Mandatory HIV testing used to bar potential immigrants

Last year Canada turned away 75 people with HIV/AIDS because the federal government said that they would place excessive demands on publically funded services. Another 207 people with HIV/AIDS were allowed to enter Canada, mainly because of exemptions to the excessive-demand provisions. HIV/AIDS organizations have objected to the government's policy of mandatory HIV-antibody testing of potential immigrants and have expressed concerns about the way in which excessive demand is calculated.     

A human rights critique of the United Kingdom's HIV response

The National AIDS Trust (NAT) is the United Kingdom's leading HIV policy and advocacy NGO. NAT is committed to promoting a human rights framework for HIV responses through work with communities, governments, professionals, and the private sector, both within the UK and internationally. In this presentation to the XIII International AIDS Conference (abstract WeOrE524), John Godwin and Saul Walker discuss current human rights issues related to HIV/AIDS in the UK, and NAT's perspective on the International Guidelines on HIV/AIDS and Human Rights as an advocacy tool.     

Parliamentarians take the initiative on HIV/AIDS

In 1999 UNAIDS and the Inter-Parliamentary Union jointly published the Handbook for Legislators on HIV/AIDS, Law and Human Rights. This section describes initiatives taken by parliamentarians to promote legal and policy responses to the HIV/AIDS epidemic which respect human rights.     

艾滋病立法与国际人权保障

国际社会已经达成共识,认为有效地控制艾滋病与人权保障之间存在着密切关系,而法律则是实现防治艾滋病的一个重要手段。因此,现实和未来都要求各国通过以保障人权为核心的相关立法,充分保护艾滋病病人和艾滋病病毒感染者的各项基本权利,切实调动社会各方面的积极因素来战胜艾滋病,最终维护人类的共同利益,实现社会的可持续发展。对此,在国际人权法的框架下,结合艾滋病的流行特点,国际社会和许多国家近年来制订了不少准则和法律,以阻止艾滋病的进一步传播。     

Criminal law and HIV/AIDS: strategic considerations

Richard Elliott's paper on criminal law and HIV/AIDS, an edited and updated version of his presentation at "Putting Third First," sets out five guiding principles for criminal law policy and HIV/AIDS; briefly outlines the rationales for criminalization; discusses three strategic legal questions regarding the criminalization of HIV transmission/exposure; and offers a number of recommendations for consideration of those needing to articulate a well-considered perspective on the ethical, legal, human rights, and public health dimensions of the criminalization of HIV transmission/exposure.     

Barcelona 2002: law, ethics, and human rights. Advancing research and access to HIV vaccines: a framework for action

In light of the continuing spread of HIV infection and the devastating impact of the disease on lives, communities, and economies, particularly in the developing world, the investment in new treatments, vaccines, and microbicides has clearly been inadequate. Efforts must be intensified to develop effective HIV vaccines and to ensure that they are accessible to people in all parts of the world. This article is a summary of a paper by Sam Avrett presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India. In the article, Avrett calls for immediate action to increase commitment and funding for HIV vaccines, enhance public support and involvement, accelerate vaccine development, and plan for the eventual delivery of the vaccines. The article briefly outlines steps that governments need to take to implement each of these objectives. The article also provides a menu of potential actions for vaccine advocates to consider as they lobby governments.     

Putting third first: critical legal issues and HIV/AIDS

On 7 July 2000, before the XIII International AIDS Conference, the Canadian HIV/AIDS Legal Network and the AIDS Law Project, South Africa held a one-day satellite meeting on legal, ethical, and human rights issues in Durban, South Africa. Entitled Putting Third First--Critical Legal Issues and HIV/AIDS, the satellite focused on legal strategies to advance the human rights of those most vulnerable to HIV/AIDS and to discrimination: people in the developing world, and people who, although they live in the industrialized world, suffer from poverty and marginalization and are at high risk of contracting HIV. The satellite grew out of the ongoing partnership between the Canadian HIV/AIDS Legal Network and the AIDS Law Project, South Africa, and was co-hosted by UNAIDS.     

Québec: an outbreak of HIV/AIDS-related stigma and discrimination

In the space of a few weeks in January 2004, actions by three different institutions in Québec combined to threaten the human rights of people living with HIV/AIDS, raise the spectre of mandatory HIV testing, and create unnecessary public fears about the spread of HIV infection. In response to what they called "the worst weeks in recent history for people living with HIV/AIDS in Québec," the Canadian HIV/AIDS Legal Network and COCQ-Sida (the Québec coalition of community-based organizations fighting AIDS) called for a province-wide campaign against HIV/AIDS-related stigma and discrimination. A victory was achieved when a Montréal catholic seminary announced that it had backed down from its initial proposal to mandatorily test all applicants for priesthood for HIV, but much more is needed to fight the rapid outbreak of mandatory-testing proposals.     

Global access to treatment: achievements and challenges

As mentioned in the previous issue, this section of the Review addresses issues related to improving access to adequate and affordable care, treatment, and support everywhere. It replaces the section previously called "Patents and Prices." In this issue, we feature a review of achievements and challenges in recent years in opening global access to HIV/AIDS treatments. The article - one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network, discussing past developments and future directions in areas of policy and law related to HIV/AIDS - describes the developments that recast the debate about access to treatment from one focused on patent entitlements to one focused on the right to health and treatment. It analyzes the role of national and international activism, strategically constructed alliances, and principled leadership in achieving this change. And it discusses continuing obstacles to equitable access to HIV/AIDS treatments for the world's population.     

African ILO meeting endorses efforts by employers' and workers' organizations to fight HIV/AIDS

In December 2003, the Tenth African International Labour Organization (ILO) Regional Meeting in Addis Ababa, Ethiopia adopted a resolution on HIV/AIDS calling on African governments to support the efforts of employers and workers to combat HIV/AIDS--by providing an enabling legal and policy framework for workplace action, by providing measures to oppose stigma and discrimination, and by strengthening national AIDS plans through the inclusion of a strategy for the world of work. The resolution also called on workers' and employers' organizations to increase their joint efforts to reduce the spread and impact of HIV/AIDS. Finally, the resolution called on the ILO to give greater priority to its efforts to combat the pandemic in Africa.     

Drug policy in Canada--the way forward

This article is one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network, discussing past developments and future directions in areas of policy and law related to HIV/AIDS. It takes a critical look at Canada's drug policy. Despite calls for a balanced approach focused on reducing drug-related harm, Canada's method of dealing with problems of illicit drug use has remained prohibitionist in nature, and by far the greatest part of federal funding is devoted to supply-reduction initiatives. Considerable changes in policy and law are needed to significantly reduce the harms associated with injection drug use in Canada. These include developing a comprehensive and integrated strategy, exploring alternative legal frameworks, piloting innovative approaches to reducing injection-related harms, and investing in broad social policies that address the determinants of injection drug use.     

HIV/AIDS and human rights revisited

In their article, Sofia Gruskin and Daniel Tarantola demonstrate how, as the number of people living with HIV and with AIDS continues to grow in nations with different economies, social structures, and legal systems, HIV/AIDS-related human rights issues are not only becoming more apparent, but also increasingly diverse. In the 1980s, the relationship of HIV/AIDS to human rights was only understood as it involved people with HIV or AIDS and the discrimination to which they were subjected. The concerns included mandatory HIV testing; restrictions on international travel; barriers to employment and housing, access to education, medical care, or health insurance; and the many issues raised by named reporting, partner notification, and confidentiality. Almost 20 years into the epidemic, these issues remain serious and most often have not been resolved. In the 1990s, however, there was increased understanding of the importance of human rights as a factor in determining people's vulnerability to HIV infection and their consequent risk of acquiring HIV infection and their chances of accessing appropriate care and support. And most recently, human rights have also come to be understood to be directly relevant to every element of the risk/vulnerability paradigm. Gruskin and Tarantola identify three situations and three levels of governmental obligations that should be considered when identifying the specific needs and related rights of individuals in the context of HIV/AIDS. They conclude that policymakers, program managers, and service providers must become more comfortable using human rights norms and standards to guide and limit government action in all matters affecting the response to HIV/AIDS; and that those involved in HIV/AIDS advocacy must become more familiar with the practicalities of using international human rights law when they strive to hold governments accountable.     

Hungary: a fight every step of the way for voluntary, anonymous, and free tests

Voluntary, anonymous, and free HIV tests must be addressed in developing any effective policy in the fight against HIV/AIDS. There are heated discussions about the first two criteria, particularly anonymous testing, but free testing can also become contentious, as the following story shows.     

HIV-related stigma and discrimination--the epidemic continues

This article is one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network, discussing past developments and future directions in areas of policy and law related to HIV/AIDS. It looks at HIV-related stigma and discrimination. The article summarizes the present situation as described in reports from numerous countries throughout the world. It reviews the institutional, non-institutional, and structural dimensions of HIV-related discrimination. It also identifies some essential components of anti-discrimination efforts: legal protection; public, workplace, and health-care programs; community mobilization; and strategizing on the determinants of health.     

Nova Scotia renews its HIV/AIDS strategy

On 1 December 2003, after a five-year process of consultation and planning, Nova Scotia embarked on a new HIV/AIDS strategy. It replaces the first strategy, launched a decade earlier. The renewed strategy is meant to promote collaborative action on the determinants of vulnerability to HIV infection and on the capacity of people living with HIV/AIDS to achieve optimal health and quality of life.     

HIV vaccines: current challenges and future directions

Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vaccines in the context of efforts to increase global access to public health measures and technologies.     

Warsaw Declaration on HIV/AIDS and injection drug use adopted

Explosive epidemics of HIV among injection drug users are occurring in both developing and developed countries. Globally, it is estimated that 10 percent of HIV infections are attributable to injection drug use, but this proportion is increasing, and is much higher in many countries. Effective interventions exist to prevent the spread of HIV among injection drug users, but in most countries they are being adopted too slowly, or not at all. On 14 November 2003, the Warsaw Declaration: A Framework for Effective Action on HIV/ADS and Injection Drug Use, was adopted at the 2nd International Policy Dialogue on HIV/AIDS. Its purpose is to provide a framework for--finally--"mounting an effective response that will slow and eventually stop the HIV/AIDS epidemic among injecting drug users worldwide."     

Rural HIV: Brief interventions for felony probationers

HIV/AIDS in Southern rural America has been described as an epidemic. Furthermore, the HIV prevalence rate among criminal justice populations is higher than the general population in both rural and urban areas. One segment of the criminal justice population, felony probationers, has not been targeted for HIV/AIDS interventions and little is known about rural HIV risk behaviors. Probation is an appropriate setting for examining HIV interventions because rural participants can be easily identified and contacted. Thus, the purpose of this paper is to describe an HIV intervention for Southern rural probationers and to profile participants (N=800) on their demographics and risk behaviors by degree of criminality. Results suggest that HIV interventions are needed to target rural probationers, especially those with extensive arrest histories since they engage in high-risk behaviors, including illicit substance use and unprotected sex. This project is supported by grant #R01DA11580 from the National Institute on Drug Abuse. The opinions expressed are those of the authors.     

Update to international guidelines on HIV/AIDS and human rights

On 10 September 2002, the Office of the UN High Commissioner for Human Rights (OHCHR) and the Joint UN Programme on HIV/AIDS (UNAIDS) released a revised international guideline on "Access to prevention, treatment, care and support." The update to Guideline 6 of HIV/AIDS and Human Rights: International Guidelines reflects significant therapeutic, political, and legal developments in this area since the 12 guidelines were originally published in 1998. The new Guideline 6 significantly expands the guidance given to governments on what international human rights norms require of them in relation to HIV/AIDS prevention, treatment, care and support.     

The effect of respondents' just world beliefs and target person's social worth and awareness-of-risk on perceptions of a person with AIDS

The present research examined how individuals' just world beliefs affected their perceptions of a person with AIDS who was depicted as having contracted the HIV virus while either aware or unaware of health risks, and who was defined as either high or low in general social deservingness or worth. Dependent variables included respondents' affective reactions to the person with AIDS, their willingness to allocate resources to him, and their perception of the fairness or the unfairness both of his general plight and that various types of resources be given to him. Results indicated that those who were higher in just world beliefs were more emotionally negative to the other with AIDS, they were less willing to contribute resources to him, and they felt that it was less fair that such resource transfers be required. Similar response patterns were found when the other with AIDS was described as lower in social worth and when he was depicted as having contracted AIDS with full awareness of health risks. Implications of the findings were discussed in terms of how psychological theories of justice might inform health care policy.