With regard to health care, Nation States, from time to time, have
succeeded in promulgating diverse international declarations, protocols and guidelines. Prominently, the following reflect international concern towards healthcare. 
• Universal Declaration of Human rights
• International Covenant on Economic, Social and Cultural rights

International Covenant on civil and Political Rights Optional Protocol to the International Covenant on Civil and Political Rights HIV/AIDS and Human Rights : International Guidelines  Declaration on the Rights of Mentally Retarded persons Universal Declaration on the Eradication of Hunger and Malnutrition Declaration on the Rights of Disabled Persons 

HIV / AIDS and Human Rights
International Guidelines 
  1. The Commission on Human Rights, at its fifty-second session, in its resolution 1996/43 of 19 April 1996, requested the then United Nations High Commissioner for Human Rights, inter alia, to continue his efforts, in cooperation with UNAIDS and non-governmental organizations, as well as groups of people living with HIV /AIDS, towards to elaboration of guidelines on promoting and protecting respect for human rights in the context of HIV / AIDS. In the same resolution, the Commission requested that the Secretary-General prepare, for the consideration of the Commission at its fifty-third session, a report on the above-mentioned guidelines, including the outcome of the second expert consultation on human rights and AIDS, and on their international dissemination. 
  
  2. The call for guidelines on human rights and HIV / AIDS was based on a recommendation contained in an earlier report of the Secretary-General to the Commission at its fifty-first session (E/CN.4/1995/45, para. 135), which stated that "the development of such guidelines or principles could provide an international framework for discussion of human rights considerations at the national, regional and international levels in order to arrive at a more comprehensive understanding of the complex relationship between the public
health rationale and the human rights rationale of HIV / AIDS. In particular, Governments could benefit from guidelines that outline clearly how human rights standards apply in the area of HIV / AIDS and indicate concrete and specific measures, both in terms of legislation and practice, that should be undertaken". 

  3. In response to the above requests, the Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV / AIDS (UNAIDS) convened the Second International Consultation on HIV / AIDS and Human Rights in Geneva, from 23 to 25 September 1996. It may be recalled that the first International Consultation on AIDS and Human Rights was organized by the then United Nations Centre for Human Rights, in cooperation with the
World Health Organization, in Geneva from 26 to 28 July 1989. In the report of the first consultation (HR/PUB/90/2), the elaboration of guidelines to assist policy makers and others in compliance with international human rights standards regarding law, administrative practice and policy had already been proposed. 

  4. The Second International Consultation on HIV / AIDS and Human Rights (E/CN.4/1997/37) brought together 35 experts in the field of AIDS and human rights, comprising government officials and staff of national AIDS programmes, people living with HIV / AIDS (PLHAs), human rights activists, academics, representatives of regional and national networks on ethics, law, human rights and HIV, and representatives of United Nations bodies and agencies, non-governmental organizations and AIDS service organizations (ASOs). The list of participants is attached as annex II to the present document. 

  5. The Consultation had before it five background papers which had been commissioned for the purpose of eliciting specific regional and thematic experiences and concerns regarding HIV / AIDS and human rights, prepared by the following non-governmental organizations and networks of people living with HIV / AIDS: Alternative Law Research and Development Centre (ALTERLAW) (Philippines); Network of African People Living with HIV / AIDS (NAP +) (Zambia); Colectivo Sol (Mexico); International Community of Women Living with HIV / AIDS
(ICW +) (global). The groups were asked, each within its specific context, to identify the most important human rights principles and concerns in the context of HIV / AIDS, as well as concrete measures that States could take to protect HIV - related human rights. 

  6. The Consultation also had before it draft guidelines on HIV / AIDS and human rights, prepared by Ms. Helen Watchirs (Australia) on the basis of the five regional background papers and others materials consulted. In additional, the international association Rights and Humanity conducted a global survey to review existing strategies and identify other measures necessary to ensure respect for human rights in the context of HIV / AIDS. An analysis of the 40 responses received to the survey were presented to the Consultation. 

  7. With regard to its methods of work, the Consultation formed four working groups to discuss and finalize the draft guidelines, focusing on the theoretical framework (WG.1), the institutional responsibilities and processes (WG.2) law review, reform and support services (WG.3) and on the promotion of a supportive and enabling environment (WG.4), respectively. In the second part of the Consultation, participants were divided into a further three working groups in order to discuss and elaborate recommendations concerning strategies to ensure
the dissemination and implementation of the guidelines, according to different actors, as follows: States (WG.6), United Nations system and regional intergovernmental bodies (WG.7) and non-governmental organizations (WG.8). 
 
  8. This document contains guidelines adopted at the Second International Consultation on HIV / AIDS and Human Rights, held in Geneva from 23 to 25 September 1996, to assist States in creating a positive, rights-based response to HIV / AIDS that is effective in reducing the transmission and impact of HIV /AIDS and consistent with human rights and fundamental freedom. 

  9. The elaboration of such guidelines was first considered by the 1989
International Consultation on AIDS and Human Rights, organized jointly by the then United Nations Center for Human Rights and the World Health Organization. The United Nations Commission on Human Rights and its Sub-Commission on Prevention of Discrimination and Protection of Minorities has repeatedly reiterated the need for guidelines. Increasingly, the international community has recognized the need for elaborating further how existing human rights principles apply in the context of HIV / AIDS and for providing examples of concrete activities to be undertaken by States to protect human rights and public health in
the context of HIV / AIDS. 
 
  10. The purpose of these Guidelines is to assist States in translating international human rights norms into practical observance in the context of HIV / AIDS. To this end, the Guidelines consist of two parts: first, the human rights principles underlying a positive response to HIV/AIDS and second, action-oriented measures to be employed by Governments in the areas of law, administrative policy and practice that will protect human rights and achieve HIV-related public health goals. 
 
  11. The Guidelines recognize that States bring to the HIV / AIDS epidemic different economic, social and cultural values, traditions and practices - a diversity, which should be celebrated as a rich resource for an effective response to HIV / AIDS. In order to benefit from this diversity, a process of participatory consultation and cooperation was undertaken in the drafting of the Guidelines, so that the Guidelines reflect the experience of people affected by the epidemic, address relevant needs and incorporate regional perspectives. Furthermore, the
Guidelines reaffirm that diverse responses can and should be designed within the context of universal human rights standards. 
 
  12. It is intended that the principal users of the Guidelines will be States, in the persons of legislators and government policy makers, including officials involved in national AIDS programmes and relevant departments and ministries, such as health, foreign affairs, justice, interior, employment, welfare and education. Other users who will benefit from the Guidelines include intergovernmental organizations
(IGOs), non-governmental organizations (NGOs), networks of persons living with HIV / AIDS (PLHAs), community-based organizations (CBOs), networks on ethics, law, human rights and HIV and AIDS service organizations (ASOs). The br0adest possible audience of users of the Guidelines will maximize their impact and make their content a reality. 
 
  13. The Guidelines address many difficult and complex issues, some of which may or may not be relevant to the situation in a particular country. For these reasons, it is essential that the Guidelines be taken by critical actors at the national and community level and considered in a process of dialogue involving a broad spectrum of those most directly affected by the issues addressed in the Guidelines. Such a consultative process will enable Governments and communities to consider how the Guidelines are specifically relevant in their country, assess priority issues presented by the Guidelines and devise effective ways to
implement the Guidelines in their respective contexts. 

  14. In implementing the Guidelines, it should be borne in mind that achieving international cooperation in solving problems of an economic, social, cultural or humanitarian character and promoting and encouraging respect for human rights and for fundamental freedoms for all, is one of the principal objectives of the United Nations. In this sense, international cooperation, including financial and technical support, is a duty of States in the context of the HIV / AIDS epidemic
and industrialized countries are encouraged to act in a spirit of solidarity in assisting developing countries to meet the challenges of implementing the Guidelines. Summary 

  15 HIV / AIDS continues to spread throughout the world at an alarming rate. The widespread abuse of human rights and fundamental freedoms associated with HIV / AIDS has emerged in all parts of the world in the wake of the epidemic. In response to this situation the experts at the Second International Consultation on HIV / AIDS and Human Rights concluded the following: 
  a. The protection of human rights is essential to safeguard human dignity in the context of HIV / AIDS and to ensure an effective, rights-based response to HIV /AIDS. An effective response requires the implementation of all human rights, civil and political, economic, social and cultural, and fundamental freedoms of all people, in accordance with existing international human rights standards 
  b. Public health interests do not conflict with human rights. On the contrary, it has been recognized that when human rights are protected, fewer people become infected and those living with HIV / AIDS and their families can better cope with HIV / AIDS; 
  c. A rights-based, effective response to the HIV / AIDS epidemic involves establishing appropriate governmental institutional responsibilities, implementing law reform and support services and promoting a supportive environment for groups vulnerable to HIV / AIDS and for those living with HIV / AIDS; 
  d.In the context of HIV / AIDS, international human rights norms and
pragmatic public health goals require States to consider measures that may be considered controversial, particularly regarding the status of women and children, sex workers, injecting drug users and men having sex with men. It is, however, the responsibility of all States to identify how they can best meet their human rights obligations and protect public health within their specific political, cultural and religious contexts; 
  e.Although States have primary responsibility for implementing strategies that protects human rights and public health, United Nations bodies, agencies and programmes, regional intergovernmental bodies and non-governmental organizations, including networks of people living with HIV / AIDS, play critical roles in this regard. 

  16.The Consultation adopted Guidelines on HIV / AIDS and Human Rights, the purpose of which is to translate international human rights norms into practical observance in the context of HIV / AIDS. To this end, the Guidelines consist of two parts: first, the human rights principles underlying a positive response to HIV/ AIDS and second, action-oriented measures to be employed by Governments in the areas of law, administrative policy and practice that will protect human
rights and achieve HIV-related public health goals. 
 
  17.There are many steps that States can take to protect HIV - related
human rights and to achieve public health goals. The 12 Guidelines
elaborated by the Consultation for States to implement an effective,
right-based responses are summarized below. 

  Guideline 1: States should establish an effective national framework for their response to HIV / AIDS which ensures a coordinated, participatory, transparent and accountable approach, integrating HIV / AIDS policy and programme responsibilities across all branches of government. 

  Guideline 2: States should ensure, through political and financial support, that community consultation occurs in all phases of HIV / AIDS policy design, programme implementation and evaluation and that community organizations are enabled to carry out their activities, including in the field of ethics, law and human rights, effectively. 

  Guideline 3: States should review and reform public health laws to ensure that they adequately address public health issues raised by HIV / AIDS, that their provisions applicable to casually transmitted diseases are not inappropriately applied to HIV / AIDS and that they are consistent with international human rights obligations. 

  Guideline 4: States should review and reform criminal laws and correctional systems to ensure that they are consistent with international human rights obligations and are not misused in the context of HIV / AIDS or targeted against vulnerable groups. 
  
  Guideline 5: States should enact or strengthen anti-discrimination and other protective laws that protect vulnerable groups, people living with HIV/AIDS and people with disabilities from discrimination in both the public and private sectors, ensure privacy and confidentiality and ethics in research involving human subjects, emphasize education and conciliation, and provide for speedy and effective administrative and civil remedies. 

  Guideline 6: States should enact legislation to provide for the regulation of HIV - related goods, services and information, as to ensure widespread availability of qualitative prevention measures and services, adequate HIV prevention and care information and safe and effective medication at an affordable price. 

  Guideline 7: States should implement and support legal support services that will educate people affected by HIV / AIDS about their rights, provide free legal services to enforce those rights, develop expertise on HIV -related legal issues and utilize means of protection in addition to the courts, such as offices of ministries of justice, ombudspersons, health complaint units and human rights commissions. 

  Guideline 8: States, in collaboration with and through the community,
should promote a supportive and enabling environment for women, children and other vulnerable groups by addressing underlying prejudices and inequalities through community dialogue, specially designed social and health services and support to community groups. 

  Guideline 9: States should promote the wide and ongoing distribution of creative education, training and media programmes explicitly designed to change attitudes of discrimination and stigmatization associated with HIV /AIDS for understanding and acceptance.
 
  Guideline 10: States should ensure that government and the private section develop codes of conduct regarding HIV / AIDS issues that translate human rights principles into codes of professional responsibility and practice, with accompanying mechanisms to implement and enforce these codes. 

  Guideline 11: States should ensure monitoring and enforcement mechanisms to guarantee the protection of HIV- related human rights, including those of people living with HIV / AIDS, their families and communities. 

  Guideline 12: States should cooperate through all relevant programmes and agencies of the Unites Nations system, including UNAIDS, to share knowledge and experience concerning HIV - related human rights issues and should ensure effective mechanisms to protect human rights in the context of HIV / AIDS at international level. 
 
I. Guidelines For State Action

  18.Recommended Guidelines for implementation by States in order to promote and protect human rights in the context of HIV / AIDS are set out below. These Guidelines are firmly anchored within a framework of existing international human rights norms and are based on many years of experience in identifying those strategies that have proven successful in addressing HIV / AIDS. The normative principles together with practical strategies provide the evidence and ideas for States to reorient and redesign their policies and programmes to ensure respect for HIV - relative rights and to be most effective in addressing the epidemic.
States should provide adequate political leadership and financial resources to enable implementation of these strategies. 
  
  19.The Guidelines focus on activities by States in view of their obligations under international and regional human rights instruments. This is not to deny, however, the responsibilities of other key actors, such as the private sector, including professional groups such as health-care workers, the media, and religious communities. These groups also have responsibilities not to engage in discrimination and to implement protective and ethical policies and practices. 
A. Institutional responsibilities and processes 
Guideline 1: National Framework 
 
  20.States should established an effective national framework for their response to HIV / AIDS which ensures a coordinated, participatory, transparent and accountable approach, integrating HIV/AIDS policy and programme responsibilities, across all branches of government. 

  21.Guideline 1 
Depending upon existing institutions, the level of the epidemic and
institutional cultures, as well as the need to avoid overlapping of
responsibilities, the following responses should be considered: 
  a. Formation of an inter-ministerial committee to ensure integrated
development and high-level coordination of individual ministerial national
action plans and to monitor and implement and additional HIV / AIDS
strategies, as set out below. In federal systems, an intergovernmental
committee should also be established with provincial/State, as well as
national representation. Each ministry should ensure that HIV / AIDS and human rights are integrated into all its relevant plans and activities,
including: 
Education; 
Law and justice, including police and corrective services; 
Science and research; 
Employment and public service; 
Welfare, social security and housing; 
Immigration, indigenous populations, foreign affairs and development
co-operation; 
Health; 
Treasury and finance; 
Defence, including armed services. 
 
  b. Ensuring that an informed and ongoing forum exists for briefing, policy discussion and law reform to deepen the level of understanding of the epidemic,in which all political viewpoints can participate at national and subnational levels, e.g. by establishing parliamentary or legislative committees with representation from major and minor political parties. 
 
  c.Formation or strengthening of advisory bodies to governments on legal and ethical issues, such as a legal and ethical subcommittee of the interministerial committee. Representation should consist of professional (public, law and education, science, bio-medical and social), religious and community groups, employers and workers organizations, NGOs and ASOs, nominees/experts and people living with HIV / AIDS. 

  d.Sensitization of the judicial branch of government, in ways consistent with judicial independence, on the legal, ethical and human rights issues relative to HIV / AIDS, including through judicial education and the development of judicial materials. 

  e. Ongoing interaction of government branches with United Nations Theme Groups on HIV / AIDS and other concerned international and bilateral actors to ensure that governmental responses to the HIV / AIDS epidemic will continue to make the best use of assistance available from the international community. Such interaction should, inter alia, reinforce cooperation and assistance to areas to HIV / AIDS and human rights. To be effective, the response to HIV / AIDS must mobilize key actors throughout all branches of government and include all policy areas, since only a combination of well-integrated and coordinated approaches can address the complexities of the epidemic. In all sectors, leadership must be developed and must demonstrate a dedication to HIV - related human rights. Governments should avoid unnecessary politicization of HIV / AIDS which diverts government energy and divides the community rather than engendering a sense of solidarity and consensus in dealing with the epidemic. Political commitment to dedicate adequate resources to respond to the epidemic within States is essential. It is equally important that these
resources are channelled into productive and coordinated strategies. Roles and lines of responsibility within government, including human rights issues, should be clarified. 
Most countries already have national AIDS committees. In some countries,there are also sub national committees. However, the persistent lack of coordination in government policy and the lack of specific attention to human rights issues relating to the HIV / AIDS epidemic suggest a need to consider possible additional structures or to strengthen and reorient those that exists to include legal and ethical issues. Several models of co-coordinating committees and multidisciplinary advisory groups exist. Similar coordination is essential within and between lower levels of government. It is necessary to focus such coordination not only in creating specialized HIV / AIDS bodies, but also in securing a place for HIV / AIDS human rights issues in existing mainstream forums, such as regular gatherings of Ministers
of, e.g. Health, Justice and Social Welfare. A multidisciplinary body with professionals and community representation should exist to advise
Governments on legal and ethical issues. These bodies at the national level should also ensure coordination with UNAIDS, its co-sponsors and other international agencies (donors, bilateral donors and others) to reinforce cooperation and assistance to areas relating to HIV / AIDS and human rights. 
 
States should ensure, through political and financial support that
community consultation occurs in all phases of HIV / AIDS policy design,programme implementation and evaluation and that community
organizations are enabled to carry out their activities, including in the fields of ethics, law and human rights, effectively. 
 
Community representation should comprise PLHAs, CBOs, ASOs,
human rights NGOs and representatives of vulnerable groups. Formal
and regular mechanisms should be established to facilitate ongoing
dialogue with and input from such community representative into HIV
- related government policies and programmes. This could be
established through regular reporting by community representatives
to the various government, parliamentary and judicial branches
described in Guideline 1, joint workshops with community
representatives on policy, planning and evaluation of State responses
and through mechanisms for receiving written submissions from the
community. 
 
Sufficient Government funding should be allocated in order to support,
sustain and enhance community organization in areas of core support,
capacity-building and implementation of activities, in such areas as HIV -related ethics, human rights and law. Such activities might involve training seminars, workshops, networking, developing promotional and educational materials, advising clients of their human and legal rights, referring clients to relevant grievance bodies, collecting data on human rights issues and human rights advocacy. 
 
Commentary on Guideline 2 
Community partners have knowledge and experience that States need in order to fashion effective State responses. This is the case particularly with regard to human rights issues, as community representatives are either directly affected by human rights problems or work directly with those who are affected. States should, therefore, ensure that this knowledge and experience are included in the development of HIV / AIDS policy, programmes and evaluation by recognizing the importance of such contributions and creating structural means by which to obtain them.The contribution of CBOs, NGOs, ASOs and PLHAs is an essential part of the overall national response to the epidemic, in such areas as ethics, law and human rights. As community representatives do no necessarily possess organizational ability or skills for advocacy, lobbying and human rights work,this contribution should be enhanced by State funding for administrative
support, capacity-building, human resource development and
implementation of activities. Collection of complaints data by CBOs and
where the most serious HIV - related human rights problems are occurring and what effective action should be implemented response. 
B. Law review, reform and support services 
 
Guideline 3: Public Health Legislation 
States should review and reform public health legislation to ensure that
they adequately address the public health raised by HIV / AIDS, that their provisions applicable to casually transmitted diseases are inappropriately applied to HIV / AIDS and that they are consistent with international human rights obligations.
Public health legislation should include the following components; 
Public health law should fund and empower public health authorities to
provide a comprehensive range of services for the prevention and
treatment of HIV / AIDS, including relevant information and education,
access to voluntary testing and counselling, STD and sexual and
reproductive health services for men and women, condoms and drug
treatment, services and clean injection materials, as well as adequate
treatment for HIV / AIDS related illnesses, including pain prophylaxis. 
Apart from surveillance testing and other unlinked testing done for
epidemiological purposes, public health legislation should ensure that HIV testing of individuals should only be performed with the specific informed consent of that individual. Exceptions to voluntary testing would need specific judicial authorization, granted only after due evaluation of the important considerations involved in terms of privacy and liberty. 
 
In view of the serious nature of HIV testing and in order to maximize
prevention and care, public health legislation should ensure, whenever
possible, that pre and post-test counselling be provided in all cases. With the introduction of home-testing, States should ensure quality control,maximize counselling and referral services for those who use such tests and establish legal and support services for those are the victims of misuse of such tests by others. 

Public health legislation should ensure that people not be subjected to
coercive measures such as isolation, detention or quarantine on the basis of their HIV status. Where the liberty of persons living with HIV is
restricted, due process protection (e.g. notice, rights of review/appeal,
fixed rather than indeterminate periods of orders and rights of
representation) should be guaranteed). 
 
Public health legislation should ensure that information relative to the HIV status of an individual be protected from unauthorized collection, use or disclosure in the health-care and other settings and that the use of HIV related information requires informed consent. 

Public health legislation should ensure that information relative to the HIV status of an individual be protected from unauthorized collection, use or disclosure in the health-care and other settings and that the use of HIV-related information requires informed consent. 

Public health legislation should authorize, but not require, that health-care professionals decide, on the basis of each individual case and ethical considerations, whether to inform their patient's sexual partners of the HIV status of their patient. Such a decision should only be made in accordance with the following criteria; The HIV-positive person in question has been thoroughly counselled; Counselling of the HIV-positive person has failed to achieve appropriate behavioural changes; The HIV-positive person has refused to notify, or consent to the notification of his/her partner(s); A real risk of HIV transmission to the partner(s) exists;The HIV-positive person is given reasonable advance notice; The identity of the HIV-positive person is concealed from the partner(s), if this is possible in practice; Follow-up is provided to ensure support to those involved, as necessary. 
Public health legislation should ensure that the blood/tissue/organ supply is free of HIV and other blood-borne diseases. 
Public health law should require the implementation of universal infection control precautions in health-care and other settings involving exposure to blood and other bodily fluids. Persons working in these settings must be provided with the appropriate equipment and training to implement such precautions. 
Public health legislation should require that health-care workers undergo a minimum of ethics and/or human rights training in order to be licensed to practice and should encourage professional societies of health-care workers to develop and enforce codes of conduct based on human rights and ethics, including HIV - related issues such as confidentiality and the duty to provide treatment. 

Guideline 4: Criminal Laws and Correctional Systems 
States should review and reform criminal laws and correctional systems to ensure that they are consistent with international human rights obligations and are not misused in the context of HIV / AIDS or targeted at vulnerable groups. 
 
Criminal and/or public health legislation should not include specific offences against the deliberate and international transmission of HIV but rather should apply general criminal offences to these exceptional cases. Such application should ensure that the elements of foresee ability, intent,causality and consent are clearly and legally established to support a guilty verdict and/or harsher penalties. 

Criminal law prohibiting sexual acts (including adultery, sodomy, fornication and commercial sexual encounters) between consenting adults in private should be reviewed, with the aim of repeal. In any event, they should not be allowed to impede provisions of HIV / AIDS prevention and care services.

With regard to adult sex work that involves no victimizations, criminal law should be reviewed with the aim of decriminalizing, then legally regulating occupational health and safety conditions to protect sex workers and their clients, including support for safe sex during sex work. Criminal law should not impede provisions of HIV / AIDS prevention and care services to sex workers and their clients. Criminal law should ensure that children and adult sex workers who have been trafficked or otherwise coerced into sex work are protected from participation in the sex industry and are not prosecuted for such participation but rather are removed from sex work and provided
with medical and psycho-social support services, including those related to HIV. 

Criminal law should not be in impediment to measures taken by States to reduce the risk of HIV transmission among injecting drug users and to provide HIV - related care and treatment for injecting drug users. Criminal law should be reviewed to consider: 
The authorization or legalization and promotion of needle and syringe
exchange programmes;  The repeal of criminalizing the possession, distribution and dispensing of needles and syringes. 
Prison authorities should take all necessary measures, including adequate staffing, effective surveillance and appropriate disciplinary measures, to protect prisoners from rape, sexual violence and coercion. Prison authorities should also provide prisoners (and prison staff, as appropriate), with access to HIV - related prevention information, education, voluntary testing and counselling, means of prevention (condoms, bleach and clean injection equipment), treatment and care and voluntary participation in HIV - related clinical trials, as well as ensure confidentiality, and should prohibit mandatory testing, segregation and denial of access to prison facilities,privileges and release programmes for HIV- positive prisoners.Compassionate early release of prisoners living with AIDS should be considered. 
 
Guideline 5: Anti-Discrimination and Protective Laws 
States should enact or strengthen anti-discrimination and other protective laws that protect vulnerable groups, people living with HIV / AIDS and people with disabilities from discrimination in both the public and private sectors that will ensure privacy and confidentiality and ethics in research involving human subjects, emphasize education and conciliation and provide for speedy and effective administrative and civil remedies. 
General anti-discrimination laws should be enacted or revised to cover
people living with asymptomatic HIV infection, people living with AIDS and those merely suspected of HIV or AIDS. Such laws should also protect groups made more vulnerable to HIV / AIDS. Such laws should also protect groups made more vulnerable to HIV/AIDS due to the discrimination they face. Disability laws should also be enacted or revised to include HIV / AIDS in their definition of disability. Such legislation should include the following: 
The areas covered should be as broad as possible,including health care, social security, welfare benefits, employment, education, sport, accommodation, clubs,trades unions, qualifying bodies, access to transport and other services; 
Direct and indirect discrimination should be covered, as
should cases where HIV / AIDS is only one of several
reasons for a discriminatory act, and prohibiting HIV/AIDS
vilification should also be considered; Independent, speedy and effective legal and/or administrative procedures for seeking redress, including
such features as fast-tracking for cases where the complainant is terminally ill, investigator powers to address systemic of discrimination in policies and procedures, ability to bring cases under pseudonym and
representative complaints, including the possibility of public interest organizations bringing cases on behalf of people living with HIV / AIDS; 

Exemptions for superannuation and life insurance should only relate to reasonable actuarial data, so that HIV/AIDS is not treated differently from analogous medical conditions. 

Traditional and customary laws, which affect the status and treatment of
various groups of society should be reviewed in the light of
anti-discrimination laws. If necessary, legal remedies should be made
available, if such laws are misused and information, education and
community mobilization campaigns should be conducted to change these laws and attitudes associated with them. 

General confidentiality and privacy laws should be enacted. HIV - related information on individuals should be included within definitions of
personal/medical data subject to protection and should prohibit the
unauthorized use and/or publication of HIV- related information on
individuals. Privacy legislation should enable an individual to see his or her own records event, complete and up to date. An independent agency should established to redress breaches of confidentiality. Provision should be made for professional bodies to discipline cases of breaches of confidentiality as professional misconduct under codes of conduct discussed below. Unreasonable invasion of privacy by the media could also be included as a component of professional codes governing journalists.
People living with HIV / AIDS should be authorized to demand that their
identity and privacy be protected in legal proceedings in which on these
matters will be raised. 
Laws, regulations and collective agreements should be enacted or reached so as to guarantee the following workplace rights; 
A national policy on HIV/AIDS and the workplace agreed upon in
a tripartite body; 
Freedom for HIV screening for employment, promotion, training or benefits; 
Confidentiality regarding all medical information, including HIV/AIDS status; 

Employment security for workers living with HIV until they are no longer able to work, including reasonable alternative working arrangement 
Defined safe practices for first aid and adequately equipped first-aid kits; Protection for social security and other benefits for workers living with HIV, including life insurance, pension,health insurance, termination and death benefits; Adequate health care accessible in or near
the workplace; Adequate supplies of condoms available free
to workers at the workplace; Workers participation in decision-making on workplace issues related to HIV / AIDS; 

Access to information and education programmes on HIV/AIDS, as well as to relevant counselling and appropriate referral; Protection from stigmatization and discrimination by colleagues, unions, employers and clients; Appropriate inclusion in workers compensation legislation
of the occupational transmission of HIV (e.g. needle stick injuries), addressing such matters as the long latency period of infection, testing, counselling and confidentiality. 

Protection laws governing the legal and ethical protection of human
participation in research, including HIV - related research, should be
enacted or strengthened in relation to: 
Non-discriminatory selection of participants, e.g. women, children, minorities; Informed consent; Equitable access to information and benefits emanating from research; 

Counselling, protection from discrimination, health and support services provided during and after participation; The establishment of local and/or national ethical review committees to ensure independent and ongoing ethical review, with participation by members of the community
affected, of the research project; Approval for use of safe and efficacious pharmaceuticals,vaccines and medical devices. 

Anti-discrimination and protective laws should be enacted to reduce human rights violations against women in the context of HIV/AIDS, so as to reduce vulnerability of women to infection by HIV and to the impact of HIV/AIDS.More particularly, laws should be reviewed and reformed to ensure equality of women regarding property and marital relations and access to oyment and economic opportunity, so that discriminatory limitations are removed on rights to own and inherit property, enter into contracts and marriage, obtain credit and finance, initiate separation or divorce, equitably share assets upon divorce or separation, and retain custody of children.Laws should also be enacted to ensure women's reproductive and sexual rights, including the right of independent access to reproductive and STD health information and services and means of contraception, including safe and legal abortion and the freedom to choose among these, the right to determine number and spacing of children, the right to determine number and spacing of children, the right to demand safer sex practices and the right to legal protection from sexual violence, outside marriage, should be consistent for males and females and the right of women and girls to refuse
marriage and sexual relations should not be treated any differently from any other analogous medical condition in making decisions regarding custody, fostering or adoption. 
 
Anti-discrimination and protective laws should be enacted to reduce human rights violations against children in the context of HIV/AIDS, so as to reduce the vulnerability of children to infection by HIV and to the impact of HIV/AIDS. Such laws should provide for children's access to HIV - related information, education and means of prevention inside and outside school, govern children's access to voluntary testing with consent by the child, in line with the evolving capacities of the child, or by the parent or appointed guardian, as appropriate, should protect children against mandatory testing, particularly if orphaned by HIV/AIDS, and provide for other forms of protection in the context of orphans, including inheritance and/or support.Such legislation should also protect children against sexual abuse, provide for their rehabilitation if abused and ensure that they are considered
victims of wrongful behaviours, not subject to penalties themselves.
Protection in the context of disability laws should also be ensured for
children. 
 
Anti-discrimination and protective laws should be enacted to reduce human rights violations against men having sex with men, including in the context of HIV/AIDS, in order, inter alia, to reduce the vulnerability of men who have sex with men to infection by HIV and to the impact of HIV/AIDS.These measures should include providing penalties for vilification of peoplewho engage in same-sex relationships, giving legal recognition to same-sex marriages and/or relationships and governing such relationships with consistent property, divorce and inheritance provisions. The age of consent to sex and marriage should be consistent for heterosexual and homosexual relationships. Laws and police practices relating to assaults adequate legal protection is given in these situations. 

Law and regulations that provide for restrictions on the movement or
association of members of vulnerable groups in the context of HIV/AIDS
should be removed in both law (decriminalized) and law enforcement. 

Public health, criminal and anti-discrimination legislation should prohibit
mandatory HIV - testing of targeted groups, including vulnerable groups. 
 
Guideline 6: Regulation of Goods, Services and Information 
States should enact legislation to provide for the regulation of HIV-related goods, services and information, so as to ensure widespread availability of qualitative prevention measures and services, adequate HIV prevention and care information and safe and effective medication at an affordable price. 
Laws and/or regulations should be enacted to enable implementation of a policy of widespread provisions of information about HIV/AIDS through the mass media. This information should be aimed at the general public, as well as at various vulnerable groups that may have difficulty in accessing such information. HIV/AIDS information should be effective for its designated audience and not be inappropriately subject to censorship or other broadcasting standards. 

Laws and/or regulations should be enacted to ensure the quality and
availability of HIV tests and counselling. If home tests and/or rapid HIV test kits are permitted on the market, they should be strictly regulated to ensure quality and accuracy. The consequences of loss of epidemiological information, the lack of accompanying counselling and the risk of unauthorized uses, such as for employment at immigration, should be addressed. Legal and social support services should be established to protect individuals from abuses arising from such testing. 

Legal quality control of condoms should be enforced and compliance with the International Condom Standard should be monitored in practice.Restrictions on the availability of preventive measures, such as condoms, bleach, clean needles and syringes, should be repealed and the provision of these through vending machines in appropriate locations should be considered, in the light of the increased accessibility and anonymity afforded to clients by this method of distribution. 
Duties, customs laws and value-added taxes should be revised so as to
maximize access to safe and effective medication at an affordable price. 

Consumer protection laws or other relevant legislation should be enacted or strengthened to prevent fraudulent claims regarding the safety and efficacy of drugs, vaccines and medical devices, including those relating to HIV/AIDS. 
 
Guideline 7: Legal Support Services 
States should implement and support legal support services that will
educate people affected by HIV/AIDS about their rights, provide free legal services to enforce those rights, develop expertise on HIV- related legal issues and utilize means of protection in addition to the courts, such as offices of Ministries of Justice, ombudspersons, health complaint units and human rights commissions. 

States should consider the following features in establishing such services: 
State support for legal aid systems specializing in HIV/AIDS case work,
possibly involving community legal aid centres and/or legal services
based in ASOs; 
State support or inducements (e.g. tax reduction) to private sector law
firms to provide free pro bono services to PLHAs in areas such as
anti-discrimination and disability, health-care rights (informed consent and confidentiality), property (wills, inheritance) and employment law; 
State support for programmes to educate, raise awareness and build
self-esteem among PLHAs concerning their rights and/or to empower them to draft and disseminate their own charters/declarations of legal and human rights; State support for production and dissemination of HIV/AIDS legal  rights brochures, resource personnel directories, handbooks, practice manuals, student texts, model curricula for law courses and continuing legal education and newsletters to encourage information exchange and networking should also be provided. Such publications could report on case-law, legislative reforms, national enforcement and monitoring systems for human rights abuses; 
State support for HIV legal services and protection through a variety of
officers, such as Ministries of Justice, procurator and other legal offices,
health complaint units, ombudspersons and human rights commissions. 

Commentary on Guidelines 3 to 7 
Since laws regulate conduct between the State and the individual and
between individuals, they provide an essential framework for the
observance of human rights, including HIV-related human rights. The
efficacy of this framework for the protection of human rights depends on
the strength of the legal system in a given society and on the access of its citizens to the system. However, many legal system worldwide are not strong enough, nor do marginalized populations have access to them. 
Nevertheless, the role of law in the response to HIV/AIDS may also be
overemphasized and provide a vehicle for coercive and abusive policies.
Although law may have an educative and normative role and may provide an important supportive framework for human rights protection and HIV/AIDS programmes, it cannot be relied upon as the only means by which to educate, change attitudes, achieve behavioural change or protect people's rights. Guidelines 3 to 7 above are, therefore, meant to encourage the enactment of meaningful and positive legislation, to describe the basic legal components necessary to provide support for the protection of HIV-related human rights and effective HIV prevention and care programmes and to be supplemented by all other Guidelines set out in this document. 
 
Guidelines 3 to 6
encourage law and law reform, which would bring national HIV - related laws into conformity with international and regional human rights standards. Although the content of the strategies primarily addresses
formal law, law reform should also encompass traditional and customary laws. The process of HIV/AIDS law review and reform should be incorporated into the State's general activities regarding the observance of human rights norms and be integrated into the national AIDS response,whilst involving the affected communities, ensuring that existing legislation does not act as an impediment to HIV prevention and care programmes (for the general population, as well as for vulnerable groups) and protecting individuals against discrimination by both government actors and private individuals or institutions. It is recognized that some of the recommendations for law and law reform, particularly those concerning the status of women, drug use, sex work and the status of men having sex with men, might be controversial in particular national, cultural and religious contexts. However, these Guidelines are recommendations to States: they are based on existing international human rights standards and designed to achieve a pragmatic approach to public health goals relative to HIV/AIDS.It is the obligation of States to establish how they can best meet their
international human rights obligations and protect the public health within their political, cultural and religious contexts. The Office of the United Nations High Commissioner for Human Rights, UNAIDS, its relevant co-sponsors and other Untied Nations bodies and agencies, such as the International Labour Organizations, can offer Governments technical assistance in the process of law review and reform. 

Guideline 7 urges that States (and the private sector) encourage and
support specialist and generalist legal services to enable PLHAs and
affected communities to enforce their human and legal rights through the use of such services. Information and research resources on legal and human rights issues should also be made available. Such services should also address the issue of reducing the vulnerability to infection within and the impact of HIV/AIDS on vulnerable groups. The location and format of the information (e.g. plain and understandable language) provided via such services should render it accessible to members of these groups. Models exist in many countries. 
C. Promotion of a supportive and enabling environment 

Guideline 8: Women Children and other Vulnerable Groups States should, in collaboration with and through the community, promote a
supportive and enabling environment for women, children and other
vulnerable groups by addressing underlying prejudices and inequalities
through community dialogue, specially designed social and health services and support to community groups. 

States should support the establishment and sustainability of community associations comprising members of different vulnerable groups for peer education, empowerment, positive behavioural change and social support. 

States should support the development of adequate, accessible and
effective HIV-related prevention and care education, information and
services by and for vulnerable communities and should actively involve such communities in the design and implementation of these programmes. 

States should support the establishment of national and local forums to
examine the impact of the HIV/AIDS epidemic on women. They should be multisectoral to include government, professional, religious and community representation and leadership and examine issues such as:
The role of women at home and in public life: 
The sexual and reproductive rights of women and men,including women's ability to negotiate safer sex and make reproductive choices; 
Strategies for increasing educational and economic opportunities for women; Sensitizing service deliverers and improving health care
and social support services for women; The impact of religious and cultural traditions on women. 
States should implement the Cairo Programme of Action of the International Conference on Population and Development and the Beijing Declaration and Platform for Action of the Fourth World Conference on Women. Primary health services, programmes and information campaigns in particular should include a gender perspective. Violence against women, harmful traditional practices, sexual abuse, exploitation, early marriage and female genital mutilation, should be eliminated. Positive measures, including formal and informal education programmes, increasing work opportunities and support services, should be established. 

States should support women's organizations to incorporate HIV/AIDS and human rights issues into their programming. 

States should ensure that all women and girls of child-bearing age have
access to accurate and comprehensive information and counselling on the prevention of HIV transmission and the risk of vertical transmission of HIV, as well as access to the available resources to minimize that risk, or to proceed with childbirth, if they so choose. 

States should ensure the access of children and adolescents to adequate health information and education, including information related to HIV/AIDS prevention and care, inside and outside school, which is tailored appropriately to age level and capacity and enables them to deal positively and responsibly with their sexuality. Such information should take into account the rights of the child to access to information, privacy, confidentiality, respect and informed consent and means prevention, as well as the responsibilities, rights and duties of parents. Efforts to educate children about their rights should include the rights of persons, including children, living with HIV/AIDS. 

States should ensure that children and adolescents have adequate access to confidential sexual and reproductive health services, including HIV/AIDS information counselling, testing and prevention measures such as condoms, and to social support services if affected by HIV/AIDS. The provision of these services to children/adolescents should reflect the appropriate balance between the rights of the child/adolescent to be involved in decision-making according to his or her evolving capabilities and the rights and duties of parents/guardians for the health and well-being of the child. 

States should ensure that persons employed to child-care agencies,
including adoption and foster-care homes, receive training in the area of
HIV-related children's issues in order to deal effectively with the special
needs of HIV-affected children including protection from mandatory testing,discrimination and abandonment. 

States should support the implementation of specially designed and
targeted HIV prevention and care programmes for those who have less
access to mainstream programmes due to language, poverty, social or legal or physical marginalization, e.g. minorities, migrants, indigenous peoples, refugees and internally displaced persons, people with disabilities, prisoners,sex workers, men having sex with men and injecting drug users. 

Commentary on Guideline 8 
States should take measures to reduce the vulnerability, stigmatization and discrimination that surround HIV/AIDS and promote a supportive and enabling environment by addressing underlying prejudices and inequalities within societies and a social environment conductive to positive behaviour change. An essential part of this enabling environment involves the empowerment of women, youth and other vulnerable groups to deal with HIV/AIDS by taking measures to improve their social and legal status,involving them in the design and implementation of programmes and assisting them to mobilize their communities. The vulnerability of some groups is due to their limited access to resources, information, education and lack of autonomy. Special programmes and measures should be designed to increase access. In many countries, community-based organizations and NG0s have already begun the process of creating a supportive and enabling environment in their response to the HIV epidemic.Governments must recognize these efforts and lend moral, legal, financial and political support to strengthen them.. 

Guideline 9:
Changing Discriminatory Attitudes Through Education,Training and the Media 
States should promote the wide and ongoing distribution of creative
education, training and media programmes explicitly designed to change attitudes of discrimination and stigmatization associated with HIV/AIDS to understanding and acceptance.,/p> 

States should support appropriate entities, such as media groups, NG0s and networks of PLHAS, to devise and distribute programming to promote respect for the rights and dignity of PLHAs and members of vulnerable groups, using a broad range of media (film, theatre, television, radio, print, dramatic presentations, personal testimonies, Internet, pictures, bus posters). Such programming should not compound stereotypes about these groups but instead dispel myths and assumptions about them by depicting them as friends, relatives, colleagues, neighbours and partners.Reassurance concerning the modes of transmission of the virus and the safety of everyday social contact should be reinforced. 

States should encourage educational institutions (primary and secondary schools, universities and other technical or tertiary colleges, adult and continuing education), as well as trades unions and workplaces to include HIV/AIDS and human rights/non-discrimination issues in relevant curricula, such as human relationships, citizenship/social studies, legal studies, health care, law enforcement, family life and/or sex education, and welfare/counselling. ,/p. 

States should support HIV-related human rights/ethics training/workshops for government officials, the police, prison staff, politicians, as well as village, community and religious leaders and professionals. 

States should encourage the media and advertising industries to be
sensitive to HIV/AIDS and human rights issues and to reduce sensationalism in reporting and the inappropriate use of stereotypes, especially in relation to disadvantaged and vulnerable groups. A training approach of this kind should include the production of useful resources, such as handbooks containing appropriate terminology, which would serve to eliminate use of  stigmatizing language; and a professional code of behaviour in order to ensure respect for confidentiality and privacy. 

States should support targeted training, peer education and information
exchange for PLHA staff and volunteers of CB0s and AS0s as well as for leaders of vulnerable groups as a means of raising their awareness of
human rights and have the means to enforce these rights. Conversely,
education and training should be provided on HIV-specific human rights
issues to those working on other human rights issues. 

States should support the use of alternative efforts such as radio
programmes or facilitated group discussions to overcome access problems for individuals who are located in remote or rural areas, are illiterate,homeless or marginalized and without access to television, films and videos and specific ethnic minority languages. 

Commentary on Guideline 9 
The use of formal standards and their implementation through government process and law alone cannot change the negative attitudes and prejudices surrounding HIV/AIDS into respect for human rights. Public programming explicitly designed to reduce the existing stigma has been shown to help create a supportive environment, which is more tolerant and understanding. The reach of such programming should be a mixture of general and focused programmes using various media, including creative and dramatic presentations, compelling ongoing information campaigns for tolerance and inclusion and interactive educational workshops and seminars. The goal should be to challenge beliefs based on ignorance, prejudices and punitive attitudes by appealing to human compassion and identifying with visible individuals. Programming based on fear can be counter-productive by engendering discrimination through panic. 

Guideline 10: Development of Public and Private Sector Standards 
And Mechanisms for Implementing These Standards 41.States should ensure that government and the private sector develop codes of conduct regarding HIV/AIDS issues that translate human rights principles into
codes of professional responsibility and practice, with accompanying mechanisms to implement and enforce these codes. 

States should require or encourage professional groups, particularly
health-care professionals, and other private sector industries (e.g. law,
insurance) to develop and enforce their own codes of conduct addressing human rights issues in the context of HIV/AIDS. Relevant issues would include confidentiality, informed consent to testing, the duty to treat, the duty to ensure safe workplaces, reducing vulnerability and discrimination and practical remedies for breaches/misconduct. 

States should require that individual government departments devise clear guidelines on the extent to which their policies and practices reflect HIV-related human rights norms and their enforcement in formal legislation and regulations, at all levels of service delivery. Coordination of these standards should occur in the national framework described in Guideline1 and be publicly available, after involvement of community and professional groups in the process. 

States should develop or promote multisectoral mechanisms to ensure
accountability. This involves the equal participation of all concerned (i.e.
government agencies, industry representatives, professional associations,NG0s, consumers, service providers and service users). The common goal should be to raise standards of service, strengthen linkages and communication and assure the free flow of information. 

Commentary on Guideline 10 
41.The development of standards in and by the public and private sectors is important. First, they translate human rights principles into practice from an insider's perspective and reflect more closely the community's concerns. Second, they are likely to be more pragmatic and acceptable to the sector involved. Third, they are more likely to be "owned" and implemented if developed by the sector itself. Finally, they might have a more immediate impact than legislation.