After a period of decline, new HIV infections among adults across the globe are on the rise again. Michel Sidibe, executive director at UNAIDS, warned delegates at this year’s International AIDS Conference in Durban, South Africa, that infection rates are on the up in most parts of the world. Nearly 2 million people become HIV-positive every year, and regions like Eastern Europe and Central Asia saw a 57 percent rise in new infections in the last five years.
HIV remains stubbornly high among men who have sex with men, sex workers, people who use drugs, and transgender women. Groups like these, which are criminalized in many places, account for more than one-third of new HIV infections worldwide. Criminalization restricts access to health care, forcing those most vulnerable to HIV to the margins of society. A special issue of the Lancet medical journal released at the Durban conference describes prisoners as the “most neglected and vulnerable of all populations in the global HIV/AIDS response.” Prison health care is abysmal in many parts of the world, and HIV prevention and treatment inside some jails is limited or nonexistent. Human Rights Watch has documented government failure to provide HIV prevention and treatment programs to prisoners, most recently in Louisiana parish jails.
While improving prison medical care is urgent, according to the Lancet, health and human rights are best promoted by keeping people out of jail in the first place. In Ukraine, for example, arresting and locking up people who inject drugs may account for half of all new HIV infections among this population – concentrating drug users in crowded, unhealthy conditions without proper treatment for opioid dependence creates a “perfect storm” of increased risk of HIV, both in prison and in the communities to which they return. Worldwide, sex workers are disproportionately affected by HIV, yet the Lancet says decriminalizing sex work could prevent up to 46 percent of new HIV infections among sex workers – and their clients – in the next decade.
New HIV infections are rising, and the alarm has now officially been sounded on a global scale. For the sake of populations most vulnerable to HIV, criminal laws need to be reformed, and fast. There is no time to waste.