Public policies, programs and laws are meant to protect everyone equally. However, this does not hold true when there is disconnect between human rights norms and public health interventions. Thus, making vulnerable and marginalized people more at risk of contracting HIV.
More than four decades into the HIV pandemic, the world is still faced with significant human rights violations, including stigma and discrimination, caused, in part, by punitive laws, policies and programs.
Typically, laws and policies that are punitive, do not protect vulnerable and marginalized people such as women and girls, gay men and other men who have sex with men, transgender people, sex workers and people who use drugs.
These laws criminalize HIV non-intentional transmission, exposure, and non-disclosure whereas others target marginalized groups with mandatory testing or travel restrictions, or residency based on one’s HIV status.
Consequently, these laws and policies do not respect the privacy and confidentiality of people and, thus, are a clear violation of their human rights which help drive and sustain public health inequalities.
They also contribute to legitimizing stigma, discrimination, and violence against marginalized groups, thereby increasing their risk of contracting HIV while reducing access to care.
The human cost of such punitive policies on people living with HIV or key populations who are at substantial risk for HIV is unimaginable. Data from UNAIDS show sex work is penalized in 14 countries in the Caribbean; and consensual same-sex sexual relations are criminalized in eight.
The possession of small amounts of drugs is criminalized in 14 countries; transmission, non-disclosure, or exposure to HIV is criminalized in six countries and in three countries, laws do not exist, but prosecutions exist based on general criminal laws. There are some restrictions on entry, stay, or residence in five countries in the region.
Only Guyana does not require parental consent for adolescents to receive the HIV test. HIV test is mandatory for marriage, work, residence or for specific groups of people in seven countries. We cannot commit to end AIDS as a public health threat by 2030 in the Caribbean if these discriminatory laws which perpetuate HIV transmission continue to exist.
For the world to achieve the shared vision of zero new HIV infections, zero AIDS related deaths and zero discrimination, countries must remove punitive laws and strive to achieve the 10-10-10 targets where less than 10 percent of countries report having punitive laws, less than 10 percent report that people living with HIV and key populations experience stigma and discrimination and, finally, less than 10 percent report of people living with HIV, women and girls, and key populations experiencing gender-based violence.
These targets were agreed by countries when they signed on to the Global AIDS Strategy 2021-2026 and endorsed by our leaders through the 2021 Political Declaration on Ending AIDS.
As we celebrate Human Rights Day, it is important to continue to remind people about how far the AIDS fight has come after more than 40 years as a pandemic.
The World AIDS Day message remains relevant in today’s human rights celebrations because inequalities, in all spheres of life, continue to drive the HIV epidemic in the Caribbean and, indeed, everywhere.
There is a need to decriminalize HIV transmission and protect and promote the rights of people, regardless of their health status, gender identity, sexual orientation, work, or other status. Some of these laws are colonial in nature which are no longer relevant in the countries of the colonialists, and so why should they remain in the region?
Finally, in the words of Nelson Mandela, “HIV indeed is more than a health issue; it is a human rights struggle too.’’
It requires respecting, protecting, and promoting the human rights of everyone.
To make this possible, state governments and duty bearers must fulfill their obligations to the human rights treaties that they have signed on to.
There is need for continuous training in human rights, including awareness raising, training of healthcare providers and law enforcement officials, access to justice for HIV-positive individuals, fighting stigma and educating young people about safe sex.
Today, UNAIDS calls on governments across the region to remove harmful and discriminatory laws and policies and do more to protect and promote the rights of everyone without distinction.
• Dr. Richard Amenyah is the UNAIDS Multi-Country director for the Caribbean.