Every year, 30 million people spend time in prisons or closed settings and 10 million are incarcerated at any given point in time. Virtually all will return to their communities, many within a few months to a year. Health in prisons and other closed settings is thus closely connected to the health of the wider society. Prisons are often overcrowded due to inappropriate, ineffective and excessive criminal laws. People who are already more likely to be exposed to HIV, including people who use drugs, sex workers, and gay men and other men who have sex with men, are overrepresented in prisons and other closed settings. Overcrowding increases vulnerability to infections such as HIV, tuberculosis and hepatitis. Prisoners are also at risk of violence and disruption in HIV prevention and treatment services, including access to harm reduction measures.

Worldwide, there are approximately 880 million adolescent girls and young women aged 15–24 years. Despite making up 12% of the world’s population, this population is often left without a voice or control of their own bodies. Gender-based violence and limited access to health care and education, coupled with systems and policies that do not address the needs of young people, are obstacles that block adolescent girls and young women from being able to protect themselves against HIV, particularly as they transition into adulthood.

After more than 30 years of the HIV epidemic—and an unprecedented medical and social response—discrimination, violence, harmful gender norms and related stigma continue to pose challenges to an effective HIV response. The findings of these assessments indicate that gender-related barriers pose significant obstacles to the uptake of services that prevent new HIV infections among children and keep mothers alive—obstacles that require urgent attention. Without dedicated attempts to overcome these gender-related barriers, current efforts will meet with limited success, and the needs and rights of both women and children will remain compromised.

The existence of national health identifiers (NHIDs) ensures that each patient has one unique identity within the health system. This facilitates the development of longitudinal medical records and allows users of services to be tracked across health-care sectors.

Since the start of the AIDS epidemic, more than 78 million people have been infected with HIV and 39 million have died. Acquiring HIV no longer means certain death. A person on HIV treatment in a high-income setting now has nearly the same life expectancy as a person who does not have the virus. However, only two out of five people living with HIV have access to antiretroviral therapy. Among people who do have access, great inequities exist. People living with HIV are being left behind because they are not benefitting from health care, employment, education or social protection. This is often due to stigma, discrimination, prohibitive laws and policies or a lack of services.

Like any other contraceptive method, sterilization should only be provided with the full, free and informed consent of the individual. However, in some countries, people belonging to certain population groups, including people living with HIV, persons with disabilities, indigenous peoples and ethnic minorities, and transgender and intersex persons, continue to be sterilized without their full, free and informed consent. This statement aims to contribute to the elimination of forced, coercive and otherwise involuntary sterilization. It reaffirms that sterilization as a method of contraception and family planning should be available, accessible, acceptable, of good quality, and free from discrimination, coercion and violence, and that laws, regulations, policies and practices should ensure that the provision of procedures resulting in sterilization is based on the full, free and informed decision-making of the person concerned.