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Human Rights and HIV/AIDSReforms concerning gender equality andthe empowerment of women do notalways receive the much-needed supportin male-dominated legislative assemblies.Entrenched conservative attitudes inmost countries in the region renders theliberalisation of laws relating tohomosexuality difficult. Laws concerningsex work, the availability of condoms inprisons and needle exchange programmesare also treated as being far toocontroversial by legislators, who prefer tosupport only what are perceived as ‘safe’and conservative measures.One issue that has dominated the lawreform scene in India and Sri Lanka isthe proposed repeal of the provision inthe respective penal codes making it anoffence to engage in “carnal intercourseagainst the order of nature with any man,woman or animal”. This section appliesto homosexual as well as heterosexualoral and anal sex, with consent not seena valid excuse. 54 In 1995, Sri Lankaamended certain sections of the PenalCode and the repeal of the provisiondealing with homosexual acts wasrecommended. 55 In passing theamendment, however, the legislature notonly decided to retain the section makinghomosexuality an offence but widenedits scope to cover sexual relationsbetween females by replacing the word“males” with “persons”. Such incidenceshave led to greater harassment of sexualminorities.4.5 Access to Treatment,Care and SupportA crucial aspect of the human rights ofPLWHA is their access to treatment.Denial or lack of such access amounts toa violation of the basic human right to life.The last decade has witnessed a numberof significant advances in the understandingof the HIV infection and how itcan lead to AIDS. These advances haveled to the development of a range ofpotent drugs to control HIV infection (seeBox 4.10). Both these developments havesubstantially altered the way in whichHIV/AIDS is regarded and treated. Thefatal course of HIV infection can now bealtered to a chronic manageable conditionthat allows a person living with HIV tolead a relatively normal life.The drugs that control HIV infection,known as Anti-retroviral drugs (ARVs),are a recent phenomenon and haveradically changed the HIV care landscapewithin a short span of a few years. Acombination of three or more differentARVs in various regimens, that as a groupare known as Highly Active Anti-Retroviral Therapy (HAART), form thestaple of HIV treatment today indeveloped countries. 56HIV is one of the most rapidly mutatingviruses and its immense capacity forgenetic variation enables it to sometimesproduce forms that are unresponsive tothe drugs that interfere with viralreplication. Treating HIV infection with asingle ARV drug-monotherapy – quicklyleads to drug resistance. The chances ofdrug resistance are also present in the caseof dual therapy. The rule, therefore, is toprovide for triple therapy or HAART,where the chances of drug resistance aregreatly reduced. In the United States, thewidespread use of HAART since 1996 hasled to a 50 per cent decline in AIDSincidence, hospital admissions andrelated deaths.4.5.1 HAART: availability andaccessDeveloping countries are home to 95 percent of PLWHA 57 and WHO estimates that6 million people in these countries arein immediate need of HAART. However,The drugs thatcontrol HIVinfection, known asanti-retroviraldrugs, are a recentphenomenon andhave radicallychanged the HIVcare landscapewithin a short spanof a few years.Regional Human Development ReportHIV/AIDS and Development in South Asia 2003 93