Human Rights: When Officials Get Serious About HIV Prevention, This is Where They’ll Start

Catherine Hanssens

Stigma, discrimination, poverty, homophobia, racism, sexism, all fuel the spread of HIV and hurt those living with it. These issues are routinely cited as critical to ending the epidemic but rarely addressed in policies and prevention strategies.

Nearly three decades after the identification of the first cases of AIDS,
our national dialogue continues to fail those living with HIV by failing to put
human rights at the center of AIDS prevention and treatment.

discrimination, poverty, homophobia, racism, sexism, and misinformation
continue to fuel the spread of HIV and hurt those living with it in very real
ways. These terms routinely are recited in our collective litanies of what
needs to be addressed, but far less frequently made concrete and specific in policy
plans and prevention strategies.  As
a community, we need to consistently insist that government officials commit to
a long-term response to HIV that treats human rights as a central theme rather
than an isolated issue that can be bargained away when politics get in the way.
Until all approaches—whether legal, medical, or political—are grounded in
respect for the dignity of those individuals they purport to help, they will
fail those individuals.

A compelling example is the issue of the criminal prosecution and
incarceration of people with HIV who dare to have sex without proof of HIV
notification to their partners.  Where
are all the government health officials on this issue?  Imagine where HIV-positive people
serving time for spitting or having sex might be if the energy, advocacy and
considerable funding invested in changing state HIV testing laws to eliminate
informed consent had instead focused on the 30-plus state laws that make
criminals of people with HIV for consensual sex, even when no transmission
occurs?  These policies reflect and
perpetuate the stigma and misinformation that keeps HIV thriving, and scare
people with or at risk of HIV a lot more than signing a consent form for
testing.  As government-created and
enforced discrimination, they are a particularly toxic manifestation of
AIDS-related stigma.

It’s true that gains have been made recently in action that demonstrates
that ONAP and other members of the Obama administration understand the
importance of human rights in addressing the AIDS crisis.  Last month, in response to advocacy by
a group of advocates including the Center for HIV Law and Policy, the ACLU,
Lambda Legal and GLAD, the U.S. Department of Justice issued a directive making
it clear that state licensing boards and agencies that interpret their
infectious/communicable disease clearance requirements to exclude people with
HIV/AIDS from trades such as massage therapy, barbering, home health care, or
physician’s assistant are in violation of federal disability antidiscrimination
law. The DOJ’s action removes long-standing employment barriers for people with
HIV or AIDS in the many states across the country that have prohibited their
pursuit of a career on the mistaken belief that their HIV made them too
dangerous for their chosen professions.  And the ACLU, representing an
army veteran who was fired from his job with a State Department contractor because
he is HIV-positive,  also just
secured an important settlement in which the State Department agreed to end the
automatic exclusion of people with HIV from working under State Department

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These are important victories, empowering potentially thousands of people
with HIV through access to meaningful employment, and hopefully sparing scarce
and under-funded legal advocates the resources required to challenge past
exclusions.  They also are HIV prevention; there are multiple studies that
demonstrate the connection between job options, the ability to earn a living
and the inclination to engage in risk-taking behavior.  Of course tests and drugs are
critically important, but so are self-sufficiency, respect, dignity, and self-worth. Most
of us rate these things as indispensable to our quality of life.  Why is
it so hard for policy-makers to see these as central to effective HIV
prevention policy as well?

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