Criminalization of HIV transmission, exposure or non disclosure • Elimination of HIV-related restrictions on entry, stay and residence • Sexual and reproductive health and rights • Eradicating stigma and discrimination: • Healthcare settings • Workplace • Community • Faith settings
Criminalization of HIV transmission, exposure or non disclosure What are the main issues Lack of evidence to prove that HIV criminalization reduces transmission Different treatment of HIV is stigmatism i.e. Why are others STIs and TB, influenza, chickenpox not criminalized? The responsibility is solely on the HIV-positive person. Failure of counselling/education to support HIV-positive in preventing infection Lack of education/ ignorance about actual transmission risks Choice/shared responsibility When it is appropriate to prosecute if a person does not disclose HIV status? HCWs in some settings are encouraging people to press charges
Criminalization of HIV transmission, exposure or non disclosure What are the main issues Risk of pushing people further underground and away from services, including key populations Effect of TasP? Will this open a new window for criminalization i.e. if decide not to go on treatment Lack of legal literacy: Important to understand what the law is. Need to ensure criminal justice systems understand HIV. Need to educate PLHIV of their rights and responsibilities.
Criminalization of HIV transmission, exposure or non disclosure What are our main advocacy asks? • Reform, review, repeal of punitive HIV related laws • Protection of key populations, including women and young people • Rights for sex workers, LGBT and drug use (and drugs) - decriminalise these behaviours. • Legal literacy • Mandatory education for policy makers by people with HIV. • Mediation for those who feel wronged. • Funding to allow people to explore and discuss these issues to avoid the tit for tat blame culture. • Questions of love, abandon, loss versus psychosocial support • World leaders to denounce criminalization at G20.
Elimination of HIV-related restrictions on entry, stay and residence What are the main issues • 46 countries, territories, and areas impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status • 20 countries, territories and areas that deport individuals once their HIV-positive status is discovered. • Testing for visa requirements is undertaken without counselling and is forced. • Illegal aliens have no or limited access to HIV prevention (condoms, testing and counselling), treatment and care, SRH services • Longer lasting repercussions (even after laws have changed USA: people who were honest prior to change of immigration law are branded as criminals with “212” notification. Travel restriction have lasting repercussions even after change
Elimination of HIV-related restrictions on entry, stay and residence What are our main advocacy asks? • Campaign for country travel law changes globally • Travel knowledge-based legal reform to be more inclusive i.e. entry and stay • The first priority should be saving peoples lives i.e. deportation cases • Base advocacy on other chronic conditions that incur no restrictions (e.g. cancer, diabetes, high blood pressure)
Sexual and reproductive health and rights What are the main issues PLHIV have a right to a sex life, though a lack of knowledge what our rights are Guilt, shame, self-esteem and how PLHIV feel about sex Serodiscordant couples/relationships in many countries do not get support and are often frowned upon. How does TAsP change the way we talk /address SRHR for PLHIV?- and serodiscordant couples Prevention strategies that don't work (ABC). The inclusion of RH for gay men/MSM in PHDP strategies. treatment optimism and the option of having children Involving the unsuppressed (those not on ARV) in the discussion of SRHR How do we transform faith based response to accept and support SRHR for PLHIV and sexuality, sexual orientation?
Sexual and reproductive health and rights What are our main advocacy asks? • Advocacy for sexuality education • Address and speak out against homophobia and attitudes towards sex workers in PLHIV networks • Rights/literacy for PLHIV and networks e.g. Stepping stones plus or She to she. • Training of health care providers, parliamentarians • Partnerships and Dialogue: faith based/religious leaders an IDLO-Rome based organization • Integrated services and funding i.e. advocating for funding for family planning. • Write, repeal or advocate for laws that protect the SRHR of PLHIV and key populations • Engage in regional policy harmonization
Eradicating stigma and discrimination in healthcare settings What are the main issues Reduced standard of care provided to PLHIV and key populations In some resource limited settings, HIV-negative people prioritized over PLHIV Inadequately trained HCW in terms of HIV- or key population-related (e.g. pain management in PUD, MSM and anal cancers) technical knowledge and attitudes Health-insurance-related issues
Eradicating stigma and discrimination in healthcare settings What are our main advocacy asks? • PLHIV have the right to the best care- no less than anyone else • Choice of care- PLHIV decide on their own what/if treatment to take. • Youth friendly services to encourage health-conscious behaviour among YPLHIV • Resources for capacity building of and action-based advocacy by PLHIV • National networks target ALL PLHIV populations • Hold HCW accountable for sensitivity to gender/age/status and confidentiality • Global standards of minimum standards of care that governments are obligated to provide. • Collaborate with non HIV-specific entities deal with SRHR. • Anti-discrimination laws where these do not exist • Ensure government funds (where available) are allocated appropriately. • In settings with private health insurance, coverage for SRHR services.
Eradicating stigma and discrimination in the workplace What is the main issue for you? Ignorance and fear around HIV – need for education (especially of management) Need for supportive work places (non-judgmental) and policies Poor management – implementation (putting policy into action) Government level commitment Updating regional and governmental guidelines
Eradicating stigma and discrimination in the workplace What are our main advocacy asks? • Support services in relation to disclosure of HIV-positive status • PLHIV Champions as role models • Confront stigma in the work place by proactively educating those around you • Collaborate with other social justice issues • Dialogue for implementing guidelines, policy and legislation • Monitor effectiveness of public policy • Educate law makers on new science and medicine • Reach out to media
Eradicating stigma and discrimination in the community What are the main issues Voice of community is not loud as community is not united Increasing serosorting and numbers of PLHIV following/seeking love How to lead a happy, productive life if our sexuality is threatened by HIV. Discrimination associated with belonging to a key population Difficulties in access to services because of stigma and internal stigma towards lifestyle and other specialities In what contexts is it correct to reveal your HIV status? Barriers in integrating services: complex approach to provide effective and cost effective services
Eradicating stigma and discrimination in the community What are our main advocacy asks? • Express openly that we are living with HIV-not condition; not disease • We have a right to have a full life (work life/religious life/family life/single life/sexual life/ etc)-celebrate it • What is your problem?-open the dialogue • Reach out to PLHIV who are in hiding and say it is ok • We are citizens and have rights-we also have responsibilities • Community leaders, who have to take responsibility for adhering to human rights principles
Eradicating stigma and discrimination in faith settings What are the main issues PLHIV made invisible within congregations Lack of knowledge about HIV Hierarchical structure of some religious communities Gender – Male domination/chauvinism Barriers of talking about HIV and sexuality because of moralising: Linking of HIV to sin Trans-phobia – lack of understanding Judgemental attitudes Even broad-minded faith settings still give mixed messages, support mixed with messages about sinfulness Linking culture with religion Use of religion as a weapon; as a justification even for violence
Eradicating stigma and discrimination in faith settings What are our main advocacy asks? • Address myths about HIV • HIV is a social justice issues • Partnership between PLHIV networks and religious associations • Dialogue/connections between faith communities and public health, doctors • Faith leaders to understand their role – i.e. are not doctors • Training: • Mainstreaming information about HIV in theological curriculum • Continuous training of religious leaders • Need peer (clergy-to-clergy) training/dialogue • Consider authority and influence of religious leaders, particularly positive religious leaders