Intern Guidelines High Comm HR HIV

International Guidelines
on HIV/AIDS and Human Rights

2006 Consolidated Version
Organized jointly by the Ofce of the United Nations
High Commissioner for Human Rights and the
Joint United Nations Programme on HIV/AIDS
5econd InternationaI ConsuItation on
HIV/AID5 and Human Pigbts
Geneva, 23-25 September 1996
Tbird InternationaI ConsuItation on
HIV/AID5 and Human Pigbts
Geneva, 25-26 July 2002
F F CE F T HE UN T E D NAT NS
H CH CMM S S NE R
F R HUMAN R CHT S
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llce ol rhe Unired Norions
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rhe Joinr Unired Norions Frogromme on Hv/ADS
lnternational Guidelines
on HlV/AlDS and Human Rights
200 Consolidored version
1
Second nrernorionol Consulrorion on
Hv/ADS ond Humon Righrs
Cenevo, 23-25 Seprem6er 1
Third nrernorionol Consulrorion on
Hv/ADS ond Humon Righrs
Cenevo, 25-2 July 2002
rgonized |oinrly 6y rhe llce ol rhe Unired Norions
High Commissioner lor Humon Righrs ond rhe Joinr Unired Norions
Frogromme on Hv/ADS
1 Editor's note: This version ol rhe nrernarional Guicelines on Hv/ADS anc Human Fihrs
consolicares rhe Guicelines lrsr puLlishec in 18 anc revisec Guiceline c lrsr puLlishec in
2002. Because ol rhe consolicarion, pararaph numLerin has chanec, anc relerences ro
rhe Guicelines shoulc incluce relerence ro rhe consolicarec version ro avoic conlusion as
ro pararaph numLerin. rher minor ecirorial chanes have Leen mace wirh rearc ro rhe
inrrocucrion, summary anc use ol some rerms. For example, "Hv/ADS" is usually shorrenec
ro "Hv" anc is inrencec ro incluce Lorh concirions, anc "FLWHA" has Leen chanec ro
"FLHv". rher rhan rhar, rhe conrenr ol rhe Guicelines has nor Leen revisec or alrerec.
F F CE F T HE UN T E D NAT NS
H CH CMM S S NE R
F R HUMAN R CHT S
UNAID5 OHCHR
22
CON1LN1S

Iorevord 4
Glossary 8
Introduction 9
Background and summary ot the Guidelines 13
l. GUlDELlNES FOR STATE ACTlON 20
A Institutional responsibilities and processes 21
B Iav reviev, retorm and support services 26
C Promotion ot a supportive and enabling environment 32
ll. RECOMMENDATlONS FOR DlSSEMlNATlON AND
lMFLEMENTATlON OF THE GUlDELlNES ON
HlV/AlDS AND HUMAN RlGHTS 69
A States 69
B Lnited Nations system and regional intergovernmental
bodies 71
C Non-governmental organizations 74
lll. lNTERNATlCNAL HMAN RlGHTS CBLlGATlCNS AND Hlv 77
A Human rights standards and the nature ot State
obligations 79
B Pestrictions and limitations 81
C 1he application ot specitc human rights in the
context ot the HIV epidemic 83
nrernorionol Cuidelines
on HlV/AlDS ond Human Rights
3
HlV/AlDS HlV/AlDS ond
Anne 1
History ot the recognition ot the importance ot human rights
in the context ot HIV 103
Anne 2
Iist ot participants at the Second International Consultation
on HIVAIDS and Human Pights 112
Anne 3
Iist ot participants at the 1hird International Consultation
on HIVAIDS and Human Pights 114
UNAID5 OHCHR
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Forevord

It has been ten years since the International Guidelines
vere adopted by the Second International Consultation on
HIVAIDS and Human Pights in 1996. In terms ot the tast and
ever-evolving epidemic, much has happened in this decade, both
good and bad. Lvidence ot the ettectiveness ot a treatment tor HIV
vas trst announced in 1996, vhich tor many changed HIV trom a
situation ot hopelessness to a manageable health condition. But as
the HIV epidemic cast its glaring light on the vast inequity in health
care across the globe, people living vith HIV, among others, began
to demand that something be done about the tact that millions vere
dying ot a treatable condition. In 2001, the Commission on Human
Pights adopted a resolution in vhich it stated that the right to the
highest attainable standard ot health includes access to antiretroviral
therapy tor HIV. lolloving this, in 2002, OHCHP and LNAIDS
sponsored the 1hird International Consultation on HIVAIDS and
Human Pights in order to revise Guideline 6 (consolidated into this
reprint, to renect the human rights dimensions ot access to HIV
prevention, treatment, care and support.
Widespread access to antiretrovirals, as vell as to HIV
prevention, care and support, remains a major global health and
human rights emergency tor millions in need. Nonetheless, the
numbers ot those having such access is rising. In this regard,
governments and the international community made commitments
in 2006 to pursue all necessary ettorts tovards achieving the goal
5
ot universal access to comprehensive HIV prevention programmes,
treatment, care and support by 2010. Other time-bound com-
mitments (including on human rights relating to HIV,, have been
made during the decade in the Millennium Declaration, and in
the Declaration ot Commitment adopted by the LN General
Assembly Special Session on HIVAIDS in 2001 and contrmed
and expanded by the Political Declaration ot the 2006 High Ievel
Meeting on AIDS at the General Assembly. 1hese commitments
renect vhat vorks in the response to HIV, as vell as much greater
political commitment to the response. Global tunding tor HIV
programmes has risen almost 30-told in the course ot the decade.
Nevertheless, the situation remains grave, vith a doubling
ot people living vith HIV vorldvide to over 40 million, vith
vomen nov comprising halt ot those living vith HIV, vith young
people, particularly young vomen, having the tastest rates ot
intection, and vith some 14 million children having been orphaned
by AIDS. HIV prevalence has grovn among those groups in society
most marginalized, such as sex vorkers, drug users and men having
sex vith men. Coverage ot interventions to educate people about
HIV, to provide them vith HIV prevention commodities, services
and treatment, to protect them trom discrimination and sexual
violence, and to empover them to participate in the response and
live successtully in a vorld vith HIV is unacceptably lov in many
places in the vorld.
UNAID5 OHCHR
Since the dratting ot the Guidelines, the epidemic

continues to contrm that the relationship betveen HIV and
human rights is protound. Vulnerability to HIV intection and
to its impact teeds on violations ot human rights, including
discrimination against vomen and violations vhich create and
sustain poverty. In turn, HIV begets human rights violations, such as
turther discrimination, and violence. During the decade, the role ot
human rights in responding to the epidemic and in dealing vith its
ettects has become evermore clear. 1he international human rights
system explicitly recognized HIV status as a prohibited ground ot
discrimination. At the same time, the impact ot HIV highlighted
the inequities and vulnerabilities leading to increased rates ot
intection among vomen, children, the poor and marginalized
groups, and thereby contributed to a reneved tocus on economic,
social and cultural rights. In this regard, the content ot the right to
health has been increasingly detned and nov explicitly includes
the availability and accessibility ot HIV prevention, treatment, care
and support tor children and adults. Lither through legislation
or litigation, many countries have recognized that their people
have the right to HIV treatment as a part ot their human rights,
contrming that economic, social and cultural rights are justiciable.
HIV has brought to the tore the dittcult issues surrounding the
human rights ot those engaged in illegal activities, and importantly
HIV has hammered home the importance ot the right to
participation ot those most attected by the epidemic - people living
vith HIV and those highly vulnerable to intection. Developments
such as these have strengthened the principles ot the indivisibility
and universality ot human rights.
7
1he Guidelines resulted trom a request made many years
ago by the Commission on Human Pights vhich underlined the
need and the imperative to provide guidance to States on hov to
take concrete steps to protect human rights in the context ot HIV.
As the epidemic has evolved, the lessons learned trom it contrm
that the protection ot human rights in the context ot HIV reduces
suttering, saves lives, protects the public health, and provides tor an
ettective response to HIV. 1his is the basis tor the joint vork ot
OHCHP and LNAIDS, the tenth anniversary ot vhich ve also
mark in 2006.
We urge governments, non-governmental organizations,
the Lnited Nations system, and regional bodies to benett trom
and build upon these Guidelines, and continue to tnd vays to
operationalise their commitment to protect human rights in the
response to HIV.
uly 2006

Louise Arbour
Lnited Nations
High Commissioner
tor Human Pights
Peter Piot
Lxecutive Director
oint Lnited Nations Programme
on HIVAIDS
UNAID5 OHCHR
8
Glossary of terns
AIDS acquired immunodetciency syndrome
APV antiretroviral
AP1 antiretroviral therapy
ASO AIDS service organization
CBO community-based organization
HIV human immunodetciency virus
IGO intergovernmental organization
NGO non-governmental organization
PIHIV people living vith HIV
VC1 voluntary counselling and testing

Introduction
1he Iuteruatiouai uioeiiues ou HI1ID: auo Humau Pihts
arose because ot various calls tor their development in light ot
the need tor guidance tor Governments and others on hov to
best promote, protect and tultl human rights in the context ot
the HIV epidemic. During the trst International Consultation
on AIDS and Human Pights, organized by the Lnited Nations
Centre tor Human Pights, in cooperation vith the World
Health Organization, in Geneva, trom 26 to 28 uly 1989,
participants discussed the possible elaboration ot guidelines to
assist policymakers and others in complying vith international
human rights standards regarding lav, administrative practice
and policy.
2
Several years later, in his report to the Commission
at its ttty-trst session (LCN.4199343, para.133,, the Lnited
Nations Secretary-General stated that the development ot
such guidelines or principles could provide an international
tramevork tor discussion ot human rights considerations
at the national, regional and international levels in order to
arrive at a more comprehensive understanding ot the complex
relationship betveen the public health rationale and the human
rights rationale ot HIVAIDS. In particular, Governments
could benett trom guidelines that outline clearly hov human
rights standards apply in the area ot HIVAIDS and indicate
concrete and specitc measures, both in terms ot legislation and
practice, that should be undertaken.
1he Commission on Human Pights at its ttty-second session
in its resolution 199643 ot 19 April 1996 requested that the
Lnited Nations High Commissioner tor Human Pights, inter
2
Feporr ol an nrernarional Consulrarion on ADS anc Human Fihrs, Geneva, 2c ro 28 July
18 (HF/FB/0/2).
UNAID5 OHCHR
10
alia, continue the ettorts, in cooperation vith LNAIDS and
non-governmental organizations, as vell as groups ot people
living vith HIVAIDS, tovards the elaboration ot guidelines
on promoting and protecting respect tor human rights in the
context ot HIVAIDS. At the same time, the Commission
requested that the Secretary-General ot the Lnited Nations
prepare tor the consideration ot the Commission at its ttty-
third session a report on the above-mentioned guidelines,
including the outcome ot the second expert consultation
on human rights and HIVAIDS, and on their international
dissemination.
In response to the above requests, the Lnited Nations Centre
tor Human Pights and the oint Lnited Nations Programme
on HIVAIDS (LNAIDS, convened the Second International
Consultation on HIVAIDS and Human Pights in Geneva,
trom 23 to 23 September 1996. 1his Consultation brought
together thirty-tve experts in the teld ot HIVAIDS and
human rights, comprising Government ottcials and statt ot
national AIDS programmes, people living vith HIV, human
rights activists, academics, representatives ot regional and
national netvorks on ethics, lav, human rights and HIV, and
representatives ot Lnited Nations bodies and agencies, non-
governmental organizations and AIDS service organizations
(ASOs,. Participants at the Consultation had betore them
tve background papers that had been commissioned tor the
purpose ot eliciting specitc regional and thematic experiences
and concerns regarding HIV and human rights. Participants
discussed the most important human rights principles and
concerns in the context ot HIV and AIDS, as vell as concrete
measures that States could take to protect HIV-related human
rights. 1he result vas the Iuteruatiouai uioeiiues ou HI1ID:
auo Humau Pihts. 1he tull text, as adopted by the Second
11
International Consultation, is contained in annex I to the
report ot the Secretary-General to the Commission on Human
Pights in document LCN.4199737. 1he Guidelines vere
published in 1998 by OHCHP and LNAIDS.
Signitcant developments have taken place vith regard to
the right to health and access to HIV-related prevention,
treatment, care and support, including advances in the
availability ot diagnostic tests and HIV-related treatments,
including antiretroviral therapies. 1here have been increased
commitments at the international, regional and domestic
levels tovards the tull realization ot all human rights related to
HIV, including improved access to health services tor people
living vith HIV. Key among these are: the Declaration ot
Commitment on HIVAIDS,
3
the Millennium Development
Goals,
4
general comment 14 ot the Committee on Lconomic,
Social and Cultural Pights,
5
and the Commission on Human
Pights resolutions on the right to the highest attainable
standard ot health
6
and access to medication.
7

In light ot advances in HIV-related treatment and antiretroviral
medication, the current global disparity in access to treatment,
as vell as political and legal developments since the elaboration
ot the Guidelines in 1996, the High Commissioner tor Human
Pights and the Lxecutive Director ot LNAIDS decided to
convene a 1hird International Consultation on HIVAIDS
and Human Pights on 23-26 uly 2002 in Geneva in order to
3
Declararion ol Commirmenr on Hv/ADS ('GloLal CrisisGloLal Acrion'), General
AssemLly resolurion S2c/2 ol 27 June 2001.
4
nirec Narions Millennium Declararion, General AssemLly resolurion 55/2 ol 8 SepremLer
2000.
5
General commenr 14 on rhe rihr ro rhe hihesr arrainaLle srancarc ol healrh, acoprec on
11 May 2000 (E/C.12/2000/4).
c
Commission on Human Fihrs resolurion 2002/31 ol 22 April 2002.
7
Commission on Human Fihrs resolurions 2002/33 anc 2002/32 ol 22 April 2002.
UNAID5 OHCHR
12
update Guideline 6. 1his document consolidates the original
Guidelines vith revised Guideline 6, together vith its related
commentary and recommendations tor implementation.
Since their original publication in 1998 and that ot revised
Guideline 6 in 2002, the Iuteruatiouai uioeiiues ou HI1ID:
auo Humau Pihts have provided important guidance to
Governments, international organizations, non-governmental
organizations and civil society groups on the development
and implementation ot ettective national strategies tor
combating HIV and AIDS. 1he Commission on Human
Pights has asked States to take all necessary steps to ensure
the respect, protection and tultlment ot HIV-related human
rights as contained in the Guidelines, and has urged States to
ensure that their lavs, policies and practices comply vith the
Guidelines.
8
1he Secretary-General has submitted reports to
the Commission on steps taken by Governments and Lnited
Nations organs, programmes and specialized agencies to
promote and implement the Guidelines.
9

Global resolve to halt and reverse the epidemic continues to
strengthen. In the 2003 World Summit Outcome,
10
vorld
leaders committed to a massive scaling-up ot HIV prevention,
treatment and care vith the aim ot coming as close as possible
to the goal ot universal access to treatment by 2010 tor all
vho need it. 1he political declaration ot the 2006 High Ievel
Meeting on AIDS attrmed and expanded these commitments.

8
Commission on Human Fihrs resolurions 17/33, 1/4, 2001/51, 2003/47, 2005/84.
E/CN.4/1/7c, E/CN.4/2001/80, E/CN.4/2003/81, E/CN.4/2005/7.

10
General AssemLly resolurion c0/1 ol 1c SepremLer 2005.
13
Bachgroun an summary oj the Cuielines
1. 1his document consolidates the Guidelines adopted at the
Second International Consultation on HIVAIDS and Human
Pights, held in Geneva trom 23 to 23 September 1996, and
revised Guideline 6 on access to prevention, treatment, care and
support adopted at the 1hird International Consultation on
HIVAIDS and Human Pights held in Geneva trom 23 to 26
uly 2002. 1he purpose ot these Guidelines is to assist States in
creating a positive, rights-based response to HIV that is ettective
in reducing the transmission and impact ot HIV and AIDS and
is consistent vith human rights and tundamental treedoms.
2. 1he elaboration ot such guidelines vas trst considered by
the 1989 International Consultation on AIDS and Human
Pights, organized jointly by the then Lnited Nations Centre
tor Human Pights and the World Health Organization.
11
1he
Lnited Nations Commission on Human Pights and its Sub-
Commission on Prevention ot Discrimination and Protection
ot Minorities repeatedly reiterated the need tor guidelines.
12

Increasingly, the international community recognized the need
tor elaborating turther hov existing human rights principles
apply in the context ot HIV and tor providing examples ot
concrete activities to be undertaken by States to protect human
rights and public health in the context ot HIV.
3. 1he purpose ot these Guidelines is to assist States in translating
international human rights norms into practical observance
in the context ot HIV. 1o this end, the Guidelines consist
11
Feporr ol an nrernarional Consulrarion on ADS anc Human Fihrs, Geneva, 2c ro 28 July
18 (HF/FB/0/2).
12
For reporrs anc resolurions on Hv/ADS anc human rihrs ol rhe nirec Narions
Commission on Human Fihrs anc irs SuLCommission on Frevenrion ol Discriminarion
anc Frorecrion ol Minoriries, see loornores c2c3.
UNAID5 OHCHR
14
ot three parts: trst, Guidelines tor State action comprising
action-oriented measures to be employed by Governments
in the areas ot lav, administrative policy and practice that
vill protect human rights and achieve HIV-related public
health goals, second, recommendations tor dissemination and
implementation ot the Guidelines, and third, international
human rights obligations and HIV, vhich describes the human
rights principles underlying a positive response to HIV.
4. 1he Guidelines recognize that States bring to the HIV
epidemic ditterent economic, social and cultural values,
traditions and practices a diversity vhich should be celebrated
as a rich resource tor an ettective response to HIV and AIDS.
In order to benett trom this diversity, a process ot participatory
consultation and cooperation vas undertaken in the dratting
ot the Guidelines, so that the Guidelines renect the experience
ot people attected by the epidemic, address relevant needs and
incorporate regional perspectives. lurthermore, the Guidelines
reattrm that diverse responses can and should be designed
vithin the context ot universal human rights standards.
3. It is intended that the principal users ot the Guidelines vill
be States, in the persons ot legislators and Government
policymakers, including ottcials involved in national AIDS
programmes and relevant departments and ministries, such
as health, toreign attairs, justice, interior, employment,
veltare and education. Other users vho vill benett trom
the Guidelines include intergovernmental organizations
(IGOs,, non-governmental organizations (NGOs,, netvorks
ot persons living vith HIV (PIHIV,, community-based
organizations (CBOs,, netvorks on ethics, lav, human rights
and HIV and AIDS service organizations (ASOs,.
15
1he broadest possible audience ot users ot the Guidelines vill
maximize their impact and make their content a reality.
6. 1he Guidelines address many dittcult and complex issues,
some ot vhich may or may not be relevant to the situation in
a particular country. lor these reasons, it is essential that the
Guidelines be taken by critical actors at the national and com-
munity level and considered in a process ot dialogue involving
a broad spectrum ot those most directly attected by the issues
addressed in the Guidelines. Such a consultative process vill
enable Governments and communities to consider hov the
Guidelines are specitcally relevant in their country, assess prior-
ity issues presented by the Guidelines and devise ettective vays
to implement the Guidelines in their respective contexts.
7. In implementing the Guidelines, it should be borne in mind
that achieving international cooperation in solving problems
ot an economic, social, cultural or humanitarian character and
promoting and encouraging respect tor human rights and tor
tundamental treedoms tor all, is one ot the principal objectives
ot the Lnited Nations. In this sense, international cooperation,
including tnancial and technical support, is a duty ot States in
the context ot the HIV epidemic and industrialized countries
are encouraged to act in a spirit ot solidarity in assisting
developing countries to meet the challenges ot implementing
the Guidelines.
8. HIV continues to spread throughout the vorld at an alarming
rate. 1he videspread abuse ot human rights and tundamental
treedoms associated vith HIV has emerged in all parts ot the
vorld in the vake ot the epidemic. In response to this situation
the experts at the Second International Consultation on HIV
AIDS and Human Pights concluded the tolloving:
UNAID5 OHCHR
1
(a, 1he protection ot human rights is essential to sateguard
human dignity in the context ot HIV and to ensure an
ettective, rights-based response to HIV and AIDS. An
ettective response requires the implementation ot all human
rights, civil and political, economic, social and cultural, and
tundamental treedoms ot all people, in accordance vith
existing international human rights standards,
(b, Public health interests do not connict vith human rights.
On the contrary, it has been recognized that vhen human
rights are protected, tever people become intected and
those living vith HIV and their tamilies can better cope
vith HIV and AIDS,
(c, A rights-based, ettective response to the HIV epidemic
involves establishing appropriate governmental institutional
responsibilities, implementing lav retorm and support
services and promoting a supportive environment tor
groups vulnerable to HIV and tor those living vith HIV,
(d, In the context ot HIV, international human rights norms
and pragmatic public health goals require States to consider
measures that may be considered controversial, particularly
regarding the status ot vomen and children, sex vorkers,
injecting drug users and men having sex vith men. It is,
hovever, the responsibility ot all States to identity hov they
can best meet their human rights obligations and protect
public health vithin their specitc political, cultural and
religious contexts,
(e, Although States have primary responsibility tor
implementing strategies that protect human rights and
public health, Lnited Nations bodies, agencies and
17
programmes, regional intergovernmental bodies and non-
governmental organizations, including netvorks ot people
living vith HIV, play critical roles in this regard.
9. 1here are many steps that States can take to protect HIV-re-
lated human rights and to achieve public health goals. 1he 12
Guidelines elaborated by the Consultations tor States to imple-
ment an ettective, rights-based response are summarized belov.
GUIDLLINL 1: :tates shouio esta|iish au effe.ti:e uatiouai frameuork
for their respouse to HI1 uhi.h eusures a .ooroiuateo, parti.ipatory,
trauspareut auo a..ouuta|ie approa.h, iuteratiu HI1 poii.y auo
proramme respousi|iiities a.ross aii |rau.hes of o:erumeut.
GUIDLLINL 2: :tates shouio eusure, throuh poiiti.ai auo fuau.iai
support, that .ommuuity .ousuitatiou o..urs iu aii phases of HI1 poii.y
oesiu, proramme impiemeutatiou auo e:aiuatiou auo that .ommuuity
oraui:atious are eua|ieo to .arry out their a.ti:ities, iu.iuoiu iu the
feio of ethi.s, iau auo humau rihts, effe.ti:eiy.
GUIDLLINL 3: :tates shouio re:ieu auo reform pu|ii. heaith iaus
to eusure that they aoeuateiy aooress pu|ii. heaith issues raiseo |y
HI1, that their pro:isious appii.a|ie to .asuaiiy trausmitteo oiseases are
uot iuappropriateiy appiieo to HI1 auo that they are .ousisteut uith
iuteruatiouai humau rihts o|iiatious.
GUIDLLINL 4: :tates shouio re:ieu auo reform .rimiuai iaus auo
.orre.tiouai systems to eusure that they are .ousisteut uith iuteruatiouai
humau rihts o|iiatious auo are uot misuseo iu the .outext of HI1 or
tareteo aaiust :uiuera|ie roups.
GUIDLLINL S: :tates shouio eua.t or streutheu autiois.rimiuatiou
auo other prote.ti:e iaus that prote.t :uiuera|ie roups, peopie ii:iu
UNAID5 OHCHR
18
uith HI1 auo peopie uith oisa|iiities from ois.rimiuatiou iu |oth
the pu|ii. auo pri:ate se.tors, eusure pri:a.y auo .oufoeutiaiity auo
ethi.s iu resear.h iu:oi:iu humau su|je.ts, emphasi:e eou.atiou auo
.ou.iiiatiou, auo pro:ioe for speeoy auo effe.ti:e aomiuistrati:e auo
.i:ii remeoies.
GUIDLLINL 6 (as revised in 2002): :tates shouio eua.t
ieisiatiou to pro:ioe for the reuiatiou of HI1reiateo ooos, ser:i.es
auo iuformatiou, so as to eusure uioespreao a:aiia|iiity of uaiity
pre:eutiou measures auo ser:i.es, aoeuate HI1 pre:eutiou auo .are
iuformatiou, auo safe auo effe.ti:e meoi.atiou at au afforoa|ie pri.e.
:tates shouio aiso take measures ue.essary to eusure for aii persous,
ou a sustaiueo auo euai |asis, the a:aiia|iiity auo a..essi|iiity of
uaiity ooos, ser:i.es auo iuformatiou for HI1 pre:eutiou, treatmeut,
.are auo support, iu.iuoiu autiretro:irai auo other safe auo effe.ti:e
meoi.iues, oiauosti.s auo reiateo te.huoioies for pre:euti:e, .urati:e
auo paiiiati:e .are of HI1 auo reiateo opportuuisti. iufe.tious auo
.ouoitious.
:tates shouio take su.h measures at |oth the oomesti. auo
iuteruatiouai ie:eis, uith parti.uiar atteutiou to :uiuera|ie iuoi:iouais
auo popuiatious.
GUIDLLINL 7: :tates shouio impiemeut auo support ieai support
ser:i.es that uiii eou.ate peopie affe.teo |y HI1 a|out their rihts,
pro:ioe free ieai ser:i.es to eufor.e those rihts, oe:eiop expertise ou
HI1reiateo ieai issues auo utiii:e meaus of prote.tiou iu aooitiou to
the .ourts, su.h as off.es of miuistries of justi.e, om|uospersous, heaith
.ompiaiut uuits auo humau rihts .ommissious.
1
GUIDLLINL 8: :tates, iu .oiia|oratiou uith auo throuh the
.ommuuity, shouio promote a supporti:e auo eua|iiu eu:iroumeut
for uomeu, .hiioreu auo other :uiuera|ie roups |y aooressiu
uuoeriyiu prejuoi.es auo iueuaiities throuh .ommuuity oiaioue,
spe.iaiiy oesiueo so.iai auo heaith ser:i.es auo support to .ommuuity
roups.
GUIDLLINL 9: :tates shouio promote the uioe auo ouoiu
oistri|utiou of .reati:e eou.atiou, traiuiu auo meoia prorammes
expii.itiy oesiueo to .haue attituoes of ois.rimiuatiou auo
stimati:atiou asso.iateo uith HI1 to uuoerstauoiu auo a..eptau.e.
GUIDLLINL 10: :tates shouio eusure that o:erumeut auo
the pri:ate se.tor oe:eiop .ooes of .ouou.t rearoiu HI1 issues
that trausiate humau rihts priu.ipies iuto .ooes of professiouai
respousi|iiity auo pra.ti.e, uith a..ompauyiu me.hauisms to
impiemeut auo eufor.e these .ooes.
GUIDLLINL 11: :tates shouio eusure mouitoriu auo eufor.emeut
me.hauisms to uarautee the prote.tiou of HI1reiateo humau
rihts, iu.iuoiu those of peopie ii:iu uith HI1, their famiiies auo
.ommuuities.
GUIDLLINL 12: :tates shouio .ooperate throuh aii reie:aut
prorammes auo aeu.ies of the uiteo âtious system, iu.iuoiu
ÎD:, to share kuouieoe auo experieu.e .ou.eruiu HI1
reiateo humau rihts issues auo shouio eusure effe.ti:e me.hauisms to
prote.t humau rihts iu the .outext of HI1 at iuteruatiouai ie:ei.
UNAID5 OHCHR
20
I. GuideIines for 5tate action
10. Pecommended Guidelines tor implementation by States in
order to promote and protect human rights in the context
ot HIV are set out belov. 1hese Guidelines are trmly
anchored vithin a tramevork ot existing international human
rights norms and are based on many years ot experience in
identitying those strategies that have proven successtul in
addressing HIV and AIDS. 1he normative principles together
vith practical strategies provide the evidence and ideas tor
States to reorient and redesign their policies and programmes
to ensure respect tor HIV-related rights and to be most
ettective in addressing the epidemic. States should provide
adequate political leadership and tnancial resources to enable
implementation ot these strategies.
11. 1he Guidelines tocus on activities by States in viev ot their
obligations under international and regional human rights
instruments. 1his is not to deny, hovever, the responsibilities
ot other key actors, such as the private sector, including
protessional groups such as health-care vorkers, the media, and
religious communities. 1hese groups also have responsibilities
not to engage in discrimination and to implement protective
and ethical policies and practices.
21
. Institutional responsililities an processes
GUIDELINE 1: NATIONAL FPAMEWOPK
12. States should establish an eIIective national Irame-
work Ior their response to HlV which ensures a
coordinated, participatory, transparent and ac-
countable approach, integrating HlV policy and
programme responsibilities, across all branches oI
government.
13. Depending upon existing institutions, the level ot the
epidemic and institutional cultures, as vell as the need to avoid
overlapping ot responsibilities, the tolloving responses should
be considered:
(a, lormation ot an interministerial committee to ensure
integrated development and high-level coordination ot
individual ministerial national action plans and to monitor
and implement the additional HIV strategies, as set out
belov. In tederal systems, an intergovernmental committee
should also be established vith provincialstate, as vell as
national representation. Lach ministry should ensure that
HIV and human rights are integrated into all its relevant
plans and activities, including:
(i, Lducation,
(ii, Iav and justice, including police and corrective
services,
(iii, Science and research,
(iv, Lmployment and public service,
(v, Weltare, social security and housing,
(vi, Immigration, indigenous populations, toreign attairs
and development cooperation,
UNAID5 OHCHR
22
(vii, Health,
(viii,1reasury and tnance,
(ix, Detence, including armed services.
(b, Lnsuring that an intormed and ongoing torum exists
tor brietng, policy discussion and lav retorm to deepen
the level ot understanding ot the epidemic, in vhich
all political vievpoints can participate at national and
subnational levels, e.g. by establishing parliamentary or
legislative committees vith representation trom major and
minor political parties.
(c, lormation or strengthening ot advisory bodies to
Governments on legal and ethical issues, such as a
legal and ethical subcommittee ot the interministerial
committee. Pepresentation should consist ot protessional
(public, lav and education, science, bio-medical and
social,, religious and community groups, employers` and
vorkers` organizations, NGOs and ASOs, nominees
experts and people living vith HIV.
(d, Sensitization ot the judicial branch ot government, in vays
consistent vith judicial independence, on the legal, ethical
and human rights issues relative to HIV, including through
judicial education and the development ot judicial materials.
(e, Ongoing interaction ot government branches vith
Lnited Nations 1heme Groups on HIVAIDS and other
concerned international and bilateral actors to ensure
that governmental responses to the HIV epidemic vill
continue to make the best use ot assistance available trom
the international community. Such interaction should, iuter
aiia, reintorce cooperation and assistance to areas related to
HIV and human rights.
23
Commeutary ou uioeiiue 1
14. 1o be ettective, the response to HIV must mobilize key
actors throughout all branches ot government and include
all policy areas, since only a combination ot vell-integrated
and coordinated approaches can address the complexities ot
the epidemic. In all sectors, leadership must be developed and
must demonstrate a dedication to HIV-related human rights.
Governments should avoid unnecessary politicization ot HIV
vhich diverts Government energy and divides the community
rather than engendering a sense ot solidarity and consensus in
dealing vith the epidemic. Political commitment to dedicate
adequate resources to respond to the epidemic vithin States
is essential. It is equally important that these resources be
channelled into productive and coordinated strategies. Poles
and lines ot responsibility vithin Government, including
human rights issues, should be clarited.
13. Most countries already have national AIDS committees.
In some countries, there are also subnational committees.
Hovever, the persistent lack ot coordination in Government
policy and the lack ot specitc attention to human rights
issues relating to the HIV epidemic suggest a need to consider
possible additional structures or to strengthen and reorient
those that exist to include legal and ethical issues. Several
models ot coordinating committees and multidisciplinary
advisory groups exist.
13
Similar coordination is essential vithin
and betveen lover levels ot government. It is necessary to
13
A successlul example ol an inrerminisrerial coorcinarin commirree is rhe Narional ADS
Frevenrion anc Conrrol Commirree chairec Ly rhe Frime Minisrer ol Thailanc since 11.
rher mocels are rhe Feceral Farliamenrary Liaison Group in Ausrralia, rhe Narional ADS
Coorcinarin Council in Wesrern Samoa, rhe Fhilippine Narional ADS Council anc rhe
Narional Commission on ADS in rhe nirec Srares. Anorher noreworrhy example is rhe
Narional AnriADS Commirree esraLlishec Ly rhe Fresicenr ol kraine as a special Srare
aurhoriry.
UNAID5 OHCHR
24
tocus such coordination not only in creating specialized HIV
bodies, but also in securing a place tor HIV human rights
issues in existing mainstream torums, such as regular gatherings
ot Ministers ot, e.g. Health, ustice and Social Weltare. A
multidisciplinary body vith protessional and community
representation should exist to advise Governments on legal
and ethical issues. 1hese bodies at the national level should also
ensure coordination vith LNAIDS, its cosponsors and other
international agencies (donors, bilateral donors and others, to
reintorce cooperation and assistance to areas relating to HIV
and human rights.
GUIDELINE 2: 5UPPOPTING COMMUNITY
PAPTNEP5HIP
1. States should ensure, through political and Inancial
support, that community consultation occurs in all
phases oI HlV policy design, programme imple-
mentation and evaluation and that community
organizations are enabled to carry out their activi-
ties, including in the Ields oI ethics, law and human
rights, eIIectively.
(a, Community representation should comprise people
living vith HIV, CBOs, ASOs, human rights NGOs
and representatives ot vulnerable groups.
14
lormal and
regular mechanisms should be established to tacilitate
ongoing dialogue vith and input trom such community
representatives into HIV-related Government policies
and programmes. 1his could be established through
14
See secrion , nrrocucrion, lor a lisrin ol vulneraLle roups.
25
regular reporting by community representatives to the
various government, parliamentary and judicial branches
described in Guideline 1, joint vorkshops vith community
representatives on policy, planning and evaluation ot State
responses and through mechanisms tor receiving vritten
submissions trom the community.
(b, Suttcient Government tunding should be allocated in order
to support, sustain and enhance community organizations in
areas ot core support, capacity-building and implementation
ot activities, in such areas as HIV-related ethics, human
rights and lav. Such activities might involve training
seminars, vorkshops, netvorking, developing promotional
and educational materials, advising clients ot their human
and legal rights, reterring clients to relevant grievance
bodies, collecting data on human rights issues and human
rights advocacy.
17. Community partners have knovledge and experience that
States need in order to tashion ettective State responses. 1his
is the case particularly vith regard to human rights issues,
as community representatives are either directly attected by
human rights problems or vork directly vith those vho are
attected. States should, theretore, ensure that this knovledge
and experience are included in the development ot HIV policy,
programmes and evaluation by recognizing the importance ot
such contributions and creating structural means by vhich to
obtain them.
18. 1he contribution ot CBOs, NGOs, ASOs and people living
vith HIV is an essential part ot the overall national response to
the epidemic, in such areas as ethics, lav and human rights. As
UNAID5 OHCHR
2
community representatives do not necessarily possess organiza-
tional ability or skills tor advocacy, lobbying and human rights
vork, this contribution should be enhanced by State tunding
tor administrative support, capacity-building, human resource
development and implementation ot activities. Collection
ot complaints data by CBOs and NGOs is vital to intorm
Governments and the international community vhere the most
serious HIV-related human rights problems are occurring and
vhat ettective action should be implemented in response.
15
B. Lau revieu, rejorm an support services
GUIDELINE 3: PULIC HEALTH LEGI5LATION
1. States should review and reIorm public health
laws to ensure that they adequately address public
health issues raised by HlV, that their provisions
applicable to casually transmitted diseases are
not inappropriately applied to HlV and that they
are consistent with international human rights
obligations.
20. Public health legislation should include the tolloving
components:
(a, Public health lav should tund and empover public health
authorities to provide a comprehensive range ot services tor
the prevention and treatment ot HIV and AIDS, including
relevant intormation and education, access to voluntary test-
ing and counselling, S1D and sexual and reproductive health
services tor men and vomen, condoms and drug treatment,
15
See Guiceline 11, pararaph cc.
27
services and clean injection materials, as vell as adequate
treatment tor HIV and AIDS-related illnesses, including pain
prophylaxis.
(b, Apart trom surveillance testing and other unlinked testing
done tor epidemiological purposes, public health legislation
should ensure that HIV testing ot individuals should only
be pertormed vith the specitc intormed consent ot that
individual. Lxceptions to voluntary testing vould need
specitc judicial authorization, granted only atter due
evaluation ot the important considerations involved in
terms ot privacy and liberty.
(c, In viev ot the serious nature ot HIV testing and in order
to maximize prevention and care, public health legislation
should ensure, vhenever possible, that pre-and post-test
counselling be provided in all cases. With the introduction
ot home-testing, States should ensure quality control,
maximize counselling and reterral services tor those vho
use such tests and establish legal and support services tor
those vho are the victims ot misuse ot such tests by others.
(d, Public health legislation should ensure that people not be
subjected to coercive measures such as isolation, detention or
quarantine on the basis ot their HIV status. Where the liberty
ot persons living vith HIV is restricted, due process protec-
tion (e.g. notice, rights ot revievappeal, txed rather than
indeterminate periods ot orders and rights ot representation,
should be guaranteed.
(e, Public health legislation should ensure that HIV and
AIDS cases reported to public health authorities tor
epidemiological purposes are subject to strict rules ot data
protection and contdentiality.
UNAID5 OHCHR
28
(t, Public health legislation should ensure that intormation
relative to the HIV status ot an individual be protected trom
unauthorized collection, use or disclosure in the health-
care and other settings and that the use ot HIV-related
intormation requires intormed consent.
(g, Public health legislation should authorize, but not require,
that health-care protessionals decide, on the basis ot each
individual case and ethical considerations, vhether to
intorm their patients` sexual partners ot the HIV status
ot their patient. Such a decision should only be made in
accordance vith the tolloving criteria:
(i, 1he HIV-positive person in question has been
thoroughly counselled,
(ii, Counselling ot the HIV-positive person has tailed to
achieve appropriate behavioural changes,
(iii, 1he HIV-positive person has retused to notity, or
consent to the notitcation ot hisher partner(s,,
(iv, A real risk ot HIV transmission to the partner(s, exists,
(v, 1he HIV-positive person is given reasonable advance
notice,
(vi, 1he identity ot the HIV-positive person is concealed
trom the partner(s,, it this is possible in practice, and
(vii, lollov-up is provided to ensure support to those
involved, as necessary.
(h, Public health legislation should ensure that the blood
tissueorgan supply is tree ot HIV and other blood-borne
diseases.
(i, Public health lav should require the implementation ot
universal intection control precautions in health-care and
other settings involving exposure to blood and other bodily
2
nuids. Persons vorking in these settings must be provided
vith the appropriate equipment and training to implement
such precautions.
(j, Public health legislation should require that health-care
vorkers undergo a minimum ot ethics andor human
rights training in order to be licensed to practise and should
encourage protessional societies ot health-care vorkers to
develop and entorce codes ot conduct based on human
rights and ethics, including HIV-related issues such as
contdentiality and the duty to provide treatment.
GUIDELINE 4: CPIMINAL LAW5 AND
COPPECTIONAL 5Y5TEM5
21. States should review and reIorm criminal laws and
correctional systems to ensure that they are con-
sistent with international human rights obligations
and are not misused in the context oI HlV or tar-
geted at vulnerable groups.
(a, Criminal andor public health legislation should not
include specitc ottences against the deliberate and
intentional transmission ot HIV but rather should apply
general criminal ottences to these exceptional cases.
Such application should ensure that the elements ot
toreseeability, intent, causality and consent are clearly and
legally established to support a guilty verdict andor harsher
penalties.
(b, Criminal lav prohibiting sexual acts (including adultery,
sodomy, tornication and commercial sexual encounters,
betveen consenting adults in private should be revieved,
UNAID5 OHCHR
30
vith the aim ot repeal. In any event, they should not be
alloved to impede provision ot HIV prevention and care
services.
(c, With regard to adult sex vork that involves no victimiza-
tion, criminal lav should be revieved vith the aim ot de-
criminalizing, then legally regulating occupational health
and satety conditions to protect sex vorkers and their
clients, including support tor sate sex during sex vork.
Criminal lav should not impede provision ot HIV pre-
vention and care services to sex vorkers and their clients.
Criminal lav should ensure that children and adult sex
vorkers vho have been trattcked or othervise coerced
into sex vork are protected trom participation in the sex
industry and are not prosecuted tor such participation but
rather are removed trom sex vork and provided vith medi-
cal and psycho-social support services, including those re-
lated to HIV.
(d, Criminal lav should not be an impediment to measures
taken by States to reduce the risk ot HIV transmission
among injecting drug users and to provide HIV-related care
and treatment tor injecting drug users. Criminal lav should
be revieved to consider:

the authorization or legalization and promotion ot
needle and syringe exchange programmes,

the repeal ot lavs criminalizing the possession,
distribution and dispensing ot needles and syringes.
(e, Prison authorities should take all necessary measures,
including adequate stattng, ettective surveillance and
appropriate disciplinary measures, to protect prisoners trom
rape, sexual violence and coercion. Prison authorities should
31
also provide prisoners (and prison statt, as appropriate,, vith
access to HIV-related prevention intormation, education,
voluntary testing and counselling, means ot prevention
(condoms, bleach and clean injection equipment,, treatment
and care and voluntary participation in HIV-related clinical
trials, as vell as ensure contdentiality, and should prohibit
mandatory testing, segregation and denial ot access to prison
tacilities, privileges and release programmes tor HIV-positive
prisoners. Compassionate early release ot prisoners living
vith AIDS should be considered.
GUIDELINE 5: ANTI-DI5CPIMINATION AND
PPOTECTIVE LAW5
22. States should enact or strengthen anti-discrimina-
tion and other protective laws that protect vulner-
able groups, people living with HlV and people
with disabilities Irom discrimination in both the
public and private sectors, that will ensure privacy
and conIdentiality and ethics in research involving
human subjects, emphasize education and concilia-
tion and provide Ior speedy and eIIective adminis-
trative and civil remedies.
(a, General anti-discrimination lavs should be enacted or re-
vised to cover people living vith asymptomatic HIV intec-
tion, people living vith AIDS and those merely suspected
ot HIV or AIDS. Such lavs should also protect groups made
more vulnerable to HIVAIDS due to the discrimination
they tace. Disability lavs should also be enacted or revised
to include HIV and AIDS in their detnition ot disability.
Such legislation should include the tolloving:
UNAID5 OHCHR
32
(i, 1he areas covered should be as broad as possible, in-
cluding health care, social security, veltare benetts,
employment, education, sport, accommodation, clubs,
trades unions, qualitying bodies, access to transport and
other services,
(ii, Direct and indirect discrimination should be covered,
as should cases vhere HIV is only one ot several rea-
sons tor a discriminatory act, and prohibiting HIV vili-
tcation should also be considered,
(iii, Independent, speedy and ettective legal andor
administrative procedures tor seeking redress, including
such teatures as tast-tracking tor cases vhere the
complainant is terminally ill, investigatory povers to
address systemic cases ot discrimination in policies and
procedures, ability to bring cases under pseudonym and
representative complaints, including the possibility ot
public interest organizations bringing cases on behalt ot
people living vith HIV,
(iv, Lxemptions tor superannuation and lite insurance
should only relate to reasonable actuarial data, so that
HIV is not treated ditterently trom analogous medical
conditions.
(b, 1raditional and customary lavs vhich attect the status and
treatment ot various groups ot society should be revieved
in the light ot anti-discrimination lavs. It necessary, legal
remedies should be made available, it such lavs are misused
and intormation, education and community mobilization
campaigns should be conducted to change these lavs and
attitudes associated vith them.
(c, General contdentiality and privacy lavs should be enacted.
HIV-related intormation on individuals should be included
vithin detnitions ot personalmedical data subject to
33
protection and should prohibit the unauthorized use and
or publication ot HIV-related intormation on individuals.
Privacy legislation should enable an individual to see his
or her ovn records and to request amendments to ensure
that such intormation is accurate, relevant, complete and
up to date. An independent agency should be established
to redress breaches ot contdentiality. Provision should be
made tor protessional bodies to discipline cases ot breaches
ot contdentiality as protessional misconduct under codes ot
conduct discussed belov.
16
Lnreasonable invasion ot privacy
by the media could also be included as a component ot
protessional codes governing journalists. People living vith
HIV should be authorized to demand that their identity
and privacy be protected in legal proceedings in vhich
intormation on these matters vill be raised.
(d, Iavs, regulations and collective agreements should be
enacted or reached so as to guarantee the tolloving
vorkplace rights:
(i, A national policy on HIV and the vorkplace agreed
upon in a tripartite body,
(ii, lreedom trom HIV screening tor employment,
promotion, training or benetts,
(iii, Contdentiality regarding all medical intormation,
including HIV status,
(iv, Lmployment security tor vorkers living vith HIV
until they are no longer able to vork, including
reasonable alternative vorking arrangements,
(v, Detned sate practices tor trst aid and adequately
equipped trst-aid kits,
1c
See Guiceline 10, pararaphs c4c5.
UNAID5 OHCHR
34
(vi, Protection tor social security and other benetts tor
vorkers living vith HIV, including lite insurance,
pension, health insurance, termination and death
benetts,
(vii, Adequate health care accessible in or near the
vorkplace,
(viii, Adequate supplies ot condoms available tree to
vorkers at the vorkplace,
(ix, Workers` participation in decision-making on
vorkplace issues related to HIV and AIDS,
(x, Access to intormation and education programmes on
HIV, as vell as to relevant counselling and appropriate
reterral,
(xi, Protection trom stigmatization and discrimination by
colleagues, unions, employers and clients,
(xii, Appropriate inclusion in vorkers` compensation leg-
islation ot the occupational transmission ot HIV (e.g.
needle stick injuries,, addressing such matters as the
long latency period ot intection, testing, counselling
and contdentiality.
(e, Protective lavs governing the legal and ethical protection
ot human participation in research, including HIV-related
research, should be enacted or strengthened in relation to:
(i, Non-discriminatory selection ot participants, e.g.
vomen, children, minorities,
(ii, Intormed consent,
(iii, Contdentiality ot personal intormation,
(iv, Lquitable access to intormation and benetts emanating
trom research,
(v, Counselling, protection trom discrimination, health and
support services provided during and atter participation,
35
(vi, 1he establishment ot local andor national ethical re-
viev committees to ensure independent and ongoing
ethical reviev, vith participation by members ot the
community attected, ot the research project,
(vii, Approval tor use ot sate and ettcacious pharmaceuti-
cals, vaccines and medical devices.
(t, Anti-discrimination and protective lavs should be enacted
to reduce human rights violations against vomen in the
context ot HIV, so as to reduce vulnerability ot vomen to
intection by HIV and to the impact ot HIV and AIDS. More
particularly, lavs should be revieved and retormed to ensure
equality ot vomen regarding property and marital rela-
tions and access to employment and economic opportunity,
so that discriminatory limitations are removed on rights to
ovn and inherit property, enter into contracts and marriage,
obtain credit and tnance, initiate separation or divorce, eq-
uitably share assets upon divorce or separation, and retain
custody ot children. Iavs should also be enacted to ensure
vomen`s reproductive and sexual rights, including the right
ot independent access to reproductive and S1D health intor-
mation and services and means ot contraception, including
sate and legal abortion and the treedom to choose among
these, the right to determine number and spacing ot chil-
dren, the right to demand sater sex practices and the right
to legal protection trom sexual violence, outside and inside
marriage, including legal provisions tor marital rape. 1he
age ot consent to sex and marriage should be consistent tor
males and temales and the right ot vomen and girls to retuse
marriage and sexual relations should be protected by lav.
1he HIV status ot a parent or child should not be treated
any ditterently trom any other analogous medical condition
in making decisions regarding custody, tostering or adoption.
UNAID5 OHCHR
3
(g, Anti-discrimination and protective lavs should be enacted
to reduce human rights violations against children in
the context ot HIV, so as to reduce the vulnerability ot
children to intection by HIV and to the impact ot HIV
and AIDS. Such lavs should provide tor children`s access
to HIV-related intormation, education and means ot
prevention inside and outside school, govern children`s
access to voluntary testing vith consent by the child,
in line vith the evolving capacities ot the child, or by
the parent or appointed guardian, as appropriate, should
protect children against mandatory testing, particularly
it orphaned by AIDS, and provide tor other torms
ot protection in the context ot orphans, including
inheritance andor support. Such legislation should also
protect children against sexual abuse, provide tor their
rehabilitation it abused and ensure that they are considered
victims ot vrongtul behaviour, not subject to penalties
themselves. Protection in the context ot disability lavs
should also be ensured tor children.
(h, Anti-discrimination and protective lavs should be
enacted to reduce human rights violations against men
having sex vith men, including in the context ot HIV,
in order, iuter aiia, to reduce the vulnerability ot men
vho have sex vith men to intection by HIV and to the
impact ot HIV and AIDS. 1hese measures should include
providing penalties tor vilitcation ot people vho engage
in same-sex relationships, giving legal recognition to
same-sex marriages andor relationships and governing
such relationships vith consistent property, divorce and
inheritance provisions. 1he age ot consent to sex and
marriage should be consistent tor heterosexual and
homosexual relationships. Iavs and police practices
37
relating to assaults against men vho have sex vith
men should be revieved to ensure that adequate legal
protection is given in these situations.
(i, Iavs and regulations that provide tor restrictions on
the movement or association ot members ot vulnerable
groups
17
in the context ot HIV should be removed in both
lav (decriminalized, and lav entorcement.
(j, Public health, criminal and anti-discrimination legislation
should prohibit mandatory HIV-testing ot targeted groups,
including vulnerable groups.
18

GUIDELINE : ACCE55 TO PPEVENTION,
TPEATMENT, CAPE AND 5UPPOPT (revised)
23. States should enact legislation to provide Ior the
regulation oI HlV-related goods, services and
inIormation, so as to ensure widespread availability
oI quality prevention measures and services,
adequate HlV prevention and care inIormation, and
saIe and eIIective medication at an aIIordable price.
24. States should also take measures necessary to en-
sure Ior all persons, on a sustained and equal basis,
the availability and accessibility oI quality goods,
services and inIormation Ior HlV/AlDS prevention,
treatment, care and support, including antiretroviral
and other saIe and eIIective medicines, diagnostics
17
18
n accirion ro vulneraLle roups, specilc employmenr roups shoulc also Le prorecrec
lrom such rarerec resrin, e.. rruck crivers, sailors, hospiraliry/rourisr incusrry workers
anc rhe milirary.
UNAID5 OHCHR
38
and related technologies Ior preventive, curative
and palliative care oI HlV and related opportunistic
inIections and conditions.
25. States should take such measures at both the
domestic and international levels, with particular
attention to vulnerable individuals and populations.
Commeutary ou uioeiiue &
26. Prevention, treatment, care and support are mutually reintorcing
elements and a continuum ot an ettective response to HIV.
1hey must be integrated into a comprehensive approach, and
a multitaceted response is needed. Comprehensive treatment,
care and support include antiretroviral and other medicines,
diagnostics and related technologies tor the care ot HIV and
AIDS, related opportunistic intections and other conditions,
good nutrition, and social, spiritual and psychological support,
as vell as tamily, community and home-based care. HIV-
prevention technologies include condoms, lubricants, sterile
injection equipment, antiretroviral medicines (e.g. to prevent
mother-to-child transmission or as post-exposure prophylaxis,
and, once developed, sate and ettective microbicides and
vaccines. Based on human rights principles, universal access
requires that these goods, services and intormation not only
be available, acceptable and ot good quality, but also vithin
physical reach and attordable tor all.
Pe.ommeuoatious for impiemeutatiou of uioeiiue &
27. States should develop and implement national plans to
progressively realize universal access to comprehensive
3
treatment, care and support tor all persons living vith HIV,
as vell as universal access to a tull range ot goods, services
and intormation tor HIV prevention. National plans should
be developed in consultation vith non-governmental
organizations to ensure the active participation ot people living
vith HIV and vulnerable groups.
28. Lniversal access to HIV prevention, treatment, care and
support is necessary to respect, protect and tultl human rights
related to health, including the right to enjoy the highest
attainable standard ot health. Lniversal access vill be achieved
progressively over time. Hovever, States have an immediate
obligation to take steps, and to move as quickly and ettectively
as possible, tovards realizing access tor all to HIV prevention,
treatment, care and support at both the domestic and global
levels. 1his requires, among other things, setting benchmarks
and targets tor measuring progress.
19
29. Access to HIV-related intormation, goods and services is
attected by a range ot social, economic, cultural, political
and legal tactors. States should reviev and, vhere necessary,
amend or adopt lavs, policies, programmes and plans to realize
universal and equal access to medicines, diagnostics and related
technologies, taking these tactors into account. As one example,
duties, customs lavs and value-added taxes may hinder access
to medicines, diagnostics and related technologies at attordable
prices. Such lavs should be revised so as to maximize access.
States should ensure that national lavs, policies, programmes
1
For example, Srares coulc make use ol rhe incicarors cevelopec Ly NADS lor measurin
lollowup on rhe nirec Narions General AssemLly's 2001 Declararion ol Commirmenr on
Hv/ADS, in parricular rhe Narional Composire Folicy ncex, which assesses a counrry's
proress in cevelopin laws, policies anc srrareies ro accress Hv anc ADS ar rhe
narional level in relarion ro prevenrion, rrearmenr, care anc supporr, as well as specilc
human rihrs issues.
UNAID5 OHCHR
40
and plans attecting access to HIV-related goods, services or
intormation are consistent vith international human rights
norms, principles and standards. States should consider the
experience and expertise ot other States, and consult vith
people living vith HIV, non-governmental organizations, and
domestic and international health organizations vith relevant
expertise.
30. States should also ensure that their lavs, policies, programmes
and practices do not exclude, stigmatize or discriminate against
people living vith HIV or their tamilies, either on the basis ot
their HIV status or on other grounds contrary to international
or domestic human rights norms, vith respect to their entitle-
ment or access to health-care goods, services and intormation.
20

31. States` legislation, policies, programmes, plans and practices
should include positive measures to address tactors that hinder
the equal access ot vulnerable individuals and populations to
prevention, treatment, care and support, such as poverty, migra-
tion, rural location or discrimination ot various kinds.
21
1hese
tactors may have a cumulative ettect. lor example, children
(particularly girls, and vomen may be the last to receive access
even it treatment is othervise available in their communities.
20
See also Guiceline 5, aLove, rearcin prorecrions aainsr ciscriminarion, inclucin in
areas such as healrh care, social securiry, wellare Lenelrs anc orher services.
21
Depencin on leal, social anc economic concirions, which may vary wicely wirhin counrries
anc across reions, incivicuals anc roups rhar may Le vulneraLle ro ciscriminarion anc
marinalizarion incluce women, chilcren, rhose livin in poverry, incienous people(s), ay
men anc orher men who have sex wirh men, miranrs, reluees anc inrernally cisplacec
persons, people wirh cisaLiliries, prisoners anc orher cerainec persons, sex workers, rrans
encer people, people who use illeal crus, anc racial, reliious, erhnic, linuisric or orher
minoriries. See also: Guiceline 3, pararaph 20 (|), anc Guiceline 10, pararaph c4 (a), on
measures ro accress ciscriminarion in rhe provision ol healrh care, Guiceline 4, pararaph
21 (e), on rhe specilc issue ol access ro Hvrelarec prevenrion, rrearmenr anc care lor pris
oners, anc Guiceline 8, pararaphs c0 (L) anc c0 (|), rearcin specilc arrenrion ro rhe
neecs ol vulneraLle roups.
41
32. States should recognize, attrm and strengthen the involvement
ot communities as part ot comprehensive HIV prevention,
treatment, care and support, vhile also complying vith their
ovn obligations to take steps in the public sector to respect,
protect and tultl human rights related to health. Mechanisms
should be developed to enable attected communities to access
resources to assist tamilies vho have lost income earners to
AIDS. Particular attention must be paid to gender inequalities,
vith respect to access to care in the community tor vomen
and girls, as vell as the burdens that delivering care at the
community level may impose on them.
33. 1o assist caregivers and, vhere relevant, employers and insurers,
States should ensure the availability, use and implementation ot
sound, scientitcally up-to-date guidelines tor prevention, treat-
ment, care and support to people living vith HIV in respect
ot available health-care goods, services and intormation. States
should develop mechanisms to monitor and improve, as neces-
sary, the availability, use and implementation ot these guidelines.
34. Iegislation, policies and programmes should take into account
the tact that persons living vith HIV may recurrently and pro-
gressively experience ill-health and greater health-care needs,
vhich should be accommodated accordingly vithin benett
schemes in both the public and private sectors. States should
vork vith employers, and employers` and vorkers` organiza-
tions, to adopt or adapt benett schemes, vhere necessary, to
ensure universal and equal access to benetts tor vorkers living
vith HIV. Particular attention must also be paid to ensuring
access to health care tor individuals outside the tormal employ-
ment sector, vho lack vork-related health-care benetts.
22
22
See also Guiceline 5, pararaph 22 (c), anc rhe Codc o| practcc on H|V/A|D5 and tnc
vor!d o| vorx, acoprec in 2001 Ly rhe nrernarional LaLour ranizarion.
UNAID5 OHCHR
42
33. States should ensure that domestic legislation provides tor
prompt and ettective remedies in cases in vhich a person living
vith HIV is denied or not provided access to treatment, care
and support. States should also ensure due process ot lav so
that the merits ot such complaints can be independently and
impartially assessed. At the international level, States should
strengthen existing mechanisms, and develop nev mechanisms
vhere they do not currently exist, enabling persons living vith
HIVAIDS to seek prompt, ettective redress tor breaches ot
States` international legal obligations to respect, protect and
tultl rights related to health.
36. States should ensure the quality assurance and control ot HIV-
related products. States should ensure, through legislative and
other measures (e.g. tunctional systems tor pre-marketing
approval and post-marketing surveillance,, that medicines,
diagnostics and related technologies are sate and ettective.
37. States should take legislative and other measures to ensure that
medicines are supplied in adequate quantities and in a timely
tashion, and vith accurate, current and accessible intormation
regarding their use. lor example, consumer protection lavs or
other relevant legislation should be enacted or strengthened
to prevent traudulent claims regarding the satety and ettcacy
ot drugs, vaccines and medical devices, including those
relating to HIV.
38. Iavs andor regulations should be enacted to ensure the
quality and availability ot HIV tests and counselling. It home
tests andor rapid HIV test kits are permitted on the market,
they should be strictly regulated to ensure quality and accuracy.
1he consequences ot loss ot epidemiological intormation, the
lack ot accompanying counselling and the risk ot unauthorized
43
use, such as tor employment or immigration, should also
be addressed. Iegal and social support services should be
established to protect individuals trom any abuses arising trom
HIV testing. States should also ensure supervision ot the quality
ot delivery ot voluntary counselling and testing (VC1, services.
39. Iegal quality control ot condoms should be entorced, and
compliance vith the International Condom Standard should
be monitored in practice. Pestrictions on the availability ot
preventive measures, such as condoms, bleach, clean needles
and syringes, should be repealed. Widespread provision ot these
preventive measures through various means, including vending
machines in appropriate locations, should be considered, in
light ot the greater ettectiveness provided by the increased
accessibility and anonymity attorded by this method ot
distribution. Condom promotion initiatives should be coupled
vith HIV intormation campaigns tor optimal impact.
40. Iavs andor regulations should be enacted to enable
videspread provision ot intormation about HIV through the
mass media. 1his intormation should be aimed at the general
public, as vell as at various vulnerable groups that may have
dittculty in accessing intormation. HIV intormation should be
ettective tor its designated audience and not be inappropriately
subject to censorship or other broadcasting standards,
particularly as this vill have the ettect ot damaging access to
intormation vital to lite, health and human dignity.
41. In order to improve prevention and therapeutic options related
to HIV, States should increase tunds allocated to the public
sector tor researching, developing and promoting therapies and
technologies tor the prevention, treatment, care and support
ot HIV and AIDS and related intections and conditions. 1he
UNAID5 OHCHR
44
private sector should also be encouraged to undertake such
research and development and to make the resulting options
videly and promptly available at prices attordable to those vho
need them.
42. States and the private sector should pay special attention to
supporting research and development that address the health
needs ot developing countries. In recognition ot the human
right to share in scientitc advancement and its benetts,
States should adopt lavs and policies, at the domestic and
international levels, ensuring that the outcomes ot research and
development are ot national and global benett, vith particular
attention to the needs ot people in developing countries and
people vho are poor or othervise marginalized.
43. States should integrate HIV prevention, treatment, care and
support into all aspects ot their planning tor development,
including in poverty eradication strategies, national budget
allocations and sectoral development plans. In so doing, States
should have particular regard, at a minimum, tor internationally
agreed targets in addressing HIV.
23

44. States should increase their national budget allocations tor
measures promoting secure and sustainable access to attordable
HIV prevention, treatment, care and support, at both the
domestic and international levels. States should, among other
steps, make contributions, in proportion to their resources,
to mechanisms such as the Global lund to light AIDS,
1uberculosis and Malaria. Developed countries should make
concrete commitments ot increased ottcial development
23
Examples incluce rhe Millennium Developmenr Goals areec in 2000 Ly rhe nirec
Narions General AssemLly, anc rhe specilc Hv/ADSrelarec oals areec in rhe nirec
Narions General AssemLly's Declararion ol Commirmenr on Hv/ADS in 2001.
45
assistance that vill move them vithout delay tovards meeting
international targets to vhich they have agreed, paying
particular attention to assistance in realizing access to health-
care goods, services and intormation.
24
43. States should ensure that international and bilateral mechanisms
tor tnancing responses to HIVAIDS provide tunds tor
prevention, treatment, care and support, including the purchase
ot antiretroviral and other medicines, diagnostics and related
technologies. States should support and implement policies
maximizing the benett ot donor assistance, including policies
ensuring that such resources are used to purchase generic
medicines, diagnostics and related technologies, vhere these are
more economical.
46. States` international and bilateral tnancing mechanisms should
also provide tunding tor strengthening health-care systems, tor
improving the capacity and vorking conditions ot health-care
personnel and the ettectiveness ot supply systems, tor tnancing
plans and reterral mechanisms to provide access to prevention,
treatment, care and support, and tor tamily, community and
home-based care.
47. States should collaborate vith non-governmental organizations,
intergovernmental organizations, and Lnited Nations
bodies, agencies and programmes in creating, maintaining
and expanding international, publicly accessible sources ot
intormation on the sources, quality and vorldvide prices
24
For example, in rheir 2001 Declararion ol Commirmenr on Hv/ADS, all nirec Narions
MemLer Srares urec cevelopec counrries rhar have nor cone so ro meer, as soon as
possiLle, rhe lonsrancin rarer ol cecicarin 0.7% ol rheir ross narional procucr ro
overall ollcial cevelopmenr assisrance anc earmarkin 0.150.20% ol rheir ross narional
procucr as ollcial cevelopmenr assisrance lor leasr cevelopec counrries. Srares lormally
reirerarec rhis call in rhe ourcome cocumenr ol rhe 2002 nrernarional Conlerence on
Financin lor Developmenr (Monrerrey, Mexico).
UNAID5 OHCHR
4
ot medicines, diagnostics and related technologies tor the
preventive, curative and palliative care ot HIV and AIDS and
related opportunistic intections and conditions.
25
48. Creditor countries and international tnancing institutions
should implement debt reliet tor developing countries more
quickly and extensively, and should ensure that resources
provided tor this purpose do not detract trom those made
available tor ottcial development assistance. Developing
countries should use the resources treed up by debt reliet (as
vell as other sources ot development tnance, in a manner that
tully takes into account their obligations to respect, protect
and tultl rights related to health. States should, among other
things, dedicate an appropriate proportion ot such resources, in
the light ot domestic conditions, priorities and internationally
agreed commitments, to HIV prevention, treatment, care and
support.
49. States should support and cooperate vith international
mechanisms tor monitoring and reporting on the measures
they have taken tor progressively realizing access to
comprehensive HIV prevention, treatment, care and support,
including antiretroviral and other medicines, diagnostics and
related technologies. States should include relevant intormation
in their reports to bodies monitoring their progress in
complying vith their international legal obligations. 1he data
in these reports should be disaggregated in a manner that
helps identity and remedy possible disparities in access to
25
For example, NCEF, NADS, WH anc rhe nonovernmenral oranizarion Mcdccn:
5an: Frontcrc: |oinrly procuce anc upcare a puLlicarion icenrilyin sources anc prices
ol selecrec crus anc cianosrics usec in provicin care anc rrearmenr ro people livin
wirh Hv. Similarly, in 2001 rhe Worlc Healrh ranizarion iniriarec an onoin pro|ecr rhar
procuces anc mainrains a lisr ol Hv/ADS crus anc cianosrics, anc rheir suppliers, who
meer WH qualiry srancarcs.
47
prevention, treatment, care and support, and should use existing,
or develop nev, evaluation tools such as indicators or audits
to measure implementation. States should actively involve
non-governmental organizations, including those representing
people living vith HIVAIDS and vulnerable groups, in
preparing such reports and in acting on the observations and
recommendations received trom such monitoring bodies.
26

30. States should pursue and implement international and
regional cooperation aimed at transterring to developing
countries technologies and expertise tor HIV prevention,
treatment, care and support. States should support cooperation
betveen developing countries in this regard, and should
join international organizations in providing and supporting
technical assistance aimed at realizing access to HIV prevention,
treatment, care and support.
31. In their conduct in international torums and negotiations, States
should take due account ot international norms, principles and
standards relating to human rights. In particular, they should
take account ot their obligations to respect, protect and tultl
rights related to health, as vell as ot their commitments to
provide international assistance and cooperation.
27
States should
also avoid taking measures that vould undermine access to
HIV prevention, treatment, care and support, including access
to antiretroviral and other medicines, diagnostics and related
technologies, either domestically or in other countries, and
should ensure that medicine is never used as a tool tor political
pressure. Particular attention must be paid by all States to the
needs and situations ot developing countries.
2c
See also Guiceline 11, lor lurrher uicance on Srare monirorin anc enlorcemenr ol
human rihrs.
UNAID5 OHCHR
48
32. States should, in light ot their human rights obligations, ensure
that bilateral, regional and international agreements, such as
those dealing vith intellectual property, do not impede access
to HIV prevention, treatment, care and support, including
access to antiretroviral and other medicines, diagnostics and
related technologies.
33. States should ensure that, in interpreting and implementing
international agreements, domestic legislation incorporates
to the tullest extent any sateguards and nexibilities therein
that may be used to promote and ensure access to HIV
prevention, treatment, care and support tor all, including access
to medicines, diagnostics and related technologies. States
should make use ot these sateguards to the extent necessary to
satisty their domestic and international obligations in relation
to human rights. States should reviev their international
agreements (including on trade and investment, to ensure
that these are consistent vith treaties, legislation and policies
designed to promote and protect all human rights and, vhere
those agreements impede access to prevention, treatment, care
and support, should amend them as necessary.
GUIDELINE 7: LEGAL 5UPPOPT 5EPVICE5
54. States should implement and support legal support
services that will educate people aIIected by HlV
about their rights, provide Iree legal services to
enIorce those rights, develop expertise on HlV-re-
lated legal issues and utilize means oI protection in
addition to the courts, such as oIIces oI Ministries
oI Justice, ombudspersons, health complaint units
and human rights commissions.
4
33. States should consider the tolloving teatures in establishing
such services:
(a, State support tor legal aid systems specializing in HIV
casevork, possibly involving community legal aid centres
andor legal service services based in ASOs,
(b, State support or inducements (e.g. tax reduction, to private
sector lav trms to provide tree pro |ouo services to people
living vith HIV in areas such as anti-discrimination
and disability, health-care rights (intormed consent
and contdentiality,, property (vills, inheritance, and
employment lav,
(c, State support tor programmes to educate, raise avareness
and build selt-esteem among people living vith HIV
concerning their rights andor to empover them to
dratt and disseminate their ovn chartersdeclarations ot
legal and human rights, State support tor production and
dissemination ot HIV legal rights brochures, resource
personnel directories, handbooks,
28
practice manuals, student
texts, model curricula tor lav courses and continuing
legal education and nevsletters to encourage intormation
exchange and netvorking should also be provided. Such
publications could report on case lav, legislative retorms,
national entorcement and monitoring systems tor human
rights abuses,
27
See also Guiceline 11, pararaph cc (e), rearcin promorion ol Hvrelarec human rihrs
in inrernarional lorums anc ensurin rheir inrerarion inro rhe policies anc prorammes ol
inrernarional oranizarions.
28
See J. Gocwin (ct a!.), Au:tra!an H|V/A|D5 Lcqa! Gudc, (2nc ecirion), Fecerarion Fress,
Sycney, 13, LamLca Leal Delense anc Ecucarion Func nc., A|D5 Lcqa! Gudc. A
ro|c::ona! Rc:ourcc on A|D5rc!atcd Lcqa! |::uc: and D:crnnaton, New York.
UNAID5 OHCHR
50
(d, State support tor HIV legal services and protection
through a variety ot ottces, such as Ministries ot ustice,
procurator and other legal ottces, health complaint units,
ombudspersons and human rights commissions.
Commeutary ou uioeiiues to 7
36. Since lavs regulate conduct betveen the State and the
individual and betveen individuals, they provide an essential
tramevork tor the observance ot human rights, including HIV-
related human rights. 1he ettcacy ot this tramevork tor the
protection ot human rights depends on the strength ot the legal
system in a given society and on the access ot its citizens to the
system. Hovever, many legal systems vorldvide are not strong
enough, nor do marginalized populations have access to them.
37. Nevertheless, the role ot lav in the response to HIV may
also be overemphasized and provide a vehicle tor coercive
and abusive policies. Although lav may have an educative
and normative role and may provide an important supportive
tramevork tor human rights protection and HIV programmes,
it cannot be relied upon as the only means by vhich to
educate, change attitudes, achieve behavioural change or
protect people`s rights. Guidelines 3 to 7 above are, theretore,
meant to encourage the enactment ot meaningtul and positive
legislation, to describe the basic legal components necessary to
provide support tor the protection ot HIV-related human rights
and ettective HIV prevention and care programmes and to be
supplemented by all other Guidelines set out in this document.
38. Guidelines 3 to 6 encourage lav and lav retorm vhich vould
bring national HIV-related lavs into contormity vith interna-
tional and regional human rights standards. Although the con-
tent ot the strategies primarily addresses tormal lav, lav retorm
51
should also encompass traditional and customary lavs. 1he pro-
cess ot HIV lav reviev and retorm should be incorporated into
the State`s general activities regarding the observance ot human
rights norms and be integrated into the national AIDS response,
vhilst involving the attected communities, ensuring that exist-
ing legislation does not act as an impediment to HIV preven-
tion and care programmes (tor the general population, as vell
as tor vulnerable groups, and protecting individuals against dis-
crimination by both Government actors and private individuals
or institutions. It is recognized that some ot the recommenda-
tions tor lav and lav retorm, particularly those concerning the
status ot vomen, drug use, sex vork and the status ot men hav-
ing sex vith men, might be controversial in particular national,
cultural and religious contexts. Hovever, these Guidelines are
recommendations to States: they are based on existing interna-
tional human rights standards and designed to achieve a prag-
matic approach to public health goals relative to HIV. It is the
obligation ot States to establish hov they can best meet their
international human rights obligations and protect the public
health vithin their political, cultural and religious contexts. 1he
Ottce ot the Lnited Nations High Commissioner tor Human
Pights, LNAIDS, its relevant co-sponsors and other Lnited
Nations bodies and agencies, such as the International Iabour
Organization, can otter Governments technical assistance in the
process ot lav reviev and retorm.
39. Guideline 7 urges that States (and the private sector, encour-
age and support specialist and generalist legal services to enable
people living vith HIV and attected communities to entorce
their human and legal rights through the use ot such services.
Intormation and research resources on legal and human rights
issues should also be made available. Such services should also
address the issue ot reducing the vulnerability to intection vith-
UNAID5 OHCHR
52
in and the impact ot HIV on vulnerable groups. 1he location
and tormat ot the intormation (e.g. plain and understandable
language, provided via such services should render it accessible
to members ot these groups. Models exist in many countries.
29

C. Promotion oj a supportive an enalling
environment
GUIDELINE 8: WOMEN, CHILDPEN AND OTHEP
VULNEPALE GPOUP5
30
0. States should, in collaboration with and through
the community, promote a supportive and enabling
environment Ior women, children and other vulner-
able groups by addressing underlying prejudices
and inequalities through community dialogue, spe-
cially designed social and health services and sup-
port to community groups.

2
Mocels incluce rhe Group lor Lile (Grupo Fela vicca) in Fio ce Janeiro, Brazil, which ollers
lree leal services, Lrochures, Lullerins, relephone horline anc mecia campains. Leal
rihrs Lrochures have Leen procucec in rhe nirec Kincom Ly rhe Terrence Hiins Trusr
anc mmuniry's Leal Cenrre (D. Taylor (ec.), H|V, You and tnc Lav). Fesource cirecrories
have Leen procucec in rhe nirec Srares Ly rhe American Bar Associarion (Drcctory o|
Lcqa! Rc:ourcc: |or cop!c vtn A|D5 & H|V, ADS Coorcinarion Fro|ecr, Washinron, D.C.,
11) anc rhe Gay Men's Healrh Crisis (M. Holrzman (ec.), Lcqa! 5crvcc: Rc|crra! Drcctory
|or cop!c vtn A|D5, New York, 11). Several orher oranizarions in rhe nirec Srares
have procucec pracririoners' or volunreers' rrainin manuals, such as rhe WhirmanWalker
Clinic (Washinron, D.C.), rhe ADS Fro|ecr (Los Aneles), rhe Narional Lawyers Guilc, Srare
ADS Leal Services ranizarion (San Francisco) anc rhe American Civil LiLerries nion
(William FuLensrein, Furh EisenLer anc Lawrence Gosrin, Tnc Rqnt: o| cr:on: Lvnq
vtn H|V/A|D5 (Sourhern llinois Fress, CarLoncale, llinois, 1c)). A manual lor paraleals
is Lein preparec in Sourh Alrica Ly rhe FierermarirzLur Lranch ol Lawyers lor Human
Fihrs wirh rhe assisrance ol rhe ADS Law Fro|ecr anc wirh rrainin coorcinarion Lein
provicec Ly rhe ADS Leal Nerwork. rher resources incluce LenchLooks lor |uces (A.F.
FuLenlelc (ec.), A|D5 cncnooox, Narional Jucicial Collee, American Bar Associarion,
Feno, Nevaca, January 11), rhe Sourhern Alrica ADS nlormarion Disseminarion Service
anc newslerrers such as rhe Canacian H|V/A|D5 o!cy and Lav Ncv:!cttcr anc Ausrralia's
Leal Link (see also A|D5/5TD Hca!tn ronoton Excnanqc, Foyal Tropical nsrirure, rhe
Nerherlancs).
30
53
(a, States should support the establishment and sustainability ot
community associations comprising members ot ditterent
vulnerable groups tor peer education, empoverment, posi-
tive behavioural change and social support.
(b, States should support the development ot adequate, acces-
sible and ettective HIV-related prevention and care educa-
tion, intormation and services by and tor vulnerable com-
munities and should actively involve such communities in
the design and implementation ot these programmes.
(c, States should support the establishment ot national and
local torums to examine the impact ot the HIV epi-
demic on vomen. 1hey should be multisectoral to include
Government, protessional, religious and community repre-
sentation and leadership and examine issues such as:
(i, 1he role ot vomen at home and in public lite,
(ii, 1he sexual and reproductive rights ot vomen and
men, including vomen`s ability to negotiate sater sex
and make reproductive choices,
(iii, Strategies tor increasing educational and economic
opportunities tor vomen,
(iv, Sensitizing service deliverers and improving health care
and social support services tor vomen, and
(v, 1he impact ot religious and cultural traditions on
vomen.
(d, States should implement the Cairo Programme ot Action
ot the International Conterence on Population and
Development
31
and the Beijing Declaration and Plattorm
tor Action ot the lourth World Conterence on Women.
Primary health services, programmes and intormation
31
A/CNF.171/13, chap. , resolurion 1, annex.
UNAID5 OHCHR
54
campaigns in particular should include a gender perspective.
Violence against vomen, harmtul traditional practices,
sexual abuse, exploitation, early marriage and temale
genital mutilation, should be eliminated. Positive measures,
including tormal and intormal education programmes,
increased vork opportunities and support services, should
be established.
(e, States should support vomen`s organizations to incorporate
HIV and human rights issues into their programming.
(t, States should ensure that all vomen and girls ot child-bear-
ing age have access to accurate and comprehensive intorma-
tion and counselling on the prevention ot HIV transmission
and the risk ot vertical transmission ot HIV, as vell as access
to the available resources to minimize that risk, or to proceed
vith childbirth, it they so choose.
(g, States should ensure the access ot children and adolescents
to adequate health intormation and education, including
intormation related to HIV prevention and care, inside and
outside school, vhich is tailored appropriately to age level
and capacity and enables them to deal positively and re-
sponsibly vith their sexuality. Such intormation should take
into account the rights ot the child to access to intormation,
privacy, contdentiality, respect and intormed consent and
means ot prevention, as vell as the responsibilities, rights
and duties ot parents. Lttorts to educate children about their
rights should include the rights ot persons, including chil-
dren, living vith HIV.
(h, States should ensure that children and adolescents have
adequate access to contdential sexual and reproductive
health services, including HIV intormation, counselling,
55
testing and prevention measures such as condoms, and to
social support services it attected by HIV. 1he provision
ot these services to childrenadolescents should renect
the appropriate balance betveen the rights ot the child
adolescent to be involved in decision-making according to
his or her evolving capabilities and the rights and duties ot
parentsguardians tor the health and vell-being ot the child.
(i, States should ensure that persons employed to child care
agencies, including adoption and toster-care homes, receive
training in the area ot HIV-related children`s issues in order
to deal ettectively vith the special needs ot HIV-attected
children including protection trom mandatory testing,
discrimination and abandonment.
(j, States should support the implementation ot specially de-
signed and targeted HIV prevention and care programmes
tor those vho have less access to mainstream programmes
due to language, poverty, social or legal or physical mar-
ginalization, e.g. minorities, migrants, indigenous peoples,
retugees and internally displaced persons, people vith dis-
abilities, prisoners, sex vorkers, men having sex vith men
and injecting drug users.
61. States should take measures to reduce the vulnerability,
stigmatization and discrimination that surround HIV and
promote a supportive and enabling environment by addressing
underlying prejudices and inequalities vithin societies and a
social environment conducive to positive behaviour change.
An essential part ot this enabling environment involves
the empoverment ot vomen, youth and other vulnerable
groups to deal vith HIV by taking measures to improve
UNAID5 OHCHR
5
their social and legal status, involving them in the design and
implementation ot programmes and assisting them to mobilize
their communities. 1he vulnerability ot some groups is due to
their limited access to resources, intormation, education and
lack ot autonomy. Special programmes and measures should be
designed to increase access. In many countries, community-
based organizations and NGOs have already begun the process
ot creating a supportive and enabling environment in their
response to the HIV epidemic. Governments must recognize
these ettorts and lend moral, legal, tnancial and political
support to strengthen them.
GUIDELINE ?: CHANGING DI5CPIMINATOPY
ATTITUDE5 THPOUGH EDUCATION, TPAINING
AND THE MEDIA
2. States should promote the wide and ongoing dis-
tribution oI creative education, training and media
programmes explicitly designed to change atti-
tudes oI discrimination and stigmatization associ-
ated with HlV to understanding and acceptance.
(a, States should support appropriate entities, such as media
groups, NGOs and netvorks ot people living vith HIV,
to devise and distribute programming to promote respect
tor the rights and dignity ot people living vith HIV
and members ot vulnerable groups, using a broad range
ot media (tlm, theatre, television, radio, print, dramatic
presentations, personal testimonies, Internet, pictures,
bus posters,. Such programming should not compound
stereotypes about these groups but instead dispel myths
and assumptions about them by depicting them as triends,
57
relatives, colleagues, neighbours and partners. Peassurance
concerning the modes ot transmission ot the virus and the
satety ot everyday social contact should be reintorced.
(b, States should encourage educational institutions (primary
and secondary schools, universities and other technical or
tertiary colleges, adult and continuing education,, as vell as
trades unions and vorkplaces to include HIV and human
rightsnon-discrimination issues in relevant curricula, such
as human relationships, citizenshipsocial studies, legal
studies, health care, lav entorcement, tamily lite andor sex
education, and veltarecounselling.
(c, States should support HIV-related human rightsethics
trainingvorkshops tor Government ottcials, the police,
prison statt, politicians, as vell as village, community and
religious leaders and protessionals.
(d, States should encourage the media and advertising
industries to be sensitive to HIV and human rights
issues and to reduce sensationalism in reporting and the
inappropriate use ot stereotypes, especially in relation to
disadvantaged and vulnerable groups. A training approach ot
this kind should include the production ot usetul resources,
such as handbooks containing appropriate terminology,
vhich vould serve to eliminate use ot stigmatizing
language, and a protessional code ot behaviour in order to
ensure respect tor contdentiality and privacy.
(e, States should support targeted training, peer education and
intormation exchange tor people living vith HIV statt
and volunteers ot CBOs and ASOs as vell as tor leaders
ot vulnerable groups as a means ot raising their avareness
ot human rights and ot the means to entorce these rights.
UNAID5 OHCHR
58
Conversely, education and training should be provided on
HIV-specitc human rights issues to those vorking on other
human rights issues.
(t, States should support the use ot alternative ettorts such
as radio programmes or tacilitated group discussions
to overcome access problems tor individuals vho are
located in remote or rural areas, are illiterate, homeless or
marginalized and vithout access to television, tlms and
videos and specitc ethnic minority languages.
63. 1he use ot tormal standards and their implementation
through Government process and lav alone cannot change
the negative attitudes and prejudices surrounding HIV into
respect tor human rights. Public programming explicitly
designed to reduce the existing stigma has been shovn to
help create a supportive environment vhich is more tolerant
and understanding.
32
1he reach ot such programming should
be a mixture ot general and tocused programmes using
various media, including creative and dramatic presentations,
compelling ongoing intormation campaigns tor tolerance
and inclusion and interactive educational vorkshops and
seminars. 1he goal should be to challenge beliets based on
ignorance, prejudices and punitive attitudes by appealing to
human compassion and identitying vith visible individuals.
Programming based on tear can be counter-productive by
engendering discrimination through panic.
32
Frolessor F. Feachem, Va!unq tnc a:t, |nvc:tnq n tnc Futurc. Eva!uaton o| tnc Natona!
H|V/A|D5 5tratcqy 34 to 5, Commonwealrh Deparrmenr ol Human Services anc
Healrh, SepremLer 15, CanLerra, pp. 1012.
5
GUIDELINE 10: DEVELOPMENT OF PULIC
AND PPIVATE 5ECTOP 5TANDAPD5 AND
MECHANI5M5 FOP IMPLEMENTING THE5E
5TANDAPD5
4. States should ensure that Government and the
private sector develop codes oI conduct regarding
HlV issues that translate human rights principles
into codes oI proIessional responsibility and
practice, with accompanying mechanisms to
implement and enIorce these codes.
(a, States should require or encourage protessional groups,
particularly health-care protessionals, and other private
sector industries (e.g. lav, insurance, to develop and
entorce their ovn codes ot conduct addressing human
rights issues in the context ot HIV. Pelevant issues vould
include contdentiality, intormed consent to testing, the
duty to treat, the duty to ensure sate vorkplaces, reducing
vulnerability and discrimination and practical remedies tor
breachesmisconduct.
(b, States should require that individual government depart-
ments devise clear guidelines on the extent to vhich their
policies and practices renect HIV-related human rights
norms and their entorcement in tormal legislation and
regulations, at all levels ot service delivery. Coordination
ot these standards should occur in the national tramevork
described in Guideline 1 and be publicly available, atter
involvement ot community and protessional groups in
the process.
UNAID5 OHCHR
0
(c, States should develop or promote multisectoral
mechanisms to ensure accountability. 1his involves the
equal participation ot all concerned (i.e. Government
agencies, industry representatives, protessional associations,
NGOs, consumers, service providers and service users,.
1he common goal should be to raise standards ot service,
strengthen linkages and communication and assure the tree
nov ot intormation.
63. 1he development ot standards in and by the public and private
sectors is important. lirst, they translate human rights principles
into practice trom an insider`s perspective and renect more
closely the community`s concerns. Second, they are likely
to be more pragmatic and acceptable to the sector involved.
1hird, they are more likely to be ovned and implemented it
developed by the sector itselt. linally, they might have a more
immediate impact than legislation.
GUIDELINE 11: 5TATE MONITOPING AND
ENFOPCEMENT OF HUMAN PIGHT5
. States should ensure monitoring and enIorce-
ment mechanisms to guarantee HlV-related human
rights, including those oI people living with HlV,
their Iamilies and communities.
(a, States should collect intormation on human rights and
HIV and, using this intormation as a basis tor policy and
programme development and retorm, report on HIV-
related human rights issues to the relevant Lnited Nations
1
treaty bodies as part ot their reporting obligations under
human rights treaties.
(b, States should establish HIV tocal points in relevant
government branches, including national AIDS
programmes, police and correctional departments, the
judiciary, Government health and social service providers
and the military, tor monitoring HIV-related human
rights abuses and tacilitating access to these branches
tor disadvantaged and vulnerable groups. Pertormance
indicators or benchmarks shoving specitc compliance vith
human rights standards should be developed tor relevant
policies and programmes.
(c, States should provide political, material and human
resources support to ASOs and CBOs tor capacity-building
in human rights standards development and monitoring.
States should provide human rights NGOs vith support tor
capacity-building in HIV-related human rights standards
and monitoring.
(d, States should support the creation ot independent national
institutions tor the promotion and protection ot human
rights, including HIV-related rights, such as human rights
commissions and ombudspersons andor appoint HIV
ombudspersons to existing or independent human rights
agencies, national legal bodies and lav retorm commissions.
(e, States should promote HIV-related human rights in inter-
national torums and ensure that they are integrated into
the policies and programmes ot international organiza-
tions, including Lnited Nations human rights bodies, as
vell as in other agencies ot the Lnited Nations system.
UNAID5 OHCHR
2
lurthermore, States should provide intergovernmental
organizations vith the material and human resources re-
quired to vork ettectively in this teld.
67. Standard-setting and promotion ot HIV-related human rights
standards alone are insuttcient to address human rights abuses
in the context ot HIV. Lttective mechanisms must be estab-
lished at the national and community levels to monitor and
entorce HIV-related human rights. Governments should see
this as part ot their national responsibility to address HIV. 1he
existence ot monitoring mechanisms should be publicized, par-
ticularly among netvorks ot people living vith HIV, in order
to maximize their use and impact. Monitoring is necessary to
collect intormation, tormulate and revise policy, and establish
priorities tor change and benchmarks tor pertormance mea-
surement. Monitoring should be both positive and negative,
i.e. reporting on good practice to provide models tor others to
emulate, as vell as identitying abuses. 1he non-governmental
sector can provide an important means ot monitoring hu-
man rights abuses, it resourced to do so, since it trequently has
closer contact vith the attected communities. lormal grievance
bodies may be too bureaucratic and their procedures too time-
consuming and stresstul to attract a representative sample ot
complaints. 1raining is necessary tor community participants to
develop skills so as to be able to analyse and report tndings at
a level ot quality vhich is credible tor States and international
human rights bodies.
3
GUIDELINE 12: INTEPNATIONAL
COOPEPATION
8. States should cooperate through all relevant pro-
grammes and agencies oI the United Nations sys-
tem, including UNAlDS, to share knowledge and
experience concerning HlV-related human rights
issues, and should ensure eIIective mechanisms to
protect human rights in the context oI HlV at the
international level.
(a, 1he Commission on Human Pights should take note ot
the present Guidelines and ot the report on the Second
International Consultation on HIVAIDS and Human
Pights and request States to caretully consider and imple-
ment the Guidelines in their national, subnational and local
responses to HIV and human rights.
(b, 1he Commission on Human Pights should request human
rights treaty bodies, special rapporteurs and representatives
and its vorking groups to take note ot the Guidelines and
include in their activities and reports all issues arising under
the Guidelines relevant to their mandates.
(c, 1he Commission on Human Pights should request
LNAIDS, its co-sponsors (LNDP, LNLSCO, LNlPA,
LNICLl, WHO and the World Bank
33
, and other relevant
Lnited Nations bodies and agencies to integrate the
promotion ot the Guidelines throughout their activities.
33
Since rhe issuin ol rhe Guicelines in 18, rhe numLer ol NADS cosponsors has rown
ro incluce rhe nrernarional LaLour ranizarion (L), rhe nirec Narions llce on Drus
anc Crime (NDC), rhe Worlc Fooc Froramme (WFF) anc rhe nirec Narions Hih
Commissioner lor Feluees (NHCF).
UNAID5 OHCHR
4
(d, 1he Commission on Human Pights should appoint
a special rapporteur on human rights and HIVAIDS
vith the mandate, iuter aiia, to encourage and monitor
implementation ot the Guidelines by States, as vell as their
promotion by the Lnited Nations system, including human
rights bodies, vhere applicable.
(e, 1he Commission on Human Pights should encourage
the Ottce ot the Lnited Nations High Commissioner tor
Human Pights to ensure that the Guidelines are dissemi-
nated throughout that Ottce and are incorporated into
all its human rights activities and programmes, particularly
those involving technical cooperation, monitoring and
support to human rights bodies and organs.
(t, States, in the tramevork ot their periodic reporting
obligations to Lnited Nations treaty monitoring bodies
and under regional conventions, should report on their
implementation ot the Guidelines and other relevant HIV-
related human rights concerns arising under the various
treaties.
(g, States should ensure, at the country level, that their
cooperation vith LNAIDS 1heme Groups includes
promotion and implementation ot the Guidelines, including
the mobilization ot suttcient political and tnancial support
tor such implementation.
(h, States should vork in collaboration vith LNAIDS,
the Ottce ot the Lnited Nations High Commissioner
tor Human Pights and non-governmental and other
organizations vorking in the teld ot human rights and
HIV to:
5
(i, Support translation ot the Guidelines into national and
minority languages,
(ii, Create a videly accessible mechanism tor communica-
tion and coordination tor sharing intormation on the
Guidelines and HIV-related human rights,
(iii, Support the development ot a resource directory on
international declarations treaties, as vell as policy
statements and reports on HIV and human rights,
to strengthen support tor the implementation ot the
Guidelines,
(iv, Support multicultural education and advocacy projects
on HIV and human rights, including educating human
rights groups vith regard to HIV and educating HIV
and vulnerable groups in human rights issues and
strategies tor monitoring and protecting human rights
in the context ot HIV, using the Guidelines as an
educational tool,
(v, Support the creation ot a mechanism to allov existing
human rights organizations and HIV organizations
to vork together strategically to promote and protect
the human rights ot people living vith HIV and those
vulnerable to intection, through implementation ot the
Guidelines,
(vi, Support the creation ot a mechanism to monitor and
publicize human rights abuses in the context ot HIV,
(vii, Support the development ot a mechanism to mobilize
grass-roots responses to HIV-related human rights
concerns and implementation ot the Guidelines,
including exchange programmes and training among
ditterent communities, both vithin and across regions,
(viii,Advocate that religious and traditional leaders take up
HIV-related human rights concerns and become part
ot the implementation ot the Guidelines,
UNAID5 OHCHR
(ix, Support the development ot a manual that vould

assist human rights and AIDS service organizations in
advocating the implementation ot the Guidelines,
(x, Support the identitcation and tunding ot NGOs and
ASOs at country level to coordinate a national NGO
response to promote the Guidelines,
(xi, Support, through technical and tnancial assistance,
national and regional NGO netvorking initiatives
on ethics, lav and human rights to enable them
to disseminate the Guidelines and advocate their
implementation.
(i, States, through regional human rights mechanisms, should
promote the dissemination and implementation ot the
Guidelines and their integration into the vork ot these
bodies.
69. 1he Lnited Nations bodies, agencies and programmes
comprise some ot the most ettective and povertul torums
through vhich States can exchange intormation and expertise
on HIV-related human rights issues and build support among
themselves to implement a rights-based response to HIV. States,
in their vork vith and governance ot these bodies, can use
these bodies as tools tor promoting the Guidelines. States must,
hovever, both encourage and enable these bodies through
political and tnancial support, to take ettective and sustained
action in terms ot promoting the Guidelines and must respond
positively to the vork done by these bodies vith steps taken at
the national level.
7
Conclusion
70. States are urged to implement these Guidelines in order to
ensure respect tor the human rights ot those attected by HIV
and to ensure an ettective and inclusive public health response
to HIV. 1hese Guidelines are based on experience gained trom
best practices vhich have proven to be ettective over the last
13 years. By implementing these Guidelines, States are able to
avoid negative and coercive policies and practices vhich have
had a devastating impact on people`s lives and on national HIV
programmes.
71. 1he practical aspects ot protecting HIV-related human rights
are more likely to be addressed it there is leadership on this
issue in the executive and legislative arms ot government and it
multisectoral structures are established and maintained. Vital to
any policy development and implementation is the involvement
ot attected communities, together vith relevant protessionals
and religious and community leaders, as equal partners in the
process.
72. As national legislation provides a critical tramevork tor
the protection ot HIV-related human rights, many ot the
Guidelines relate to the need tor lav retorm. Another major
instrument ot social change is the provision ot a supportive
and enabling environment vithin vhich to conduct HIV-
related prevention, care and support activities. Part ot this
enabling environment can be obtained by changing attitudes
through general and targeted education, public intormation
and education campaigns vhich deal vith HIV-related
rights, tolerance and inclusion. Another part ot this enabling
environment involves the empoverment ot vomen and
vulnerable groups to deal vith HIV by taking measures to
UNAID5 OHCHR
8
improve their social and legal status and to assist them in
mobilizing their communities.
73. HIV and AIDS continue to challenge our societies in many
vays. It is incumbent on States, communities and individuals
to address extremely dittcult and pervasive societal issues
vhich have alvays been present in our societies, and to identity
solutions thereto. With the advent ot HIV, ve can no longer
attord to evade these issues because to do so threatens the lives
ot millions ot men, vomen and children. 1hese issues relate
to the roles ot vomen and men, the status ot marginalized
or illegal groups, the obligations ot States concerning health
expenditure and the role ot lav in achieving public health
goals, the content ot privacy betveen individuals and betveen
individuals and their Governments, the responsibility and
ability ot people to protect themselves and others, as vell as
the relationship betveen human rights, health and lite. 1hese
Guidelines are means tor giving guidance on these dittcult
matters guidance vhich has evolved trom the international
human rights regime and trom the courageous and inspiring
vork ot millions the vorld over vho have demonstrated that
protecting the human rights ot people means protecting their
health, lives and happiness in a vorld vith HIV.

II. Pecommendations for dissemination

and impIementation of tbe GuideIines
on HIV/AID5 and Human Pigbts
74. At the Second International Consultation on HIVAIDS
and Human Pights, the participants considered strategies tor
dissemination and implementation ot the Guidelines. It vas
considered that there are three groups ot key actors vho,
jointly and separately, are critical to the implementation ot the
Guidelines, namely States, the Lnited Nations system, regional
intergovernmental organizations and non-governmental
and community-based organizations. Pecommendations tor
measures that these actors are encouraged to take in order
to ensure that the Guidelines are videly disseminated and
ettectively implemented are set out belov.
. States
73. States, at the highest level ot Government (Head ot State,
Prime Minister andor relevant ministers,, should promulgate
the Guidelines and ensure that the political veight ot the
Government is behind the dissemination and implementation
ot the Guidelines throughout all branches ot the executive,
legislature and judiciary.
76. States, at the highest level ot Government, should assign
appropriate governmental bodiesstatt the responsibility
to devise and implement a strategy tor dissemination and
implementation ot the Guidelines and establish periodic
monitoring ot this strategy through, tor example, reports to the
UNAID5 OHCHR
70
Lxecutive Ottce and public hearings. States should establish
vithin the executive branch a statt member(s, responsible tor
this strategy.
77. States should disseminate the Guidelines, endorsed by the
executive, to relevant national bodies, such as interministerial
and parliamentary committees on HIV and national AIDS
programmes, as vell as to provincial and local-level bodies.
78. States, through these bodies, should give tormal consideration
to the Guidelines in order to identity vays to build them into
existing activities and prioritize necessary nev activities and
policy reviev. States should also organize consensus vorkshops
vith the participation ot non-governmental organizations,
community-based organizations and AIDS service organizations
(ASOs,, netvorks ot people living vith HIV, netvorks on
ethics, lav, human rights and HIV, Lnited Nations 1heme
Groups on HIVAIDS, as vell as political and religious groups:
(a, 1o discuss the relevance ot the Guidelines to the local
situation, to identity obstacles and needs, to propose
interventions and solutions, and to achieve consensus tor the
adoption ot the Guidelines,
(b, 1o elaborate national, provincial and local plans ot action tor
implementation and monitoring ot the Guidelines vithin
the local context,
(c, 1o mobilize and ensure the commitment ot relevant
governmental ottcials to apply the Guidelines as a vorking
tool to be integrated into their individual vorkplans.
79. States, at national, subnational and local levels, should establish
mechanisms to receive, process and reter issues, claims and
71
intormation in relation to the Guidelines and to the human
rights issues raised therein. States should create tocal points
to monitor the implementation ot the Guidelines in relevant
government departments.
80. States, in vays consistent vith judicial independence, should
disseminate the Guidelines videly throughout the judicial
system and use them in the development ot jurisprudence,
conduct ot court cases involving HIV-related matters and HIV-
related trainingcontinuing education ot judicial ottcers.
81. States should disseminate the Guidelines throughout
the legislative branch ot government and particularly to
parliamentary committees involved in the tormulation ot
policy and legislation relevant to the issues raised in the
Guidelines. Such committees should assess the Guidelines to
identity priority areas tor action and a longer-term strategy to
ensure that relevant policy and lav are in contormity vith the
Guidelines.
B. Unite âtions system an regional intergovern-
mental loies
82. 1he Lnited Nations Secretary-General should submit the
Guidelines to the Commission on Human Pights as part ot
the report on the Second International Consultation on HIV
AIDS and Human Pights.
83. 1he Secretary-General should transmit the Guidelines to heads
ot State:
(a, Pecommending that the document be distributed
nationally through the appropriate channels,
UNAID5 OHCHR
72
(b, Ottering, vithin the mandates ot LNAIDS and the
Ottce ot the Lnited Nations High Commissioner tor
Human Pights, technical cooperation in tacilitating the
implementation ot the Guidelines,
(c, Pequesting that compliance vith the Guidelines be
included in national reports to existing human rights treaty
bodies,
(d, Peminding Governments ot the responsibility to uphold
international human rights standards in promoting
compliance vith the Guidelines.
84. 1he Secretary-General should transmit the Guidelines to
the heads ot all relevant Lnited Nations bodies and agencies,
requesting that they be videly disseminated throughout the
relevant programmes and activities ot the bodies and agencies.
1he Secretary-General should request that all relevant Lnited
Nations bodies and agencies consider their activities and
programmes on HIV in the light ot the provisions ot the
Guidelines and support the implementation ot the Guidelines
at national level.
83. 1he Commission on Human Pights and the Sub-Commission
on Prevention ot Discrimination and Protection ot Minorities,
as vell as all human rights treaty bodies, should consider and
discuss the Guidelines vith a viev to incorporating relevant
aspects ot the Guidelines into their respective mandates.
Human rights treaty bodies, in particular, should integrate the
Guidelines, as relevant, in their respective reporting guidelines,
questions to States and vhen developing recommendations and
general comments on related subjects.
86. 1he Commission on Human Pights should appoint a special
rapporteur on human rights and HIV vith the mandate,
73
iuter aiia, to encourage and monitor implementation ot
the Guidelines by States, as vell as their promotion by the
Lnited Nations system, including human rights bodies, vhere
applicable.
87. 1he Ottce ot the Lnited Nations High Commissioner
tor Human Pights should ensure that the Guidelines are
disseminated throughout that Ottce and incorporated into
its activities and programmes, particularly those involving
support tor the Lnited Nations human rights bodies, technical
assistance and monitoring. 1his should be coordinated by a
statt member vith exclusive responsibility tor the Guidelines.
Similarly, the Lnited Nations Division tor the Advancement
ot Women should ensure the tull integration ot the Guidelines
into the vork ot the Committee on the Llimination ot
Discrimination against Women.
88. LNAIDS should transmit the Guidelines throughout the
system to co-sponsors ot the LNAIDS Programme
Coordinating Board, Lnited Nations 1heme Groups on HIV
AIDS, LNAIDS statt, including country programme advis-
ers and tocal points and should ensure that the Guidelines
become a tramevork tor action tor the vork ot the Lnited
Nations 1heme Groups on HIVAIDS and LNAIDS statt,
1heme Groups should use the Guidelines to assess the HIV-
related human rights, legal and ethical situation at country level
and to elaborate the best means tor supporting implementation
ot the Guidelines at that level.
89. Pegional bodies (such as the Inter-American Commission
on Human Pights, the Organization ot American States, the
Atrican Commission on Human and Peoples` Pights, the
Organization ot Atrican Lnity, the Luropean Commission
on Human Pights, the Luropean Commission, the Council
UNAID5 OHCHR
74
ot Lurope, the Association ot South-Last Asian Nations,
etc., should receive the Guidelines and make them available
to the largest possible number ot members and relevant
divisions vith a viev to assessing hov their activities might
be made consistent vith the Guidelines and promote their
implementation.
90. Specialized agencies and other concerned bodies (such as
the International Iabour Organization, the International
Organization tor Migration, the Ottce ot the Lnited Nations
High Commissioner tor Petugees, the Lnited Nations
Pesearch Institute tor Social Development and the World
1rade Organization, should receive the Guidelines and
transmit them videly among members and throughout their
programmes vith a viev to assessing hov their activities can
be made consistent vith the Guidelines and promote their
implementation.
C. ôn-governmental organi:ations
34
91. NGOs should implement the Guidelines vithin a broad
tramevork ot communication in terms ot HIV and human
rights, including the establishment ot ongoing communication
betveen the HIV community and the human rights
community by:
(a, Lstablishing contacts at the international, regional and local
levels betveen netvorks ot ASOs, human rights NGOs, and
people living vith HIV.
34
nclucin ADS service oranizarions, communiryLasec oranizarions, reional anc
narional nerworks on erhics, law, human rihrs anc Hv anc nerworks ol people livin wirh
Hv. These nerworks comprise nor only nonovernmenral anc ADS service oranizarions
Lur also prolessionals (e.. lawyers, healrhcare workers, social workers), people livin
wirh Hv, acacemics, research insrirurions anc orher concernec cirizens. The nerworks are
imporranr voices lor moLilizin chane anc prorecrin human rihrs.
75
(b, Developing mechanism(s, tor ongoing communication
and dissemination and implementation ot the Guidelines,
such as a bulletin board andor home page on the Internet
alloving tor input and exchange ot intormation on human
rights and HIV and database linkages betveen groups
vorking on human rights and HIV,
(c, Netvorking vith human rights NGOs at meetings ot
Lnited Nations human rights bodies,
(d, Promoting discussion ot the Guidelines in their nevsletters
and other publications, as vell as through other media,
(e, Developing an action-oriented and accessible version(s, ot
the Guidelines,
(t, Developing a strategy and process tor the dissemination
ot the Guidelines and seeking tunding and technical
cooperation in that regard.
92. Non-governmental organizations at the regional level should:
(a, Lstablish or use existing tocal points to disseminate the
Guidelines, vith popularization andor training,
(b, Lstablish a regional technical group to introduce the
Guidelines to the region,
(c, Lse the Guidelines as a tool tor advocacy, interpretation,
monitoring abuse and establishing best practices,
(d, Prepare regular reports on the implementation ot the
Guidelines to human rights bodies (human rights treaty
bodies and Lnited Nations extra-conventional tact-
tnding mechanisms, such as special rapporteurs and
UNAID5 OHCHR
7
representatives, as vell as regional commissions, and other
relevant international agencies,
(e, Bring cases ot HIV-related discrimination and other
violations ot human rights in the context ot HIV
to regional human rights judicial and quasi-judicial
mechanisms.
93. In order to advocate the Guidelines, NGOs at the national
level should obtain consensus on their acceptance and
establish a joint strategy vith governmental and non-
governmental partners as a baseline tor monitoring the
Guidelines, through the tolloving actions:
(a, hold national NGO strategy meetings on the Guidelines
that include human rights NGOs (including vomen`s
organizations and prisoners` rights organization,, ASOs,
community-based organizations, netvorks on ethics, lav,
human rights and HIV and netvorks ot people living vith
HIV,
(b, Hold meetings vith national governmental human rights
bodies,
(c, Hold meetings vith national Government (relevant
ministries,, legislative and the judiciary,
(d, Lstablish or use existing national tocal points to gather
intormation and develop systems ot intormation exchange
on HIV and human rights, including the Guidelines.
77
III. InternationaI buman rigbts
obIigations and HIV
Introuction: HI1, human rights an pullic health
94. Several years ot experience in addressing the HIV epidemic
have contrmed that the promotion and protection ot human
rights constitute an essential component in preventing
transmission ot HIV and reducing the impact ot HIV and
AIDS. 1he protection and promotion ot human rights are
necessary both to the protection ot the inherent dignity
ot persons attected by HIV and to the achievement ot the
public health goals ot reducing vulnerability to HIV intection,
lessening the adverse impact ot HIV and AIDS on those
attected and empovering individuals and communities to
respond to HIV.
93. In general, human rights and public health share the common
objective to promote and to protect the rights and vell-being
ot all individuals. lrom the human rights perspective, this
can best be accomplished by promoting and protecting the
rights and dignity ot everyone, vith special emphasis on those
vho are discriminated against or vhose rights are othervise
intertered vith. Similarly, public health objectives can best be
accomplished by promoting health tor all, vith special emphasis
on those vho are vulnerable to threats to their physical,
mental or social vell-being. 1hus, health and human rights
complement and mutually reintorce each other in any context.
1hey also complement and mutually reintorce each other in
the context ot HIV.
UNAID5 OHCHR
78
96. One aspect ot the interdependence ot human rights and public
health is demonstrated by studies shoving that HIV prevention
and care programmes vith coercive or punitive teatures result
in reduced participation and increased alienation ot those at risk
ot intection.
35
In particular, people vill not seek HIV-related
counselling, testing, treatment and support it this vould mean
tacing discrimination, lack ot contdentiality and other nega-
tive consequences. 1heretore, it is evident that coercive public
health measures drive avay the people most in need ot such
services and tail to achieve their public health goals ot preven-
tion through behavioural change, care and health support.
97. Another aspect ot the linkage betveen the protection ot hu-
man rights and ettective HIV programmes is apparent in the
tact that the incidence or spread ot HIV is disproportionately
high among some populations. Depending on the nature ot the
epidemic and the legal, social and economic conditions in each
country, groups that may be disproportionately attected include
vomen, children, those living in poverty, minorities, indigenous
people, migrants, retugees and internally displaced persons,
people vith disabilities, prisoners, sex vorkers, men having sex
vith men and injecting drug users-that is to say groups vho
already sutter trom a lack ot human rights protection and trom
discrimination andor are marginalized by their legal status.
Iack ot human rights protection disempovers these groups to
avoid intection and to cope vith HIV, it attected by it.
36

98. lurthermore, there is groving international consensus that
a broadly based, inclusive response, involving people living
35
J. Dwyer, "Leislarin ADS Away: The Limirec Fole ol Leal Fersuasion in Minimizin rhe
Spreac ol Hv", in Journa! o| Contcnporary Hca!tn Lav and o!cy 1c7 (13).
3c
For rhe purposes ol rhese Guicelines, rhese roups will Le relerrec ro as "vulneraLle"
roups alrhouh ir is reconizec rhar rhe ceree anc source ol vulneraLiliry ol rhese
roups vary wicely wirhin counrries anc across reions.
7
vith HIV in all its aspects, is a main teature ot successtul HIV
programmes. Another essential component ot comprehensive
response is the tacilitation and creation ot a supportive legal and
ethical environment vhich is protective ot human rights. 1his
requires measures to ensure that Governments, communities
and individuals respect human rights and human dignity and
act in a spirit ot tolerance, compassion and solidarity.
99. One essential lesson learned trom the HIV epidemic is that
universally recognized human rights standards should guide
policymakers in tormulating the direction and content ot HIV-
related policy and torm an integral part ot all aspects ot national
and local responses to HIV.
. Human rights stanars an the nature oj State
olligations
100. 1he Vienna Declaration and Programme ot Action, adopted
at the World Conterence on Human Pights in une 1993,
37

attrmed that all human rights are universal, indivisible,
interdependent and interrelated. While the signitcance ot
national and regional particularities and various historical,
cultural and religious backgrounds must be borne in mind,
States have the duty, regardless ot their political, economic
and cultural systems, to promote and protect universal human
rights standards and tundamental treedoms.
101. A human rights approach to HIV is, theretore, based on these
State obligations vith regard to human rights protection.
HIV demonstrates the indivisibility ot human rights since the
realization ot economic, social and cultural rights, as vell as
37
A/CNF.157/24 (Farr ), chap. .
UNAID5 OHCHR
80
civil and political rights, is essential to an ettective response.
lurthermore, a rights-based approach to HIV is grounded in
concepts ot human dignity and equality vhich can be tound
in all cultures and traditions.
102. 1he key human rights principles vhich are essential to
ettective State responses to HIV are to be tound in existing
international instruments, such as the Lniversal Declaration
ot Human Pights, the International Covenants on Lconomic,
Social and Cultural Pights and on Civil and Political
Pights, the International Convention on the Llimination
ot All lorms ot Pacial Discrimination, the Convention
on the Llimination ot All lorms ot Discrimination against
Women, the Convention against 1orture and Other Cruel,
Inhuman or Degrading 1reatment or Punishment and the
Convention on the Pights ot the Child. Pegional instruments,
namely the American Convention on Human Pights, the
Luropean Convention tor the Protection ot Human Pights
and lundamental lreedoms and the Atrican Charter on
Human and Peoples` Pights also enshrine State obligations
applicable to HIV. In addition, a number ot conventions and
recommendations ot the International Iabour Organization
are particularly relevant to the problem ot HIV, such as IIO
instruments concerning discrimination in employment
and occupation, termination ot employment, protection ot
vorkers` privacy, and satety and health at vork. Among the
human rights principles relevant to HIVAIDS are, iuter aiia:
1he right to non-discrimination, equal protection and
equality betore the lav,
1he right to lite,
1he right to the highest attainable standard ot physical and
mental health,
81
1he right to liberty and security ot person,
1he right to treedom ot movement,
1he right to seek and enjoy asylum,
1he right to privacy,
1he right to treedom ot opinion and expression and the
right to treely receive and impart intormation,
1he right to treedom ot association,
1he right to vork,
1he right to marry and to tound a tamily,
1he right to equal access to education,
1he right to an adequate standard ot living,
1he right to social security, assistance and veltare,
1he right to share in scientitc advancement and its benetts,
1he right to participate in public and cultural lite,
1he right to be tree trom torture and cruel, inhuman or
degrading treatment or punishment.
103. Particular attention should be paid to human rights ot children
and vomen.
B. Restrictions an limitations
104. Lnder international human rights lav, States may impose
restrictions on some rights, in narrovly detned circumstances,
it such restrictions are necessary to achieve overriding goals,
such as public health, the rights ot others, morality, public
order, the general veltare in a democratic society and national
security. Some rights are non-derogable and cannot be
restricted under any circumstances.
38
In order tor restrictions
38
These incluce rhe rihr ro lile, lreecom lrom rorrure, lreecom lrom enslavemenr or ser
viruce, prorecrion lrom imprisonmenr lor ceLr, lreecom lrom rerroacrive penal laws, rhe
rihr ro reconirion as a person Lelore rhe law anc rhe rihr ro lreecom ol rhouhr, con
science anc reliion.
UNAID5 OHCHR
82
on human rights to be legitimate, the State must establish that
the restriction is:
(a, Provided tor and carried out in accordance vith the lav,
i.e. according to specitc legislation vhich is accessible,
clear and precise, so that it is reasonably toreseeable that
individuals vill regulate their conduct accordingly,
(b, Based on a legitimate interest, as detned in the provisions
guaranteeing the rights,
(c, Proportional to that interest and constituting the least
intrusive and least restrictive measure available and
actually achieving that interest in a democratic society, i.e.
established in a decision-making process consistent vith the
rule ot lav.
39
103. Public health is most otten cited by States as a basis tor
restricting human rights in the context ot HIV. Many such
restrictions, hovever, intringe on the principle ot non-
discrimination, tor example vhen HIV status is used as
the basis tor ditterential treatment vith regard to access to
education, employment, health care, travel, social security,
housing and asylum. 1he right to privacy is knovn to
have been restricted through mandatory testing and the
publication ot HIV status and the right to liberty ot person is
violated vhen HIV is used to justity deprivation ot liberty or
segregation. Although such measures may be ettective in the
case ot diseases vhich are contagious by casual contact and
susceptible to cure, they are inettective vith regard to HIV
since HIV is not casually transmitted. In addition, such coercive
measures are not the least restrictive measures possible and
3
F. Sieharr, A|D5 and Hunan Rqnt:. A UK cr:pcctvc, Brirish Mecical Associarion
Founcarion lor ADS, Loncon, 18, pp. 1225.
83
are otten imposed discriminatorily against already vulnerable
groups. linally, and as stated above, these coercive measures
drive people avay trom prevention and care programmes,
thereby limiting the ettectiveness ot public health outreach. A
public health exception is, theretore, seldom a legitimate basis
tor restrictions on human rights in the context ot HIV.
C. 7he application oj specifc human rights in the
conte:t oj the HI1 epiemic
106. Lxamples ot the application ot specitc human rights to HIV
are illustrated belov. 1hese rights should not be considered
in isolation but as interdependent rights supporting the
Guidelines elaborated in this document. In the application
ot these rights, the signitcance ot national and regional
particularities and various historical, cultural and religious
backgrounds must be taken into consideration. It remains the
duty ot States, hovever, to promote and protect all human
rights vithin their cultural contexts.
1. NON-DI5CPIMINATION AND EOUALITY
EFOPE THE LAW
107. International human rights lav guarantees the right to equal
protection betore the lav and treedom trom discrimination
on any ground such as race, colour, sex, language, religion,
political or other opinion, national or social origin, property,
birth or other status. Discrimination on any ot these grounds is
not only vrong in itselt but also creates and sustains conditions
leading to societal vulnerability to intection by HIV, including
lack ot access to an enabling environment that vill promote
behavioural change and enable people to cope vith HIV.
Groups suttering trom discrimination, vhich also disables
UNAID5 OHCHR
84
them in the context ot HIV, are vomen, children, those living
in poverty, minorities, indigenous people, migrants, retugees
and internally displaced persons, people vith disabilities,
prisoners, sex vorkers, men having sex vith men and injecting
drug users. Pesponses by States to the epidemic should
include the implementation ot lavs and policies to eliminate
systemic discrimination, including vhere it occurs against
these groups.
108. 1he Commission on Human Pights has contrmed that oth-
er status in non-discrimination provisions is to be interpreted
to include health status, including HIVAIDS.
40
1his means
that States should not discriminate against people living vith
HIV or members ot groups perceived to be at risk ot intection
on the basis ot their actual or presumed HIV status.
41

109. 1he Human Pights Committee has contrmed that the right
to equal protection ot the lav prohibits discrimination in lav
or in practice in any telds regulated and protected by public
authorities and that a ditterence in treatment is not necessarily
discriminatory it it is based on reasonable and objective
criteria. 1he prohibition against discrimination thus requires
States to reviev and, it necessary, repeal or amend their lavs,
policies and practices to proscribe ditterential treatment vhich
is based on arbitrary HIV-related criteria.
42

40
See, ntcr a!a, Commission on Human Fihrs resolurions 15/44 ol 3 March 15 anc
1c/43 ol 1 April 1c.
41
rher roups sinlec our lor ciscriminarory measures in rhe conrexr ol Hv, such as
mancarory screenin, are rhe milirary, rhe police, peacekeepin lorces, prenanr women,
hospiral parienrs, rourisrs, perlormers, people wirh haemophilia, ruLerculosis or sexually
rransmirrec ciseases (STDs), rruck crivers anc scholarshipholcers. Their parrners, lamilies,
lriencs anc care provicers may also Le suL|ecr ro ciscriminarion Lasec on presumec Hv
srarus.
42
Human Fihrs Commirree, General Commenr No. 18 (37). C||ca! Rccord: o| tnc Gcncra!
A::cno!y, Forty||tn 5c::on, Supplemenr No. 40 (A/45/40), vol. , annex v A.
85
2. HUMAN PIGHT5 OF WOMEN
110. Discrimination against vomen, de tacto and de jure, renders
them disproportionately vulnerable to HIV and AIDS.
Women`s subordination in the tamily and in public lite is one
ot the root causes ot the rapidly increasing rate ot intection
among vomen. Systematic discrimination based on gender
also impairs vomen`s ability to deal vith the consequences ot
their ovn intection andor intection in the tamily, in social,
economic and personal terms.
43

111. With regard to prevention ot intection, the rights ot vomen
and girls to the highest attainable standard ot physical and
mental health, to education, to treedom ot expression, to
treely receive and impart intormation, should be applied to
include equal access to HIV-related intormation, education,
means ot prevention and health services. Hovever, even
vhen such intormation and services are available, vomen and
girls are otten unable to negotiate sater sex or to avoid HIV-
related consequences ot the sexual practices ot their husbands
or partners as a result ot social and sexual subordination,
economic dependence on a relationship and cultural attitudes.
1he protection ot the sexual and reproductive rights ot
vomen and girls is, theretore, critical. 1his includes the rights
ot vomen to have control over and to decide treely and
responsibly, tree ot coercion, discrimination and violence,
on matters related to their sexuality, including sexual and
reproductive health.
44
Measures tor the elimination ot sexual
43
See reporr ol rhe Experr Group Meerin on Women anc Hv/ADS anc rhe Fole ol
Narional Machinery lor rhe Acvancemenr ol Women, convenec Ly rhe Division lor rhe
Acvancemenr ol Women, vienna, 2428 SepremLer 10 (EGM/ADS/10/1).
44
Bei|in Declararion anc Flarlorm lor Acrion, Fourrh Worlc Conlerence on Women, Bei|in,
4/5 SepremLer 15 (A/CNF.177/20).
UNAID5 OHCHR
8
violence and coercion against vomen in the tamily and
in public lite not only protect vomen trom human rights
violations but also trom HIV intection that may result trom
such violations.
112. Violence against vomen in all its torms during peacetime
and in connict situations increases their vulnerability to HIV
intection. Such violence includes, iuter aiia, sexual violence,
rape (marital and other, and other torms ot coerced sex, as
vell as traditional practices attecting the health ot vomen and
children. States have an obligation to protect vomen trom
sexual violence in both public and private lite.
113. lurthermore, in order to empover vomen to leave
relationships or employment vhich threaten them vith
HIV intection and to cope it they or their tamily members
are intected vith HIV, States should ensure vomen`s rights
to, iuter aiia, legal capacity and equality vithin the tamily, in
matters such as divorce, inheritance, child custody, property
and employment rights, in particular, equal remuneration
ot men and vomen tor vork ot equal value, equal access to
responsible positions, measures to reduce connicts betveen
protessional and tamily responsibilities and protection against
sexual harassment at the vorkplace. Women should also be
enabled to enjoy equal access to economic resources, including
credit, an adequate standard ot living, participation in public
and political lite and to benetts ot scientitc and technological
progress so as to minimize risk ot HIV intection.
114. HIV prevention and care tor vomen are otten undermined
by pervasive misconceptions about HIV transmission and
epidemiology. 1here is a tendency to stigmatize vomen as
vectors ot disease, irrespective ot the source ot intection. As
87
a consequence, vomen vho are or are perceived to be HIV-
positive tace violence and discrimination in both public and
in private lite. Sex vorkers otten tace mandatory testing vith
no support tor prevention activities to encourage or require
their clients to vear condoms and vith little or no access to
health-care services. Many HIV programmes targeting vomen
are tocused on pregnant vomen but these programmes otten
emphasize coercive measures directed tovards the risk ot
transmitting HIV to the toetus, such as mandatory pre- and
post-natal testing tolloved by coerced abortion or sterilization.
Such programmes seldom empover vomen to prevent
perinatal transmission by prenatal prevention education and an
available choice ot health services and overlook the care needs
ot vomen.
113. 1he Convention on the Llimination ot All lorms ot
Discrimination against Women obliges States parties to address
all aspects ot gender-based discrimination in lav, policy and
practice. States are also required to take appropriate measures
to modity social and cultural patterns vhich are based on
ideas ot superiorityinteriority and stereotyped roles tor
men and vomen. 1he Committee on the Llimination ot
Discrimination against Women (CLDAW,, vhich monitors
the Convention has underscored the link betveen vomen`s
reproductive role, their subordinate social position and their
increased vulnerability to HIV intection.
45

45
CEDAW, eneral recommencarion No. 15 (ninrh session, 10). C||ca! Rccord: o| tnc
Gcncra! A::cno!y, Forty||tn 5c::on, 5upp!cncnt No. 33 (A/45/38), chap. v.
UNAID5 OHCHR
88
3. HUMAN PIGHT5 OF CHILDPEN
116. 1he rights ot children are protected by all international human
rights instruments and, in particular, under the Convention
on the Pights ot the Child, vhich establishes an international
detnition ot the child as every human being belov the age
ot eighteen years unless under the lav applicable to the child,
majority is attained earlier (art. 1,. 1he Convention reattrms
that children are entitled to many ot the rights that protect
adults (e.g. the rights to lite, non-discrimination, integrity ot
the person, liberty and security, privacy, asylum, expression,
association and assembly, education and health,, in addition to
particular rights tor children established by the Convention.
117. Many ot these rights are relevant to HIV prevention, care
and support tor children, such as treedom trom trattcking,
prostitution, sexual exploitation and sexual abuse since sexual
violence against children, among other things, increases their
vulnerability to HIV. 1he treedom to seek, receive and impart
intormation and ideas ot all kinds and the right to education
provide children vith the right to give and receive all HIV-
related intormation needed to avoid intection and to cope
vith their status, it intected. 1he right to special protection
and assistance it deprived ot his or her tamily environment,
including alternative care and protection in adoption, in
particular protects children it they are orphaned by HIV. 1he
right ot disabled children to a tull and decent lite and to special
care and the rights to abolition ot traditional practices vhich
are prejudicial to the health ot children, such as early marriage,
temale genital mutilation, denial ot equal sustenance and
inheritance tor girls are also highly relevant in the context ot
HIV. Lnder the Convention, the right to non-discrimination
and privacy tor children living vith HIV and tnally the rights
8
ot children to be actors in their ovn development and to
express opinions and have them taken into account in making
decisions about their lives should empover children to be
involved in the design and implementation ot HIV-related
programmes tor children.
4. PIGHT TO MAPPY AND TO FOUND A FAMILY AND
PPOTECTION OF THE FAMILY
118. 1he right to marry and to tound a tamily encompasses the
right ot men and vomen ot tull age, vithout any limitation
due to race, nationality or religion,.to marry and to tound a
tamily, to be entitled to equal rights as to marriage, during
marriage and at its dissolution and to protection by society
and the State ot the tamily as the natural and tundamental
group unit ot society.
46
1heretore, it is clear that the right ot
people living vith HIV is intringed by mandatory pre-marital
testing andor the requirement ot AIDS-tree certitcates as
a precondition tor the grant ot marriage licences under State
lavs.
47
Secondly, torced abortions or sterilization ot HIV-
intected vomen violates the human right to tound a tamily, as
vell as the right to liberty and integrity ot the person. Women
should be provided vith accurate intormation about the risk
ot perinatal transmission to support them in making voluntary,
intormed choices about reproduction.
48
1hirdly, measures
to ensure the equal rights ot vomen vithin the tamily are
4c
Arricle 1c ol rhe niversal Declararion ol Human Fihrs.
47
Feople livin wirh Hv shoulc Le aLle ro marry anc enae in sexual relarions whose narure
coes nor impose a risk ol inlecrion on rheir parrners. Feople livin wirh Hv, like all people
who know or suspecr rhar rhey are Hvposirive, have a responsiLiliry ro pracrise aLsrinence
or saler sex in orcer nor ro expose orhers ro inlecrion.
48
The chances ol an Hvinlecrec woman ivin Lirrh ro an Hvposirive LaLy is approximare
ly 1 in 3. This rare may Le sinilcanrly recucec il rhe woman is aLle ro uncero preanc
posrnaral rrearmenr wirh anrirerrovirals. Since exrremely cillculr anc complex erhical anc
personal cecisions are involvec, rhe choice ro have a chilc shoulc Le lelr ro rhe woman,
wirh inpur lrom her parrner, il possiLle.
UNAID5 OHCHR
0
necessary to enable vomen to negotiate sate sex vith their
husbands partners or be able to leave the relationship it they
cannot assert their rights (see also Human rights ot vomen
above,. linally, recognition ot the tamily as the tundamental
unit ot society is undermined by policies vhich have the
ettect ot denying tamily unity. In the case ot migrants, many
States do not allov migrants to be accompanied by tamily
members, and the resulting isolation can increase vulnerability
to HIV intection. In the case ot retugees, mandatory testing
as a precondition ot asylum can result in HIV-positive tamily
members being denied asylum vhile the rest ot the tamily is
granted asylum.
5. PIGHT TO PPIVACY
119. Article 17 ot the International Covenant on Civil and Political
Pights provides that No one shall be subjected to arbitrary
or unlavtul interterence vith his privacy, tamily, home or
correspondence, nor to unlavtul attacks on his honour and
reputation. Lveryone has the right to the protection ot the
lav against such interterence or attacks. 1he right to privacy
encompasses obligations to respect physical privacy, including
the obligation to seek intormed consent to HIV testing
and privacy ot intormation, including the need to respect
contdentiality ot all intormation relating to a person`s HIV
status.
120. 1he individual`s interest in hisher privacy is particularly
compelling in the context ot HIV, trstly, in viev ot the
invasive character ot a mandatory HIV test and, secondly,
by reason ot the stigma and discrimination attached to the
loss ot privacy and contdentiality it HIV status is disclosed.
1he community has an interest in maintaining privacy so
1
that people vill teel sate and comtortable in using public
health measures, such as HIV prevention and care services.
1he interest in public health does not justity mandatory HIV
testing or registration, except in cases ot bloodorgantissue
donations vhere the human product, rather than the person, is
tested betore use on another person. All intormation on HIV
sero-status obtained during the testing ot donated blood or
tissue must also be kept strictly contdential.
121. 1he duty ot States to protect the right to privacy, theretore,
includes the obligation to guarantee that adequate sateguards
are in place to ensure that no testing occurs vithout intormed
consent, that contdentiality is protected, particularly in health
and social veltare settings, and that intormation on HIV status
is not disclosed to third parties vithout the consent ot the
individual. In this context, States must also ensure that HIV-
related personal intormation is protected in the reporting and
compilation ot epidemiological data and that individuals are
protected trom arbitrary interterence vith their privacy in the
context ot media investigation and reporting.
122. In societies and cultures vhere traditions place greater
emphasis on the community, patients may more readily
authorize the sharing ot contdential intormation vith their
tamily or community. In such circumstances, disclosure to the
tamily or community may be tor the benett ot the person
concerned and such shared contdentiality may not breach the
duty to maintain contdentiality.
123. 1he Human Pights Committee has tound that the right to
privacy under article 17 ot the International Covenant on
Civil and Political Pights is violated by lavs vhich criminalize
private homosexual acts betveen consenting adults. 1he
UNAID5 OHCHR
2
Committee noted that . the criminalization ot homosexual
practices cannot be considered a reasonable means or
proportionate measure to achieve the aim ot preventing the
spread ot HIVAIDS.by driving underground many ot the
people at risk ot intection.
[it| vould appear to run counter to the implementation
ot ettective education programmes in respect ot the
HIVAIDS prevention.
49
124. 1he Committee also noted that the term sex in article 26
ot the Covenant vhich prohibits discrimination on various
grounds includes sexual orientation. In many countries,
there exist lavs vhich render criminal particular sexual rela-
tionships or acts betveen consenting adults, such as adultery,
tornication, oral sex and sodomy. Such criminalization not
only interteres vith the right to privacy but it also impedes
HIVAIDS education and prevention vork.
. PIGHT TO ENJOY THE ENEFIT5 OF 5CIENTIFIC
PPOGPE55 AND IT5 APPLICATION5
123. 1he right to enjoy the benetts ot scientitc progress and its
applications is important in the context ot HIV in viev ot the
rapid and continuing advances regarding testing, treatment
therapies and the development ot a vaccine. More basic
scientitc advances vhich are relevant to HIV concern the
satety ot the blood supply trom HIV intection and the use
ot universal precautions vhich prevent the transmission ot
HIV in various settings, including that ot health care. In this
connection, hovever, developing countries experience severe
resource constraints vhich limit not only the availability ot
4
Human Fihrs Commirree, Communicarion No. 488/11, Ncno!a: Toonan v. Au:tra!a (views
acoprec on 31 March 14, llrierh session). C||ca! Rccord: o| tnc Gcncra! A::cno!y, Forty
nntn 5c::on, 5upp!cncnt No. 40 (A/4/40), vol. , annex X EE, para. 8.5.
3
such scientitc benetts but also the availability ot basic pain
prophylaxis and antibiotics tor the treatment ot HIV-related
conditions. lurthermore, disadvantaged andor marginalized
groups vithin societies may have no or limited access to
available HIV-related treatments or to participation in clinical
and vaccine development trials. Ot deep concern is the need
to share equitably among States and among all groups vithin
States basic drugs and treatment, as vell as the more expensive
and complicated treatment therapies, vhere possible.
7. PIGHT TO LIEPTY OF MOVEMENT
126. 1he right to liberty ot movement encompasses the rights ot
everyone lavtully vithin a territory ot a State to liberty ot
movement vithin that State and the treedom to choose his
her residence, as vell as the rights ot nationals to enter and
leave their ovn country. Similarly, an alien lavtully vithin a
State can only be expelled by a legal decision vith due process
protection.
127. 1here is no public health rationale tor restricting liberty ot
movement or choice ot residence on the grounds ot HIV
status. According to current international health regulations,
the only disease vhich requires a certitcate tor international
travel is yellov tever.
50
1heretore, any restrictions on these
rights based on suspected or real HIV status alone, including
HIV screening ot international travellers, are discriminatory
and cannot be justited by public health concerns.
128. Where States prohibit people living vith HIV trom longer-
term residency due to concerns about economic costs, States
should not single out HIVAIDS, as opposed to comparable
50
WH nrernarional Healrh Feularions (1c).
UNAID5 OHCHR
4
conditions, tor such treatment and should establish that such
costs vould indeed be incurred in the case ot the individual
alien seeking residency. In considering entry applications,
humanitarian concerns, such as tamily reunitcation and the
need tor asylum, should outveigh economic considerations.
8. PIGHT TO 5EEK AND ENJOY A5YLUM
129. Lveryone has the right to seek and enjoy asylum trom
persecution in other countries. Lnder the 1931 Convention
relating to the Status ot Petugees and under customary
international lav, States cannot, in accordance vith the
principle ot non-retoulement, return a retugee to a country
vhere she or he taces persecution. 1hus, States may not return
a retugee to persecution on the basis ot his or her HIV status.
lurthermore, vhere the treatment ot people living vith HIV
can be said to amount to persecution, it can provide a basis tor
qualitying tor retugee status.
130. 1he Lnited Nations High Commissioner tor Petugees issued
policy guidelines in March 1988 vhich state that retugees and
asylum seekers should not be targeted tor special measures
regarding HIV intection and that there is no justitcation tor
screening being used to exclude HIV-positive individuals trom
being granted asylum.
51

131. 1he Human Pights Committee has contrmed that the right
to equal protection ot the lav prohibits discrimination in lav
or in practice in any telds regulated and protected by public
authorities.
52
1hese vould include travel regulations, entry
requirements, immigration and asylum procedures. 1heretore,
51
NHCF Healrh Folicy on ADS, 15 FeLruary 188 (NHCF/DM).
52
Human Fihrs Commirree, eneral commenr No. 18 (37), op. cir.
5
although there is no right ot aliens to enter a toreign
country or to be granted asylum in any particular country,
discrimination on the grounds ot HIV status in the context ot
travel regulations, entry requirements, immigration and asylum
procedures vould violate the right to equality betore the lav.
?. PIGHT TO LIEPTY AND 5ECUPITY OF PEP5ON
Pights provides that Lveryone has the right to liberty and
security ot person. No one shall be subjected to arbitrary arrest
or detention. No one shall be deprived ot his liberty except on
such grounds and in accordance vith such procedures as are
established by lav.
133. 1he right to liberty and security ot person should, theretore,
never be arbitrarily intertered vith, based merely on HIV
status by using measures such as quarantine, detention in
special colonies, or isolation. 1here is no public health
justitcation tor such deprivation ot liberty. Indeed, it has been
shovn that public health interests are served by integrating
people living vith HIV vithin communities and benetting
trom their participation in economic and public lite.
134. In exceptional cases involving objective judgments concerning
deliberate and dangerous behaviour, restrictions on liberty may
be imposed. Such exceptional cases should be handled under
ordinary provisions ot public health, or criminal lavs, vith
appropriate due process protection.
133. Compulsory HIV testing can constitute a deprivation ot
liberty and a violation ot the right to security ot person. 1his
coercive measure is otten utilized vith regard to groups least
UNAID5 OHCHR
able to protect themselves because they are vithin the ambit

ot Government institutions or the criminal lav, e.g. soldiers,
prisoners, sex vorkers, injecting drug users and men vho have
sex vith men. 1here is no public health justitcation tor such
compulsory HIV testing. Pespect tor the right to physical
integrity requires that testing be voluntary and that no testing
be carried out vithout intormed consent
10. PIGHT TO EDUCATION
136. Article 26 ot the Lniversal Declaration ot Human Pights states
in part that Lveryone has the right to education. .Lducation
shall be directed to the tull development ot the human person-
ality and to the strengthening ot respect tor human rights and
tundamental treedoms. It shall promote understanding, toler-
ance and triendship.. 1his right includes three broad com-
ponents vhich apply in the context ot HIVAIDS. lirstly, both
children and adults have the right to receive HIV-related educa-
tion, particularly regarding prevention and care. Access to edu-
cation concerning HIV is an essential lite-saving component ot
ettective prevention and care programmes. It is the State`s ob-
ligation to ensure, in every cultural and religious tradition, that
appropriate means are tound so that ettective HIV intorma-
tion is included in educational programmes inside and outside
schools. 1he provision ot education and intormation to children
should not be considered as promoting early sexual experimen-
tation, rather, as studies indicate, it delays sexual activity.
53

137. Secondly, States should ensure that both children and adults
living vith HIV are not discriminatorily denied access to
53
M. Alexancer, "nlormarion anc Ecucarion Laws", in Dr. Jayasuriya (ec.) H|V, Lav, Etnc: and
Hunan Rqnt:, NDF, New Delhi, 15, p. 54. mpacr ol Hv anc sexual healrh ecucarion
on rhe sexual Lehaviour ol youn people: a review upcare, NADS, 17.
7
education, including access to schools, universities, scholarships
and international education or subject to restrictions because
ot their HIV status. 1here is no public health rationale tor
such measures since there is no risk ot transmitting HIV
casually in educational settings. 1hirdly, States should, through
education, promote understanding, respect, tolerance and non-
discrimination in relation to persons living vith HIV.
11. FPEEDOM OF EXPPE55ION AND INFOPMATION
Pights states in part that Lveryone shall have the right to
hold opinions vithout interterence. .Lveryone shall have
the right to treedom ot expression, this right shall include
the treedom to seek, receive and impart intormation and
ideas ot all kinds.. 1his right, theretore, includes the right
to seek, receive and impart HIV-related prevention and care
intormation. Lducational material vhich may necessarily
involve detailed intormation about transmission risks and may
target groups engaged in illegal behaviour, such as injecting
drug use and sexual activity betveen the same sexes, vhere
applicable, should not be vrongtully subject to censorship
or obscenity lavs or lavs making those imparting the
intormation liable tor aiding and abetting criminal ottences.
States are obliged to ensure that appropriate and ettective
intormation on methods to prevent HIV transmission is
developed and disseminated tor use in ditterent multicultural
contexts and religious traditions. 1he media should be
respecttul ot human rights and dignity, specitcally the right to
privacy, and use appropriate language vhen reporting on HIV.
Media reporting on HIV should be accurate, tactual, sensitive
and avoid stereotyping and stigmatization.
UNAID5 OHCHR
8
12. FPEEDOM OF A55EMLY AND A55OCIATION
139. Article 20 ot the Lniversal Declaration ot Human Pights
provides that Lveryone has the right to treedom ot peacetul
assembly and association. 1his right has been trequently
denied to non-governmental organizations vorking in the
teld ot human rights, AIDS service organizations (ASOs, and
community-based organizations (CBOs,, vith applications tor
registration being retused as a result ot their perceived criticism
ot Governments or ot the tocus ot some ot their activities, e.g.
sex vork. In general, non-governmental organizations and
their members involved in the teld ot human rights should
enjoy the rights and treedoms recognized in human rights
instruments and the protection ot national lav. In the context
ot HIVAIDS, the treedom ot assembly and association vith
others is essential to the tormation ot HIV-related advocacy,
lobby and selt-help groups to represent interests and meet the
needs ot various groups attected by HIV, including people
living vith HIV. Public health and an ettective response to
HIV are undermined by obstructing interaction and dialogue
vith and among such groups, other social actors, civil society
and Government.
140. lurthermore, persons living vith HIV should be protected
against direct or indirect discrimination based on HIV status
in their admission to organizations ot employers or trade
unions, continuation as members and participation in their
activities, in contormity vith IIO instruments on treedom
ot association and collective bargaining. At the same time,
vorkers` and employers` organizations can be important tactors
in raising avareness on issues connected vith HIV and in
dealing vith its consequences in the vorkplace.
13. PIGHT TO PAPTICIPATION IN POLITICAL AND

CULTUPAL LIFE
141. Pealization ot the right to take part in the conduct ot
public attairs,
54
as vell as in cultural lite,
55
is essential to
guaranteeing participation by those most attected by HIV
in the development and implementation ot HIV-related
policies and programmes. 1hese human rights are reintorced
by the principles ot participatory democracy, this assumes the
involvement ot people living vith HIV and their tamilies,
vomen, children and groups vulnerable to HIV in designing
and implementing programmes that vill be most ettective
by being tailored to the specitc needs ot these groups. It is
essential that people living vith HIV remain tully integrated
in the political, economic, social and cultural aspects ot
community lite.
142. People living vith HIV have the right to their cultural
identity and to various torms ot creativity, both as a means
ot artistic expression and as a therapeutic activity. Increasing
recognition has been given to the expression ot creativity as a
popular medium tor imparting HIV intormation, combating
intolerance, and as a therapeutic torm ot solidarity.
14. PIGHT TO THE HIGHE5T ATTAINALE 5TANDAPD OF
PHY5ICAL AND MENTAL HEALTH
143. 1he right to the highest attainable standard ot physical and
mental health comprises, iuter aiia, the prevention, treatment
and control ot epidemic.diseases and the creation ot
conditions vhich vould assure to all medical service and
medical attention in the event ot sickness.
56
54
Arricle 25 ol rhe nrernarional Covenanr on Civil anc Folirical Fihrs.
55
Arricle 15 ol rhe nrernarional Covenanr on Economic, Social anc Culrural Fihrs.
5c
Arricle 12 ol rhe nrernarional Covenanr on Economic, Social anc Culrural Fihrs.
UNAID5 OHCHR
100
144. In order to meet these obligations in the context ot HIV,
States should ensure the provision ot appropriate HIV-
related intormation, education and support, including access
to services tor sexually transmitted diseases, to the means ot
prevention (such as condoms and clean injection equipment,
and to voluntary and contdential testing vith pre-and post-
test counselling, in order to enable individuals to protect
themselves and others trom intection. States should also
ensure a sate blood supply and implementation ot universal
precautions to prevent transmission in settings such as
hospitals, doctors` ottces, dental practices and acupuncture
clinics, as vell as intormal settings, such as during home births.
143.States should also ensure access to adequate treatment and
drugs, vithin the overall context ot their public health
policies, so that people living vith HIV can live as long and
as successtully as possible. People living vith HIV should
also have access to clinical trials and should be tree to
choose amongst all available drugs and therapies, including
alternative therapies. International support is essential trom
both the public and private sectors, tor developing countries
tor increased access to health care and treatment, drugs and
equipment. In this context, States should ensure that neither
expired drugs nor other invalid materials are supplied.
146. States may have to take special measures to ensure that all
groups in society, particularly marginalized groups, have
equal access to HIV-related prevention, care and treatment
services. 1he human rights obligations ot States to prevent
discrimination and to assure medical service and medical
attention tor everyone in the event ot sickness require States to
ensure that no one is discriminated against in the health-care
setting on the basis ot their HIV status.
101
15. PIGHT TO AN ADEOUATE 5TANDAPD OF LIVING AND
5OCIAL 5ECUPITY 5EPVICE5
147. Article 23 ot the Lniversal Declaration ot Human Pights
states that Lveryone has the right to a standard ot living
adequate tor the health and vell-being ot himselt and his
tamily, including tood, clothing, housing and medical care and
necessary social services, and the right to security in the event
ot unemployment, sickness, disability, vidovhood, old age or
other lack ot livelihood in circumstances beyond his control.
Lnjoyment ot the right to an adequate standard ot living is
essential to reduce vulnerability to the risk and consequences
ot HIV intection. It is particularly relevant to meeting the
needs ot people living vith HIVAIDS, andor their tamilies,
vho have become impoverished by HIVAIDS as a result
ot increased morbidity due to AIDS andor discrimination
vhich can result in unemployment, homelessness and poverty.
It States introduce priority ranking tor such services tor
resource allocation purposes, then PIHAs and persons vith
comparable conditions and disabilities should quality tor
preterential treatment due to their dire circumstances.
148. States should take steps to ensure that people living vith HIV
are not discriminatorily denied an adequate standard ot living
andor social security and support services on the basis ot their
health status.
1. PIGHT TO WOPK
149. Lveryone has the right to vork.[and| to just and tavourable
conditions ot vork.
57
1he right to vork entails the right
ot every person to access to employment vithout any
57
Arricle 23, ol rhe niversal Declararion ol Human Fihrs.
UNAID5 OHCHR
102
precondition except the necessary occupational qualitcations.
1his right is violated vhen an applicant or employee is
required to undergo mandatory testing tor HIV and is retused
employment or dismissed or retused access to employee
benetts on the grounds ot a positive result. States should
ensure that persons vith living vith HIV are alloved to
vork as long as they can carry out the tunctions ot the job.
1hereatter, as vith any other illness, people living vith HIV
should be provided vith reasonable accommodation to be
able to continue vorking as long as possible and, vhen no
longer able to vork, be given equal access to existing sickness
and disability schemes. 1he applicant or employee should
not be required to disclose his or her HIV status to the
employer nor in connection vith his or her access to vorkers`
compensation, pension benetts and health insurance schemes.
States` obligations to prevent all torms ot discrimination in the
vorkplace, including on the grounds ot HIV, should extend to
the private sector.
130. As part ot tavourable conditions ot vork, all employees have
the right to sate and healthy vorking conditions. In the vast
majority ot occupations and occupational settings, vork does
not involve a risk ot acquiring or transmitting HIV betveen
vorkers, trom vorker to client, or trom client to vorker.
38

Hovever, vhere a possibility ot transmission does exist in the
vorkplace, such as in health-care settings, States should take
measures to minimize the risk ot transmission. In particular,
vorkers in the health sector must be properly trained in uni-
versal precautions tor the avoidance ot transmission ot intection
and be supplied vith the means to implement such procedures.
58
Consulrarion on ADS anc rhe Workplace (Worlc Healrh ranizarion, in associarion wirh
rhe nrernarional LaLour ranizarion), Geneva, 188, secr. , "nrrocucrion".
103
17. FPEEDOM FPOM CPUEL, INHUMAN OP DEGPADING
TPEATMENT OP PUNI5HMENT
131. 1he right to treedom trom cruel, inhuman or degrading
treatment or punishment can arise in a variety ot vays in the
context ot HIV, tor example in the treatment ot prisoners.
132. Imprisonment is punishment by deprivation ot liberty but
should not result in the loss ot human rights or dignity. In
particular, the State, through prison authorities, oves a duty ot
care to prisoners, including the duty to protect the rights to
lite and to health ot all persons in custody. Denial to prisoners
ot access to HIV-related intormation, education and means
ot prevention (bleach, condoms, clean injection equipment,,
voluntary testing and counselling, contdentiality and HIV-
related health care and access to and voluntary participation in
treatment trials, could constitute cruel, inhuman or degrading
treatment or punishment. 1he duty ot care also comprises
a duty to combat prison rape and other torms ot sexual
victimization that may result, iuter aiia, in HIV transmission.
133. 1hus, all prisoners engaging in dangerous behaviour, including
rape and sexual coercion, should be subject to discipline
based on their behaviour, vithout reterence to their HIV
status. 1here is no public health or security justitcation tor
mandatory HIV testing ot prisoners, nor tor denying inmates
living vith HIV access to all activities available to the rest ot
the prison population. lurthermore, the only justitcation
tor segregation ot people living vith HIV trom the prison
population vould be tor the health ot themselves. Prisoners
vith terminal diseases, including AIDS, should be considered
tor early release and given proper treatment outside prison.
105
ANNEX I
History ot the recognition ot the importance ot
human rights in the contet ot HIV
1. 1he World Health Organization (WHO, held an International
Consultation on Health Iegislation and Lthics in the lields ot
HIVAIDS in April 1988 at Oslo. It advocated bringing dovn
barriers betveen people vho vere intected and those vho
vere not intected and placing actual barriers (e.g. condoms,
betveen individuals and the virus. On 13 May 1988, the
World Health Assembly passed resolution WHA41.24 entitled
Avoidance ot discrimination in relation to HIV-intected
people and people vith AIDS, vhich underlined hov vital
respect tor human rights vas tor the success ot national AIDS
prevention and control programmes and urged member States
to avoid discriminatory action in the provision ot services,
employment and travel. In uly 1989, the trst international
consultation on AIDS and human rights vas organized by the
then Lnited Nations Centre tor Human Pights, in cooperation
vith the World Health OrganizationGPA. 1he report ot the
consultation highlighted the human rights issues raised in
the context ot HIVAIDS and proposed the elaboration ot
guidelines. Pesolution WHA43.33 ot 14 May 1992 recognized
that there is no public health rationale tor measures vhich
arbitrarily limit individual rights, such as mandatory screening.
In 1990, the World Health Organization conducted regional
vorkshops on the legal and ethical aspects ot HIVAIDS at
Seoul, Brazzaville and Nev Delhi. 1he trst ot these vorkshops
developed guidelines to evaluate current and elaborate
UNAID5 OHCHR
10
tuture legal measures tor the control ot HIV to be used as a
check-list by countries considering legal policy issues.
39
In
November 1991, the WHO Pegional Ottce tor Lurope and
the International Association ot Pights and Humanity held a
Pan-Luropean Consultation on HIVAIDS in the Context
ot Public Health and Human Pights in Prague, vhich
considered the Pights and Humanity Declaration and Charter
and developed a consensus statement (the Prague Statement,.
1hree turther consultations on HIV, lav and lav retorm vere
convened during 1993 by the WHO Pegional Ottce tor
Lurope, tor countries in Lastern Lurope and Central Asia.
2. 1he Lnited Nations Development Programme held Inter-
Country Consultations on Lthics, Iav and HIV in Cebu
(Philippines, in May 1993 and in Dakar, in une 1994.
60

Both ot these consultations produced consensus documents
reattrming a commitment to voluntarism, ethics and the
human rights ot those attected (the Cebu Statement ot Beliet
and the Dakar Declaration,. LNDP also held Pegional
1raining Workshops on HIV Iav and Iav Petorm in Asia and
the Pacitc at Colombo, Beijing and Nadi (liji, in 1993.
3. Iav retorm programmes tocusing on human rights have
been ongoing in countries such as Australia, Canada, the
Lnited States, South Atrica and in the Iatin American region,
together vith netvorks ot legal advocates, practitioners and
activists at governmental and community levels. One concrete
achievement ot such groups has been the successtul lobbying
tor general anti-discrimination legislation at national and local
levels vhich detnes disability broadly and sensitively enough to
5
See WH cocumenr FS/0/GE/11(KF).
c0
F. Glick (ec.), |ntcrCountry Con:u!taton on Etnc:, Lav and H|V (CeLu), New Delhi, ncia,
15, NDF, |ntcrCountry Con:u!taton on Etnc:, Lav and H|V, Dakar, Seneal, 15.
107
explicitly include HIVAIDS. Such civil legislation exists in the
Lnited States, the Lnited Kingdom, Australia, Nev Zealand
and Hong Kong. In lrance, such a detnition is contained in
the Penal Code. Some countries have constitutional guarantees
ot human rights vith practical entorcement mechanisms, such
as the Canadian Charter ot Pights.
4. 1he Lnited Nations General Assembly, in its resolutions
43187 ot 21 December 1990 and 46203 ot 20 December
1991, emphasized the need to counter discrimination and
to respect human rights and recognized that discriminatory
measures drove HIVAIDS underground, making it more
dittcult to combat, rather than stopping its spread. 1he Special
Papporteur ot the Lnited Nations Sub-Commission on
Prevention ot Discrimination and Protection ot Minorities on
discrimination against HIV-intected people and people living
vith AIDS presented a series ot reports to the Sub-Commission
betveen 1990 and 1993.
61
1he Special Papporteur`s reports
highlighted the need tor education programmes to create
a genuine climate ot respect tor human rights in order to
eradicate discriminatory practices vhich are contrary to
international lav. 1he right to health can only be implemented
by advising people ot the means ot prevention and the Special
Papporteur made specitc reterence to the vulnerable situation
ot vomen and children in the spread ot HIV. Since 1989, the
Sub-Commission, at its annual sessions, has adopted resolutions
on discrimination against people living vith HIV.
62

c1
E/CN.4/SuL.2/10/, E/CN.4/SuL.2/11/10, E/CN.4/SuL.2/12/10 anc E/CN.4/
SuL.2/13/.
c2
SuLCommission resolurions anc cecisions 18/17, 10/118, 11/10, 12/108,
13/31, 14/2, 15/21, 1c/33, 17/40.
UNAID5 OHCHR
108
3. 1he Lnited Nations Commission on Human Pights, at
its annual sessions since 1990, has also adopted numerous
resolutions on human rights and HIV vhich, iuter aiia, contrm
that discrimination on the basis ot HIVAIDS status, actual or
presumed, is prohibited by existing international human rights
standards and clarity that the term or other status used in the
non-discrimination clauses ot such texts should be interpreted
to include health status, such as HIVAIDS.
63

6. 1here have also been prestigious academic international studies
ot HIV and human rights: these include the vork ot the late
Paul Sieghart tor the British Medical Association loundation
tor AIDS,
64
the lranois-Xavier Bagnoud Center tor Health
and Human Pights, Harvard School ot Public Health,
65
the
International lederation ot Ped Cross and Ped Crescent
Societies, the National Advisory Committee on AIDS in
Canada,
66
the Pan-American Health Organization (PAHO,,
67

the Sviss Institute ot Comparative Iav,
68
by the Danish Centre
on Human Pights
69
and by the Georgetovnohns Hopkins
Lniversity Program in Iav and Public Health.
70

c3
Commission on Human Fihrs resolurions 10/c5, 12/5c, 13/53, 14/4, 15/44
anc 1c/43. Felevanr reporrs ol rhe SecreraryGeneral suLmirrec ro rhe Commission on
Human Fihrs are E/CN.4/15/45 anc E/CN.4/1c/44 anc E/CN.4/17/37.
c4
F. Sieharr, op. cir.
c5
nrernarional Fecerarion ol rhe Fec Cross anc Fec Crescenr Socieries, ADS, Healrh anc
Human Fihrs: An Explanarory Manual, Geneva, 15. See, in parricular, p. 43 on rhe Four
Srep mpacr Assessmenr ol FuLlic Healrh anc Human Fihrs.
cc
Hv anc Human Fihrs in Canaca, suLmirrec ro rhe Minisrer ol Narional Healrh anc
Wellare, January 12.
c7
FAH, Etnc: and Lav n tnc 5tudy o| A|D5, Scienrilc FuLlicarion No. 530, Washinron,
D.C., 12.
c8
Swiss nsrirure ol Compararive Law (Lausanne), Conparatvc 5tudy on D:crnnaton o|
cr:on: |n|cctcd vtn H|V or 5u||crnq |ron A|D5, Council ol Europe, Sreerin Commirree
lor Human Fihrs, CDDH (2) 14 Fev. Bil., SrrasLour, SepremLer 12.
c
Danish Cenrre on Human Fihrs, A|D5 and Hunan Rqnt:, Akacemisk Forla, Copenhaen,
188.
70
L. Gosrin anc Z. Lazzarini, uo!c Hca!tn and Hunan Rqnt: n tnc H|V andcnc, xlorc
niversiry Fress, 17.
10
7. Numerous charters and declarations vhich specitcally
or generally recognize the human rights ot people living
vith HIV have been adopted at national and international
conterences and meetings, including the tolloving:
Iondon Declaration on AIDS Prevention, World Summit ot
Ministers ot Health, 28 anuary 1988,
Paris Declaration on Women, Children and AIDS, 30 March
1989,
Pecommendation on the Lthical Issues ot HIV Intection
in the Health Care and Social Settings, Committee ot
Ministers ot the Council ot Lurope, Strasbourg, October
1989 (Pec. 8914,,
Council ot Lurope, Committee ot Ministers,
Pecommendation P(87, 23 to member States concerning
a common Luropean public health policy to tght AIDS,
Strasbourg, 1987,
Luropean Lnion, Luropean Parliament and Council
Decisions on Lurope Against AIDS programme (including
dec. 91317LLC and dec. 127993LC,,
Declaration ot Basic Pights ot Persons vith HIVAIDS,
Organizing Committee ot the Iatin American Netvork
ot Community-Based Non-Governmental Organizations
lighting AIDS, November 1989,
Declaration ot the Pights ot the People vith HIV and
AIDS, Lnited Kingdom, 1991,
Australian Declaration ot the Pights ot People vith HIV
AIDS, National Association ot People Iiving vith HIV
AIDS, 1991,
Prague Statement, Pan-Luropean Consultation on HIV
AIDS in the Context ot Public Health and Human Pights,
November 1991,
UNAID5 OHCHR
110
Pights and Humanity Declaration and Charter on HIV
and AIDS, Lnited Nations Commission on Human Pights,
1992,
71
South Atrican AIDS Consortium Charter ot Pights
on AIDS and HIV, 1 December 1992,
Cebu Statement ot Beliet, LNDP Inter-Country
Consultations on Lthics, Iav and HIV, the Philippines, May
1993,
Dakar Declaration, LNDP Inter-Country Consultations on
Lthics, Iav and HIV, Senegal, uly 1994,
Phnom Penh Declaration on Women and Human Pights
and the Challenge ot HIVAIDS, Cambodia, November
1994,
Paris Declaration, World AIDS Summit, Paris, 1 December
1994,
Malaysian AIDS Charter: Shared Pights, Shared
Pesponsibilities, 1993,
Chiang Mai Proposal on Human Pights and Policy tor
People vith HIVAIDS, submitted to the Poyal 1hai
Government, September 1993,
Asia-Pacitc Council ot AIDS Service Organization's
Compact on Human Pights, September 1993,
Montreal Manitesto ot the Lniversal Pights and Needs ot
People Iiving vith HIV Disease,
Copenhagen Declaration on Social Development and
Programme ot Action ot the World Summit tor Social
Development, March 1993,
Nev Delhi Declaration and Action Plan on HIVAIDS,
Interdisciplinary International Conterence: AIDS, Iav and
Humanity, December 1993.
71
E/CN.4/12/82, annex.
111
8. 1he tormulation ot the present Guidelines is a culmination
ot these international, regional and national activities and
an attempt to drav on the best teatures ot the documents
described above, vhilst also tocusing on strategic action plans to
implement them. It has been noted that, although some positive
measures at the national level to promote and protect human
rights in the context ot HIVAIDS are in place, a dramatic gap
exists betveen protessed policy and implementation on the
ground.
72
It is hoped that these Guidelines, as a practical tool
tor States in designing, coordinating and implementing their
national HIV policies and strategies, vill assist in closing the gap
betveen principles and practice and be instrumental in creating
a rights-based and ettective response to HIV.
72
See E/CN.4/15/45 anc E/CN.4/1c/44.
UNAID5 OHCHR
112
ANNEX II
List of participants of the Second International
Consultation on HIV/AIDS and Hunan Rights
Geneva, 23-23 September 1996
Chair
Michael Kirby
udge ot the High Court ot Australia, Canberra
Participants
Aisha Bhatti [Pights and Humanity, Iondon|
Edgar Carrasco
[Accin Ciudadana contra el SIDA (ACCSI,, Caracas|
David
Chipanta [Netvork ot Atrican People living vith HIVAIDS
(NAP,, Iusaka|
Isabelle Deteu [International Community

ot Women Iiving vith HIVAIDS (ICW,, Iondon|
Lavrence Gostin [Georgetovn Lniversity, Iav Center,

Washington|
Anand Grover [Iavyers Collective, Bombay|
Meskerem Grunitzki-Bekele [National AIDS Programme,

Iome|
)ulia Hausermann [Pights and Humanity, Iondon|
Mark Heyvood [AIDS Iav Project, Centre tor Applied

Iegal Studies, Lniversity ot Witvatersrand, Witvatersrand|
Babes Igancio [AI1LPIAW, Manila|
Ralph ]urgens
[Canadian HIVAIDS Iegal Netvork, Montreal|
Yuri
Kobyshcha [National Anti-AIDS Committee, Kiev|
]oanne
Mariner [Human Pights Watch, Nev York|
Shaun Mellors
[Global Netvork ot People Iiving vith HIVAIDS (GNP,,
Amsterdam|
Ken Morrison [International Council ot AIDS

Service Organisations (ICASO,, Vancouver|
Galina Musat
[Asociatia Pomana Anti-SIDA (APAS,, Bucharest|
Sylvia
Panebianco [Consejo Nacional de Prevencin y Control del
113
SIDA (CONASIDA,, Mexico City|
Alissar Rady [National

AIDS Programme, Beirut|
Eric Savyer [HIVAIDS Human

Pights Project, Nev York|
Aurea Celeste Silva Abbade

[Grupo de Apoio a Prevencao a AIDS, Sao Paolo|
Donna
Sullivan [lranois-Xavier Bagnoud Center tor Health
and Human Pights, BostonNev York|
El Hadj (As) Sy
[AlPICASO, Dakar|
Helen \atchirs [Australian Attorney-

General`s Department, Barton|
Martin Vazquez Acua

[PLD-IAC, Buenos Aires|
Olservers
]ane Connors [Division tor the Advancement ot Women,
Lnited Nations Headquarters|
Sev Iluss [World Health

Organization, Geneva|
Angela Krehbiel [NGO Iiaison

Ottce, Lnited Nations Ottce at Geneva|
Lesley Miller
[Lnited Nations Children`s lund (LNICLl,, Geneva|
David
Patterson [Lnited Nations Development Programme (LNDP,,
Nev York|
Mari Sasaki [Lnited Nations Population lund

(LNlPA,, Geneva|
Irank Steketee [Council ot Lurope,

Strasbourg|
]anusz Symonides [Lnited Nations Scientitc,

Cultural and Lducational Organization (LNLSCO,, Paris|
Benjamin \eil [Lnited Nations Development Programme

(LNDP,, Dakar|
Others
Genevieve ]ourdan [Women`s International Ieague tor Peace
and lreedom, Geneva|
]ames Sloan [International Service

tor Human Pights, Geneva|
]acek 1yszko [Permanent

Mission ot Poland to the Lnited Nations Ottce at Geneva|
UNAID5 OHCHR
114
ANNEX III
List of participants of the 1hird International
Consultation on HIV/AIDS and Hunan Rights
Geneva, 23-26 uly 2002
Chair
Michael Kirby
udge ot the High Court ot Australia, Canberra
Participants
]avier Luis Hourcade Bellocq [Ped Iatinoamericana de
Personas Viviendo con el VIHSIDA PLD IA, Buenos Aires|
Pascale Boulet [Medecins Sans lrontires, Paris|
Richard
Burzynski [International Council ot AIDS Service Organization,
1oronto|
Edvin Cameron [udge ot the Supreme Court ot

Appeal, Bloemtontein|
Edgar Carrasco [Accin Ciudadana

Contra el SIDA (ACCSI, and Iatin America and the Caribbean
AIDS Service Organization, Caracas|
]oanne Csete [Human

Pights Watch, Nev York|
Mandeep Dhalival [International

HIVAIDS Alliance, Iondon|
Vivek Divan [Iavyers

Collective, Nev Delhi|
Richard Elliott [Canadian HIV

AIDS Iegal Netvork, Montreal|
Michaela Iigueira [AIDS

Iav Lnit, Iegal Assistance Centre, Windhoek|
Charles
Gilks [World Health Organization, Geneva|
Sona Gruskin
[lranois-Xavier Bagnoud Center tor Health and Human
Pights, Harvard School tor Public Health, Boston|
Mark
Heyvood [1reatment Action Campaign (1AC,, Centre
tor Applied Iegal Studies, Lniversity ot the Witvatersrand,
Witvatersrand|
Ralt ]rgens [Canadian HIVAIDS Iegal

115
Netvork, Montreal|
Esther Mayambala Kisaakye [Lganda

Netvork on Human Pights, Lthics and Iav, Kampala|
Ieli
Morka [Social and Lconomic Pights Action Centre, Iagos|
Helen \atchirs [Pesearch School ot Social Sciences,

Australian National Lniversity, Canberra|
Bretton \ong
[Asia Pacitc Netvork ot People Iiving vith HIVAIDS
(APN,, Singapore|
Frocucec wirh environmenrlriencly marerials
The llce ol rhe Hih Commissioner lor Human Fihrs (HCHF), a ceparrmenr ol rhe nirec Narions Secrerariar,
is uicec in irs work Ly rhe mancare provicec Ly rhe General AssemLly in resolurion 48/141, rhe Charrer ol rhe
nirec Narions, rhe niversal Declararion ol Human Fihrs anc suLsequenr human rihrs insrrumenrs, rhe 13
vienna Declararion anc Froramme ol Acrion, anc rhe 2005 Worlc Summir urcome Documenr. perarionally,
HCHF works wirh overnmenrs, leislarures, courrs, narional insrirurions, civil sociery, reional anc inrernarional
oranizarions, anc rhe nirec Narions sysrem ro cevelop anc srrenrhen capaciry, parricularly ar rhe narional
level, lor rhe prorecrion ol human rihrs in accorcance wirh inrernarional norms. nsrirurionally, HCHF is
commirrec ro srrenrhenin rhe nirec Narions human rihrs proramme anc ro provicin ir wirh rhe hihesr
qualiry supporr. HCHF is commirrec ro workin closely wirh irs nirec Narions parrners ro ensure rhar human
rihrs lorm rhe Lecrock ol rhe work ol rhe nirec Narions.
The Joinr nirec Narions Froramme on Hv/ADS (NADS) Lrins roerher ren N aencies in a common
ellorr ro lhr rhe epicemic: rhe llce ol rhe nirec Narions Hih Commissioner lor Feluees (NHCF), rhe
nirec Narions Chilcren's Func (NCEF), rhe Worlc Fooc Froramme (WFF), rhe nirec Narions Developmenr
Froramme (NDF), rhe nirec Narions Fopularion Func (NFFA), rhe nirec Narions llce on Drus anc
Crime (NDC), rhe nrernarional LaLour ranizarion (L), rhe nirec Narions Ecucarional, Scienrilc anc
Culrural ranizarion (NESC), rhe Worlc Healrh ranizarion (WH), anc rhe Worlc Bank.
NADS, as a cosponsorec proramme, unires rhe responses ro rhe epicemic ol irs ren cosponsorin
oranizarions anc supplemenrs rhese ellorrs wirh special iniriarives. rs purpose is ro leac anc assisr an
expansion ol rhe inrernarional response ro Hv/ADS on all lronrs. NADS works wirh a Lroac rane ol
parrners overnmenral anc nonovernmenral, Lusiness, scienrilc anc lay ro share knowlece, skills anc
Lesr pracrices across Louncaries.
UNAIDS
20 AVENUE APPIA
CH-1211 GENEVA 27
SWITZERLAND
Tel: (+41) 22 791 36 66
Fax: (+41) 22 791 41 87
e-mail: bestpractice@unaids.org
www.unaids.org
NlTED NATlCNS
OHCHR
PALAIS DES NATIONS
CH-1211 GENEVA 10
SWITZERLAND
Tel: (+41) 22 917 9000
Fax: (+41) 22 917 9008
publications@ohchr.org
www.ohchr.org

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International Guidelines

on HIV/AIDS and Human Rights

Since the dratting ot the Guidelines, the epidemic

E/CN.4/1/7c, E/CN.4/2001/80, E/CN.4/2003/81, E/CN.4/2005/7.

(ix, Support the development ot a manual that vould

II. Pecommendations for dissemination

able to protect themselves because they are vithin the ambit

13. PIGHT TO PAPTICIPATION IN POLITICAL AND

Isabelle Deteu [International Community

Lavrence Gostin [Georgetovn Lniversity, Iav Center,

Anand Grover [Iavyers Collective, Bombay|

Meskerem Grunitzki-Bekele [National AIDS Programme,

)ulia Hausermann [Pights and Humanity, Iondon|

Mark Heyvood [AIDS Iav Project, Centre tor Applied

Babes Igancio [AI1LPIAW, Manila|

Ken Morrison [International Council ot AIDS

Alissar Rady [National

Eric Savyer [HIVAIDS Human

Aurea Celeste Silva Abbade

Helen \atchirs [Australian Attorney-

Martin Vazquez Acua

Sev Iluss [World Health

Angela Krehbiel [NGO Iiaison

Mari Sasaki [Lnited Nations Population lund

Irank Steketee [Council ot Lurope,

]anusz Symonides [Lnited Nations Scientitc,

Benjamin \eil [Lnited Nations Development Programme

]ames Sloan [International Service

]acek 1yszko [Permanent

Pascale Boulet [Medecins Sans lrontires, Paris|

Edvin Cameron [udge ot the Supreme Court ot

Edgar Carrasco [Accin Ciudadana

]oanne Csete [Human

Mandeep Dhalival [International

Vivek Divan [Iavyers

Richard Elliott [Canadian HIV

Michaela Iigueira [AIDS

Ralt ]rgens [Canadian HIVAIDS Iegal

Esther Mayambala Kisaakye [Lganda

Helen \atchirs [Pesearch School ot Social Sciences,

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