue. This is why it is essential to keep human rights in the spotlight. 

What does the report say? 

In many countries, rights are being rolled back. And there is increasing hostility to gender equality and the rights of people most affected by HIV. This threatens to undo or slow advances on HIV. 

Harassment of civil society groups is increasing, which is damaging community-led responses. But there are places where civic space is expanding. For example, in 2023 Kenya’s Supreme Court ruled that the National Gay and Lesbian Human Rights Commission must be allowed to register as a nongovernmental organisation. 

Laws and criminalisation 

The report includes a large body of evidence that shows how damaging criminalisation and rights violations are to the HIV response. 

Countries with policies and laws that promote, protect and respect the rights of people most affected by HIV achieve much better HIV outcomes than countries with punitive approaches. 

A 2021 study found that people with HIV in countries that criminalise sex work, same-sex relations and drug use had 18-24% lower levels of HIV testing and viral suppression than countries without such laws. A landmark study from Asia, Africa and eastern Europe suggests that decriminalising sex work could avert 33-46% of new HIV infections among sex workers over 10 years. 

In a number of countries that are making huge progress on HIV, more needs to be done to include marginalised people. For example, in 2023 ART coverage overall in Kenya was 96%. But coverage was below 50% among sex workers, gay men and other men who have sex with men, people who inject drugs and transgender people. 

Some countries are ending harmful laws and policies. In 2022, Zimbabwe stopped criminalising HIV transmission. And in 2024, Namibia’s High Court ended the criminalisation of same-sex relations. Other countries that have removed anti-LGBTQ+ laws in recent years include Angola, Botswana, Gabon, Lesotho and Mozambique. In Zimbabwe, the constitutional court has stopped the police from arresting sex workers for loitering. Police harassment of sex workers has largely stopped since, and more sex workers are accessing healthcare. 

Stigma and discrimination 

Recent surveys from 42 countries found nearly half of people (47%) held discriminatory attitudes towards people with HIV. Data from 33 African countries suggests that, when more than 50% of people in a community have stigmatising attitudes, people with HIV are 17% less likely to be on antiretroviral treatment (ART), and HIV viral suppression rates are 15% lower than average. 

Women and people living in rural areas are more likely to experience HIV-related stigma than men or people in cities or suburban areas. 

Nearly one in seven people with HIV (13%) surveyed between 2020 and 2023 experienced stigma and discrimination from staff when accessing HIV care, particularly women. And 25% experienced stigma and discrimination when accessing other health services. Among people who had stopped ART, 34% said they delayed re-starting as they were worried health staff would mistreat them or disclose their HIV status without their consent. 

The right to education 

Women and girls with poor school attendance and education levels are more at risk of HIV than other females. Comprehensive sexuality education (CSE) is proven to increase the use of HIV services among adolescent girls and young women. But in many countries, access to CSE is being denied or rolled back. 

What does this mean for HIV services? 

AIDS will only end if all people’s human rights are upheld, if harmful laws are removed, and if stigma, discrimination and violence are tackled.  

The report shows that committed, long-term advocacy can change things, as demonstrated by the end of some discriminatory laws in Namibia, Zimbabwe and other countries. It highlights a useful advocacy toolkit, which outlines 14 proven tactics to tackle discriminatory laws and policies. 

Supporting people who are criminalised, discriminated against and marginalised to access HIV information, prevention and treatment is one of the most useful things that people working on HIV can do. Sharing information from Be in the KNOW can be one way to provide accurate information, which is especially important for young people who are denied access to CSE.  

Challenging unequal gender norms, attitudes and behaviours is another important area. Specific attention is needed to engage men and boys in such efforts. 

The report includes a roadmap, which sets out the following rights-related actions that can make a difference: 

• stigma and discrimination reduction work 

• providing HIV-related legal services 

• monitoring and reforming laws, regulations and policies relating to HIV 

• running “know your rights” legal-literacy programmes  

• sensitising law-makers and police on the rights of people affected by HIV 

• training healthcare providers on human rights and medical ethics related to HIV 

• reducing discrimination against women and girls in the context of HIV.