Many of those at highest risk of HIV have one thing in common: their status is effectively criminalized by law. Police officers charged with enforcing antidrug, antiprostitution, and antisodomy laws routinely extort bribes and confessions from defenseless people, sometimes committing heinously violent acts against them, including rape and murder. Punitive approaches to drug use, sex work, and homosexuality fuel stigma and hatred against socially marginalized groups, pushing them further into hiding and away from services to prevent, treat, and mitigate the impact of HIV and AIDS.
- People who use illicit drugs represent the smallest fraction of individuals receiving antiretroviral treatment in many countries, despite accounting for a majority of people living with HIV. Harsh drug laws effectively criminalize the status of being a drug user, leading police officers to extort bribes and confessions from vulnerable groups in order to meet arrest quotas. People who use drugs end up in prison or in a revolving door of ineffective and coercive rehabilitation programs, rarely receiving the services for drug addiction or HIV prevention and treatment they desperately need.
- Sex workers, whose conduct also attracts criminal penalties under laws prohibiting prostitution, soliciting, pimping, brothelkeeping, and trafficking, often lack access to HIV services due to widespread police abuse. Forcible displacement of sex workers from commercial development areas further interferes with sex workers’ access to community-based HIV services. Prejudicial and coercive treatment of sex workers in health facilities deters them from seeking HIV treatment and care. Aggressive efforts to abolish human trafficking often translate into opposition to programs that focus on the health and human rights of sex workers.
- Men who have sex with men and transgender people face widespread violence and discrimination around the world. Sodomy remains criminalized in many countries. The continued stereotype of AIDS as a “gay disease” fuels social exclusion against gay men, transgender people, and people living with HIV alike, often driving these populations from mainstream health services. In many jurisdictions, police officers are more likely to ridicule or compound violence against gay men and transgender persons rather than investigate these crimes properly. Politicians in many countries pander to antigay prejudice rather than demonstrating the political will needed to combat HIV among vulnerable groups.
- Prisoners and detainees in many countries have little or no access to voluntary HIV testing and to treatment. They are often denied access to HIV prevention information and tools, even in places where these are available outside prison. Condoms and sterile syringes are often not provided, despite strong evidence of their effectiveness in preventing HIV without posing a risk to the wider prison population. Segregation of HIV-positive prisoners and detainees, denial of medical release, and failure to take effective action against prison rape are among the many human rights abuses that fuel HIV and worsen the impact of AIDS in prisons and other places of detention throughout the world.