Abstract presentation at the XIX International AIDS Conference, 26 July 2012, by Sara Simon. This presents a sampling of the NGO Delegation's 2011 NGO Report findings and focused on the response from UNAIDS and its Member States when the Delegation requested controversial action items from the UNAIDS Board. View more at http://unaidspcbngo.org/?page_id=15047.

1. Voices from the field
HOW LAWS AND POLICIES AFFECT
HIV RESPONSES
SARA SIMON
26 July 2012
Legal Barriers, Legal Access
IAS, Washington, DC

2. I. Global report: Context and methodology
Experience of civil society with legal issues and HIV
responses
27 focus groups from all regions
248 persons from affected and at risk communities
Qualitative discussions around 10 key questions:
 knowledge and experience with the legal environment;
 personal experiences in the use and enforcement of laws;
 and coping mechanisms

3. Global consultation respondents

4. Global consultation respondents
Latin America &
Africa Asia & the Pacific Europe North America MENA Total
Caribbean
HIV Status
Negative 16 19 3 22 23 9 92
Positive 11 10 11 19 66 10 127
Don’t know 8 2 2 4 16
No data 5 8 13
Self-Identification[1]
Gay men/men who have sex
15 6 10 19 13 63
with men
Lesbian/women who have sex
3 1 2 3 1 10
with women
Sex workers 3 7 1 5 3 4 23
People who use drugs 22 7 5 14 48
People with disabilities 1 2 22 25
Young people 2 4 1 7 14
Migrants/ Refugees 3 3 4 1 11
Displaced persons 2 2
People with histories of
1 1 3 5 3 13
incarceration
Self-indicated persons living
with HIV
Men 5 9 5 9 19 6 54
Women 5 6 10 42 4 67
Transgender
1 1 7 9
females
Other[2] 3 1 7 2 13
[1] Individuals could associate with more than one population.
[2] People self-identified beyond choices, for example as bisexual, grandparent, or senior.

5. Findings: 1. HIV-related stigma creates an
environment for punitive laws
• Misinformation in the general
population fuels stigma and fear
• Legal systems are not well-
versed in HIV
• Media often exacerbates stigma;
reports often violate privacy and
impartiality
• Insensitive or unprofessional
treatment by health care
providers discourages access

6. Findings: 2. Punitive laws and polices undermine
HIV responses
• Many not accessing HIV-related services due to fear and stigma,
especially respondents whose behavior has been criminalized
• Repressive laws toward women and girls limit access to HIV services
• Criminalization of HIV non-disclosure, perceived exposure or
transmission discourages testing
• Criminalization of sex work increases vulnerability to violence and
inhibits access to health care
• Criminalization of drug use and the lack of availability of harm reduction
methods is impacting ability to access HIV-related services
• Undocumented workers and immigrants are afraid to seek health care

7. Findings: 3. Legal protections are insufficient;
experience of law enforcement is negative
• Anti-discrimination laws are
being undermined by HIV-
related stigma
• Workplace discrimination
and mandatory testing
continue
• Experiences with law
enforcement were negative
• Incarceration can lead to
treatment disruption and
inhumane conditions

8. Findings: 4. Individuals do not know their rights
• Legal aid is important and helpful but not widely
available. Legal information not always clear, leaving
service providers unclear as to how to interpret laws to
their clients.
• Cooperation between AIDS service organizations and
legal aid needs to be increased.

9. II. Focus on North America:
Consultation respondents

10. North America: Consultation respondents

11. North America: Key findings
Need to increase the availability of: insurance
coverage, housing and mental health services
Legal aid services have helped and need to be more
widepsread
Lack of protective laws specific to immigrants, MSM,
transgender persons, sex workers and people who
use drugs is limiting access to HIV-related services

12. Recommendations
1. Support anti-stigma and HIV education campaigns to
increase and enforce protective laws.
2. Oppose and repeal laws that criminalize HIV non-
disclosure, exposure or transmission, homosexuality,
gender identity/expression, abortion, sex work and drug
use.
3. Foster protective laws and knowledge of protective laws
and human rights within the justice system.
4. Support and promote programs to know your rights/laws
and access justice.

13. Reaction to the report
Difficulty in discussing key issues and bringing
recommendations to the UNAIDS board
Not all governments willing or able to recognize
human rights issues or key populations
Inability to hold substantive discussions on follow up
or gain state commitments
Is this a board level issue?

14. III. Next steps
Advocacy by and with communities at global and
national levels based on these and other findings;
avoiding tokenistic representation
Continued work at country levels to address stigma
and discrimination, especially with government
leaders
More quantitative prevention research on how HIV
criminal laws affect HIV testing rates
Research in NA as to how laws, including health
insurance reform, are affecting health care outcomes

15. Thank you!
 All participants in the surveys and focus groups that led to this information
 Focus group facilitators: Kwaku Adomako, Tariq Alaoui, Akram Algawi, Marcela Alsina, Abdul Hafed
Alward, Rola Baraket, Calum Bennachie, Catalina Castillo, Catherine Healy, Ian Mcknight, Karla
Montalvo, Dasha Ocheret, Shiba Phurailatpam, Abdul Rahim Rejaey, Peter Richtig, Eunice Sinyemu,
Mohan Sundararaj, Irina Teplinskaya, Olivier Vandecasteele, and Younes Yatine
 Advisory Group and especially Edwin Bernard, Michaela Clayton, Laurel Sprague, Nina Sun, and
Susan Timberlake.
 UNAIDS Human Rights Reference Group, especially Ralf Jürgens
 Video clip: Hungarian Civil Liberties Union and Istvan Gábor Takács
 NGO Delegation 2011: George Ayala, Mabel Bianco, Jane Bruning, Amira Herdoiza, Felicita Hikuam,
Ebony Johnson, Nadia Rafif, Rathi Ramanathan, Rhon Reynolds, Matthew Southwell
 NGO Delegation 2012: George Ayala, Mabel Bianco, Jane Bruning, Ebony Johnson, Laura
Kirkegaard, Joel Nana, Ed Ngoksin, Alessandra Nilo, Nadia Rafif, Matthew Southwell
 Amy Coulterman of the Communications Facility for support in data review and layout
 Translators: António Guarita, Oswaldo Rada, Jodat Turataliev, Heba Wanis and the Dongjen Center
for Human Rights Education and Action in Beijing
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