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Human Rights Watch calls on
the Dominican Republic government to protect women’s rights to privacy, the
highest attainable standard of health, nondiscrimination, work, and freedom
from violence in the context of the HIV/AIDS epidemic. The following actions
are essential first steps:
The Ministry of Public Health and Social Support (Secretaría
de Estado de Salud Pública y Asistencia Social, SESPAS) should immediately
stop all HIV testing without informed consent, and should insist on adequate
pre- and post-test counseling in all relevant programs and policies. The
ministry should establish an effective and independent oversight and complaint
mechanism to ensure the proper implementation of the program to prevent
parent-to-child HIV transmission and other health policies and norms relating
to HIV/AIDS, including voluntary counseling and testing. This oversight
mechanism should also periodically assess the level of information received by
women whom medical personnel claim have given informed consent. The ministry
should investigate and sanction all health personnel who disclose confidential
HIV test results without authorization, if necessary with the revocation of
medical licenses.
The Directorate for Control of Sexually Transmitted Infections,
HIV and AIDS (Dirección General de Control de las ITS/VIH y SIDA,
DIGECITSS) should launch awareness campaigns to inform the public about women’s
human rights violations that contribute to the spread of HIV/AIDS, such as
domestic and sexual violence, subordinate social status, and sex discrimination
in the workplace and in access to work and services.
The Ministry of Labor (Secretaría de Estado de Trabajo,
SET) should ensure that all illegal HIV testing as a condition to gain or
retain employment cease immediately. The ministry should investigate
vigorously and in a timely fashion all allegations of HIV-based discriminatory
practices and punish those responsible for such practices. The ministry should
also ensure that labor inspectors are adequately trained in the enforcement of
the AIDS law and actively investigate alleged violations of the prohibition on
involuntary HIV testing. The legal assistance unit of the Ministry of Labor
and other public legal assistance units should offer all necessary legal
assistance for those living with HIV or AIDS whose employment has been
wrongfully terminated or job applications illegally denied due to their HIV
status, including through offering free legal aid and the possibility of
pursuing anonymous legal claims. The ministry should ensure, through public
awareness campaigns and other means, that workers and employers in the Dominican Republic are aware of the rights of people living with HIV.
The Directorate for Security and Health at Work (Dirección
General de Seguridad y Salud en el Trabajo) should ensure that hygiene and
security committees (bi-partite committees charged with monitoring worker’s
health and security in the workplace) receive appropriate training in the
contents of the AIDS law and the Labor Code regarding the prohibition on
discrimination because of HIV status. The office should ensure that the
committees monitor for illegal HIV testing as a condition to gain and retain
work, and that they understand how and where to report violations.
The Ministry of Tourism (Secretaría de Estado de Turismo)
should ensure that all illegal HIV testing as a condition to gain or retain
employment in the tourism sector cease immediately. The ministry should
investigate alleged HIV testing practices and punish hotels responsible for such
practices, for example by revoking their operating licenses.
The Ministry of Education (Secretaría de Estado de Educación,
SEE) should ensure access to sex education in primary and secondary schools,
both private and public. Sex education—tailored appropriately to age level and
capacity—should cover the correct and consistent use of condoms as the most
effective way to prevent HIV transmissions during sexual intercourse, including
in long-term unions. Sex education should also include information on the
inequality between men and women that contributes to putting women at risk of
HIV transmission in the Dominican Republic.
On behalf of the Dominican Republic government, the president
should publicly condemn involuntary HIV testing as a condition to gain or
retain employment as discrimination based on health status, indicating that
such discrimination will not be tolerated and that appropriate sanctions will
be applied to those responsible for violations. The president should also
condemn unauthorized release of HIV test results and announce a zero-tolerance
policy for such breaches of confidentiality. Finally, the president should
publicly endorse and push for financial support for broad voluntary HIV
counseling and testing programs that include adequate pre- and post-test
counseling.
The Dominican Republic congress should require ministries and
appropriate government agencies, by law, to implement thorough training for
work inspectors, health personnel, judges, magistrates, lawyers, and relevant
local and national officials on the laws and regulations that prohibit
involuntary testing for HIV. Congress should also adopt adequate legal
measures to allow persons living with HIV/AIDS to bring legal cases regarding
alleged discrimination in anonymity and increase fines applicable for HIV-based
discriminatory practices to allow for meaningful sanctions.
Human Rights Watch calls on
the Presidential AIDS Council to prioritize the prevention of violations of women’s
human rights as a critical tool in combating the continued spread of the
disease. As essential first steps, COPRESIDA should implement the following
actions:
Monitor and coordinate effective enforcement of the AIDS law with
regard to the prohibition on HIV testing in access to health care services and
work, as well as provisions to protect the confidentiality of those tested for
HIV. Refer violations to relevant governmental agencies for further
investigation and sanctions.
Discourage legal or policy measures that infringe upon women’s
human rights, such as involuntary HIV testing or testing without proven access
for all tested invidviduals to adequate pre- and post-test counseling and
without stringent confidentiality protections.
Engage community-based organizations that work with women living
with HIV or AIDS, regardless of their current membership in the NGO AIDS
Coalition which is part of COPRESIDA, to ensure the broadest possible reach of
COPRESIDA’s coordination work and information.
Human Rights Watch calls on
international bilateral and multilateral donors and United Nations agencies and
entities to work with the Dominican Republic government to ensure that all
mandatory and involuntary HIV testing practices cease immediately, and that
HIV/AIDS related programs and policies do not discriminate against women in
their intent or effect. The following actions are essential first steps:
Donors and international organizations that fund health or HIV/AIDS-related
programs in the Dominican Republic should engage with the Dominican Republic to prevent involuntary HIV testing. Donors should support government and NGO
programs for voluntary HIV counseling and testing services with adequate
confidentiality protections, and should actively oppose involuntary testing or
testing without explicit consent and adequate pre- and post-test counseling.
Donors should support information campaigns aimed at eliminating women’s human
rights violations that contribute to the spread of HIV/AIDS, such as domestic
and sexual violence and sex discrimination in the workplace and in access to
work and services. Donors should also expand prevention options for women and
girls, and fund prevention projects that aim to change the attitudes and
behaviors that perpetuate women’s subordinate status and the related risk of
HIV infection.
Donors and international organizations that fund programs in the Dominican Republic related to HIV/AIDS in the workplace, including the U.S. Department of
Labor, should require that the programs address not solely HIV/AIDS prevention,
but HIV/AIDS-related employment discrimination as well. Such donors should
also support government and NGO information campaigns to educate workers about
their right to refuse involuntary HIV testing by current or potential employers
and about available mechanisms for redress if they are illegally tested.
As part of monitoring of compliance with the International
Covenant on Economic, Social and Cultural Rights, the U.N. Committee on
Economic, Social and Cultural Rights should report on states’ implementation or
condoning of HIV testing without informed consent, adequate pre- and post-test
counseling, and guarantees for the confidentiality of HIV test results.
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