Homophobia and criminalization of consensual adult sexual behaviour represent major barriers to effective responses to HIV.

By signing the 2006 United Nations Political Declaration on HIV/AIDS, governments committed to removing legal barriers and passing laws to protect vulnerable populations. However, over 80 countries still criminalize consensual same sex acts among adults.

It is against this repressive context that communities worldwide celebrate the International Day Against Homophobia each 17 May, which marks the anniversary of the World Health Organization’s decision to remove homosexuality from its list of mental disorders in 1990. Therefore, 17 May is an opportunity to highlight once again the urgent need for joint efforts to reduce and end discrimination, violence and criminalization based on sexual orientation.

Homophobia and criminalization of consensual adult sexual behaviour represent major barriers to effective responses to HIV. Such responses depend on the protection of the dignity and rights of all people affected by HIV, including their right and ability to organize and educate their communities, advocate on their behalf, and access HIV prevention and treatment services.

“The decision to criminalize same sex relations is a serious setback to the AIDS response and to the rights of those affected by the law,” said Michel Sidibé, Executive Director of UNAIDS. “As these discriminatory laws can drive people underground, they will have a negative impact both on the delivery of HIV prevention programmes and on access to treatment for those living with HIV.”

Evidence shows that protection of the rights of men who have sex with men, lesbians and transgenders, both in law and practice, combined with scaled-up HIV programming to address their HIV and health needs are necessary and complementary components for a successful response to the epidemic.

UNAIDS urges all governments to take steps to eliminate stigma and discrimination faced by men who have sex with men, lesbians and transgenders and create social and legal environments that ensure respect for human rights and universal access to HIV prevention, treatment, care and support.

“There is no place for homophobia. Universal access to HIV prevention, treatment, care and support must be accessible to all people in need—including men who have sex with men,” said UNAIDS Executive Director Michel Sidibé.

Countries that have non-discrimination laws against men who have sex with men, injecting drug users and sex workers have achieved higher rates of coverage of HIV prevention efforts.

People living with or affected by HIV often require practical assistance to maintain adequate housing, keep child custody, enforce property and inheritance rights, or access health care, education or employment without discrimination.
Credit: UNAIDS/P.Virot

Experience in the response to AIDS has shown that access to legal services is an important part of guaranteeing protection from discrimination, getting redress for human rights violations, and expanding access to HIV prevention and treatment. Yet such programmes are not sufficiently supported by national AIDS responses, and where they do exist, quality and scale are often insufficient.

The International Development Law Organization (IDLO), the UNAIDS Secretariat and the United Nations Development Programme (UNDP) hosted an international expert consultation on strengthening and expanding HIV legal services at IDLO headquarters in Rome, 3-6 May.

Meeting participants contributed to the development of tools for improving access to legal services for people living with HIV and key populations at higher risk of HIV infection, particularly those in low- and middle-income countries. The tools will support countries to develop and strengthen programmes and proposals for funding, including to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Susan Timberlake, Senior Human Rights and Law Adviser with the UNAIDS Secretariat, explains that UNAIDS advocates that access to justice must be a basic, programmatic component of the movement for universal access to HIV prevention, treatment, care and support. “The persistent reality of discrimination – whether due to HIV status, gender, or social status – means that legal services are a critical and necessary part of a comprehensive response to the epidemic,” says Timberlake.

People living with or affected by HIV often require practical assistance to maintain adequate housing, keep child custody, enforce property and inheritance rights, or access health care, education or employment without discrimination. Access to legal services is even more important in punitive legal environments. An increasing number of countries are passing overly-broad laws to criminalize HIV transmission. Men who have sex with men, sex workers and people who use drugs face criminal sanctions in many countries, blocking access to HIV services and heightening HIV vulnerability. According to research commissioned in 2008 by the International Task Team on HIV-related Travel Restrictions, some 60 countries deny entry, stay and residence based on HIV status.

No “one size fits all” for legal services

Legal services in the context of HIV take many forms. These include: legal information and advice, including through telephone “hotlines”; formal litigation, including strategic litigation to create legal policy; mediation and other forms of dispute resolution; assistance with informal or traditional legal systems (e.g. village courts); and community legal education. Legal service providers are not always lawyers. They may be paralegals, volunteers, students or peer educators. Such services are provided in a range of settings, including HIV treatment and counselling centres, “mainstream” legal aid centres, as well as prisons and community settings. Work may also be linked to advocacy for law reform.

According to Mandeep Dhaliwal, Cluster Leader on Gender, Human Rights & Sexual Diversities with the UNDP HIV Practice, the rationale for supporting HIV legal services rests on two related arguments. “One, they are essential as a means to protect the human rights of marginalized and vulnerable populations. Two, they are essential as a means to ensure optimal public health and development outcomes – both of which are underpinned by the realization of rights,” says Dhaliwal.

However, too often such programmes do not get the support they need. “One of our goals as the Joint UN Programme on HIV/AIDS is to support countries to recognize how important legal services can be to their national HIV response, and then work with them to develop a strategy to scale-up these services,” explains Dhaliwal. “Existing HIV legal services are generally small in scale and patchy in coverage. With high levels of ‘legal’ marginalization of vulnerable populations, the achievement of universal access to prevention, treatment, care and support demands a commitment to legal protection and access to legal services.”

The meeting in Rome supported the development of three tools to improve access to HIV legal services:

1. Models of legal services applicable in different situations
2. Training curriculum for lawyers
3. Resource mobilization strategies.

“There are extraordinary examples of great work being done to provide legal services. We know the importance of providing an enabling legal environment to HIV prevention and treatment access,” says David Patterson, Manager of IDLO's HIV and Health Law Programme, “Why have such legal services not been taken to scale with the same urgency that we seek to provide treatment?”

Participants included legal service providers and leaders of organizations working with people living with HIV, women’s groups, people who use drugs, men who have sex with men and sex workers, as well as representatives from IDLO, UNAIDS, UNDP, and the Global Fund. They came from diverse countries and epidemic settings, including Australia, Botswana, Brazil, China, Denmark, Egypt, Georgia, Guatemala, India, Indonesia, Nepal, Papua New Guinea, St Lucia, Uganda, Ukraine, the United States of America and Viet Nam.

Elizabeth Mataka, UN Special Envoy for HIV/AIDS in Africa.
Credit: UNDP

If more women are to avoid HIV infection, laws on inheritance and property rights should be revisited, revised or better enforced. This was one of the key messages emerging from a high-profile side-event on women’s inheritance, land and housing rights in the context of HIV, which took place yesterday, 12 March, during the 53rd session of the Commission on the Status of Women held at UN Headquarters in New York.

The discussion brought together a range of speakers including Elizabeth Mataka, UN Special Envoy for HIV/AIDS in Africa and Rose Gawaya, Senior Gender Adviser of the UNDP HIV/AIDS Practice based in Johannesburg, South Africa. The event focused on reviewing innovative work that has been done to increase women’s access to, control over, and ownership of land and housing in a bid to mitigate the impact of AIDS. Realistic and workable strategies, from the grassroots to international level, were explored.

Ms Mataka highlighted the increased vulnerability of women due to AIDS and called on governments to harmonise often conflicting laws and legislation. She said “Lack of equal rights for women to inheritance and property excludes women from accessing resources that would help reduce their vulnerability to HIV and improve their ability to cope with the consequences of the epidemic.”

The issue of such rights for women is of critical importance in addressing HIV. When a woman’s husband dies from AIDS, she might lose her home and land, inheritance and livelihood. This can leave her in a situation where she is forced to enter into relationships and behaviours that render her more vulnerable to the virus. The panellists contended that when women have enhanced access to ownership and control of land and property rights they have a greater range of choices, are far more able to exercise autonomy and, ultimately, are better able to protect themselves.

As well as the revision or implementation of existing laws on inheritance, the panellists recommended increased access to information and legal experts, enhanced partnerships among organizations working in the area and strengthened networks to raise awareness of the issues, with a focus on grassroots women as critical drivers of change. They also suggested greater use of the media and creative ways of sharing and packaging messages, while highlighting the need to increase the scope of research.

Other participants in the panel included: Jeanmarie Fenrich, Fordham Leitner Centre for International Law and Justice; Seodi White, Women and Law in Southern Africa (Malawi); Esther Mwaura, GROOTS Kenya, Huairou Commission; and Anne Gathumbi, Open Society Initiative for East Africa, Law and Health Initiative.

This event was organized by UNDP, the Huairou Commission and Soros/OSI with support from UNAIDS, GROOTS, ICRW, COHRE, Fordham Law Leitner Center and WLSA Malawi.

Credit: Jacky Ly

Social issues like gender inequality, violence against women and the criminalization of activities like sex work, injecting drug use and same sex intercourse are factors that can make people more vulnerable to HIV infection. To discuss the challenges of social drivers, UNAIDS Secretariat, UNESCO and the Social Change Communication Working Group held a satellite session at ICASA on Sunday 7 December.

“Programmes to address these social or “structural” factors that make people more vulnerable to HIV take time to produce results. It is urgent that they be adapted to communities’ local needs and be implemented, evaluated, and continuously improved as core parts of national AIDS strategies, operational plans and budgets,”  said Barbara de Zalduondo, UNAIDS Chief Division of programmatic priorities support.

Barbara de Zalduondo, UNAIDS Chief Division of programmatic priorities support. Credit: Jacky Ly

UNAIDS consultations in more than 120 countries in 2006 revealed that many obstacles to effective HIV programmes are down to social, legal and political reasons rather than strictly technical ones. Gender inequality and violence against women is a large factor. As is the approach of criminalization of activities such as sex work, injecting drug use and same sex intercourse. The persistence of HIV-related stigma and other violations of human rights are also obstacles.

These social challenges are not new. Although well documented for over two decades, all too often they are not addressed by concrete programmes on a large enough scale in national and sub-national responses to AIDS.

For this reason, the ICASA session brought together experts who have designed, implemented, and measured successful programmes to address gender inequality, sexual violence, HIV related stigma and discrimination and other violations of human rights in multiple African contexts. The experts illustrated programme approaches which go beyond building individual knowledge and motivation to also tackle laws, policies and social norms.

The satellite session was an opportunity for HIV programme planners and and community advocates and donors to discuss effective HIV programming.

Participants shared examples of programmes that are catalyzing and supporting change in harmful social norms, which they can consider for application or adaptation at home.

Experts also exchanged information on existing tools for measuring HIV related stigma and discrimination, gender inequitable norms, and concurrent sexual partnerships. Also, programme examples and evaluation methods and data, were shared and discussed.

The 15th International Conference on AIDS and STIs in Africa (ICASA) closes today in Dakar. Over the last few days, hundreds of African and international delegates have held discussions on HIV developments and trends in the region.

The International Planned Parenthood Federation (IPPF) launched on 13 November 2008 a new report Verdict on a Virus: Public Health, Human Rights and Criminal Law.

The International Planned Parenthood Federation (IPPF) launched on 13 November 2008 a new report Verdict on a Virus: Public Health, Human Rights and Criminal Law. The aim of the publication is to provide information about the criminalization of HIV transmission or exposure and its related health, human rights and legal implications.

The report brings together opinions from legal experts, human rights groups, medical and health professionals and HIV activists. Ten questions around the criminalization of HIV transmission are explored as chapters which also provide answers followed by explanatory text and illustrated with case studies.

Verdict on a virus is also a call to action to advocate for “good strategies and laws” that promote HIV prevention, while working with governments to discourage and prevent new laws criminalizing transmission of HIV from being passed.

“The law can be a powerful tool in addressing HIV if it is used to empower those vulnerable to HIV infection and to its impact, by guaranteeing access to services and protecting people from discrimination and the sexual violence that can drive HIV vulnerability,” said Susan Timberlake UNAIDS Senior Advisor, Human Rights and Law. “We need to make scarce legal resources work for the HIV response, not against it,” she added.

As Justice Cameron explained at a lecture at Peking University Law School, from his perspective, the law serves two important functions. Credit: UNAIDS/Zhou Dao

During his recent trip to Beijing as a guest of UNAIDS, Justice Edwin Cameron of South Africa’s Supreme Court of Appeals used every opportunity to raise the question, “What role can the law play in China in response to HIV?”

As Justice Cameron explained at a lecture at Peking University Law School, from his perspective, the law serves two important functions. First, it is an embodiment of public morality. Second, the law constrains the exercise of government power. In both these capacities, the law can have a profound impact on the lives of people living with HIV.

For example, in South Africa, the 1995 Labor Relations Act prohibits pre-employment testing for HIV. Justice Cameron applauds the law because it guides social conduct to be consistent with the moral stance underlying the law. “There are very few legitimate reasons to deny someone work because of HIV status,” said Justice Cameron.

The most important Chinese law embodying public morality about HIV is State Council Decree 457 of 2006, which prohibits discrimination against people living with HIV. Although this law sets a vital standard for Chinese society, public awareness of the law is low. As former Minister of Health Wang Longde explained at a joint press conference with Justice Cameron, even medical professionals often don’t know that they are not permitted to discriminate against HIV positive individuals. Professor Wang called for an educational campaign for medical professionals.

While Decree 457 is a good law that faces some implementation challenges, other laws are less positive. At a round table discussion held at UNAIDS China offices during Justice Cameron’s visit, he described the disturbing trend in African countries of laws criminalizing HIV transmission. Some of these laws require HIV positive individuals to disclose their status prior to engaging in sexual contact, but without clarifying when a person must disclose, or what constitutes “sexual contact.”

In Justice Cameron’s analysis, while these laws are intended to protect people — a laudable motivation — they can have devastating public health consequences. First, the laws are not effective as a means of stopping transmission; no law can accomplish that. As Justice Cameron explained, most acts of transmission occur between individuals who do not know they are HIV positive.

Second, the laws increase stigma and discourage people, especially women, from getting tested. Under some of these laws, women can incur legal liability for exposing their unborn child to HIV, even if transmission doesn’t occur. Many women and men find remaining ignorant about their HIV status preferable to risking criminal prosecution. Ultimately, by discouraging people from getting tested and seeking treatment for HIV, these laws lead to more people dying needlessly.

Justice Cameron pointed out that, ironically, these laws are unnecessary. In the event that anyone deliberately transmits HIV to another person, existing laws of assault or murder would apply.

China doesn’t have any laws that specifically criminalize transmission of HIV. But one article of the Chinese law does criminalize the intentional transmission of a sexually-transmitted disease (STD) by sex workers, and another law criminalizes intentionally causing harm to another person. Some critics have pointed out that the STD law has caused some sex workers to stop getting health check-ups. Justice Cameron commented that, although China’s criminal laws appear to have some negative ramifications for public health, the laws were general, and were not targeted to HIV specifically.

In recent years, there has been an apparent increase in the number of people prosecuted for transmitting HIV, particularly in Europe and North America, with cases now numbering in the hundreds in the English-speaking world alone. There is also an increase in laws that criminalize HIV transmission and exposure to the virus, as reported in sub-Saharan Africa, Asia, and Latin America and the Caribbean.

As early as 1996, UNAIDS and the Office of the UN High Commissioner for Human Rights expressed concern over the inappropriate and overly broad application of criminal law to HIV transmission and provided guidance on it in the International Guidelines on HIV/AIDS and Human Rights. In 2002, UNAIDS issued a more detailed policy options paper on the subject. However, in light of growing concern over the spread of such laws, UNAIDS and UNDP felt it necessary to recently publish a policy brief entitled “Criminalization of HIV transmission”.

Intentional transmission of HIV

The policy brief makes specific recommendations for governments, civil society and international partners, urging that criminalization be limited to cases of intentional transmission of HIV. While UNAIDS and UNDP acknowledge that use of the criminal law may be justified in these limited circumstances – i.e. where a person knows his or her HIV positive status, acts with the intention to transmit HIV, and does in fact transmit it – they are concerned that going beyond such cases risks applying criminal sanctions to people who are not actually blameworthy, further stigmatizes people living with HIV, and creates disincentives for mutual responsibility for sexual health and to finding out one’s HIV.

The policy brief highlights concerns about possible negative impacts on effective prevention of HIV transmission, problematic disclosure and partner notification provisions, miscarriage of justice, as well as the possible negative impact on women and girls.

International Consultation on the Criminalization of HIV Transmission

In November 2007, the UNAIDS Secretariat and UNDP hosted an “International Consultation on the Criminalization of HIV Transmission” in order to consider recent developments in the area. The meeting brought together diverse points of view but also a shared concern over the apparent trend of criminalizing HIV transmission. An in-depth report from the three-day meeting has been released, giving an overview of the discussions, summary of the main issues and conclusions by the participants who included parliamentarians, members of the judiciary, criminal law experts, civil society representatives and people living with HIV, alongside representatives of WHO, ILO and the Office of the UN High Commissioner for Human Rights.

The report also includes the summary provided by Justice Edwin Cameron, judge of the Supreme Court of Appeal, South Africa.

“What meeting participants underlined was the fact that laws criminalizing HIV exposure and transmission are a dangerous and ineffective ‘sideshow’ in the response to AIDS,” said Susan Timberlake, Senior Human Rights and Law Adviser, UNAIDS Secretariat.

“Criminal law will never do the work of comprehensive and evidence-informed HIV prevention programmes. In fact, widespread criminalization may set back prevention efforts by deterring people from learning their HIV status, disclosing it to partners, and accessing treatment.”

No evidence that the use of criminal law reduces transmission of HIV

The main reasons advanced for applying criminal law are either punishment for someone who has caused harm or to deter risky behaviours that lead to HIV transmission.

However, there is no evidence that the use of criminal law is an effective measure for reducing transmission of HIV, and experts are concerned that criminalization is likely to have a negative impact on the overall response to HIV, including HIV prevention.

Potential negative impacts of use of criminal law

For fear of prosecution, people may be more reluctant to get tested and find out about their HIV status, as a perceived “legal defense”. Such laws and the reporting of individual cases in the media risk undermining the public health message that it is best to take responsibility for your own protection, rather than rely on a legal obligation of HIV positive people to disclose their status.

Criminalization may also create distrust in relationships with health service providers as courts might subpoena medical records in court cases. Finally, though many of these laws appear to have been passed as a “measure to protect women”, many experts fear that these laws will actually be disproportionately applied to women living with HIV. Women are often the first to find out their status and cannot tell their partners for fear of violence or abandonment. They also are less likely to have access to legal counsel than men.

For these and other reasons, many experts are concerned that the potential adverse consequences for both public health and human rights far outweigh any perceived benefits that could arise from an increased and overly broad application of criminal law to HIV transmission.

The International Task Team on HIV-related Travel Restrictions concluded its third meeting with draft recommendations towards the elimination of HIV-specific restrictions on entry, stay and residence. In the coming months, these will be finalized and presented to the boards of the Global Fund and UNAIDS this November and December.

Restricting entry, stay or residence in a country due to HIV positive status alone is discriminatory, and in today’s highly mobile world, such restrictions have even greater impact on people living with HIV. In 2008, some 67 countries continue to have such restrictions.

In early 2008, UNAIDS set up an international task team of governments, civil society groups and international organizations to bring the issue of HIV-related travel restrictions back onto the agenda and promote action towards their elimination. Co-chaired by UNAIDS and the Government of Norway, the Task Team met for the first time in Geneva in February 2008, followed by a second meeting at the Office of the UN High Commissioner for Human Rights in Geneva in April, and the third and final meeting in Madrid at the headquarters of the World Tourism Organization (UNWTO).

At the third meeting, the Task Team took
stock of all the advocacy and activities
conducted by Task Team members against
travel restrictions and noted that there
indeed is much greater momentum toward
their elimination. Credit: UNAIDS

The third meeting, which took place from 24-26 June, was opened by Francisco Elías de Tejada Lozano, former Spanish Ambassador to the Global Fund, Spanish Ministry of Foreign Affairs, and Francesco Frangialli, Secretary-General of UNWTO. Frangialli underlined that travel restrictions based on HIV status are discriminatory, and are a major concern to the entire tourism sector.

“HIV is not something that transmits through the air. If there are going to be restrictions, they have to be rational and reflect legitimate public health concerns. For HIV, what’s needed is prevention information and dialogue,” said Frangialli.

At the third meeting, the Task Team took stock of all the advocacy and activities conducted by Task Team members against travel restrictions and noted that there indeed is much greater momentum toward their elimination.

For example, civil society groups conducted significant advocacy leading up to the High-Level Meeting on AIDS at the UN General Assembly in June. At that meeting, both UN Secretary-General Ban Ki-Moon and UNAIDS Executive Director Peter Piot called for the end of HIV-related travel restrictions in their speeches at the opening session of the General Assembly. “Stigma and discrimination around AIDS remain as strong as ever: and in this context I join my voice with the Secretary General and I call on all countries to drop restrictions on entry to people simply because they are living with HIV,” said Dr Piot.

Task Team members also underlined during the third meeting that ongoing awareness-raising is needed, and that the Task Team’s work has to be followed by intense country-level action that leads to the elimination of travel restrictions.

“At this point in the epidemic, with over 25 years of experience, it’s hypocrisy if there’s no change and governments say that they’re committed to ending stigma and discrimination,” said Craig McClure, Executive Director of the International AIDS Society.

Susan Timberlake, Task Team Co-chair and Senior Human Rights and Law Adviser at UNAIDS, stated that more effort is needed to ensure that tourists, migrants and other mobile populations are addressed in national AIDS responses.

“Countries need to understand that any HIV vulnerability related to mobility is not just about tourists and migrants, it is also about nationals, entering, departing and re-entering. If governments really want to reduce HIV vulnerability related to mobility they should ensure that all mobile people benefit from appropriate HIV programmes and services. In the era of Universal Access and increasing globalization, no comprehensive AIDS response should leave out people on the move,” she said.

Restrictions on the entry, stay and residence of people living with HIV will be highlighted during a Special Session at the International AIDS Conference in Mexico this August, as well as the Global Forum on Migration and Development in the Philippines in October. The final recommendations of the Task Team will be presented in a report at the next meeting of UNAIDS Programme Coordinating Board in December 2008 and to the board of the Global Fund of Fight AIDS, TB and Malaria in November.

Anand Grover, head of the HIV/AIDS
Unit of Lawyer’s Collective (India)
and a member of the UNAIDS
Reference Group on HIV and
Human Rights

Anand Grover, head of the HIV/AIDS Unit of Lawyer’s Collective (India) and a member of the UNAIDS Reference Group on HIV and Human Rights, has been appointed the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health by the UN Human Rights Council.

A well-known long-time advocate and activist on HIV and human rights, Anand Grover is a practicing lawyer in the Bombay High Court and the Supreme Court of India. He has argued many cases relating to the rights of people living with HIV, including rights of sex workers and the first HIV case in India relating to employment law.

Mr. Grover has worked closely with UNAIDS on HIV-related rights and law issues for many years and has been a valuable resource for the Programme. In this regard, he has served on the UNAIDS Reference Group on HIV and Human Rights which advises UNAIDS on how it can strengthen the commitment and capacity of governments, civil society and the private sector to protect and promote human rights in relation to HIV. At the request of the Government of India, Anand Grover and the Lawyers Collective HIV/AIDS Unit drafted the HIV Bill which is likely to be introduced in Parliament this year.

Mr Grover takes over from Paul Hunt, who has been the Special Rapporteur since the mandate was created in 2002 and has completed his maximum term of six years. Paul Hunt is also a member of UNAIDS Reference Group on HIV and Human Rights. In his country visits and reports to the Human Rights Council, Mr Hunt has been a great champion of human rights issues related to HIV.

Susan Timberlake, UNAIDS Senior Human Rights and Law Adviser, believes that UNAIDS engagement with Special Rapporteurs is an important way to bring greater attention to HIV-related human rights issues globally and in countries.

“We are delighted at the appointment of Anand Grover to UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. A tireless HIV and human rights activist, he will no doubt continue the pioneering work of his predecessor Paul Hunt. We look forward to working closely with him to help ensure the full realization of the human rights and fundamental freedoms that are critical to a successful response to HIV.”

Special Rapporteurs

Special Rapporteurs are independent experts that serve in their personal capacity, supported by the Office of the UN High Commissioner for Human Rights (OHCHR). They undertake country missions at the invitation of a country or on the basis of a standing invitation. During such country missions, they assess the general human rights situation, as well as specific issues under their respective mandates. They meet with national and local authorities, including judges and parliamentarians; the national human rights institution; the UN and other inter-governmental agencies; the media and victims of human rights violations.

On the basis of their findings, they present conclusions and recommendations through public reports to the UN Human Rights Council, and to the concerned governments. Special Rapporteurs also have a mandate to take up individual cases of human rights violations which they address directly to the Minister of Foreign Affairs in a country.

More information about the mandate of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (including reports of country missions and summaries of communications to governments) can be found on the OHCHR web site

In 1990, the World Health Assembly approved the 10th Edition of the International Classification of Diseases (World Health Organization) on May 17, which established that sexual orientation (heterosexual, bisexual or homosexual), on its own, would no longer “be considered as a disorder”. For this reason May 17 is used to mark the International Day against Homophobia.

Of the 192 member states of the United Nations, 85 have laws that criminalize homosexual behaviour. In some of these countries, conviction can result in the death penalty.

The criminalization of homosexuality fuels discrimination and can force people to hide their sexuality for fear of prosecution. Where people cannot live openly with their sexual orientation, the risk of HIV infection and the impact of AIDS are greatly enhanced as people may be too afraid to access HIV prevention or treatment services. This is compounded where human rights violations on the basis of sexual orientation and gender identity are widespread. These violations include violence, vilification, arbitrary arrests, forced HIV tests, and discrimination.

In many cases—particularly where political or social leaders deny the existence of same sex sexuality or criminalize it—HIV services tailored to their needs are absent altogether from national responses to AIDS.

Infection rates remain disproportionately high among men who have sex with men. “To reduce HIV incidence among this group, as well as protect their human rights, we have to confront, condemn, and eradicate homophobia” said Susan Timberlake UNAIDS Senior Advisor, Human Rights and Law.

UNAIDS works with governments, civil society and the media to fight homophobia and other forms of stigma and discrimination directly and indirectly related to HIV.