HIV integration

UNAIDS applauds Argentina for the approval of its new human rights-based HIV law

04 July 2022

4 July 2022—UNAIDS congratulates the Argentinian Congress on the approval of a new law on a comprehensive response to HIV, viral hepatitis, tuberculosis and sexually transmitted infections (STIs). The bill, which has had input from a number of civil society organizations, replaces 30-year-old legislation and changes the country’s health approach from a biomedical approach to an approach more focused on gender and human rights. The new law calls for an end to stigma and discrimination against people living with HIV or STIs and aims to stop criminalization of HIV exposure or transmission.

By prohibiting mandatory testing for HIV and other STIs as part of pre-employment exams, the new law also seeks to protect against discrimination in all areas (with emphasis on the workplace) and ensures the privacy of the diagnosis.

“We join the civil society and community movements in this important celebration. The new law is evidence-based and written from the perspective of human rights,” celebrates Alberto Stella, UNAIDS Country Director for Argentina, Chile, Paraguay and Uruguay. “The HIV response in the country now counts on a broad framework of social protection, very much in line with the Global AIDS Strategy (2021-2026), which focuses on ending inequalities to end the AIDS epidemic.”

Besides eradicating discriminatory practices, the new legislation also includes the possibility of early retirement at 50 years old for people who have been living with the virus for ten years and who have paid at least 20 years of pension contributions. It also allows access to a non-contributory pension for life in cases of social vulnerability.

The new bill pays a historical debt for dozens of activists who occupied the balconies of Congress in recent voting sessions and the thousands of people living with HIV they represent. “We are one step closer to eliminating barriers to the implementation of self-testing and promoting prevention strategies such as Pre-Exposure Prophylaxis (PrEP)”, celebrated Fundación Huesped, an Argentinian organization with a regional reach that has advocated for the right to health since 1989.

The new law also recognizes specific rights of women, guarantees the right to health of their children and ensures compliance with the rights recognized in the law for the Integral Protection of Women.

“This is the result of the articulated work conducted by civil society who not only led its elaboration but who also did excellent and hard work on advocacy,” says Stella. “Along with the National HIV, TB, Hepatitis and STI department of the Ministry of Health, UNAIDS was able to contribute with advocacy efforts and the facilitation of dialogues, providing evidence and the informing on international guidelines.”

The new bill also proposes the national production of medication and supplies.

The latest estimates from the UNAIDS 2021 Global AIDS Update report show that 140 000 people are living with HIV in Argentina and 65% of whom are on antiretroviral treatment. Every year 5600 people are newly infected with HIV, and 1400 people die from AIDS-related illnesses.

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.

Contact

UNAIDS Latin America
Daniel de Castro
decastrod@unaids.org

Key considerations to integrate HIV and mental health interventions

28 April 2022

A new publication by UNAIDS and the World Health Organization (WHO) emphasizes the importance of integrating HIV and mental health services and other interventions, including linkages to social protection services, for people living with HIV and other vulnerable populations.

Mental health conditions increase the risk of HIV infection, and people living with HIV have an increased risk of mental health conditions, which are associated with lower retention in HIV care, increased risk behaviours and lower engagement with HIV prevention.

Furthermore, despite an increasing body of evidence showing that effective methods of prevention, screening and diagnosis of, and treatments for, common mental health conditions, including depression and anxiety, exist and can be implemented in low- and middle-income countries, services for mental health, neurological and substance use conditions are often not integrated into packages of essential services and care, including for HIV.

“We know that integration of screening, diagnosis, treatment and care for mental health conditions and psychosocial support with HIV services does not need to be expensive,” said Eamonn Murphy, UNAIDS Deputy Executive Director, a.i., Programme. “The integrated approaches that are people-centred and local context-specific ensure better HIV and overall health outcomes, well-being and quality of life.”

The publication is primarily intended for national and local policy-makers, global, regional, country and local programme implementers, organizations working in and providers of health, HIV, mental health and other relevant services, civil society and community-based and community-led organizations and advocates.

Although focus is on the integration of mental health with HIV services and other interventions, the considerations in the publication may be relevant to other services, including for HIV comorbidities such as tuberculosis, viral hepatitis and sexually transmitted infections.

“Our publication successfully brings together tools, best practices, case studies and guidelines that can help countries and facilitate the integration of interventions and services to address the interlinked public health challenges of mental health and HIV, all while improving access to care for persons who are the most vulnerable, such as adolescents and key populations,” said Meg Doherty, Director, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, WHO.

“With this joint UNAIDS/WHO publication, we hope we can collectively support countries, service providers and other practitioners, policy-makers, programme implementers and communities in their efforts to address HIV, mental health, neurological and substance use conditions for affected individuals in an integrated and impactful way,”  said Devora Kestel, Director, Mental Health and Substance Use, WHO.

Integration of mental health and psychosocial support with HIV services and interventions, including those led by communities, is one of the key priority actions included in the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS and the 2021 United Nations Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. Both documents call for addressing the interlinked issues of HIV and mental health through integrated services by investing in robust, resilient, equitable and publicly funded systems for health and social protection, by reversing health and social inequalities and by ending stigma and discrimination.

The new publication stresses that the AIDS epidemic cannot end without addressing the mental health of people living with, at risk of or affected by HIV, ensuring equitable access to HIV services for people with mental health issues and conditions and achieving universal health coverage.

Integration of mental health and HIV interventions — Key considerations

40 years of the AIDS response

This infographic is also available in Arabic and Chinese

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Statement by Winnie Byanyima, Executive Director of UNAIDS, on the occasion of World Health Day

07 April 2021

Winnie Byanyima, Executive Director of UNAIDS and Under-Secretary-General of the United Nations

7 April 2021

Tisha (not her real name), a young woman from the slums in east Africa, was three weeks past her due date when she was referred as an emergency case to the maternity facility in the main town.

With specialist medical attention, Tisha gave birth to a healthy baby boy, whom she named Okello. But instead of being a moment of joy for Tisha and her family, when she was unable to pay the US$ 30 delivery fee the hospital refused to discharge her.

Tisha was promptly moved to a special detention ward housing 42 other poor mothers and allocated a bed already shared by two women and their babies. Tisha and Okello would not be allowed to leave until she cleared her bill, which, the nurses told her, would rise daily. Tisha and her son were held captive until she could find the money to pay her bill.

This tragic story is all too common. Paying for health is the most regressive way of financing health care. Yet, according to the World Bank, two thirds of African countries are charging user fees at all levels of care.

Ten thousand people die every day because they cannot access health care and the cost of health services mean that every year 100 million people are pushed into extreme poverty paying for them. That equates to three people every second.

These huge inequalities in health care continue to widen as health systems around the world increasingly become profit-led. Many of the poorest countries in the world are trying to sell health through health insurance and user fees. But how can you sell health to somebody who does not have even the basics to survive, to someone who doesn’t have a job and is struggling to find the next meal.

Many governments claim that they cannot afford to pay for health, but the reality is that they can if they tax progressively so that everyone pays their fair share, stop companies from hiding their profits offshore and end tax exemptions. This would go a long way towards balancing the glaring inequalities in access to public services, including health care.

These profit-driven models have fragmented already weak health systems that exclude many people—poor people, lesbian, gay, bisexual, transgender and intersex people, prisoners, sex workers, people who inject drugs and numerous marginalized groups. The way health is financed is inequitable. In addition, the lack of human rights for marginalized groups denies them access to quality health care.

Inequalities in human rights result in inequalities in health. The right to health of ALL is part of the 1948 Universal Declaration of Human Rights. It states that, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

The biggest steps forward in health have often happened in response to a major crisis—think of the post-Second World War health systems across Europe and in Japan, or how AIDS led to universal health care in Thailand.

Now, in the midst of the COVID-19 crisis, leaders across the world have an opportunity to build the health systems that were always needed, and which cannot be delayed any longer. We cannot tinker around the edges—we need radical, transformative shifts. The COVID-19 response gives us an opportunity to change the rules and guarantee equality.

On World Health Day 2021, let us make that call to ensure that people’s lives come before profits. Let governments make the commitment that they will guarantee that everyone, without discrimination, has access to quality health care. The right to health is an inalienable human right.

This coronavirus crisis we find ourselves in today could, like other global crises before, create the global and national solutions in health care we so desperately need. Let’s seize the moment! 

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.

Contact

UNAIDS Geneva
Sophie Barton-Knott
tel. +41 79 514 6896
bartonknotts@unaids.org

Islamic Republic of Iran bans stigma and discrimination against people living with HIV in health-care settings

27 January 2021

The Islamic Republic of Iran has issued a new regulation prohibiting stigma and discrimination against people living with HIV in health-care settings.

Global experience has shown that stigma and discrimination limits access to HIV services at every step and stops people exercising their basic human rights, including the right to health. Studies in the Islamic Republic of Iran have identified health-care settings as an important venue where HIV-related stigma and discrimination needs to be addressed. 

In 2019, the Islamic Republic of Iran joined the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination and set three priority areas—health settings, humanitarian settings and communities—for action. This new regulation is a direct result of the work in the partnership by both the country and UNAIDS.

The regulation covers all private and public health institutions and requires them to protect people living with HIV and key populations from stigma and discrimination. The regulation also covers a number of other areas, including raising awareness about HIV and the rights of people living with HIV, protecting the rights of people living with and affected by HIV and ensuring the discrimination-free provision of health care and treatment to people at higher risk of HIV and people living with HIV.

“This important breakthrough in the national response to HIV lays the ground for significantly controlling HIV in the country in the future,” said Fardad Doroudi, the UNAIDS Country Director for the Islamic Republic of Iran.

The UNAIDS country office has supported the efforts to eliminate stigma and discrimination in the country over many years. In 2010, to help understand the problem, the country office, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) through the United Nations Development Programme (UNDP) and the National AIDS Programme (NAP) supported the Iranian Research Center for HIV and AIDS (IRCHA) and the Global Network of People Living with HIV (GNP+) to conduct the first People Living with HIV Stigma Index study, which clearly showed that people living with HIV faced discrimination in health-care settings. A follow-up study conducted in collaboration with Harvard University on the root causes of stigma introduced a mathematical model on discrimination and showed the route to overcoming stigma. Currently, an Iranian coalition of people living with HIV, with support from NAP, IRCHA, GNP+, ICW, Johns Hopkins University and the UNAIDS country office, is conducting the country’s second People Living with HIV Stigma Index, using the updated 2.0 methodology.

With the knowledge from these studies, UNAIDS has worked against stigma and discrimination in the country in a variety of ways. With support of the Global Fund through UNDP, UNAIDS established “positive clubs” to provide services by and with people living with HIV in a stigma-free environment, advocated with policymakers and religious leaders and held national sensitization campaigns on stigma and discrimination in collaboration with civil society. UNAIDS also invested in the next generation of medical students, working with the International Federation of Medical Students through a series of workshops and courses to help to change the attitude of university students about HIV and stigma and discrimination.

In 2020, the UNAIDS country office technically and financially supported NAP to develop an ethical framework for the fifth National HIV Strategic Plan (2021–2025), as well as the anti-discrimination regulation, in a process backed by a team of national experts in the fields of law and ethics.

“It has been a long journey to get to this stage, but this is what I have waited so long for—a structural change, something that we could refer to if discrimination occurs in a health-care setting,” added Mr Doroudi.

UNAIDS continues to support and collaborate with the Government of the Islamic Republic of Iran to achieve its objectives to eliminate HIV-related stigma and discrimination in other areas.

“I pledge not to allow any interruption to occur on delivery, quality or quantity of HIV services across the country,” said Saeed Namaki, the Minister of Health and Medical Education of the Islamic Republic of Iran.

Related: Online games fighting HIV stigma and discrimination in the Islamic Republic of Iran

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