GENEVA, 20 December 2022—UNAIDS welcomes the judgement by the High Court of Kenya at Nairobi recognizing that coerced sterilization of women living with HIV is a violation of their human rights.  

The judgement follows a case brought forward in 2014 by a Kenyan woman living with HIV who was coerced by professionals at a health facility to undergo tubal ligation thus taking away her ability to have children. The High Court found that the performance of this operation without consent amounted to a violation of her rights to non-discrimination, to dignity, to health and to family.  

“This decision is an important step in protecting the sexual and reproductive health and rights of women living with HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “UNAIDS stands ready to work with all governments to ensure such practices are eliminated completely and that women living with HIV are able to access health services without stigma or discrimination.” 

UNAIDS intervened in this case with an amicus curiae (friend of the court) brief that informed the Kenyan High Court on the health guidelines and human rights standards that each country must follow to respect, protect and guarantee the human rights of people living with HIV, and the impact that such involuntary practices can have on the HIV response. The Kenyan Legal and Ethical Issues Network on HIV/AIDS (KELIN) and the African Gender and Media Initiatives Trust (GEM) were also petitioners in this case.  

HIV-related stigma and discrimination has a significant impact on the health, lives and well-being of people living with or at risk of HIV. Stigma and discrimination hinders the HIV response by limiting access to broader sexual and reproductive health and other health services. UNAIDS continues to work daily to ensure that governments invest in preventing and responding to violations linked to the forms of intersectional discrimination to which people living with HIV have been subjected. 

The plaintiff in the case stated, “This was never about the money. I wanted to fight for justice for myself and all women who have had this experience, and to ensure this does not happen to other women who are living with HIV who need access to reproductive health services.”  

“This case is an important moment for reproductive justice and the feminist movement. Coercive sterilization of women living with HIV is a violation of women’s most fundamental human rights and undermines effective HIV responses,” said UNAIDS Country Director for Kenya, Medhin Tsehaiu. “It is only through a human rights approach that we will end AIDS as a public health threat.” 

A rights-based approach includes the right to start a family and have children, the right to decide the number and spacing of their children, the right to reproductive autonomy and the right to access quality services to support their reproductive health choices, based on their informed, safe and voluntary consent. These are fundamental human rights that belong to all women, regardless of HIV status, and are guaranteed in global and regional treaties.  

“We welcome the court’s decision and although it took a long time, we are happy that the court found the client’s rights had been violated, and particularly the finding of discrimination on the basis of sex and HIV status,” said Allan Maleche, Executive Director, KELIN. 

The Global AIDS Strategy 2021–2026: End Inequalities, End AIDS includes a central role for the promotion of human rights, gender equality and dignity, free from stigma and discrimination for all people living with and affected by HIV. It is a commitment by UNAIDS to an ambitious vision to end gender inequalities and realize human rights, including the right to health, calling on all partners and stakeholders in the HIV response in all countries to transform unequal gender norms and end stigma and discrimination.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Tanzania became the 13^th African country to join the Education Plus Initiative, committing to provide greater investments to ensure boys and girls complete secondary school. 

Education Plus is an initiative spearheaded by UNAIDS to accelerate action and investments in education to prevent HIV. Evidence shows that completing secondary education reduces the risk of HIV infection and early pregnancy and improves their livelihoods and prosperity for girls and young women. The education Plus initiative is centred on empowering adolescent girls and young women and achieving gender equality in sub-Saharan Africa.

On 30 November 2022, during the HIV week commemoration, the Office of the Prime Minister, led by the Minister of State for Policy, Coordination and Parliamentary Affairs, Mr George Simbachawene, alongside the Deputy Minister of Health Dr Godwin Mollel, launched the initiative in Lindi region, Tanzania. 

"Young people aged 15-24 years make up one of the largest groups of new infections, among all new infections every year, approximately 30% are among people aged 15–24. That means for every 10 new infections, three are from this age group,'" said Mr. Simbawachane 

The launch of Education Plus in Tanzania will accelerate the ongoing country's adolescent education, health and wellbeing agenda.  Tanzania has been particularly affected by HIV. In 2021 around 1.7 million people were living with HIV; 74% of new HIV infections among young people aged between 15 and 24 were among young women, showing the disproportionate impact HIV is having on young women and girls.

Minister Simbachawene said the country would increase primary education opportunities for adolescents and enable them to stay in school by removing all barriers to completion of primary and secondary school education. Through the initiative, Tanzania will strengthen efforts to bring HIV education, reproductive health, and life skills to adolescents inside and outside of school.

The initiative comes at a time when Tanzania has made good progress in adopting global treaties and agreements to address gaps in education and health rights and increase opportunities for girls and boys. Most commitments have been translated into national policies and strategies, as demonstrated by the government’s commitment to offering free basic and secondary education. Tanzania has also adopted policy decisions to implement a re-entry program for children who drop out and to include comprehensive sexuality education into the curriculum. The country has also amended the HIV and AIDS Act to lower the age of consent for HIV testing and allow HIV self-testing.

The minister also pledged to do more to eliminate gender-based and sexual violence by providing youth-friendly education, skills building, and enhancing referrals by connecting youth to health and community services.

However, key gaps remain, with national surveys showing increased rates of teenage pregnancy, school dropouts, and high levels of gender-based violence. Around 27% of young women aged between 15 and 19 years already have a child or are pregnant and 50% of ever-married women aged between 15 and 49 report experiencing physical, sexual, or emotional violence.

The total number of students enrolled in secondary education is still below 50%, and for those in school, there is a high dropout rate, and some do not complete their schooling. The country has a low completion rate in secondary schools at 11.3%, and dropout in secondary schools due to pregnancy was reported at 4% in 2020.

Despite increased political will and significant achievements, women's and girls' vulnerabilities remain very high. Adolescent girls and young women in Tanzania continue to shoulder the burdens of domestic work, gender inequality in education, and harmful norms. Many are entrenched in cycles of poverty and extreme vulnerabilities.

At the launch, the government committed to strengthening policies to facilitate the provision of education and essential skills to prepare and equip young people for employment and other economic opportunities.  

The launch was attended by key partners including Dr Leonard Maboko, the Executive Director for Tanzania Commission for AIDS (TACAIDS) youth representative Pudensiana Mbwiliza; Permanent secretary office of the Prime Minister, Dr John Jingu and Hon Judith Nguli from Lindi Regional Commissioner’s office and Tanzania PEPFAR coordinator Jessica Greene;  representatives from  UNAIDS, UNESCO, International Labour Organisation (ILO), UNICEF and the World Health Organisation (WHO). 

The event brought together civil society organisations, young people’s networks, and representatives of people living with HIV and partners. Co-lead by five United Nations agencies working with governments, women’s and youth movements; the initiative is of even greater urgency as the COVID-19 pandemic has pushed millions of African girls out of school.

As part of the Education Plus initiative, young women advocates in Senegal have met with key female figures in the region to discuss the education of girls in sub-Saharan Africa and the challenges they face.

A social work student in her second year of professional training said young women like her who are living with HIV still face stigma and economic marginalization in most spheres of life “Sometimes, the medicines are not in stock, and young women living with HIV often have to share their medication with each other while waiting for a new supply.” According to her, education guarantees a better future for young people, as it did for her in helping her to overcome the challenges she faces because of her HIV status and her difficult upbringing.

Another participant, Maah Koudia Keita (known as Lady Maah Keita), a Senegalese woman with albinism, and a musician, said that women with albinism are victims of harassment and the majority of them have experienced rape and sexual violence.

She is one of three professional female bass players in Africa and the only one in Senegal. She said, “People like me who were lucky to get an education now have to do the work of dispelling myths around women with albinism that drive the violence.” According to Ms Keita, the more educated and aware the community is, the better women and people with albinism can defend themselves.

Adama Pouye, a feminist activist and member of the Senegalese feminist collective that led the Buul Ma Risu (Don’t Mess with Me) movement, spoke at length during the meeting about raising awareness on sexual assault on public transport.

“Every day, you hear violent words and women come to believe that’s what they deserve,” she said. “You are told how far you can go by standards put in place by a patriarchal society, by men, and by religious standards, but our religious interpretations cannot be about oppressing women,” Ms Pouye said.

Young women are key advocates who the Education Plus initiative is working with to rally political leadership, development partners and communities in order to fulfil every adolescent girl’s right to education and health by enabling all girls to complete a quality secondary education in a violence-free environment.

As UNAIDS Executive Director Winnie Byanyima stressed at the meeting, “In this region of western and central Africa, the vulnerability of girls is high.”

She also said that four out of 10 young women are married before the age of 18 years, saying that children becoming brides is a gross violation and a failure to harness the full potential of girls.

“Keeping girls in a classroom, if she stays and completes secondary school, has a protective effect for girls from HIV. What we fought and won for primary school is what is needed for secondary education,” Ms Byanyima said.

Fatou Nar Mbaye Diouf, the Deputy Executive Secretary of the National AIDS Council, Senegal, could not agree more. “We know that allowing girls to complete secondary education protects them from HIV and improves many other health and development factors,” she said.

Sharing key data from Senegal, Ms Nar said the level of comprehensive knowledge about HIV increases with the level of education. “Among young women, it is 10% among those with no education and 41% among those with secondary education or higher, while among young men knowledge of HIV varies from 9% among those with no education to 51% with education,” she said. “Education is key.”

The Regional Director for West and Central Africa for UN Women, Oulimata Sarr, concluded the intergenerational dialogue by saying that girls’ education is not a threat, nor should it be seen as that. “We want to move the needle and move it together with young women,” she said.

Ms Sarr wants the next generation to be supported as they seek more space in decision-making. “We need to pass the baton to young people, who organize differently from us, create an intergenerational legacy with young people holding us to account.”

GENEVA, 27 May 2022—UNAIDS welcomes the Chilean Government’s public acknowledgement of international responsibility in the emblematic case of violations of the rights of women living with HIV who were sterilized without their consent. The President of Chile, Gabriel Boric Font, has issued a public apology as part of a settlement resulting from a case brought before the Inter-American Commission on Human Rights against the Chilean state by Francisca, a Chilean woman living with HIV who was sterilized without her consent shortly after giving birth in 2002.

“We welcome the recognition of international accountability in this emblematic case of human rights violations that women living with HIV and their reproductive autonomy have long suffered,” said Luisa Cabal, Director of the UNAIDS Regional Support Team for Latin America and the Caribbean. “It vindicates a journey of more than 10 years, both for Francisca and the organizations that accompanied her, in her quest for justice.” 

When Francisca—a young woman from a rural town in Chile—turned 20 years old, she and her partner received the happy news of the arrival of their first child. She was diagnosed with HIV in a routine prenatal test. Francisca took all appropriate measures to minimize the risk of vertical transmission of HIV and gave birth to an HIV-negative baby boy in November 2002. However, the day after the caesarean section, Francisca received the devastating news that the surgeon on duty had decided to sterilize her during delivery and without her consent. 

In 2009, the Center for Reproductive Rights and the Chilean organization Vivo Positivo took Francisca’s case to the Inter-American Commission on Human Rights. This case was part of a documentation of stories of Chilean women living with HIV who were often pressured not to become pregnant, as well as to undergo surgical sterilization. One of the documented accounts tells of another woman, identified as Daniela, who, after giving birth, was told that she could not hug or kiss her newborn child because she would transmit HIV to her baby. She said in interviews that this was how she understood what discrimination was. 

After more than a decade of international litigation and after the Inter-American Commission on Human Rights studied the case, a friendly settlement agreement was signed with the Chilean state, in which the government accepted its responsibility and committed to redress the violations and to take measures to ensure that such acts would not happen again. 

UNAIDS intervened in this case with an amicus curiae (friend of the court) brief that informed the Inter-American Commission on Human Rights on the health guidelines and human rights standards that each country must follow to respect, protect and guarantee the human rights of people living with HIV. 

“I would like to start by apologising to Francisca, who I understand is on the other side of the camera, for the serious violation of your rights and also for the denial of justice and for all the time you had to wait for this,” Mr Boric said at the opening of his speech during the official ceremony, broadcast live on social media. “How many people like you do we not know? It hurts to think that the state, which today I have the honour to represent, is responsible for these cases. I pledge to you, and to those who today represent you here in person, that while we govern, we will give the best of each one of us as authorities so that something like this will never happen again and certainly so that in cases where these atrocities have already been committed, they will be properly redressed.” 

“I would love to have been me, with my voice, my face and my body, the one who after so many years of struggle stood present to lead this act in my own name. However, making my identity known would have closed endless doors for me,” said Carmen Martinez, the Associate Director of Legal Strategies for Latin America and the Caribbean for the Center for Reproductive Rights, as she read the words shared by Francisca to the audience. “To this day, people who carry HIV are still looked down upon with contempt as if it was our decision to become infected. However, I want to believe with conviction that this will change.” 

“Finally, justice was done; through this case we call on all governments to continue to invest in the elimination of HIV discrimination in all services, including health care,” said Sara Araya, the Coordinator of Live Positive Gender. “The message is clear: the autonomy and physical integrity of women and all people living with HIV must be secured without discrimination. No more rights violations against women living with HIV.”  

HIV-related stigma and discrimination has a significant impact on the health, lives and well-being of people living with or at risk of HIV. Stigma and discrimination hinders the HIV response by limiting access to broader sexual and reproductive health and other health services. UNAIDS continues to work daily to ensure that governments invest in preventing and responding to violations linked to the forms of intersectional discrimination to which people living with HIV have been subjected.

Francisca delivered a healthy baby boy in 2002 and was then sterilized without her consent by the doctor who carried out her caesarean section, making the decision that a woman living with HIV should not be able to have children. The friendly agreement announced this week comes after more than a decade’s litigation by the woman and her legal teams.

“This settlement is a significant moment for women around the world who have been fighting for reproductive justice for decades. Coercive sterilization of women living with HIV is a violation of women’s most fundamental human rights,” said the Executive Director of UNAIDS, Winnie Byanyima. “Unfortunately, this practice is still happening in many countries and efforts to stop it and bring justice to more women must be stepped up.”

This settlement comes after years of efforts before the Inter-American Commission on Human Rights after an earlier complaint in the Chilean justice system was unsuccessful. The case was litigated by the Chilean organization Vivo Positivo and the international human rights organization Center for Reproductive Rights.

The Global AIDS Strategy 2021–2026: End Inequalities, End AIDS is based on the promotion of human rights, gender equality and dignity, free from stigma and discrimination for all people living with and affected by HIV. It is a commitment by UNAIDS to an ambitious vision to end gender inequalities and realize human rights, including the right to health, calling on all partners and stakeholders in the HIV response in all countries to transform unequal gender norms and end stigma and discrimination.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Gender inequality and discrimination robs women and girls of their fundamental human rights, including the right to education, health and economic opportunities. The resulting disempowerment also denies women and girls sexual autonomy, decision-making power, dignity and safety.

These impacts are most pronounced in sub-Saharan Africa, where adolescent girls and young women (aged 15 to 24 years) accounted for 25% of HIV infections in 2020, despite representing just 10% of the population.

8 March 2022

Winnie Byanyima

Executive Director of UNAIDS

Under-Secretary-General of the United Nations

Congratulations on International Women’s Day to all whose determination and solidarity is the light of hope and the power for change.

Women are not waiting to be offered a seat at the table, they are bringing their own fold-up chair.

This year’s theme calls for “Gender equality today for a sustainable tomorrow”. As the women’s movements have brought to the fore, and as all the evidence demonstrates, every development goal depends on ensuring the rights of all women and girls.

Gender inequality is a threat to everyone. We cannot uphold patriarchy and defeat AIDS.

The COVID-19 crisis has exacerbated the intersecting inequalities women face. Surges have been reported in gender-based violence, forced child marriages and teenage pregnancies. Almost one in two women reported that they or a woman they know experienced violence since the COVID-19 pandemic started. Calls to helplines have increased fivefold in some countries during the pandemic. Violence against and harassment of lesbian, gay, bisexual, transgender and intersex people has increased, as has stigma and discrimination against marginalized communities. The trajectory to gender parity, which already had been 100 years away, is now 36 more years away.

The goal cannot only be to get back to normal, however: normal was the problem. Instead, leaders need to seize this moment of crisis and opportunity to secure transformation. They need to deliver now on the bold policy shifts and upscaled investments that will ensure equality.

We must end gender-based violence. Violence violates the dignity and freedom of women. Violence drives the AIDS pandemic. In areas of high HIV burden, women subjected to intimate partner violence face up to a 50% higher chance of acquiring HIV.

We must remove all barriers to access to sexual and reproductive health and rights. Only 55% of women and adolescent girls report being in control of decisions about their own sexual and reproductive health and rights. Maternal mortality is the leading cause of death for adolescent girls aged 15–19 years globally, and HIV is the third leading cause of death among women aged 15–49 years—both preventable when women control their own bodies.

We must ensure that every girl is educated and empowered. Research shows that completion of secondary education can reduce a girl’s risk of acquiring HIV by up to half, and by even more if this is complemented by a package of rights and services. We need all girls,  including those who dropped out during the COVID-19 pandemic and those who were out of school even before COVID-19, in school, safe and strong.

As countries struggle with the current fiscal challenges, services vital for gender equality are among sectors that are suffering the biggest budget cuts. If we do not find the money, we will all pay a much higher price as a consequence.

The only effective route map to ending AIDS, achieving the Sustainable Development Goals and ensuring health, rights and shared prosperity, is a feminist route map. Equality is the means of progress and is the right of every woman.

Women, in all your wonderful diversity, we the United Nations are on your side, and by your side. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The ARTiSHOCK Theatre in Almaty, Kazakhstan, recently premiered an extraordinary performance: all its actresses were women living with HIV, ex-prisoners and women who use drugs. They played the role of women who faced stigma, discrimination and violence, an echo of their own life stories.

The performance, the script for which was written by female activists, was the idea of the Revanche Center for Comprehensive Care (also known as the Revanche Foundation), supported by the UNAIDS Country Office for Kazakhstan and the Eurasian Network of Women Living with HIV.

“The idea of ​​a social theatre was a dream that has finally become a reality,” said Anna Kozlova, a social worker for the Revanche Foundation. “We decided to talk about the experience of violence. After all, it is not only physical or sexual. To be rejected by society and discriminated against is also violence, but psychological.”

Nadezhda Plyaskina, the play’s director, said that it was not easy to work with the aspiring actresses. “I was afraid: these women have such considerable life experience; what can I teach them? In addition, it was necessary to teach acting in a way that did not hurt: they are all vulnerable. Each rehearsal revealed them to me as real, amazing, wonderful people. I told them: “Play with your heart.””

And they played with their hearts, telling their stories of imprisonment, abuse, stigma, loneliness and hope. The performance was a great success and was widely covered by Kazakh media.

Ms Kozlova began using drugs when she was 17 years old, which landed her in prison for 17 years. “All women who come out of prison are already victims. They are broken, vulnerable, don’t know how to live, where to go. They need help to become strong.” Four years ago, she went to the Revanche Foundation for help, and there she found a job, a family and a purpose. “I know from my experience that things can change,” she said.

Zulfiya Saparova has been living with HIV for 15 years; she is on antiretroviral therapy and works as a peer consultant for Equal to Equal Plus. She faced abused and violence and tells her story from the stage. “My heroine in the performance comes on stage holding a frying pan. This story is imprinted in my memory: my neighbour constantly walked around with black eyes. She was beaten by a drunken husband. Once her daughter came to visit her, and a black eye appeared on the husband’s face—she had protected her mother by beating him with a frying pan.”

Natalya Kovaleva, a social worker for the Revanche Foundation, spent eight years in prison. Her last term was three years and compulsory treatment for drug addiction. Currently, she works with young people who use drugs on HIV prevention. “If it wasn’t for the Revanche Foundation, I would either be behind bars or dead,” she said. “I have a mission here.”

The heroine she plays faces physical and psychological violence, total control, prohibitions and beatings. “I don't want to arouse pity, so I played a strong, independent woman who refuses to endure bullying. All this was in my own life,” said Ms Kovaleva.

The Revanche Foundation helps women in difficult situations, including women living with HIV, women who use drugs, children who lived in orphanages and former prisoners.

Elena Bilokon, the director of the Revanche Foundation, says that her work is focused on the most vulnerable and socially unprotected women, as there are no state support programmes for them. “Yes, the state provides patients with HIV drugs, but there is no psychosocial and social support. This year alone, 285 women living with HIV applied for our help,” she added.

“There is a clear link between violence against women and HIV. Studies show that women living with HIV are more likely to have experienced violence, and women who have experienced violence are more likely to be living with HIV,” said Gabriela Ionescu, the UNAIDS Country Director for Kazakhstan. “For this reason, UNAIDS highlights the need to address violence against women as a key human rights issue and the need to provide support to the most vulnerable women, including social and psychological help.”

The next performance will take place on 1 March, Zero Discrimination Day. The activists also plan to perform the play in several prisons in Kazakhstan. 

The UNAIDS Joint Programme and partners agree that a new initiative is needed to accelerate and support action at the global, regional, country and community levels to urgently end AIDS among children, adolescents and mothers. To meet the needs of all stakeholders and ensure the engagement of all partners, we are undertaking a global consultation survey to gather ideas and opinions on what the priorities should be for ending AIDS among children, adolescents and mothers.

Eliminating vertical (mother-to-child) transmission of HIV and ending AIDS among children are among the global priorities highlighted in the new Global AIDS Strategy 2021–2026: End Inequalities, End AIDS.

In 2020, there were 1.7 million children living with HIV globally, almost half (46%) of whom were not on life-saving HIV treatment. In the same year, there were 150 000 new HIV infections among children. Most of these new child infections could have been prevented if adolescent girls and women had universal access to HIV testing, prevention and treatment services and the support they need to stay in prevention care or on HIV treatment throughout pregnancy and breastfeeding.

Over the past decade the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive, followed by the Start Free, Stay Free, AIDS Free 2016–2020 framework, helped to coordinate, accelerate, support and monitor the global response to HIV among children, adolescents and mothers. Significant progress was made from 2010 to 2020, with coverage of HIV treatment to prevent vertical transmission for pregnant women living with HIV increasing from 45% in 2010 to 85% in 2020 and with a 53% reduction in new child HIV infections over the same period. However, this progress was not enough to reach any of the global targets set for the end of 2020.

New targets have been set for ending AIDS among children, adolescents and mothers in the Global AIDS Strategy 2021–2026. Urgent and coordinated action is needed, from the global to the community levels, to reach these ambitious new targets, and we need your input on how best to accelerate action, especially at the community and country levels.

Please complete the online survey, which is available in English, French, Russian and Spanish, by 20 December.

• Consultation for English speakers - https://bit.ly/3DMkjJ2
• Consultation for French speakers - https://bit.ly/30MT7f7
• Consultation for Spanish speakers - https://bit.ly/3rBc27F
• Consultation for Russian speakers - https://bit.ly/3G13wm2