HIV, TB and human rights in Southern and Eastern Africa

August 26, 2016

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In its HIV, TB & Human Rights in Southern and East Africa 2016 Report, the international network ARASA (AIDS and Rights Alliance for Southern Africa) examines the legal and regulatory framework for responding to HIV, AIDS and tuberculosis in countries in Southern and East Africa.

The purpose of this exercise is to determine whether:

  • Laws, regulations and policies protect and promote the rights of all people, including key populations in the context of HIV, AIDS and TB.
  • Populations are aware of their rights, are able to access justice and are able to enforce their rights in the context of HIV, AIDS and TB.

Issues highlighted in the report include among others: the criminalisation of HIV transmission; gender inequality and gender-based violence; and the protection of the rights of key populations (LGBTI people, sex workers and people who use drugs). In addition, the report provides country reports for 18 countries in the region.

Little progress on protective laws for key populations

The 2014 ARASA HIV and Human Rights report found that some progress had been made in improving protective legal frameworks for people living with HIV, but expressed concerns that little progress had been made in developing laws that recognised the human rights of key populations, advanced their rights to access HIV prevention, treatment, care and support and protected them from violence, stigma and discrimination. While there has been significant progress in recognising key populations, in particular men who have sex with men and sex workers, in national HIV responses, this progress has not been matched by protective laws. The high rates of HIV infection amongst these groups is a testament to the detrimental effects of criminalising consensual adult sex. 

As an example, almost every country under review for this report has identified gay men who have sex with men as a key population in their HIV programming. The majority are providing HIV prevention information and education to them. However, only Madagascar, Mozambique, Seychelles and South Africa do not criminalise sex between men. The DRC does not explicitly criminalise sex between men but uses indecency laws to prosecute them. Malawi recently announced a moratorium on prosecution of same-sex sexual practices while it reviews its laws in this regard. In the remaining countries under review, sex between men is illegal and gay men and men who have sex with men are subject to violence, discrimination and stigma, often at the hands of their own governments.

Access to health care and justice

The report states: “The law not only criminalises their most intimate acts, but drives them away from needed health care and HIV prevention services and undermines their access to justice when they are abused and beaten. These laws are often enforced based on perceived sexual orientation and practices, resulting in transgender women being arrested and/or prosecuted for essentially heterosexual relationships.

Sex work is directly or indirectly criminalised in every country reviewed in this report, but every country has also recognised sex workers as a key population. Sex workers too describe grave violations of their human rights that expose them to HIV and undermine their access to sexual and reproductive health care. Sex workers are particularly vulnerable to abuse by law enforcement and have little or no redress when their rights are violated.

People who use drugs are also beginning to be recognised as a key population, but in every country under review, drug possession for personal use is criminalised and laws make it difficult to provide harm reduction and link people who use drugs to HIV prevention, treatment and care.”


Source: HIV, TB & Human Rights in Southern and East Africa 2016 Report. ARASA, 2016