PL06.1 Legal and human rights dimensions of hiv and sti: historical background and policy implications

Abstract

The degree of regulation of sexuality has been very diverse through times and cultures. Christianity regulated it heavily, and many of its views became part of the European legal tradition. The last thirty years have seen considerable changes in Western culture, including the emergence of social movements around gender equity, sexual diversity, and HIV. In connection with the struggles of these movements as well as other social and political changes, there has been considerable progress in the situation of women and people with non-heterosexual identities, although in this case there has been a greater range of changes, including some on the negative side, such as criminalization. Finally, the global HIV movement made significant changes in the relationship between scientists, doctors, community and regulatory agencies, and led a crusade to expand access to treatment and prevention. Because HIV is primarily sexually transmitted, and more prevalent in socially excluded groups in countries without generalized epidemics, AIDS was doubly stigmatized: as a deadly and mysterious disease, and as an indicator of social exclusion. Predictably, HIV stigma led to discrimination in access to services. In most of the world, the promotion of condom use did reduce, but never eliminated HIV transmission. Such finding brought a focus both to cultural differences and to structural vulnerability. HIV is clearly more frequent among socially excluded people, who need public interventions to reduce such vulnerability. In its history of more than three decades, HIV has elicited a variety of responses in legislative and regulatory frameworks, both positive and negative, some of which will be discussed. The history of the response to STIs, with emphasis on the modern HIV epidemic shows the growing relationship between public health, public policy and legislation, and the potential role of genuine community participation based on both scientific evidence and international human rights principles.