Criminalization

Officially, she calls herself Juliana, but she also goes by the name Anna Morena and has an organization of the same name—the Anna Foundation Uganda.

The small, youth-led organization promotes sexual and reproductive health and rights, HIV prevention, advocacy, research, entrepreneurship and fundraising for the transgender community in central Uganda.

As a response to the malnutrition experienced by transgender people because of the COVID-19 outbreak, the foundation has raised US$ 1600 from a private donor to support transgender people and their dependents with food relief, which has reached more than 200 people.

Members of the foundation volunteer their time to conduct referrals for mental health and supply medical services, including deliveries of treatment and hormone therapy to transgender people who cannot currently access facilities due to the COVID-19 pandemic.

Ms Morena named herself and the foundation in memory of a friend who moved to Kampala, the capital of Uganda, at the age of 16 years. She was working as a sex worker to survive, met a man in a nightclub one night and was found dead the next day.

“I thought that maybe I could be “Anna” too, because she had a dream—to live as a normal person,” said Ms Morena wistfully.

Ms Morena doesn’t like labels, but she refers to herself as a “trans girl” because she wants people to know that she’s “not just a sex worker.”

She is open about being a sex worker so she can encourage others to come out and speak about it. She also volunteers to educate people about being transgender, which she does “out of love.” The sex work is to put food on the table.

“Most of the trans women I know are doing sex work. They are usually between the ages of 16 and 25 years, a time when hormones are high and one’s understanding of sexuality and gender identity is still developing,” she said.

Globally, transgender people are 12 times more likely to become infected with HIV than the general population. Nineteen countries worldwide, including Uganda, prosecute and/or criminalize transgender people.

In their daily lives, transgender people experience exclusion from family and society, barriers to employment and extreme forms of sexual, physical, emotional and psychological violence. According to Ms Morena, the COVID-19 pandemic is making things worse.

“COVID-19 has led to an increase in gender-based violence and a scarcity in commodities such as condoms and lubricants. Most sex workers are still doing sex work so that they can survive and we are seeing a rise in infections,” said Ms Morena.

She said prices for essentials such as mobile phone data have risen, making it harder for community-based transgender organizations to stay connected to their members.

In the absence of funding for vocational training, the only choice for transgender people who want to make a difference is to volunteer, said Ms Morena, because there is limited donor funding for transgender organizations. “Donors are very specific about what they will support, meaning there is a lot of competition for funding,” she said.

In addition, there is limited data on transgender people in the eastern and southern African region and Ms Morena believes that donors are not primarily interested in funding community-led research. But, she said, research is critical. “It is a way to help our governments understand the specific needs we have; it helps influence change and policies.”

Influencing change is something that Ms Morena does every day. During workshops run by the foundation, in partnership with other transgender and female-led community organizations, she tries to educate people about what it feels like to live in a transgender body by getting them to draw a picture of their bodies on a piece of paper they place on top of their heads.

Drawing one’s body out of sight always guarantees that it comes out a mess. This is Ms Morena’s advocacy punchline.

She holds up the drawing and tells them, “This is the pain I have to go through daily. This is how the world sees a transgender person.”

“This is not the body I want. I want to transition, but I don’t have the support of my family. I honestly love them. At times I try to do what I can to make them comfortable, but I also need to be happy,” she said.

This is the reason why the transgender community is so important, said Ms Morena. Solidarity helps.

“Trans women need safe spaces, places to stay and access to mental health services,” said Ms Morena. “The Government of Uganda is not willing to facilitate such spaces, so community-based organizations must bring these services until the fight for decriminalization has been won.”

With the United Nations Commission on Narcotic Drugs meeting this week in Vienna, Austria, diplomatic attention is once again being given to drugs. In 2018, people who inject drugs accounted for 12% of worldwide new HIV infections.

Laws that criminalize key populations or discriminate against people living with HIV undermine efforts to prevent new HIV infections and AIDS-related deaths in dozens of countries across all regions. Decriminalization of drug use and possession for personal use reduces the stigma and discrimination that hampers access to health care, harm reduction and legal services. In countries where drug use is decriminalized and comprehensive harm reduction is available, HIV prevalence and transmission tend to drop sharply among people who use drugs.

Czechia, the Netherlands, Portugal and Switzerland are among a handful of countries that have decriminalized drug use and possession for personal use and that have also invested in harm reduction programmes. Consequently, diagnoses among people who inject drugs in those countries are low.

With drug use or consumption and/or possession of drugs for personal use a criminal offence in at least 67 countries, it’s time for countries to take the bold step towards decriminalization.

GENEVA, 2 December 2019—UNAIDS applauds the decision by the parliament of Australia’s Northern Territory to decriminalize sex work. The Sex Industry Bill 2019 enhances the safety of sex workers and their clients by applying public health legislation to operators of sex service businesses and by allowing sex workers to work together. The legislation explicitly prohibits the exploitation of sex workers, supports their access to justice and outlaws any involvement of children.

“I commend this decision by Australia’s Northern Territory, which upholds the human rights of sex workers and means that they can operate within existing laws and regulations, including laws relating to employment, occupational health and safety, workers’ rights and discrimination,” said the UNAIDS Executive Director, Winnie Byanyima. “The decriminalization of sex work reduces the risk of HIV transmission for both sex workers and their clients.”

Globally, sex workers are 21 times more likely to acquire HIV than the general adult population. A 2014 study published in the Lancet indicated that the decriminalization of sex work is the single intervention that would have the greatest impact on the course of the HIV epidemic over 10 years, with reductions in new HIV infections among sex workers and their clients estimated at between 33% and 46%.

“This is a huge achievement built on the advocacy of sex workers and their supporters over many years and the result of best practice collaboration between the government and sex workers,” said the Chief Executive Officer of Scarlet Alliance, the Australian Sex Workers’ Association, Jules Kim. “Decriminalization means that sex workers in the Northern Territory are able to access justice in the event of a crime without fear of being arrested. We will also be able to implement occupational health and safety strategies and prioritize the health and safety of all those involved in sex work.”

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.

Fifty years after the Stonewall riots in New York, United States of America―a major milestone in the modern struggle to recognize the human rights of lesbian, gay, bisexual, transgender and intersex people―more people are benefiting from the rights that the Stonewall protesters campaigned for. The number of people living in countries that criminalize consensual same-sex sexual relationships has steadily declined since 1969.

In June 2019, Botswana became the latest country to decriminalize same-sex relationships, but Africa still accounts for about half of the world’s population living in countries with anti-homosexuality laws. In 2018, the proportion of the world’s population that lives in countries that criminalize same-sex sexual relations plummeted from about 40% to 23% following the Indian Supreme Court’s decision that decriminalized all consensual sex among adults. This was the largest annual decline since China decriminalized same-sex sexual relationships in 1997.

Prohibitive laws and policies against key populations increase their vulnerability to HIV. It is therefore vital to ensure the full respect of the human rights of all people, regardless of their sexual orientation and gender identity, including through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination and addressing homophobia and transphobia.

Consensual same-sex sexual relations remain criminalized in at least 67 countries and territories worldwide.

Laws discriminate in many ways, but the criminalization of people is one of the most devastating forms of discrimination. Despite calls for reform and the commitments under the 2030 Agenda for Sustainable Development to remove discriminatory laws and reduce inequalities:

• Sixty-nine countries still criminalize same-sex sexual relationships.
• More than 100 countries criminalize drug use or the personal possession of drugs and 98 countries criminalize some form of sex work.
• One in five people in prison are there because of drug-related crimes and 80% of those are there for personal possession or use.
• Nineteen countries deport non-nationals on the grounds of their HIV status.

A high-level political forum is meeting in New York, United States of America, from 9 to 18 July to review the progress made against the commitments of Member States towards achieving the Sustainable Development Goals, including those on inequality and on peace, justice and strong institutions.

“As a judge, I have seen the effect that criminal law can have on communities. It takes people outside systems of protection, declares their actions or identity illegitimate, increases stigma and excludes them from any protections our judicial, social and economic systems may provide,” said Edwin Cameron, Justice of the Constitutional Court of South Africa.

Criminalization affects access to health services, housing, education, social protection and employment. The criminalization of same-sex sexual relationships, sex work or drug use prevents people from accessing health-care services, including HIV prevention, testing and treatment. Data show that gay men and other men who have sex with men are 28 times more at risk of HIV than the general population, people who inject drugs are 22 times more at risk and sex workers and transgender women are 13 times at risk. 

“To fully implement the Sustainable Development Goal agenda and make sure that no one is left behind, we need to ensure the laws are protecting people from discrimination and not pushing people into hiding from society,” said Lloyd Russell Moyle, United Kingdom Member of Parliament.

Groups that represent criminalized people are often barred from registering as nongovernmental organizations, and, for example, sex workers often can’t unionize. Propaganda laws may mean that information on, for example, HIV prevention can’t be disseminated.

“Ending AIDS and meeting the health-related Sustainable Development Goals targets will not be possible without addressing discrimination, violence and exclusion. We have an opportunity to harness the lessons from the AIDS movement and place rights and the meaningful participation of the most marginalized at the centre of the response,” said Luisa Cabal, Director for Human Rights and Gender, UNAIDS.

Criminalized groups often experience higher rates of violence than the general population. Victims of violence who are also criminalized often can’t report crimes against them to the police, and lawyers risk violence and other repercussions if they take up their cases.

“Discrimination against and criminalization of people living with HIV still continues to this day. And we are facing in Indonesia persistent stigma against and criminalizing of key populations. We will never end AIDS if we are not making their needs and rights a top priority for access to health care, protection against violence and realization of the right to health,” said Baby Rivona, from the Indonesian Positive Women Network.

Countries that decriminalize drug use and make harm reduction services available have seen reductions in new HIV infections. Evidence shows that decriminalizing sex work could avert between 33% and 46% of new HIV infections among sex workers and clients over 10 years. However, reductions in new HIV infections are not the only outcome—other outcomes include improvements in well-being and trust in law enforcement, reductions in violence and increased access to health-care and support services. Above all, however, decriminalization of people results in them no longer being seen as criminals and stigmatized by society.

GENEVA, 13 June 2019—UNAIDS welcomes the decision of the Constitutional Court of Colombia to remove the section of the criminal code that criminalizes HIV and Hepatitis B transmission. Overly broad criminalization of HIV transmission is ineffective, discriminatory and does not support efforts to prevent new HIV infections.

“Public health goals cannot be pursued by denying people their individual rights. The decision by the Constitutional Court of Colombia is a concrete step to ensure the law works for the HIV response, and not against it,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “UNAIDS will continue to advocate for a protective legal environment and the removal of punitive laws, policies, practices, stigma and discrimination that block effective responses to HIV.”

The Constitutional Court of Colombia established that the law violated the principles of equality and non-discrimination, as it singled out people living with HIV, stigmatising them and limiting their rights. The Court established that the law created a differential treatment that is not reasonable —and therefore constituted discrimination. The Court further established that such law violated the sexual rights of people living with HIV and it was ineffective to meet any public health objectives.

Overly broad and inappropriate application of criminal law against people living with HIV remains a serious concern across the globe. Nine jurisdictions in South and Central America and at least 77 others worldwide still criminalize HIV non-disclosure, exposure and transmission.

UNAIDS filed an intervention before the Constitutional Court of Colombia indicating that no data support the broad application of criminal law to HIV transmission to prevent HIV transmission. Rather, such application risks undermining public health goals and human rights protections. UNAIDS strongly commends the decision taken by the Constitutional Court to restore the dignity and rights of people living with HIV in Colombia.

In 2018, UNAIDS, the International Association of Providers of AIDS Care and the International AIDS Society convened an expert group of scientists who developed an Expert Consensus Statement on the Science of HIV in the Context of Criminal Law. The statement calls on the criminal justice system to ensure science informs the application of the law in criminal cases related to HIV. 

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.

GENEVA, 24 May 2019 — UNAIDS deeply regrets the decision of the High Court of Kenya to maintain key provisions of Sections 162 and 165 of the Kenyan Penal Code. Those provisions criminalize certain private sexual acts and lead to discrimination and violence against lesbian, gay, bisexual and transgender (LGBT) people in Kenya.

“Today’s ruling is a missed opportunity for Kenya to uphold human rights and to restore privacy, respect and dignity to the lesbian, gay, bisexual and transgender (LGBT) community,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “I share the deep disappointment and frustration felt by LGBT people in Kenya and I want to assure them of UNAIDS’ continued support in reaching justice and equality for all.”

UNAIDS has been working together with the National Gay and Lesbian Human Rights Coalition and other LGBT groups as well as civil society organizations and other partners to promote a more enabling legal environment in Kenya.

There are indications that the judgement will be appealed.

Criminalization of consensual same-sex sexual relations is a violation of human rights and legitimizes stigma, discrimination and violence against LGBT people. Criminalization stops people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV.

“The failure to decriminalize consensual same-sex relations will undermine Kenya’s aim of reaching universal health coverage,” said Ms Carlsson.

Globally, the risk of acquiring HIV is 28 times higher among gay men and other men who have sex with men than among the general population and 13 times higher for transgender women. Prohibitive legal and policy environments and a lack of tailored services for key populations increase their vulnerability to HIV. UNAIDS urges countries to ensure the full respect of the human rights of all people, regardless of their sexual orientation, through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination, addressing homophobia and transphobia and ensuring that crucial health services are made available.

“We need to move towards a more humane, compassionate and rights-based approach towards same-sex relations worldwide. This decision entrenches unjust laws that criminalize same-sex sexual relations and block people’s access to essential services, including to health care,” said Ms Carlsson.

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.

GENEVA, 22 May 2019—The West Africa Commission on Drugs, UNAIDS and the Global Commission on Drug Policy today presented the Model Drug Law for West Africa to ministers of health of the Economic Community of West African States.

Drug laws in western Africa are not having the intended effect. Neither drug use nor drug trafficking have been effectively reduced. Drug trafficking in western Africa has reached such an extent that the drug trade threatens stability in the region. Data from the United Nations Office on Drugs and Crime from 2014 show that the use of cannabis in western Africa is much higher than globally―12.4% of people in the region had used cannabis in 2014, whereas only 3.9% of the global population had done so―and the problematic use of prescription and synthetic drugs is increasing. The rise in prison populations owing to pre-trial detention and drug-related offences has led to serious prison overcrowding in most countries.

“People who use drugs need help and care, not punishment. Stigmatizing them and locking them up in ever-increasing numbers only worsens health issues and puts enormous pressure on the already over-stretched criminal justice systems,” said Olusegun Obasanjo, former President of Nigeria and Chair of the West Africa Commission on Drugs. “It took our region years to adopt evidence-based policies regarding the response to HIV, and we are now enjoying life-saving successes every year. Our view is that drug policy needs the same pragmatic, health-based and people-centred approach as the HIV response.”

The model drug law provides concrete templates that countries can adapt to reform their drug laws—legal provisions and how they relate to international legal obligations—as well as useful commentary that explains different options and reasons for choosing the proposed legal solution. The model drug law offers a measured way for decriminalizing drug use and possession for personal use by introducing thresholds, thereby allowing people who use drugs to access health services and seek support. The model drug law acknowledges that barriers must also be removed so that the millions of people in need of health services, including people living with cancer or with HIV, can access the treatment and care they need.

“Countries need to take a human rights approach to HIV and drug use and to make sure that the health and well-being of people come first,” said Gunilla Carlsson, UNAIDS Executive Director, a.i., while presenting the report to the ministers of health on the margins of the seventy-second session of the World Health Assembly, being held in Geneva, Switzerland. “We know that harm reduction works, we know that decriminalization works―countries cannot continue to disregard the evidence and urgently need to take action.”

The widespread stigma and discrimination, violence and poor health faced by people who inject drugs are compounded by high rates of HIV. While the incidence of HIV infection globally declined by 25% between 2010 and 2017, new HIV infections among people who inject drugs continue to rise. Of the 10.6 million people who injected drugs worldwide in 2016, more than half were living with hepatitis C, and one in eight were living with HIV.

International experience has shown that it is possible to muster the political will to make these wide-ranging changes to drug laws in order to address the spread of infectious diseases and their burden on development. Ruth Dreifuss, former President of Switzerland and Chair of the Global Commission on Drug Policy, said, “This is a defining moment where governments can turn the tide and control health epidemics by providing the right sets of prevention, treatment and harm reduction tools, or fail to do so if they maintain the prohibitionist status quo.” 

Global Commission on Drug Policy  

The purpose of The Global Commission on Drug Policy is to bring to the international level an informed, science-based discussion about humane and effective ways to reduce the harm caused by drugs and drug control policies to people and societies.

West Africa Commission on Drugs

Convened by Kofi Annan, the West Africa Commission (WACD) on Drugs comprises a group of distinguished West Africans from the worlds of politics, civil society, health, security and the judiciary. The Commission, chaired by former President Olusegun Obasanjo of Nigeria, is an independent body and can therefore speak with impartiality and directness.

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.