Human rights and HIV

Protecting human rights is crucial to protecting the health of all. Societies that stigmatise people living with HIV and laws that discriminate against key groups like gay men or criminalise marginalised groups like sex workers hinder access to HIV prevention and treatment.

Minorities are not stigmatised because they have a greater risk of HIV, rather they have a higher risk of HIV because they are stigmatised. It is social inequality that increases vulnerability to HIV.

Health is protected when living isn’t criminalised: that applies as much in Switzerland as it does throughout the world.

More on this: UNAIDS: Save Lives - Decriminalise

Protecting the rights of at-risk groups is crucial to the success of HIV prevention measures. In societies where minorities receive equal treatment and protection against discrimination, their health is better too: this stigma effect is well documented in research. Each step towards equality is a contribution towards human rights, but equally crucial progress in the fight to prevent HIV.

Progress has and continues to be made: at the beginning of the AIDS pandemic in the 1980s, two thirds of the world’s countries criminalised gay men; today two thirds of countries do not do this. But in recent times in particular, there have been attempts to infringe upon the rights of women, LGBTQ people, sex workers and others. This threatens not only the freedom of the wider public, but also its health.

People living with HIV

Almost one hundred countries have laws that criminalise people living with HIV. Such laws are counter-productive because, rather than supporting, they serve to undermine all efforts to prevent new HIV infections – and they violate human rights, including rights to equality and non-discrimination. Stigmatisation and criminalisation undermine effective HIV prevention: fear of discrimination puts people off getting tested and seeking treatment. People living with HIV do not feel comfortable speaking openly with professionals, revealing their HIV status or accessing available treatment (UNAIDS Factsheet 2021).

Gay men and other men who have sex with men

Studies have shown that knowledge in relation to HIV status among gay men and other men who have sex with men is three times as high in the countries with the least repressive laws as it is in the countries with the most repressive laws (Stannah et al. 2019). Vice versa, HIV prevalence among gay men and other men who have sex with men is five times higher in countries in which same-sex sexual acts are criminalised than it is in countries in which this is not the case. This figure was as much as twelve times higher in countries where homophobic criminal prosecutions have recently taken place  (Lyons et al. 2023 and UNAIDS Factsheet 2021).

Trans and non-binary people

The discrimination and criminalisation of trans and non-binary people happens on a global-scale. Such measures and laws contribute to the perpetuation of stigmatisation, discrimination, hate crimes and violence. This has resulted in an extreme lack of available data on the health of trans people, especially in relation to HIV and sexual health. What is clear is that stigmatisation has a profound impact on access to healthcare and a healthy life – and thus increased vulnerability to sexually transmitted infections (UNAIDS Factsheet 2021).

Sex workers

The criminalisation of sex work increases their risk of getting infected with HIV as well as their vulnerability to violence by customers, the police, and third parties. Likewise, the criminalisation of sex work customers has a negative impact on the health and safety of sex workers, i.e. as a result of less condom use and more violence. A study in ten African countries south of the Sahara revealed that sex workers in countries that criminalise sex work are seven times more likely to live with HIV than those in countries that have legalised aspects of sex work (Lyons et al. 2020 and UNAIDS Factsheet 2021).

People that consume substances

The decriminalisation of drug use and possession for personal use is accompanied by a significant reduction in the incidence of HIV among people who inject drugs, including through better access to harm reduction services, a reduction in violence and arrest or harassment by law enforcement. A review study showed that repressive policing against substance users is related to sharing needles, avoiding harm reduction, and increasing HIV infections (Baker et al. 2020 and UNAIDS Factsheet 2021).

People that migrate

Migration, especially when fleeing war and crises, can put people in extremely vulnerable situations: exploitation, sexual violence and precarious circumstances increase the risk of HIV. In most countries, people in the asylum procedure or without papers (sans-papiers) face complex obstacles, such as the lack of access to health services. But social exclusion also makes migrants more vulnerable to HIV (UNAIDS Report 2014).

People in closed settings

The rights of people in closed institutions such as psychiatric hospitals, youth homes, institutions for people with disabilities and prisons must be particularly protected – including sexual rights, access to sexuality, means of protection such as condoms or clean syringes, and anonymous testing services. Access to treatment is also not always guaranteed – especially in the event of admission, transfer or discharge, care interruptions occur. People in closed institutions, especially in asylum shelters and prisons, have the same right to health standards and health care as all other people in Switzerland (UNAIDS Factsheet 2021).