Advancing the Sexual and Reproductive Health and Human Rights of People Living With HIV pdf

Advancing the Sexual and

Reproductive Health and Human

Rights of People Living With HIV

*A Guidance Package

GNP+ • ICW • Young Positives • EngenderHealth • IPPF • UNAIDS

Advancing the Sexual and Reproductive Health and Human Rights of People Living With HIV: A Guidance Package

GNP+ • ICW • Young Positives • EngenderHealth • IPPF • UNAIDS

Advancing the Sexual and

Reproductive Health and Human

Rights of People Living With HIV

*A Guidance Package

Published by:

The Global Network of People Living with HIV/AIDS (GNP+)

p.o. box 11726

1001 gs Amsterdam

The Netherlands

Website: www.gnpplus.net

E-mail: [email protected]

Some rights reserved: This document may be freely shared, copied, translated, reviewed and distributed, in part or

in whole, but not for sale or use in conjunction with commercial purposes. Only authorised translation, adaptation

and reprints may bear the emblems of GNP+ and/or individual partners to the Guidance Package. Enquiries should

be addressed to GNP+, p.o. box 11726, 1001 gs, Amsterdam, The Netherlands, [email protected].

© May 2009. The Global Network of People Living with HIV/AIDS (GNP+)

Design: www.samgobin.nl

isbn 978-94-90241-01-8

Suggested citation: EngenderHealth, GNP+, ICW, IPPF, UNAIDS, Young Positives. 2009. Advancing the Sexual and

Reproductive Health and Human Rights of People Living With HIV: A Guidance Package. Amsterdam, GNP+.



ACKNOWLEDGEMENTS 5

LIST OF ACRONYMS AND ABBREVIATIONS 6

EXECUTIVE SUMMARY 7

1 INTRODUCTION AND RECOMMENDATIONS 9

I. Towards a Better Understanding of the Sexual and

Reproductive Rights of People Living with HIV 10

II. Overview of the Guidance Package 11

III. Specific Recommendations 12

2 CREATING A SUPPORTIVE HEALTH SYSTEM 14

I. Structural Issues 16

Financing 16

Linking services 16

Supplies and technologies 17

Health care workers 18

HIV Stigma and discrimination 19

Non-state actors: community organisations and

informal health workers 19

Reaching marginalised populations 20

Monitoring and evaluation 20

II. Clinical Services 20

HIV testing and counselling 21

Sex education 22

Psychosocial support 23

Family planning and dual protection 23

Abortion 24

Conception, pregnancy and childbirth 25

Sexually transmitted infections 26

Cancer diagnosis and treatment 26

Violence 27

Sexual dysfunction 27

Positive prevention 28

III. Protecting Human Rights, Advancing Public

Health 28

3 LEGAL AND POLICY CONSIDERATIONS 29

I. Sexual and Reproductive Health-Related Laws and

Policies 31

Criminalisation of HIV transmission 31

Anal sex 31

HIV testing and counselling 32

Family planning and abortion 32

Marriage, divorce, and child custody 33

Women’s property and inheritance rights 33

Male circumcision 34

The greater involvement of people living with HIV 34

II. Policies Affecting Key Populations At Higher Risk 34

Young people 34

Sex workers 35

Drug users 36

Men who have sex with men 37

Transgender People 37

Prisoners 38

Migrants 38

III. Linking Legal Reforms to Sexual and Reproductive

Health 39

4 EFFECTIVE ADVOCACY 41

I. Challenges To Effective Advocacy 42

HIV stigma and discrimination 43

Gender inequality and violence 43

Marginalisation 44

Poverty 45

Lack of collaboration 45

II. Improving Advocacy 46

Rely on the unique expertise of people living

with HIV 46

Provide education and training 46

Collect policy-relevant evidence 47

Monitor and evaluate 48

Strengthen networks and alliances 49

III. Empowerment and Health Through More Effective

Advocacy 49

Appendixes

More Information And Useful Tools 53

List of Recommendations 56

Endnotes 58

Photo Credits 63

Contents