Women living with HIV including women from key populations continue to suffer widespread reproductive coercion, mistreatment, and neglect when seeking reproductive health services and rights around the world, a new report by the International Community of Women Living with HIV (ICW) has revealed today. The report was launched at a joint ICW/UNAIDS event at the 25^th International AIDS Conference taking place in Munich, Germany.

The report, Confronting Coercion: A global scan of coercion, mistreatment and abuse experienced by women living with HIV in reproductive and sexual health services, shows that women living with HIV face practices that undermine their bodily autonomy. Reproductive choices are monitored, and women are subjected to various coercive practices.

The report documents experiences of sexual and reproductive health and rights (SRHR) violations and violence faced by women living with HIV and women from key populations from more than 60 countries across 3 regions and offers concrete actions for the reduction of coercive practices.

“This report offers a chilling reality of what women living with HIV experience every day in their struggle to realize their full sexual and reproductive health rights,” said Charity T. Mkona, Global Coercion Scan Committee, ICW ISC Global Chairperson. "For women living with HIV who have been subjected to coercive practices, mistreatment or abuse, the ability to heal and realize their full sexual and reproductive health and rights, demands accountability and justice."

The report reveals that reproductive coercion and mistreatment of women and gender diverse people living with HIV in SRHR services are a common, persistent, and widespread issues that require urgent action. Women living with HIV who reported engagement in sex work, drug use, or had disabilities reported experiencing coercive practices at higher rates than other women living with HIV.

Younger women living with HIV and women living with HIV who were migrants were also more likely to have experienced coercive practices than older women and women who were not migrants. Women have reported experiencing a lack of confidentiality and consensual care, as well as inappropriate medical interventions, such as unnecessary caesarean sections and forced or coerced abortions. Denial of care, stigmatizing comments or insults, and various forms of abuse - verbal, emotional, physical and sexual - were also documented.

While information about sexual and reproductive health and rights of women may be supplied to them, it is not always accurate, comprehensive, or up-to-date to empower them to claim their rights and often does not reflect the realities of women's lives.

"To end coercive practices experienced by women living with HIV, we must recognize the systemic and entrenched nature of these violations and understands that reform requires a systemic sea change and culture shift that respects women's bodily autonomy.” Sophie Brion, Director of Global Programmes at ICW.

“In a world where significant scientific advancements have been made in the treatment of HIV—including breakthroughs that allow women living with HIV whose viral load is undetectable to give birth to HIV negative babies—it’s shocking that some health care workers are not informed that women living with HIV can give birth without transmitting the virus,” said Christine Stegling, UNAIDS Deputy Executive Director for Policy, Advocacy and Knowledge. “This lack of education and coercive practices, including the forced sterilization of women living with HIV, must stop immediately.”

ICW is calling on governments worldwide, including donors and ministries of health, to eliminate these harmful practices. The organization is also calling on governments to ensure that health systems support women living with HIV to realize their full right to health, including sexual and reproductive health and rights, bodily autonomy and rights to informed consent.

"This report issues a powerful call to action to put the autonomy, desires and needs of women living with HIV at the centre of their sexual and reproductive health care programmes." said Immaculate Owomugisha Bazare, Global Coercion Scan Committee,  ICW Global Steering Committee Member.

Background

The Confronting Coercion report was developed through a blend of qualitative and quantitative research, incorporating insights from a gendered analysis of recent Stigma Index 2.0 data, a desk review of literature, and a qualitative study involving women, trans and gender non-binary people living with HIV who shared experiences of reproductive coercion over the past 3 years. The qualitative part of the study looked at coercion, mistreatment and neglect related to the SRHR of women and gender diverse people living with HIV in HIV, SRH and maternity care settings.

UNAIDS has supported the development of the report to address systematic gender inequalities, in particular gender-based discrimination and violence against women living with HIV, which fuels the HIV epidemic.

MUNICH, 22 JULY 2024 – A new United Nations report released today shows that the HIV response in Eastern Europe and Central Asia is critically off track. Data in UNAIDS’ global report The Urgency of Now: AIDS at a Crossroads reveals that in this region, new HIV infections have risen by 20% and AIDS-related deaths have risen by 34%, since 2010. Only half of the 2.1 million people living with HIV in the region are accessing treatment, and only 42% of all people living with HIV in the region have suppressed viral load, the lowest rate globally. The report shows that it is still possible to end AIDS as a public health threat by 2030, but only if governments reform laws to protect everyone’s human rights and increase resources to ensure services are available for all.

“The promise to end AIDS is off track in Eastern Europe and Central Asia. But leaders can get on the path that ends AIDS. Programmes need to focus especially on people most affected by HIV, who are often the most marginalized and vulnerable. Community organizations need to be properly funded, supported and enabled to provide HIV services to people affected by HIV. The barriers of stigma and discrimination need to be broken down,” said Winnie Byanyima, UNAIDS Executive Director. 

The new data shows that in 2023, there were 140,000 new HIV infections across the region, with 93% occurring in Russia, Ukraine, Uzbekistan, and Kazakhstan. Eight out of 13 countries in the region reported increases in new infections.

Because stigma, discrimination and harmful punitive laws obstruct marginalised communities’ access to vital services, 94% of new infections were among people from key populations - including men who have sex with men, people who inject drugs, and sex workers - and the sexual partners of people from key populations. Only 58% of sex workers, 43% of gay men, 52% of people who inject drugs, and 65% of transgender people receive HIV prevention services. Only 12% of resources are dedicated to prevention programmes for key populations.

The criminalization of small amounts of drug possession for personal use, of sex work, and of HIV transmission and exposure, are driving the people most in need underground and out of reach of HIV services. All 16 countries in the region criminalize sex work, 13 criminalize the non-disclosure, exposure, or transmission of HIV, and 7 criminalize small amount of drug possession for personal use. Studies show criminalization increases HIV prevalence among key populations. Unless countries can ensure fear-free access to HIV prevention services for everyone, new infections will continue to grow.

“Restrictive legal environments and stigma are obstructing progress in the region,” said Eamonn Murphy, UNAIDS Regional Director for Eastern Europe and Central Asia and Asia Pacific. “Restrictive laws, along with aggressive policing and stigma, push people away from medical care. If people are pushed underground, the HIV response will not succeed.”

Powerful prevention technologies like PrEP are also not widely accessible for the same reason.  Criminalization fuels stigma, with many avoiding medical care due to discrimination. Nearly half of people surveyed who inject drugs in Kyrgyzstan and 32% of people living with HIV in Tajikistan reported avoiding medical care due to stigma and discrimination. UNAIDS data shows that people in key populations are experiencing high levels of violence.

"Supporting the leadership of communities is essential for reaching marginalised people providing vital outreach services. Without community leadership and the integration of community services into the health system, reaching these groups is too difficult," said Yelena Rastokina, lead of the ‘Answer-Kazakhstan’ Association.

Recent years have seen worrying restrictions of civic space and limits to communities’ involvement in public health initiatives, including those related to harm reduction, access to public health services for LGBTQ+ people, sex workers and other marginalised people. Restrictive systems at local, national, and regional levels are holding back communities’ contribution to public health.

Ganna Dovbach, Executive director of the Eurasian Harm Reduction Association, highlighted: “The shrinking of civic space and attacks on human rights threaten our response to HIV, which is based on community-led or civil society provided services. Addressing these interconnected issues is essential for a sustainable response to the AIDS epidemic in our region.”

The region’s HIV response has also been hurt by the war in Ukraine.

But despite the conflict, Ukraine remains committed to its HIV response. Through a strong coalition of the government, civil society, international organizations and donors, HIV services have been maintained, with 143,600 people receiving treatment in 2023. This collaboration has ensured vital supplies of antiretroviral and tuberculosis medicine, and opioid agonist therapy, contributing to uninterrupted HIV treatment and other services. As of January 2024, 7,900 Ukrainian refugees in other countries and 1,900 returnees were accessing antiretroviral therapy.

Many community organizations working on HIV in Ukraine refocused their efforts to addressing humanitarian issues and supporting community members while continuing national advocacy for access to HIV services and the protection of human rights.

With support from the UNAIDS and other donors ALLIANCE.GLOBAL oversees a network of five specialized shelters across the country, providing shelter, humanitarian aid, and access to specialised services, including HIV prevention and treatment, for key populations and LGBTQ+ people who are internally displaced.

Despite the war, ALLIANCE.GLOBAL together with other community-led organisations continue advocating for laws that better protect LGBTQ+ people from intolerance and from hate crimes, to enhance access to public health services, including HIV-related services.

UNAIDS new report calls on leaders to develop sustainable plans for the HIV response to2030 and beyond. These plans should include enabling legal environments, support for community-led response and a boost in domestic funding. Repealing laws and norms that prevent people from accessing services is crucial.

“Ensuring access to services and treatment for all is how we end AIDS,” said Mr Murphy.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Despite significant gains in many countries, critical gaps continue to undermine efforts to end AIDS in children

GENEVA/MUNICH, 22 July 2024—Despite progress made in reducing HIV infections and AIDS-related deaths among children, a new report released today by the Global Alliance for Ending AIDS in Children by 2030 shows that an urgent scale up of HIV services in countries worst affected by the pandemic is required to end AIDS by 2030.

The report, Transforming Vision Into Reality, shows that programmes targeting vertical transmission of HIV have averted 4 million infections among children aged 0-14 years old since 2000. Globally, new HIV infections among children aged 0-14 years old have declined by 38% since 2015 and AIDS-related deaths have fallen by 43%.     

Among the 12 Global Alliance countries, several have achieved strong coverage of lifelong antiretroviral therapy among pregnant and breastfeeding women living with HIV, with Uganda nearing 100%, United Republic of Tanzania at 98%, and South Africa at 97%. Mozambique has achieved 90% coverage, with Zambia at 90%, Angola at 89%, Kenya at 89%, Zimbabwe at 88%, and Cote d'Ivoire at 84%.

“I applaud the progress that many countries are making in rolling out HIV services to keep young women healthy and to protect babies and children from HIV,” said UNAIDS Executive Director, Winnie Byanyima. “With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children who are living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure that they reach all children everywhere. We cannot rest on our laurels. The death of any child from AIDS related causes is not only a tragedy, but also an outrage. Where I come from, all children are our children. The world can and must keep its promise to end AIDS in children by 2030.”

Global Alliance countries are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite advances neither the world nor Global Alliance countries are currently on track to reach HIV-related commitments for children and adolescents and the pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.

“Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation, and a political choice,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Twelve countries are demonstrating they have made that choice, but significant challenges remain. While we have made progress in increasing access for pregnant women to testing and treatment to prevent vertical transmission of HIV, we are still far from closing the paediatric treatment gap. We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents.”

Around 120 000 children aged 0-14 years old became infected with HIV in 2023, with around 77 000 of these new infections occurring in the Global Alliance countries. AIDS-related deaths among children aged 0-14 years old numbered 76 000 globally with Global Alliance countries accounting for 49 000 of these unnecessary deaths. Vertical transmission rates remain extremely high in some locations, particularly in Western and Central Africa, with rates exceeding 20% in countries including Nigeria and the Democratic Republic of the Congo.

“In the fight against HIV, we must do a much better job for children,” said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provides funding for HIV programmes in over 100 countries through a country-led partnership model. “In support of national programmes, we have been procuring the latest dolutegravir-based paediatric treatment regimens at negotiated prices. Our investments in laboratory systems are helping ensure exposed infants are rapidly tested and that those that test positive are quickly initiated on age-appropriate antiretroviral treatment. Differentiated testing and treatment approaches are helping close the diagnostic gap and ensuring more child-centred service delivery.”

It is concerning that the treatment gap between adults and children continues to widen.

“Just 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults,” said UNICEF Associate Director HIV/AIDS, Anurita Bains. “Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents and puts them at risk of death. To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need.”

In 2023, there were 210 000 new infections globally among young women and girls aged 15—24 years old (130 000 in Global Alliance countries), four times higher than the 2025 goal set at 50 000. Preventing new infections among this age group is critical both to protect the health and wellbeing of young women and to reduce the risk of new infections among children.

Gender inequalities and human rights violations are increasing women’s vulnerability to HIV and diminishing their ability to access essential services. Globally, nearly one in three women have encountered some form of violence during their lifetime, with adolescent girls and young women disproportionately affected by intimate partner violence. In the four Global Alliance countries with available data, countries are not currently on track to achieve the target of ensuring that by 2025 less than 10% of women, key populations and people living with HIV experience gender-based inequalities and gender violence.

"It has been remarkable to see how many more children's lives can be saved when all stakeholders and partners come together to commit to end AIDS in children. While much progress has been made, notably through the successful introduction of pediatric dolutegravir, large gaps still remain across the pediatric cascade and we must recommit ourselves with purpose and innovation to fulfill the promises we have made by 2025 and beyond,” said Ambassador John N. Nkengasong, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy.

The Global Alliance for Ending AIDS in Children by 2030 was launched in 2022 by WHO, UNICEF and WHO to reinvigorate the paediatric HIV agenda. It has now grown, and in addition to the United Nations agencies, the alliance includes civil society movements, including the Global Network of People living with HIV, national governments in the most affected countries, and international partners, including PEPFAR and the Global Fund. Twelve countries are members: Angola, Cameroon, Côte d'Ivoire, The Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Every pain yields a lesson, and every lesson transforms a person

Parisa's life was forever altered by HIV 25 years ago. The virus struck her family, snatching her husband's job and halting her child's education. Tragically, her husband passed away two years later, leaving Parisa to navigate the daunting landscape of loss and discrimination.

Undeterred by adversity, Parisa embarked on a relentless mission for human rights, determined to combat the pervasive stigma and discrimination surrounding HIV. Initially, she immersed herself in seminars and conferences, volunteering tirelessly at counselling centres, where she shared her own experiences to chip away at the stigma and discrimination.

Her unwavering dedication caught the attention of Dr Minoo Mohraz, the former director of the Iranian Research Centre for HIV/AIDS (IRCHA), who offered her a pivotal role in a Positive Club—a sanctuary for those grappling with similar challenges. Thus began Parisa's transformative journey, marked by a series of initiatives aimed at raising awareness, eradicating stigma and discrimination, and supporting her peers.
 

WHAT IS THE POSITIVE CLUB INITIATIVE? The Positive Club is a meeting place for people living with HIV, who run the club themselves, with supervision from Parisa and colleagues. At the club, people receive training in arts, and sports, and as peer educators.  The Positive Club initiative was one of the successful programmes aimed at promoting positive health, dignity, and HIV prevention; it has been running for over 12 years with support from UNAIDS in collaboration with national partners and civil society organizations. Through this initiative, over 10,000 people living with HIV have been supported across 25 Positive Clubs, empowering them through training classes, workshops on HIV prevention, care and treatment, counselling sessions, and psychosocial support.

Over the years, Parisa's efforts have been nothing short of extraordinary. From managing a Positive Club in Tehran to representing people living with HIV in various influential platforms, including Iran's Country Coordinating Mechanism, its Oversight Committee, and Global Fund, she has been a relentless advocate for change. 

Her initiatives have spanned diverse arenas, from radio shows and collaborations with filmmakers to training workshops for religious leaders and healthcare providers. Parisa's impact reverberates across borders, as she leverages regional platforms like MENA Rosa --the first regional network dedicated to women living with HIV in the Middle East and North Africa-- to exchange experiences and champion global efforts against HIV stigma and discrimination with a particular focus on Women living with and affected by HIV.

Amid the COVID-19 pandemic, Parisa's compassion for people living with and affected by HIV was once again evident. She mobilized support networks to provide essential supplies for Positive Club members and vulnerable families, ensuring that the crisis does not exacerbate the challenges faced by PLHIV.

Reflecting on the progress made over the last 25 years, Parisa acknowledged the remarkable strides in combating HIV-related stigma and discrimination. Efforts to eliminate HIV-related stigma and discrimination have been led by the UNAIDS Country Office for Iran, alongside national partners of the AIDS Control Programme. Notably, the first PLHIV Stigma Index study, conducted in 2010, laid the foundation for understanding the landscape of stigma in Iran. Subsequently, a second PLHIV Stigma Index study, was carried out by the network of PLHIV in collaboration with UNAIDS, Global Network of PLHIV (GNP+), International Community of Women Living with HIV (ICW), Johns Hopkins Medical University (JHMU), National AIDS Programme (NAP), and with financial support from Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) /UNDP. Parisa played an important role in implementing the Stigma Index 2.0 which provided updated insights.
 

COMPARING OF BOTH OF IRAN’S STIGMA INDEX STUDIES A comparison between the two Stigma Index studies conducted ten years apart, using updated methodologies, revealed promising changes. The prevalence of self-stigma among PLHIV decreased significantly from 80% to 40%. Similarly, the percentage of PLHIV refraining from seeking medical help has decreased from 80% to 19%, underscoring improved accessibility to healthcare services and increased health-seeking behaviour among affected individuals. Overall, reports of stigma and discrimination have decreased from 71% to 47%, reflecting tangible improvements in societal attitudes to HIV.

Parisa reflects on these notable shifts in HIV-related Stigma observed between the two studies. In the initial Stigma Index conducted a decade ago, internal stigma was predominant among PLHIV, followed by societal and healthcare provider stigma. However, in the subsequent study, internal stigma was significantly reduced, while stigma and discrimination from healthcare providers emerged as the most prevalent issue. The improvement observed in internal stigma among PLHIV could be partly attributed to the work of the empowering Positive Clubs. Additionally, this improvement highlights the importance of ongoing efforts to address stigma and discrimination comprehensively, with a particular focus on healthcare settings. By acknowledging these shifts and persisting in their efforts, UNAIDS Iran, Parisa and her colleagues remain committed to building a future free from the burdens of HIV-related stigma and discrimination.

Through her nearly two decades of hotline counselling experience, Parisa has witnessed a shift in attitudes, with increased awareness and openness surrounding HIV discourse. 

She credits grassroots campaigns and community-led initiatives for driving this transformation, paving the way for a more inclusive society.

In 2019, Iran joined the Global Partnership to Eliminate all forms of HIV-related stigma and discrimination, prioritizing a strong emphasis on interventions within communities, emergency/humanitarian settings, and healthcare facilities. With support from UNAIDS, protocols and training packages were developed to address stigma and discrimination in these critical areas. These efforts were carried out in close collaboration with national partners and civil society organizations, with training workshops being a key component of the initiative.
 

OVERVIEW OF GLOBAL PARTNERSHIP The Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination is a critical vehicle for action to mobilise all countries to reach the political declaration and Global AIDS Strategy targets. It leverages partnerships to enhance coordination of interventions and funding; it provides knowledge and evidence-guided technical support; and increases accountability mechanisms and community leadership.

Parisa was actively involved in the implementation phase of these projects. Her contributions have been instrumental in advancing the work to eradicate HIV-related stigma and discrimination across humanitarian, healthcare, and community settings.

However, Parisa acknowledges the persistent challenges faced by PLHIV, from sporadic bouts of self-doubt to occasional rejections and the lingering shadows of depression and fear. Despite these hurdles, she remains steadfast in her belief that we can achieve a future free from stigma and discrimination.

As Parisa continues her tireless advocacy, her journey stands as a testament to the resilience of the human spirit and the power of collective action in fostering a world where every individual, regardless of their HIV status, is embraced with dignity and compassion. 

UNAIDS has played a pivotal role in the establishment and sustained operation of Positive Clubs for over a decade, catalyzing transformative changes in the lives of people living with HIV such as Parisa and in the fight against stigma and discrimination. Nonetheless, the journey towards eliminating stigma and discrimination remains unfinished, albeit considerably smoother and more steadfast with the collaborative efforts and political commitment of initiatives such as the Global Partnership.

Joint Statement by UN High Commissioner for Human Rights Volker Türk and UNAIDS Executive Director Winnie Byanyima

GENEVA, 19 July 2024 — As courts and parliaments in a number of countries are in the midst of considering the legal framework around the rights of LGBTQ+ people, we highlight that punitive laws against lesbian, gay, bisexual, transgender and queer people violate human rights and undermine public health.

Such laws cost lives.

Laws criminalizing LGBTQ+ people must be consigned to history – and a growing number of countries are doing just that. 

The big – and very welcome – global shift is away from criminalization. Over two-thirds of countries now do not criminalize LGBTQ+ people.

In the last 10 years alone, Angola, Antigua and Barbuda, Barbados, Belize, Bhutan, Botswana, Cook Islands, Dominica, Gabon, India, Mauritius, Mozambique, Namibia, Nauru, Palau, Saint Kitts and Nevis, Seychelles, Singapore, and Trinidad and Tobago have all repealed laws that had criminalized LGBTQ+ people. 

There is a whole host of reasons why such laws must be scrapped.

Such laws are based on prejudice.

As Namibia's High Court recently noted, "the enforcement of the private moral views of a section of the community (even if they form the majority of that community), which are based to a large extent on nothing more than prejudice, cannot qualify as such a legitimate governmental purpose."

Such laws infringe upon human rights. 

The Eastern Caribbean Supreme Court put it clearly: “The criminalization of same-sex sexual expression between consenting adults is intrusive by its very nature and thereby offends the right to liberty and personal privacy.”

Many such laws are actually legacies of colonialism, imposed by colonial powers themselves. 

The now scrapped punitive anti-LGBTQ+ law in Mauritius, the Supreme Court of Mauritius recently noted, “was not the expression of domestic democratic will but was a course imposed on Mauritius and other colonies.”

Such laws harm public health.

Criminalization of LGBTQ+ people generates justified fear amongst people who need access to health services, and amongst the frontline workers who provide those services.

In criminalizing countries, there is decreased provision and uptake of HIV prevention services, and decreased uptake of HIV care and treatment services. A study in sub-Saharan Africa showed that HIV-prevalence among gay men and men who have sex with men was five times higher in countries that criminalized same-sex relationships than in non-criminalized settings.

Criminalizing countries have significantly lower rates of both knowledge of HIV status and HIV viral suppression among all people living with HIV.

Such punitive laws have no “law and order” justification.

In decriminalizing homosexuality in Singapore, there was clear recognition by the Government that there was no basis for making private sexual behaviour between consenting adults a crime.

Such laws lead to harassment.

As the Supreme Court of India has stated, punitive legislation has “become an odious weapon for the harassment of the LGBT community by subjecting them to discrimination and unequal treatment.”

There is extensive evidence that such discriminatory laws increase exposure of people to brutal hate crimes, police abuse, harassment, blackmail, torture, and denial of access to healthcare, education and housing. 

They also drive impunity and undermine the rule of law, harming LGBTQ+ people, their families, communities, and the whole of society. 

Stigma kills. Solidarity saves lives.

The progress that has been won around the world, in legislation and attitudes, needs to continue, as does the increasing recognition that people should not be criminalized for who they are and whom they love.

Anti-rights policies, proposals and propaganda need to be challenged head on.

Together, we call on all countries to remove all punitive laws against lesbian, gay, bisexual, transgender and queer people.

Decriminalization of LGBTQ+ people is vital for protecting everyone’s human rights and everyone’s health.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 12 July 2024— UNAIDS welcomes the adoption, by consensus, of a critical resolution on human rights in the context of HIV and AIDS at the 56^th session of the UN Human Rights Council.

The 2024 resolution 56/20 Human Rights in the Context of HIV and AIDS, recognizes the centrality of human rights to the HIV response. The resolution reaffirms that, “the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV epidemic and its sustainability.”

It also recognizes the importance of human rights and community leadership in the HIV response, ensuring access to available and affordable HIV prevention, testing and treatment services for all, without discrimination.  The resolution also calls on countries to tackle discriminatory attitudes and punitive laws and policies that prevent access to health services and to support community-led organizations as well as protect civic space.

This ground-breaking text includes the first unqualified recognition of sexual and reproductive health and rights in a UN resolution and calls on countries to scale up comprehensive education on sexual and reproductive health with information on, “sexuality and comprehensive HIV prevention, gender equality and women’s and girls’ empowerment, human rights, and physical, psychological and pubertal development, to enable them to build self-esteem and risk reduction skills and to empower them in their decision-making, communication and development of respectful relationships, in order to enable them to protect themselves from HIV infection.” .

Every week, 4000 adolescent girls and young women (aged 15–24 years) became infected with HIV worldwide. 3100 of these infections occurred in sub-Saharan Africa, also where 6 out of 7 new HIV infections in adolescents (aged 10–19 years) were among girls.

UNAIDS Executive Director, Winnie Byanyima said, “We would not be where we are today in the HIV response, with 29 million people on treatment and a 56% reduction in new HIV infections, without having human rights and communities at the center of the response. However, the status quo is not enough. All stakeholders need to scale up action to respect, protect and fulfil human rights in the HIV response if we are to end inequalities and end AIDS for everyone.”

Human Rights Council members expressed concern that key populations face multiple and intersecting forms of discrimination, stigma, violence and abuse. This affects their access to clinics and/or peer-led drop-in centers and called on member states to take action to ensure access to non-stigmatizing health services free from discrimination and legal barriers.

The resolution recognizes the importance of the Global AIDS Strategy’s societal enabler targets and calls on countries to take action to remove punitive legal and policy frameworks, and end stigma. This also includes   addressing gender-based violence and inequalities, as well as changing gender stereotypes and negative social norms.

The societal enabler targets, outlined in both the 2021 Political Declaration on HIV and AIDS and the Global AIDS Strategy, 2021-2026, commit countries to the following targets: that by 2025, less than 10% of people living with HIV and key populations experience stigma and discrimination, less than 10% experience gender-based inequalities and violence and less than 10% of countries have punitive laws and policies.

Progress towards the 2025 milestone has been mixed, with many countries failing to make significant progress required to be on track to meet these targets and other human rights goals.

This resolution is an important commitment by countries to re-double their efforts to ensure human rights are at the center of a sustainable HIV response.

Going forward the resolution calls on OHCHR and UNAIDS, in collaboration with other stakeholders to hold a panel at the 58^th session of the Human Rights Council in 2025 to discuss the realization of human rights in sustaining and increasing the gains made in the HIV response. The session will include recommendations to countries and will be followed by a report on sustainability and human rights to be presented at the 60^th HRC session.

In 2025, countries are set to develop a new Global AIDS Strategy that will take the world to the 2030 deadline to meet the Sustainable Development Goals, which includes ending AIDS as a global health threat by 2030.

UNAIDS commends the leadership of Brazil and the other members of the core group, Colombia, Portugal and Thailand, for continuing to lead the resolution on HIV at the Human Rights Council and their significant success in bringing consensus back to this relevant resolution.

More information here: OHCHR | 56th regular session of the Human Rights Council: Resolutions, decisions and President’s statements

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

BEIJING, 15 July 2024 – The Joint United Nations Programme on HIV/AIDS (UNAIDS) and China signed two new Memoranda of Understanding (MOU) to advance joint strategic efforts to end AIDS in China and globally.

The first agreement was signed on 10 July by Wang Hesheng, Vice Minister of the National Health Commission and Administrator of the National Disease Control and Prevention Administration (NDCPA) and Winnie Byanyima, Executive Director of UNAIDS, in Beijing. UNAIDS and China have agreed to deepen their collaboration to reach the 2030 Sustainable Development Goals, within the context of China’s Global Development Initiative (GDI) and the Belt and Road Initiative (BRI). The agreement acknowledges China’s commitment to take a leadership role in the global HIV response including mobilizing partners and supporting efforts to end AIDS in middle- and lower-income countries. 

Mr Wang thanked UNAIDS’ for technical support and guidance around China’s HIV response, particularly in formulating HIV response plans and strategies, monitoring and assessment, as well as UNAIDS’ data collection and analysis.

“We expect to continue and further our cooperation with UNAIDS with this MOU,” he said. “The first steps will be to boost communication and coordination, and actively participate in global health governance.”

According to the agreement, NDCPA will make an annual contribution of USD$1 million to UNAIDS from 2025 to 2029, totaling USD$5 million, which includes increased core funding.

The other agreement signed in Beijing on 13 July with the China International Development Cooperation Agency (CIDCA) addresses critical global development issues to achieve the Sustainable Development Goals (SDGs), which includes promoting health and ending AIDS globally, especially in other developing countries in Africa and Asia Pacific.

Luo Zhaohui, Chairman of the CIDCA recognizes UNAIDS’ leadership in the global HIV response and encouraged UNAIDS to apply for more Global Development and South-South Cooperation Fund (GDF) to address the HIV epidemic.

“Let’s work together to improve people’s health especially after the COVID-19 pandemic.” he said. "HIV is a new area for CIDCA but UNAIDS has a lot of experience so there is huge prospect to have more cooperation.”

As part of this agreement, UNAIDS and CIDCA will fund projects in developing partner countries through policy coordination, community engagement, capacity building and technical insight.

Since its founding in 2019, the CIDCA has provided steady financial support to UN agencies and developing member states. As highlighted at the annual Steering Committee of UNSDCF, 13 UN agencies mobilized more than US$ 100 million in South-South funding, predominantly from CIDCA, which assisted 85 partner countries in the areas of COVID response and resilience, social inclusion, agriculture, climate and energy efforts. Earlier this year, UNAIDS received the first GDF to support Iran’s upscaling of rapid HIV testing. UNAIDS is the second UN entity to sign a MOU with the CIDCA.

UNAIDS looks forward to deepening cooperation with China especially in South-South Cooperation and China-Africa cooperation in the areas of local drug production as well as supporting partner countries.

Ms Byanyima said, “Global South solidarity is the bedrock of the HIV response. It is only by standing together that we can end AIDS by 2030 and I welcome steps towards a deeper partnership building China and African countries.”

UNAIDS will also closely work with the African Union, the African Center for Disease Control and Prevention and the African Medicine Agency.   

Ms Byanyima’s week-long mission to China is her first to the country since she became Executive Director of UNAIDS.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 10 July 2024— UNAIDS has welcomed the release of Gilead Sciences’ trial results on the injectable long-acting HIV medicine Lenacapavir for HIV prevention. The result “provides hope of accelerating efforts to end AIDS”, UNAIDS says, “but only if Gilead ensures that all people who need it can have access to this game-changing medicine.”

The recent trial of the medicine among cis-gender women in Uganda and South Africa was so successful that it was halted early. Twice-yearly injections of Lenacapavir showed overwhelming efficacy for preventing HIV infections compared to standard oral preventative HIV medicines, known as pre-exposure prophylaxis (PrEP). Additional trials are ongoing in Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the United States.

UNAIDS has welcomed the “exciting development,” and urged the company to allow generic production of Lenacapavir to all low- and middle-income countries by negotiating voluntary licensing agreements through the Medicines Patent Pool (MPP). The MPP is a UN-backed programme with extensive experience negotiating generics agreements between originators and generic pharmaceutical companies.

Gilead has not yet announced its plans for low and middle-income countries. However, UNAIDS is concerned that Gilead’s latest statement regarding its access strategy for low and middle-income countries mentions only “high incidence countries and resource limited countries” and makes no specific mention of upper-middle-income countries or the Medicines Patent Pool. Upper middle-income countries account for 41% of new HIV infections and 37% of all people living with HIV. These countries are home to millions who cannot afford the prices Gilead charges high-income countries.

“The success of Gilead’s recent Lenacapavir trial is an exciting development. While we still await regulatory approvals, normative guidance and results from the other ongoing trials, this news offers hope that we can enable everyone who would benefit, including especially the most marginalised communities, to have access to the help they need. Enabling equitable global access to new technologies can help get the world on track to end AIDS as a public health threat by 2030,” said Winnie Byanyima, Executive Director of UNAIDS. "However, it is concerning that Gilead’s latest announcement seems to mention neither upper-middle income countries, where people cannot afford anything like Lenacapavir’s current $42,250 price tag, nor a commitment to work with the UN-backed Medicines Patent Pool. Without these safeguards, it cannot be assured that this game-changing medicine will reach all those who need it."

Notes

Data in this press release comes from UNAIDS 2023 Epidemiological estimates (aidsinfo.unaids.org)

The UNAIDS Executive Director joined more than 300 experts and activists calling for a generic version of Lenacapavir to be licensed to all low and middle-income countries through the MPP, in a letter coordinated by the People’s Medicines Alliance: https://peoplesmedicines.org/wp-content/uploads/2024/05/Gilead-Open-Letter_May-2024.pdf

The AIDS Vaccine Advocacy Coalition provides an overview of the Lenacapavir for PrEP trials: https://avac.org/resource/infographic/an-overview-of-lenacapavir-for-prep-trials/ 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Girls’ education as a tool to prevent HIV infection has been centered at the 1st African Union Pan-African Conference on Girls’ and Women’s Education in Africa. This followed African leaders designating education as the 2024 African Union theme of the year.

At a high-level side event hosted by the Education Plus Initiative on the first day of conference held at the African Union Commission in Addis Ababa, Ethiopia, leaders, girls’ and women’s networks and advocates called for greater investments in girls’ education.

“Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them,” said UNAIDS Executive Director, Winnie Byanyima. “We can get all our girls and boys to complete secondary education; that should be our legacy."

UNICEF calculates that 34 million girls in sub-Saharan Africa are out of secondary school. According to the Global Education Monitoring (GEM) Report 2023, in all regions in Africa, there are more girls out of school at the secondary level than boys, with gender disparities worsening as children move up to higher levels of education in favour of boys over girls. In sub-Saharan Africa, less than half of adolescent girls complete secondary education, their percentage standing at 42% and there has been no progress at all in closing this gap in the past 20 years.  Sub-Saharan Africa is the region furthest from parity at the expense of girls, with no progress since 2011 at the lower secondary level and since 2014 in upper secondary.

Gender is a key factor linked to disparities in enrolment, retention, completion, and learning outcomes through social conditioning, gender-based differences in parental expectations and education-related investments, child marriages and early childbearing, female genital mutilation, child labour, gender-based violence, period poverty and discrimination.

More than forty years into the HIV response, Africa remains an epicenter of the AIDS epidemic with adolescent girls and young women being disproportionately affected. Every week 3100 adolescent girls and young women acquired HIV in sub-Saharan Africa. Every three minutes, an adolescent girl or young woman aged 15-24 years acquired HIV in 2022 in sub-Saharan Africa.  Adolescent girls and young women aged 15-24 years in the region were more than three times as likely to acquire HIV than their male peers in 2022.

UN agencies, African Union representatives, government ministers, and young women leaders called for accelerated actions to translate commitments to action through leveraging girls' education for gender equality and preventing HIV, child marriage, teenage pregnancies, violence, gender-related stigma and discrimination in Africa.

Speakers emphasized the connection between health and education. Ministers spoke about key policy reforms and best practices aimed at promoting girls' education, including creating safe and inclusive school environments, strategies to get girls into secondary school, and the readmission policy that addresses high dropout rates due to pregnancy.  UN co-leads emphasised the need for improved collection of data disaggregated by sex and other relevant population characteristics to better understand educational participation, progression, and learning, and using gender-sensitive data for policymaking and planning. 

Other issues highlighted included the integration of digital literacy programs into the secondary education and vocational training curriculum to facilitate smooth transitions from school to employment; integrate gender equality into all aspects of the education system, including curriculum-based comprehensive sexuality education  and life skills, address gender-based violence  within schools and discriminatory laws and practices, and access to information, non-discriminatory HIV and sexual and reproductive health services access.

Young women leaders spoke on the role of partnerships and young women's leadership. Participants highlighted the upcoming 30th anniversary of the Beijing Declaration as an opportunity moment to accelerate accountability and commitments, as well as the CSW Resolution 60/2, Women, the Girl Child and HIV and AIDS as significant mechanisms to address political and resource gaps so no woman or girl is behind in the HIV response.

Education Plus is a rights-based, gender-responsive action agenda to ensure adolescent girls and young women have equal access to quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.  Co-led by five UN agencies, the initiative builds on existing frameworks like the Transforming Education Summit, the Continental Education Strategy for Africa (CESA) and the Dakar Education for All (EFA) Declaration to push for access and completion of education for women and girls in Africa.

Quotes

GENEVA, 27 June 2024—At the 54^th meeting of UNAIDS’ Programme Coordinating Board (PCB) which concluded today in Geneva, Switzerland, governments, civil society and United Nations agencies united in a shared commitment to accelerate progress to meet the 2025 AIDS targets and sustain the gains of the global HIV response toward 2030 and beyond.   

In her opening remarks to the meeting, the Executive Director of UNAIDS, Winnie Byanyima, highlighted the urgency of accelerating progress to meet the 2030 target of ending AIDS as a public health threat. “The world has six years to reduce new HIV infection rates, expand antiretroviral treatment, and reduce AIDS-related deaths, but only 18 months to reach the 2025 targets which will determine whether or not countries will be able to end their pandemics by 2030.”

She warned that there was ‘nothing sustainable about an expanding pandemic’ and called on members to join UNAIDS in ‘throwing everything we can’ at HIV prevention, making medicines and health technologies for HIV prevention and treatment equitable, affordable and accessible, and building stronger health systems’.

“We have a choice,” said Ms Byanyima. “We can accelerate now, drive rates down, and succeed. Or we can get distracted, focus only on what we’ve gained so far, and miss the opportunity to end AIDS. We must accelerate in order to sustain.”

She noted that sustainability also requires progress on widening fiscal space and addressing indebtedness of low- and middle-income countries, protecting human rights and gender equality, and called on all partners and allies to embrace a ‘bold vision of sustainability—one capable of ending the AIDS pandemic.’

Ms Byanyima emphasised the funding constraints which are hampering progress in the AIDS response highlighting the US$ 8.5 billion shortfall in funding for HIV. In 2022, US$ 20.8 billion was available for HIV funding in low- and middle-income countries whereas the estimated need by 2025 is US$ 29.3 billion. She called on all donors to ensure that the Joint Programme is fully funded to the agreed minimum levels of US$ 160 million for 2024.

On the opening day of the meeting Germany announced that it would be increasing its funding to UNAIDS. “Germany has decided to increase its contribution to UNAIDS in 2024 by € 2 million, from € 4.75 million in 2023 to € 6.75 million. We trust that this decision shall contribute to the minimum budget requirements of US$ 160 million to ensure that UNAIDS can adequately implement its workplan and budget,” said Binod Mahanty, Senior Policy Advisor, Federal Ministry of Health of Germany.

The Board reviewed the performance of the Joint Programme and appreciated the wide scope and in-depth contribution of UNAIDS to the global AIDS response at the global, regional and country levels.

The critical role of communities in continuing to lead the way in responding to HIV was highlighted as central to sustainability of the HIV response, which was the focus of the thematic segment on the final day: Sustaining the gains of the global HIV response to 2030 and beyond.

Ms Byanyima said, “To end AIDS, the foundation must be people living with HIV, civil society and communities. They are indispensable and non-negotiable for ending the pandemic, sustaining the response and ensuring accountability for all.

Florence Riako Anam, Co-Executive Director of the Global Network of People Living with HIV (GNP+), gave a powerful keynote address during the thematic session, she said, “People living with HIV will be here in 2031. For us, the sustainability of the HIV response is a journey of transformation and not a destination with an end date.” Other keynote speakers included H.E. Edwin Dikoloti, Minister of Health of Botswana and the Former President of the Republic of Chile Michelle Bachelet.

Ahead of the PCB, building on its longstanding partnership with the Global Fund to Fight AIDS, TB and Malaria, UNAIDS signed a new strategic framework for cooperation and collaboration to end AIDS. Joining the PCB discussions the Director of the Global Fund, Peter Sands said, “Optimizing HIV and primary health care integration requires well-coordinated partnerships between governments, private sector companies, international organizations, and non-government organizations.”

John Nkengasong, U.S. Global AIDS Coordinator and head of PEPFAR, said that gains were fragile and need to be sustained. "2030 is critical because at that point the global community either says ‘we have done our best and we don’t know what else to do’ or do we say, ‘YES! we can get to the finish line’...2030 is a mountaintop moment.” He also called for UNAIDS to be fully funded to continue its life-saving work.

The Board meeting provided an opportunity for UNAIDS to announce a new high-level panel on a resilient and fit-for-purpose UNAIDS Joint Programme. The Panel will consider the evolution of the pandemic and the global response as well as the evolving country needs within the overall context of the Joint Programme’s mandate.

This week also saw the release of a new report by on Drug Use, Harm Reduction and the Right to Health, demonstrating the public health necessity of moving away from punitive approaches to people who use drugs – a step towards ensuring access to health care for marginalized communities.

The 54^th PCB was chaired by Kenya, represented by Harry Kimtai, Principal Secretary, State Department for Medical Services, Nairobi, with Brazil serving as the Vice-Chair and Netherlands as Rapporteur. The Report to the Board by the UNAIDS Executive Director, and the reports for each agenda item and the PCB’s decisions can be found at: 54^th UNAIDS Programme Coordinating Board.

The 55^th meeting of the PCB will take place 10-12 December 2024, in Nairobi, Kenya.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.