(from left) Ms Ruth Morgan Thomas, Global Coordinator for the Network of Sex Work Projects (NSWP); Dr Bernhard Schwartländer, Director of UNAIDS Department of Evidence, Strategy and Results. Credit: UNAIDS/Anne Rauchenberger

For every two people who start on HIV treatment, five are newly infected. With the need to focus on HIV prevention becoming ever more acute, how can those at risk of contracting HIV be targeted to produce impact? What can we scale up? How to bring coordination in interventions that complement each other? These are some of the key questions explored in a UNAIDS Satellite Session at the XVIII International AIDS Conference in Vienna.

Entitled Combination prevention in action: targeted approaches, the session highlighted the need to address prevention in a range of key populations, including sex workers and their clients, injecting drug users, men who have sex with men, populations in humanitarian crisis, and migrants.

Representatives from the UN system and civil society emphasised the importance of coordinated HIV prevention efforts and addressing gaps in the AIDS response at a country, regional and global level. They shared experiences and built on lessons learned in dealing with HIV in specific populations, discussing the opportunities and challenges of combination prevention.

Opening the discussions, Ms Purnima Mane, UNFPA’s Deputy Executive Director, explained that UNAIDS advocates a combination approach to HIV prevention which takes into account the realities of local epidemics. Combination prevention requires action on both immediate personal risks and on the underlying drivers of the epidemic. It means a multi-pronged strategy providing services and programmes for individuals as well as investment in structural interventions, such as legal reforms to outlaw discrimination against people living with HIV.

Satellite session: Combination prevention in action: targeted approaches. Credit: UNAIDS/Anne Rauchenberger

Chaired by Dr Bernhard Schwartländer, Director of UNAIDS Department of Evidence, Strategy and Results, the session attracted a broad range of speakers. These included Signe Rotberga, a UNODC Regional Project Coordinator who shared lessons about AIDS prevention and care among injecting drug users and in prison settings in the Baltic states.

HIV and sex work in humanitarian settings was the subject of the contribution from UNHCR’s Dr.Patterson Njogu, Senior Regional Global HIV/AIDS Coordinator for East and Horn of Africa. ILO’s Richard Howard, HIV/AIDS Regional Specialist for Asia and the Pacific, spoke about reaching sex workers clients through workplace interventions. Ying-Ru Lo from WHO explained ongoing processes for the development of global guidance tools on prevention and treatment of HIV among most at risk populations.

Ruth Morgan Thomas for the Global Coordinator for the Network of Sex Work Projects (NSWP) and Shona Schonning from the Eurasian Harm Reduction Network (EHRN) gave insightful perspective of civil society on the different interventions.

Coming from myriad countries and settings, the participants shared a common goal: to reinforce the importance of targeted combination prevention that addresses the needs of the individual and promotes the creation of a safe and supportive environment based on human rights, protection and reduction of vulnerability. 

Y-PEER event at AIDS 2010, 23 July 2010. Credit: UNAIDS/Heimo Aga

Harnessing the power of the mass media and new technologies to reach young people with information about HIV and reproductive health was high on the agenda at the XVIII International AIDS conference yesterday during a series of events sponsored by Y-PEER, a youth initiative pioneered by the United Nations Population Fund (UNFPA).

According to UNFPA a youth-centred approach, such as Y-PEER, is critical to genuine engagement for change.“If we want to engage young people on health and lifestyle issues that affect them, we need to be where they are, sharing information through platforms they are connecting to every day,” said Purnima Mane, UNFPA Deputy Executive Director (Programmes).

“Run by youth for youth, Y-Peer continues to grab hold of the latest trends in entertainment and social media through innovative partnerships to promote health and prevent HIV infection.”

In an innovative session, Using Edutainment for Social and Behaviour Change, one of Hollywood’s top writers and producers, Zoanne Clack of the award-winning US series Grey’s Anatomy, joined experts, such as Colin Dixon of Dance4Life, AIDS activists and Y-PEER ambassadors to discuss how HIV is dealt with in the entertainment media.

Y-PEER phone app launched at AIDS2010, 23 July 2010. Credit: UNAIDS/Heimo Aga

Y-PEER is partnering with the Hollywood Health Society (HHS), which was represented by its director, Sandra de Castro Buffington, during the event. HHS, based at the University of Southern California, aims to provide writers and producers with accurate information for health storylines. Y-PEER works with HHS to try to identify similar models that can be easily replicated in other regions with the aim of sensitising the film industry and to encourage featuring HIV in popular programmes.

The session explored how education-entertainment, or ‘edutainment’, can bring issues around sexual and reproductive health, sexuality and HIV alive for a young audience, and how this can contribute to them making informed decisions in this critical area, helping them better protect themselves against the virus and reducing their vulnerability.  Empowering young people to protect themselves from HIV is one of the ten priority areas in the UNAIDS Outcome Framework (2009-11).

Recognising the role that celebrities can play in using their influence to highlight issues and change attitudes, beliefs and behaviour, a number of stars who are also Y-PEER ambassadors attended the session as guest speakers. These included Hollywood resident actor and activist Sammy Sheikh (who appeared in the series ‘24’, United States of Tara and LOST) and singers Daniela Dimitrovska (Macedonia), Lotfi (Tunisia) and Ana Stanic (Serbia).

Last night also saw the launch of Y-PEER knowledge applications for smart phones. Building on the Y-PEER programme, this new ‘app’ is intended to test young people’s skills and knowledge surrounding adolescent sexual and reproductive health. It contains more than 500 questions with four different types of quiz play focussing on eight topics, such as HIV, gender and sexuality and drug use. As well as testing their knowledge, users can learn more about Y-PEER activities and compare their scores with other players. Y-PEER has thousands of members in 48 countries around the globe in a movement which builds capacity and mobilises young people to participate in the national and global response. Members work to highlight issues around sexual and reproductive health and rights, seeking to empower young people, especially the most vulnerable, to make informed choices.

Dr Peter Ghys, Chief of Epidemiology and Analysis Division UNAIDS, presented the findings of the new analysis together with the Vienna Youth Force at the International AIDS Conference. Credit: UNAIDS/Anne Rauchenberger

A change is happening among young people across the world, especially in parts of sub-Saharan Africa. Young people are waiting longer to become sexually active, have fewer multiple partners and are increasingly using condoms among those with multiple partners. As a result, HIV prevalence among young people is dropping in many key countries according to a new analysis by UNAIDS.

Dr Peter Ghys, Chief of Epidemiology and Analysis Division UNAIDS, presented these findings together with the Vienna Youth Force today at the International AIDS Conference.

The study shows that HIV prevalence trends in 16 countries is declining among young people aged 15–24, and according to the study declines are largely due to falling new HIV infections among young people. In 15 out of 21 countries most affected by HIV in the world, a decline of 25% has been noted.

According to Dr Ghys, the results show a good concordance between trend in sexual behaviour and trends in HIV prevalence.

“UNAIDS calls on countries to implement comprehensive set of programmes to reduce the risk of young people; and young people themselves can and must be actors in these changes,” said Dr Ghys.

Young people engaged in the AIDS response in countries which are experiencing this decline were invited to comment on the new findings.

Kuena Diaho, the World Young Women’s Christian Association Lesotho, said that programmes targeting young people need to be shaped in a way so that they are not too heavy. “In Lesotho, we do edutainment; HIV prevention activates through poetry and sport.  This way, it’s a little less heavy,” said Diaho.

“We’re a large network of young women’s organizations. We use facebook to share information, and we organize gatherings to talk about sexual and reproductive health education,” said Yvonne Akotho from the Girl scouts in Kenya.

Remmy Shawa, UNAIDS special youth fellow, from Zambia stressed that this new evidence should be used as an advocacy tool to show leaders what happens when young people are placed at the centre of the AIDS response.

Dr Ghys concluded the session noting that these encouraging results are an early return on investments made in HIV prevention. “These investments need to continue and programmes with and for young people need to be scaled up,” said Dr Ghys.

Credit: World Bank

Stigma and discrimination are widely recognised as two of the major barriers to an effective and successful AIDS response. But how, with both often entrenched and hard to challenge, can they be meaningfully addressed? The World Bank and The International Center for Research on Women (ICRW) focused on this central question during a satellite session at the XVIII International AIDS Conference in Vienna entitled: Making the case for stigma-reduction and moving to action, the experience of South Asia.

Stigma reduction

The session made the case for stigma reduction as a critical strategy for effective HIV prevention and treatment programmes, with a range of speakers sharing the latest evidence on why investing in stigma-reduction is critical for effective HIV programming.

The results from the South Asia Region Development Marketplace, (SARDM) were a key focus. Spearheaded by the World Bank in 2008, this competitive grants programme identified and supported small scale, community-driven, projects demonstrating a creative approach to reducing stigma and discrimination. An innovative range of interventions included beauty pageants, traditional folk art and a restaurant run by sex workers. There is also a theatre programme designed to change attitudes that make it harder for men who have sex with men to access legal redress; a project challenging internalised stigma among injection drug users, helping them get back on their feet economically and socially, and a radio programme produced by journalists living with HIV featuring positive role models.

Experiences of what works for successful community-based stigma reduction were shared by a number of the implementers.  

“These remarkable programmes have now touched the lives of 100,000 people across South Asia,” said Mr Michal Rutkowski, the World Bank’s Director for Human Development in South Asia.

“The results have been very impressive. We have learned about tried and true ideas that really work. Our hope is that we can persuade government and community leaders and others to take these on-board and expand them and take them nationwide.”

The satellite session provided an opportunity to launch a new global network for action on stigma and discrimination and the World Bank report detailing the full extent of the SARDM programme with its successes and challenges.

Writing in the introduction to the publication, UNAIDS Executive Director, Mr Michel Sidibé, pointed out the significance of community empowerment. “When communities assume leadership of their own programmes, they become equitable and sustainable. It breaks the cycle of stigma and discrimination. It restores their dignity and rights to good health and development.”

Right for you! satellite. Credit: UNAIDS/Anna Rauchenberger

The thoughts and voices of young people took centre stage at the Vienna AIDS Conference yesterday as an innovative satellite session explored how they can best protect themselves from HIV. The session was organized by UNAIDS, UNESCO, UNFPA, UNICEF and WHO. It provided an interactive platform for youth from around the world to discuss sexual and reproductive health services and provision of comprehensive information including sexuality education, condom use and HIV counselling and testing.

Called ‘Right for You! Creating Game Changing Strategies for HIV and Young People’, the event was structured around the outcome of an online survey, promoted across varied social media platforms, such as Facebook, Twitter, AIDSspace and Conversations for a better world, to find out what young people really think about how to mount a meaningful and effective personal challenge to HIV. It was moderated by Ms Purnima Mane, United Nations Population Fund (UNFPA) Deputy Executive Director (Programme).

The session explored how to achieve three bold goals for young people:

• Ensure at least 80% of young people in and out school have comprehensive knowledge of HIV.
• Double young people’s use of condoms during their last sexual intercourse.
• Double young people’s use of HIV testing and counselling services.

‘Empowering Young People to Protect Themselves against HIV’, is one of the priority areas of the UNAIDS Outcome Framework 2009-2011. The aim is to reduce new HIV infections among young people by 30% by 2015.

The three goals discussed in yesterday’s satellite are far-reaching and ambitious in scope. They were highlighted in the UNAIDS business case on empowering young people. The business case is an advocacy tool which outlines  why UNAIDS has prioritized young people and it recommends that the three results should be achieved in at least 9 of the 17 countries that have largest number of young people living with HIV by 2011, as well as in countries experiencing low and concentrated epidemics.

Those gathered at the event discussed how such results can be achieved and how the necessary good quality programmes can be scaled up at country level. An expert panel that included a youth facilitator, Ishita Chaudhry from India, Dr Doug Kirby, co-author of International Technical Guidance on Sexuality Education: An evidence informed approach for schools, teachers and health educators, Darlington Muyambwa, Programme Manager, SAYWHAT Programme, Zimbabwe , and Shaffiq Essajee, WHO, responded to feedback from participants who expressed their views or asked questions via the web forums.

Exploring ways of empowering young people to protect themselves against HIV is vitally important given latest estimates showing that 15-24 year olds account for some 40% of all adult HIV infections globally. In 2007, far fewer than half of young people around the world had accurate knowledge about HIV.

Additionally, in many parts of the world young people have inadequate access to sexual and reproductive health services and commodities like condoms. Socio-cultural norms can act as barriers to these essential services and commodities which discourage young people from learning about and discussing sex and sexuality and accessing the services. The session explored ways to address these challenges and empower young people to make informed decisions about this key aspect of their lives.

Ms Jan Beagle, UNAIDS Deputy Executive Director, Management and External Relations Branch, addressed the ceremony on behalf of the Executive Director. Credit: UNAIDS/Anna Rauchenberger

A ceremony to celebrate the 25 winners of the 2010 Red Ribbon Award was held in Vienna 21 July, with a host of global AIDS leaders joining the award winners and some 250 guests. The award event, which included a formal gala dinner, took place during the XVIII International AIDS Conference. Mr Jeffrey O’Malley, Director of HIV/AIDS Practice at the United Nations Development Programme, (UNDP), filled the role of Master of Ceremonies and Ms Jan Beagle, UNAIDS Deputy Executive Director, Management and External Relations Branch, addressed the ceremony on behalf of the Executive Director.

Ms Beagle paid tribute to this year’s winners and the wider community who play a key role in making a difference.

“The AIDS response counts on community organizations. The Red Ribbon Award is one of the rare opportunities we have for celebrating those exceptional organizations and individuals," said Ms Beagle. "The twenty-five organizations we are celebrating tonight are making an essential contribution to reaching our vision: Zero! zero! zero!"

The winners, representing a broad range of community-based organizations from 17 countries, were recognized for their outstanding work in reducing the spread and impact of AIDS. The Red Ribbon Award, named after the vivid symbol of the global response to the epidemic, is a joint effort of the UNAIDS family and is hosted by UNDP.

Chosen for their remarkable efforts in innovation, creativity, impact, sustainability and leadership, each winner receives a cash award and international acknowledgement of their contribution to the strengthening of the AIDS response.

Red Ribbon Awards. Credit: UNAIDS/Anna Rauchenberger

Six special recognition winners were announced during the ceremony, one for each of five 2010 award categories and one extraordinary winner:

• Ensuring that people living with HIV receive treatment
  Winner: Penitentiary Initiative, Ukraine
• Supporting HIV prevention, treatment and care programmes for people who use drugs
  Winner: Spin Plus, Tajikistan
• Supporting human rights
  Winner: Nikat, Ethiopia
• Stopping violence against women and girls and promoting gender equality
  Winner: POWA, Belize
• Enhancing social support for those affected by HIV, including orphans and vulnerable children
  Winner: Widows, orphans and people living with HIV (WOPHA), Sudan

An exceptional award was also given:

• AIDS and the Millennium Development Goals
  Winner: NAIRN, Thailand

Ms Elizabeth Matake, Special Envoy of the UN Secretary-General for AIDS in Africa. Credit: UNAIDS/Anna Rauchenberger

Leaders of the global AIDS response taking part in the ceremony included, Prof Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Ms Elizabeth Mataka, Special Envoy of the UN Secretary-General for AIDS in Africa; Ms Svetlana Izambaeva, Russian activist and advocate, giving the key note address; and Ms Anandi Yuvaraj, Asia-Pacific Regional Coordinator of the International Community of Women Living with HIV/AIDS (ICW).

Out of 720 nominations from over 100 countries, the winners were selected by a Technical Review Committee of civil society representatives who are experts in the community response to HIV.

According to Jeffrey O’Malley, “These organizations clearly demonstrate that effective responses to the epidemic require the full participation of front-line, community-based groups. Community groups recognise that AIDS is one of many issues that are tied together. They understand that AIDS requires an exceptional response but they also understand that you need to link AIDS to broader issues of health, development and justice to be effective.”

Dr Paul De Lay, Deputy Executive Director of UNAIDS was one of the keynote speakers at the event. Credit: UNAIDS/Anne Rauchenberger

While there is a growing recognition of the interrelationships between disability and HIV, people with disabilities still lack access to HIV prevention information, treatment, care and support services.

In order to raise awareness on these gaps, as well as provide a platform for exchange of good practice and innovative advocacy ideas, there is a disability and HIV networking zone at this year’s International AIDS Conference and a range of events on the conference calendar.

On 21 July a satellite session was convened by Health Canada in collaboration with the Global Partnership for Disability and Development (GPDD), to look more specifically at the integration of HIV and disability issues into HIV programmes at the country level.

Dr Paul De Lay, Deputy Executive Director of UNAIDS was one of the keynote speakers at the event.

He described UNAIDS’ work with WHO and the Office of the UN High Commissioner for Human Rights to develop a Policy Brief on HIV and Disability. This was achieved with valuable inputs from organizations representing people with a disability, networks of people living with HIV, UNAIDS Reference Group on HIV and Human Rights, and a number of others.

The policy brief gives recommendations for governments, civil society and the UN, for a range of challenges currently in the response to AIDS and disabilities.
These challenges include:

• Persons with disabilities are not included in most HIV policies/processes; people living with HIV not included in most disability policies/processes.
• Some policies exist on HIV and disability and there is mention in national strategies, but implementation is weak and often does not go beyond project level.
• Strategies and programmes fail to adequately address how disability affects men and women differently
• Training for health and other professionals is insufficient
• Data are weak or totally absent (prevalence, incidence, programme needs/coverage) and research is insufficient. Existing research is not being translated into programmes/action.

Dr De Lay noted that a key challenge is to ensure that organizations representing people with a disability are part of the development of National Strategic Plans on HIV and, where it exists, the national partnership forum.

Dr De Lay emphasized that “a normal part of “doing business” in today’s HIV response should be ensuring the full accessibility of mainstream services and information. Standalone programmes should be used where the community says that this is the best way to address our needs. This agenda needs to be planned for, fully funded, and evaluated,” he continued.

Elizabeth Lule addresses the Disability and AIDS event. Credit: UNAIDS/Anne Rauchenberger

Professor Nora Groce of University College London moderated the event. Mr Stephen Lewis of AIDS Free World also was a keynote speaker. Other participants included Elizabeth Lule; Specioza Mwankina, chairperson and founder of the Network of Disabled People Living with HIV; Steven Estey, Disabled Peoples International; and Rosangela Berman Bieler, of Inter-American Institute on Disability and Inclusive Development (IIDI).

Hendrietta Bogopane-Zulu, Deputy Minister of Public Works, South Africa underlined that the Treatment 2.0 approach is important agenda as simplified treatment regimens and services closer to where people are would make a huge difference to the lives of people with disabilities who are living with HIV.

There was a consensus in the discussions on the need for enhanced collaboration between development actors, donors, national partners, and civil society to foster the scale-up, integration and development of inclusive HIV programmes for persons with disabilities.

People with a disability

Around 650 million people, or 10% of the world’s population, have a disability. Although people with disabilities are found within the populations at higher risk of exposure to HIV, not much attention has been paid in the past to the relationship between HIV and disability.

Persons with disabilities experience all of the risk factors associated with HIV, and are often at increased risk because of poverty, severely limited access to education and health care, lack of information and resources, lack of legal protection, increased risk of violence and rape, vulnerability to substance abuse, and stigma.

Downtown Vienna was the backdrop for last night’s HIV and human rights march and rally on 20 July. The public event took place during the 18th International AIDS Conference which has brought some 20,000 activists and HIV professionals to the Austrian capital.

Mr Michel Sidibé, executive director of UNAIDS addressed the rally at the end of the march saluting the thousands of marchers as being “a force for change… a force for human rights.”

“It is a great privilege to be here with you at the most exciting event of the Conference. To rally with you for Human Rights! To end this epidemic we must hold governments, civil society, the UN, ourselves accountable to deliver on human rights.”

Mr Sidibé then introduced on stage UNAIDS’ latest global Goodwill Ambassador and international singer Ms Annie Lennox who headlined the rally. “I turn now to introduce a woman and a human rights activist you all know very well.  An artist, a singer and a star. And we are blessed that she has given her heart and her song and her voice to help us against HIV! Ms. Annie Lennox!”

Ms Lennox gave a live performance and showed short films on impact of HIV on the lives of people and about her SING campaign.

Ms Lennox spoke about how AIDS affects all of us - mothers, fathers, sons and daughters - and she emphasized how we must end the darkness of stigma and discrimination.

In solidarity Ms Lennox and the audience stood in silence to honour the millions of lives already lost to the epidemic. All the lights were turned off at the famous Heldenplatz (Hero's Square) and Ms Lennox encouraged the marchers to turn on their lighters and mobiles as a personal symbol of re-commitment to the fight against AIDS.

Other high-level participants who addressed the rally following the march included the Austrian Minister of Health Mr Alois Stöger, Dr Michel Kazatchkine, Executive Director of the Global Fund to fight AIDS, TB and Malaria, and Ms Sonja Wehsely, Executive Councillor for Public Health and Social Affairs of the City of Vienna, and members of civil society.

Human Rights and HIV: Now More Than Ever

The march was a conference-affiliated event led by a global coalition of organizations including Lennox’s SING campaign and the International AIDS Society, and supported by the Open Society Institute and local partners including Aids Hilfe Wien and Homosexuelle Initiative Wien (HOSI).

The Now More Than Ever campaign has grown through three successive International AIDS Conferences: from Toronto in 2006, where the joint statement was first published; to Mexico City in 2008, where activists organized the first-ever Human Rights Networking Zone and march and rally for human rights at an International AIDS Conference; to Vienna, where thousands gathered for a march, rally and concert for human rights.

Detention of HIV positive drug users is not treatment for their dependence. Drug dependence is a health disorder and punishment is not the appropriate response. This was the key message contained in a UNODC discussion paper launched at the XVIII AIDS Conference in Vienna today.

Entitled “From coercion to cohesion: Treating drug dependence through health care, not punishment”, the paper was released in conjunction with the re-launch of the Open Society Institute’s (OSI) 2010 report, “Detention as Treatment: Detention of methamphetamine users in Cambodia, Laos and Thailand”.

The UNODC report highlights problematic issues on the compulsory centres approach for people who use drugs. It argues that detention of drug users, in either prisons or compulsory centres, is on the increase. It notes that within these settings human rights violations, including forced labour and violence, often occur in contravention of internationally recommended approaches.

HIV prevalence in such detention centres is often higher than in the general population. This is exacerbated by a number of factors: drug users, especially those who inject, can be highly vulnerable to HIV infection through the use of non-sterile drug equipment. In addition, there is often an absence of HIV prevention programmes, limited heath services and lack of access to antiretroviral drug treatment.

The launch session of “From coercion to cohesion” was moderated by Christian Kroll, Global Coordinator for HIV and AIDS at UNODC. Speakers included Gilberto Gerra, Chief of the Drug Prevention and Health Branch at UNODC; Anand Grover, UN Special Rapporteur on the Right to Health; Rebecca Schleiffer, Advocacy Director, Health and Human Rights Division at Human Rights Watch and Daniel Wolfe, Director of International Harm Reduction Development at OSI.

The panellists explored and examined how public security and public health systems implement drug dependence treatment. UNODC maintains that this type of treatment  should be evidence-based, promote prevention of HIV, respect the human rights of people who use drugs, and be managed by public health professionals.  In order to move away from coercion and foster cohesion, the paper contends that voluntary, community-based drug dependence treatment services are more likely to attract those drug users that need treatment, and are more cost effective.

UNODC is the lead agency within UNAIDS for HIV prevention, treatment, care and support for injecting drug users and in prison settings.

Vienna, 21 July 2010 – Some 19 of 48 countries in the Asia Pacific region continue to criminalize male-to-male sex, and these laws frequently lead to abuse and human rights violations. Correspondingly, HIV prevalence has reached alarming levels among men who have sex with men and transgender populations in many countries of the region. If countries fail to address the legal and human rights context of HIV, this already critical situation is likely to become worse. The implementation of effective, national HIV responses requires governments to consider and address the effects of laws and law enforcement practices on the health of men who have sex with men and transgender people.

This warning came as a key finding in the report entitled Legal environments, human rights and HIV responses among men who have sex with men and transgender people in Asia and the Pacific: An agenda for action.

Commissioned by the United Nations Development Programme (UNDP) and the Asia Pacific Coalition on Male Sexual Health (APCOM), this report and its key findings were presented during the session on Criminalizing Homosexual Behavior: Human Rights Violation and Obstacles to Effective HIV/AIDS Prevention at the XVIII International AIDS Conference in Vienna.

The study found that a range of laws, such as public order and vagrancy offences, are selectively enforced against men who have sex with men and transgender people in many countries of the region. Even in the absence of criminalization, the arbitrary and inappropriate enforcement of other legal provisions often violate the rights of men who have sex with men and transgender persons, thereby obstructing advocacy, outreach, and delivery of HIV and health services. The issue of effective access to HIV services was at the heart of the 2009 landmark ruling by the Delhi High Court that Section 377 of the Indian Penal Code unfairly discriminates against men who have sex with men.

The existence of punitive laws across the Asia Pacific Region along with selective, discriminatory enforcement practices continues to reduce the effectiveness of national HIV responses. According to Jeff O’Malley, Director of UNDP’s HIV Practice, “repressive legal environments institutionalize discrimination, limit funding and in effect obstruct the participation of men who have sex with men and transgender people in protecting themselves and their families, friends and communities from HIV. In the context of HIV and in the context of human rights, we must continue to vigorously defend and promote rights based HIV, health and development policies and programme responses – this necessitates working to remove punitive laws and discriminatory practices.”

The study highlighted that there are some recent examples of protective laws, judicial and policy actions to improve the legal environment for men who have sex with men and transgender people, including important court judgments in Nepal, India, Pakistan, Philippines, Fiji, South Korea and Hong Kong SAR. However, these are exceptional developments and action is required to improve the legal environment in all countries.

“There is a way forward towards ensuring that all citizens of a country, irrespective of their sexual orientation or gender identity can access health services to prevent unnecessary infection,” said Shivananda Khan, Chair of APCOM. “Developing strategic partnerships and alliances between affected communities, the legal profession, human rights bodies, parliamentarians, policy makers and the media is critical.”

Many national HIV policies now accord a priority to men who have sex with men, even though the legal environment remains repressive. Some 22 national HIV responses in the Asia and Pacific region have identified men who have sex with men as a priority population for the purposes of HIV prevention and four countries have specific strategic plans or action plans on men who have sex with men and HIV (Cambodia, China, Indonesia and India). Furthermore, the Global Fund to Fight AIDS, Tuberculosis and Malaria is funding a regional multi-country programme in South Asia on men who have sex with men and HIV, which has been endorsed by seven South Asian countries.

The report is available for download at: http://regionalcentrebangkok.undp.or.th/practices/hivaids