Guide to an effective human rights response to the HIV epidemic

C. The link between human rights and
the HIV epidemic
Section C illustrates the links between human rights and HIV. It especially focuses on the
situation of vulnerable and marginalised groups whose exposure to HIV is heightened as a
result of human rights violations.
Unlike many other public health emergencies in
the history of humanity, the response to the AIDS
pandemic has incorporated human rights analyses
or approaches. The human rights approach is
based on the idea that the traditional bio-medical
approach to public health emergencies, is in itself
inadequate to comprehensively address the myriad
socio-cultural and economic aspects of the epidemic.
In addition, the emphasis on the rights of people
living with HIV or vulnerable to HIV infection is
deemed a fundamental element of the response
to HIV.
However, calls for the end of “AIDS exceptionalism”
2 have recently coincided with a questioning
of the efficacy of the human rights-based approach
in addressing the epidemic. Critics of the human
rights-based approach argue that the failure, thus
far, to respond effectively to HIV should lead to a
shift of paradigm towards the application of a public
health-centred approach to HIV. 3
With the rapidly increasing inequalities in the world,
particularly in countries most affected by HIV, now
more than ever, the inextricable links between human
rights and HIV cannot be denied nor underestimated.
The failure to respect, protect, promote
and fulfil human rights fuels the spread, and exacerbates
the impact of, HIV. Similarly, HIV can lead to
violation of human rights through the infringement
or denial of the rights of people living with HIV.
Protecting and promoting human rights are critical
to the response to HIV for at least three reasons: 4
Violations of human rights
increase vulnerability to HIV
Certain groups are more vulnerable to HIV infection
because they are unable to realise their civil, political,
economic, social and cultural rights. For example,
individuals who are denied the right to freedom of
association and access to information may be precluded
from discussing issues related to HIV, participating
in AIDS service organisations and self-help
groups, and taking other preventive measures to
protect themselves from HIV infection. Similarly,
individuals who are denied services or are marginalised
due to their national origin such as refugees
2 See Bayer R ‘Public health policy and the AIDS pandemic: An end to AIDS exceptionalism’ (1991) New England
Journal of Medicine 324 1500-04.
3 De Cock K et al ‘Shadow on the continent: public health and HIV/AIDS in Africa in the 21st century’ (2002) The
Lancet 360 67-72.
4 The following exploration of the links between HIV and human rights is adapted from UNHCHR ‘Introduction
to HIV/AIDS and Human Rights’. Available at http://www.ohchr.org/english/issues/hiv/introhiv.htm.
12 | Guide to an effective human rights response to the HIV epidemic