More than thirty years after the first clinical evidence of acquired immunodeficiency syndrome was reported, AIDS has become one of the most devastating diseases humankind has ever faced. Since the epidemic began, more than 60 million people have been infected with the virus and nearly 30 million people have died of HIV-related causes. AIDS has become the sixth-largest cause of death worldwide.
At the end of 2009, an estimated 33.3 million people globally were living with HIV. In that year alone, there were an estimated 1.8 million AIDS-related deaths and 2.6 million new HIV infections. Data from 2009 shows that the AIDS epidemic is beginning to change course as the number of people newly infected with HIV is declining and AIDS –related deaths are decreasing. This is in large part due to more people living longer as access to antiretroviral theraphy increases, but these gains remain fragile and disparities continue to exist among countries and within countries. Sub-Saharan Africa continues to be the region most affected with 69% of all new infections and in seven mostly Eastern European and Central Asian countries, new HIV infection rates have increased by 25%. Furthermore, 90% of governments reported that they address stigma and discrimination in their HIV programmes, however, less than 50% costed of budgeted such programmes. Vulnerability to HIV linked to a number of human rights challenges remains a concern (see the 2010 Global Report on the AIDS Epidemic (UNAIDS).
What do human rights have to do with HIV and AIDS?
Human rights are inextricably linked with the spread and impact of HIV on individuals and communities around the world. A lack of respect for human rights fuels the spread and exacerbates the impact of the disease, while at the same time HIV undermines progress in the realisation of human rights. This link is apparent in the disproportionate incidence and spread of the disease among certain groups which, depending on the nature of the epidemic and the prevailing social, legal and economic conditions, include women and children, and particularly those living in poverty. It is also apparent in the fact that the overwhelming burden of the epidemic today is borne by developing countries, where the disease threatens to reverse vital achievements in human development. AIDS and poverty are now mutually reinforcing negative forces in many developing countries.
The relationship between HIV/AIDS and human rights is highlighted in three areas:
Increased vulnerability: Certain groups are more vulnerable to contracting the HIV virus because they are unable to realize their civil, political, economic, social and cultural rights. For example, individuals who are denied the right to freedom of association and access to information may be precluded from discussing issues related to HIV, participating in AIDS service organizations and self-help groups, and taking other preventive measures to protect themselves from HIV infection. Women, and particularly young women, are more vulnerable to infection if they lack of access to information, education and services necessary to ensure sexual and reproductive health and prevention of infection. The unequal status of women in the community also means that their capacity to negotiate in the context of sexual activity is severely undermined. People living in poverty often are unable to access HIV care and treatment, including antiretrovirals and other medications for opportunistic infections.
Discrimination and stigma: The rights of people living with HIV often are violated because of their presumed or known HIV status, causing them to suffer both the burden of the disease and the consequential loss of other rights. Stigmatisation and discrimination may obstruct their access to treatment and may affect their employment, housing and other rights. This, in turn, contributes to the vulnerability of others to infection, since HIV-related stigma and discrimination discourages individuals infected with and affected by HIV from contacting health and social services. The result is that those most needing information, education and counselling will not benefit even where such services are available.
Impedes an effective response: Strategies to address the epidemic are hampered in an environment where human rights are not respected. For example, discrimination against and stigmatization of vulnerable groups such as injecting drug users, sex workers, and men who have sex with men drives these communities underground. This inhibits the ability to reach these populations with prevention efforts, and thus increases their vulnerability to HIV. Likewise, the failure to provide access to education and information about HIV, or treatment, and care and support services further fuels the AIDS epidemic. These elements are essential components of an effective response to AIDS, which is hampered if these rights are not respected.
What is a human rights approach to HIV and AIDS?
Where individuals and communities are able to realize their rights – to education, free association, information and, most importantly, non-discrimination – the personal and societal impacts of HIV and AIDS are reduced. Where an open and supportive environment exists for those infected with HIV; where they are protected from discrimination, treated with dignity, and provided with access to treatment, care and support; and where AIDS is de-stigmatized; individuals are more likely to seek testing in order to know their status. In turn, those people who are HIV positive may deal with their status more effectively, by seeking and receiving treatment and psychosocial support, and by taking measures to prevent transmission to others, thus reducing the impact of HIV on themselves and on others in society.
The protection and promotion of human rights are therefore essential in preventing the spread of HIV and to mitigating the social and economic impact of the pandemic. The reasons for this are threefold. First the promotion and protection of human rights reduces vulnerability to HIV infection by addressing its root causes. The adverse impact on those infected and affected by HIV is lessened. Third individuals and communities have greater ability to respond to the pandemic. An effective international response to the pandemic therefore must be grounded in respect for all civil, cultural, economic, political, economic and social rights and the right to development, in accordance with international human rights standards, norms and principles.
States’ obligations to promote and protect HIV-related human rights are defined in existing international treaties. HIV/AIDS-related human rights include the right to life; the right to liberty and security of the person; the right to the highest attainable standard of mental and physical health; the right to non-discrimination, equal protection and equality before the law; the right to freedom of movement; the right to seek and enjoy asylum; the right to privacy; the right to freedom of expression and opinion and the right to freely receive and impart information; the right to freedom of association; the right to marry and found a family; the right to work; the right to equal access to education; the right to an adequate standard of living; the right to social security, assistance and welfare; the right to share in scientific advancement and its benefits; the right to participate in public and cultural life; and the right to be free from torture and other cruel, inhuman or degrading treatment or punishment.
The United Nations human rights instruments and mechanisms provide the normative legal framework as well as the necessary tools for ensuring the implementation of HIV-related rights. Through their consideration of States reports, concluding observations and recommendations, and general comments, the UN treaty monitoring bodies provide States with direction and assistance in the implementation of HIV-related rights. The Special Procedures of theHuman Rights Council, including special representatives, thematic and country rapporteurs, and working groups also are in a position to monitor respect for HIV-related rights. The Human Rights Council also requests the Secretary-General to solicit comments from Governments, United Nations bodies, programmes and specialized agencies and international and NGOs on steps they have taken to promote and implement, where applicable, programmes to address the urgent HIV-related human rights of women, children and vulnerable groups in the context of prevention, care and access to treatment.