DR RICHARD AMENYAH and ELTONETTE ANDERSON
SINCE HIV was discovered and the first cases of AIDS were reported in 1981, there have been ongoing discussions about the criminalisation of HIV transmission, exposure and non-disclosure and vulnerable populations most affected by HIV.
It is no secret that people from marginalised groups who are living with or most affected by HIV are often criminalised and at risk of contracting HIV, as well as experience violence, stigma and discrimination, which inevitably affect their access to healthcare.
Criminalisation undermines effective HIV prevention, treatment, care and support as people might become fearful of being prosecuted. Such laws are unconstitutional, discriminatory and a breach of equality.
The 2022 UNAIDS Global AIDS report, "In Danger," states that 134 countries impose punitive measures on HIV transmission, exposure and non-disclosure of status and now 68 countries worldwide still criminalise consensual same-sex relations. There are 14 countries within Latin America and the Caribbean that have HIV-specific criminal laws.
Criminalisation of HIV flies in the face of human rights as it is discriminatory and limits access to health services. The human cost of such punitive policies on people living with HIV or key populations who are at substantial risk of HIV transmission is unimaginable.
Data from a study conducted by Matthew Kavanagh et al in 2021 found the rates of viral suppression were 8.1 per cent lower in countries that criminalise same-sex relations, 5.9 per cent lower under sex work criminalisation, and 14.5 per cent lower when drug use was criminalised.
Criminal and punitive laws against key populations, such as sex workers, heighten vulnerability to HIV and undermine access to HIV prevention, testing, treatment and care services. For example, in countries where there are laws that criminalise sex workers, they are seven times more likely to be living with HIV than if it were to be partly legalised.
The Global AIDS Strategy expressly recognises that decriminalisation is a societal enabler of the HIV response and necessary to achieve the global AIDS targets toward ending AIDS as a public health threat by 2030.
The 2021 political declaration, endorsed by 165 governments at the UN General Assembly, agreed to the ambitious 2025 global targets amongst which there was a commitment to achieve the 10-10-10 targets: less than 10 per cent of countries with legal and policy environments that deny or limit access to HIV services; less than 10 per cent of people living with HIV and key populations experiencing stigma and discrimination; and less than 10 per cent of people living with HIV, women and girls and key populations experiencing gender-based inequalities and gender-based violence.
To be successful in reforming the punitive legal and policy environment, we need champions and advocates who understand how the legal system works either as duty-bearers or rights-holders. We need the legislature, judiciary and law enforcement officers actively enga
