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February 5, 2010

Rights of vulnerable people and the future of HIV/AIDS

"Despite these gains, prejudice, discrimination, and stigmatisation of people with HIV/AIDS, and key groups most affected by and at most risk of the disease, continue to hamper efforts to tackle the pandemic. The welcome news that the USA has at last lifted a 22 year travel restriction that prevented people with HIV/AIDS entering the country, and that South Korea has removed a similar ban, reminds us that almost 30 countries worldwide still block entry by and repatriate foreign nationals with HIV/AIDS. And in Uganda, the attempt to introduce the death penalty for people known to have engaged in homosexual acts and further criminalise individuals, including health workers, who support such people is a terrifying sign that addressing issues of vulnerability, discrimination, and human rights will be key to future gains in the battle against the pandemic.

"About a third of people living with HIV/AIDS in countries without generalised epidemics are men who have sex with men, sex workers, and injecting drug users, and in countries with generalised epidemics people in these key groups have a higher prevalence of HIV/AIDS than do the general population. The WHO Towards Universal Access report, released last year, identified these as target populations in the fight against HIV, since infections in these groups are likely to drive epidemics in the future. ...

"But funding bodies can help to improve the situation of key populations, not only by providing funds directly, but also by putting conditions on donations to ensure that countries act to remove discrimination and improve the health of people in vulnerable groups. Over the past 5 years, the Ukraine has managed to turn the tide in a rapidly escalating HIV/AIDS crisis by opening needle exchanges and offering counselling for drug users with donations from the Global Fund given on the condition that the country legalised methodone replacement therapy."

Read more in The Lancet Infectious Diseases, February 4, 2010 (free registration to The Lancet required).