HIV/AIDS

Policy, advocacy and stakeholder mobilization


Promoting a rights-based approach to HIV testing and counselling

The promotion of a rights-based approach to HIV testing and counselling services helps to normalize them in health facilities and in communities. It is also critical for improving people's perceptions about the benefits of HIV testing and counselling; this has a direct impact on the uptake of services.

The rights-based approach to HIV testing and counselling means that:

  • people have a right to know their HIV status;
  • HIV testing must be voluntary, the decision to test or not to test being based on an understanding of accurate, objective and relevant information;
  • post-test services are crucial;
  • confidentiality must be protected;
  • non-discrimination in service delivery is critical;
  • testing and counselling must be scaled up, eventually leading to universal access.

Most countries are signatories to international legal instruments, declarations and guidelines that are vital components of the rights-based approach to HIV testing and counselling services. These countries are required to adhere to the principles laid down in the instruments, which form a framework of rights and give countries a basis for formulating their local laws, policies and practices. International instruments provide standards that facilitate the creation of an enabling environment for HIV testing and counselling.

An enabling environment includes policies and and procedures that:
  • enable voluntary and informed consent for all populations, including youth;
  • enable the promotion of confidentiality and beneficial disclosure and guard against inappropriate disclosure;
  • ensure non-discrimination in service provision, facilitating access for a range of population groups;
  • ensure the availability of HIV-related prevention, care and support services;
  • ensure that a supportive social, policy and legal framework is in place to maximize positive outcomes and minimize potential harms to clients or patients;
  • establish a monitoring and evaluation system that promotes an enabling environment.

TOOLS

The right to know: new approaches to HIV testing and counselling

This document is the executive summary, printed separately, of the WHO Consultation on Increasing Access to HIV Testing and Counselling, held in Geneva on 19-21 November 2002. It forms the basis of current WHO policy on T&C and emphasises guiding principles for T&C implementation and activities.

Opening up the HIV/AIDS epidemic: guidance on encouraging beneficial disclosure, ethical partner counselling and appropriate use of HIV case-reporting

This guide provides recommendations for encouraging beneficial disclosure, ethical partner counselling and appropriate use of HIV case reporting. The annex comprises general guiding principles that need to be taken into consideration by governments and policy makers when planning national strategies. The document gives clear guidance on the necessary steps involved if confidentiality is to be breached in the interests of a third party.

Informed consent to perform an HIV test

This is a form that provides information on HIV testing with an attached attestation (consent form) to be signed by the client as well as the counsellor in accordance with New York's Public Health Laws.

Guidance on provider-initiated HIV testing and counselling in health facilities

WHO and UNAIDS has issued new guidance on informed, voluntary HIV testing and counselling in the world's health facilities, with a view to significantly increasing access to needed HIV treatment, care support and prevention services. The new guidance focuses on provider-initiated HIV testing and counselling (recommended by health care providers in health facilities).

UN Convention on the Rights of the Child: General Comment No 3: HIV/AIDS and the rights of the child

At its seventeenth session (1998), the Committee on the Rights of the Child held a day of general discussion on the theme of HIV/AIDS and children’s rights, in which it recommended that a number of actions be taken, including facilitating the engagement of States parties on HIV/AIDS issues in relation to the rights of the child.

HIV testing of specific populations: children and adolescents

The issue paper by the Global Reference Group on HIV/AIDS and Human Rights concludes that laws, policies, and social norms may individually or in combination facilitate or impede access to testing and eventually treatment for children and adolescents. This can be the case even where laws and policies about testing are themselves silent about how they affect children and adolescents. In considering how to increase access to testing and treatment (with due regard to promoting and protecting human rights), it is important to question how all three – laws, policies, and social norms interact in a given situation.

Information sheets on HIV testing in Canada

This is a series of 12 info sheets on HIV testing in Canada

Guidance on Ethics and Equitable access to HIV treatment and care

This document which provides guidance for government officials, programme managers at various levels, community-based and non-governmental organizations, groups of people living with HIV, international organizations and donor agencies raises awareness of the ethical issues and helps plan and implement the scale-up of ART and other HIV-related treatment and care programmes in an equitable fashion.

SIGNIFICANT BARRIERS

The most significant barriers that deny people access to HIV testing and counselling are stigmatizing laws and practices which discriminate against vulnerable populations such as sex workers, injecting drug users (IDUs), men who have sex with men (MSM), as well as to women and children. They also discriminate against people with HIV on issues of employment, marriage and founding a family, and are responsible for denial of access to health care and medicines, and prevent people from seeking HIV testing and counselling.

Stigmatizing, discriminatory laws impede public health objectives and should be repealed or reformed. Vulnerable populations should have access to ethical, appropriate and effective HIV testing and counselling services as well as to follow-up prevention, care, treatment and support services, otherwise it is to be exepcted that the existing inequities and inequalities will be exacerbated.

TOOLS

Policy and advocacy in HIV/AIDS prevention

The handbook provides an overview of how to contribute to making policy an effective component of HIV/AIDS prevention. The document includes assessing current policies, steps in developing policy recommendations and advocacy for policy adoption.

Information sheets on HIV testing

This document contains information on Canada's laws and policies regarding counselling and testing, including issues regarding consent, access, anonymity, counselling, home testing, mandatory testing, confidentiality, partner notification, etc.

HIV-related Stigma, Discrimination and Human Rights Violations (2005)

HIV-related stigma and discrimination and human rights violations constitute great barriers to preventing HIV infection; providing care, support and treatment; and alleviating the impacts of the epidemic. This publication documents case studies of successful action in different countries addressing HIV-related human rights violations, stigma and discrimination.

International Guidelines on HIV/AIDS and Human Rights (2006)

The Guidelines explain how countries can take concrete steps to protect human rights in the context of HIV. Three parts include: action-oriented measures for governments in the areas of law, administrative policy and practice; recommendations for dissemination and implementation of the Guidelines; and international human rights obligations and principles underlying a positive response to HIV.

INTERNATIONAL INSTRUMENTS AND GUIDELINES

International instruments and guidelines essentially set out a commitment on HIV testing and counselling services whereby countries:

  • establish an effective national framework that is transparent and participatory;
  • take measures to ensure for all persons, on a sustained and equal basis, the availability and accessibility of goods, services and information of satisfactory quality for HIV/AIDS prevention, treatment, care and support, including ARVs, other medicines, diagnostic and related technologies, and HIV testing and counselling services.

TOOLS

Report of the 3rd International Consultation on HIV/AIDS and human rights

Advancing care, treatment and support for people living with HIV/AIDS. Updating Guideline 6 of the HIV/AIDS and Human Rights, International Guidelines, July 2002

Declaration of Commitment on HIV/AIDS

In June 2001, Heads of State and Representatives of Governments met at the United Nations General Assembly Special Session dedicated to HIV/AIDS. At the meeting, Heads of State and Representatives of Governments issued the Declaration of Commitment on HIV/AIDS. The Declaration remains a powerful tool that is helping to guide and secure action, commitment, support and resources for the AIDS response.

Declaration of Commitment on HIV/AIDS: five years later. 2006 Report of the Secretary-General

The 2006 follow-up meeting on the outcome of the twenty-sixth special session: implementation of the Declaration of Commitment on HIV/AIDS took place from 31 May - 2 June 2006 at the United Nations in New York, USA. The Secretary-General presented the report to the General Assembly on progress made until the end of 2005, a year when targets in the Declaration were due.