(Vienna) - Governments should take concrete steps to expand human rights protection for those most vulnerable to HIV infection to address the global AIDS pandemic effectively, Human Rights Watch said today on the eve of the 18th International AIDS Conference in Vienna.
Twenty-five thousand delegates from around the world are gathering for the biennial meeting to review progress and obstacles to addressing AIDS. The theme of the conference is "Rights Here Right Now."
"We know what works in the fight against AIDS" said Joseph Amon, health and human rights director at Human Rights Watch. "Only by protecting the human rights of marginalized and vulnerable populations can we succeed in ending HIV transmission and ensuring universal access to care."
Human Rights Watch highlighted examples from around the globe where human rights violations are fueling AIDS epidemics and where governments are failing to implement effective and rights-based programs:
- In Ukraine, which has the most severe HIV epidemic in Europe, an estimated 15 percent of prisoners are HIV-positive. The government has taken steps to increase access to methadone and buprenorphine in the community, but neither is available in prison.
- In the United States, one in five prisoners is incarcerated for drug-related crimes and many others for crimes committed to support a drug habit. Most have no access to evidence-based HIV services for drug users or to effective drug treatment. Methadone is unavailable to most prisoners, and harsh punishment of drug users denies treatment to those who may need it most.
- In Zambia, poor conditions of confinement and minimal medical care for prisoners expose them to HIV and tuberculosis, including difficult-to-treat and potentially drug-resistant strains, threatening the lives and health of inmates and the general public.
- People with disabilities have an HIV infection rate up to three times as high as that of people without disabilities because of their risk of physical abuse, isolation, poverty, and lack of access to services and information.
- Since 2005, 14 African countries have passed HIV-specific laws that potentially criminalize all sexual behavior among HIV-positive individuals. In Uganda, a proposed law would criminalize "attempted transmission" of HIV and require mandatory testing of pregnant women and forced disclosure of HIV status.
- In Cambodia, police routinely abuse sex workers. Ahead of public holidays, municipal authorities detain sex workers and other "undesirable populations" in a misguided effort described as HIV prevention. HIV-positive sex workers detained for days in government centers and at least one shelter operated by a nongovernmental organization have gone without crucial antiretroviral medicine.
- In Vietnam, between 32,000 and 35,000 people who use drugs are locked in drug detention centers for terms as long as four years, without trial or due process. Instead of getting effective treatment for drug dependency, detainees are forced to work long hours for below-market wages and beaten if they fail to meet work quotas.
- In China, an estimated 500,000 people are interned at any given time in compulsory drug detention centers, where they can be detained without trial or due process on suspicion of drug use for up to six years. Detainees are routinely beaten, denied access to effective treatment for drug dependency, and subjected to unpaid forced labor.
- Palliative care and pain treatment are poorly integrated into HIV services. The World Health Organization estimates that 1 million end-stage AIDS patients face moderate to severe pain but have no access to pain treatment. Much of this suffering could be alleviated with morphine, an effective, safe, and inexpensive medication.
"Thirty years into this epidemic we know that it is not enough to talk about education, HIV testing, or treatment without addressing the human rights abuses that act as barriers to these services," Amon said. "Governments and donors shouldn't simply preach prevention and care while ignoring the need to reduce stigma and violence, and we need to challenge them when they do"
Human Rights Watch highlighted the need for governments to remove punitive laws and policies that criminalize specific groups or behaviors. Laws in more than 160 countries that criminalize sex workers, drug users, men who have sex with men, and HIV exposure or transmission impede effective HIV outreach and discourage people from seeking treatment, Human Rights Watch said. Much like laws protecting "morality" or "decency," these laws also create a risk of selective or arbitrary prosecution, Human Rights Watch said.
"Punitive laws that criminalize certain groups or behaviors fuel stigma and discrimination, increase the risk of HIV, and prevent HIV/AIDS services from reaching the most vulnerable populations," Amon said.
