The next phase of HIV decriminalisation: closing the translation gap

Last month, I wrote about the limits of relying on “U=U” as the primary message for HIV decriminalisation. In doing so, I also reflected on how “U=U” has transformed the lives of people living with HIV. Grounded in compelling science and amplified through years of advocacy, it has become a powerful message of hope, dignity and self-acceptance. Its success also demonstrates something broader: science changes lives only when it is translated into policy, practice and public understanding.

HIV criminalisation reminds us that translating science into justice remains unfinished. Forty-five years into the HIV epidemic, advances in HIV science have fundamentally transformed our understanding of transmission, treatment and prognosis. Yet people living with HIV continue to be investigated, prosecuted and imprisoned based on outdated assumptions about risk and harm.

This contradiction formed the basis of my presentation yesterday at AIDS 2026, the 26th International AIDS Conference in Rio de Janeiro. The question I posed was simple: Why does HIV criminalisation persist despite contemporary HIV science? The answer, I argued, lies in what I call the translation gap: the persistent failure – or refusal – to translate contemporary HIV science into law, policy and practice.

Scientific evidence does not change society on its own. It changes society only when institutions choose to translate it into legal standards, public policy and everyday practice. That process is never purely technical; it is shaped by politics, power and values.

The evidence for this is clear. Over the past decade, 50 jurisdictions across 28 countries have moved towards HIV decriminalisation through legislative reform, constitutional and supreme court decisions, and updated prosecutorial guidance. Together, these reforms demonstrate that when contemporary HIV science is effectively translated into law and policy, legal systems do change.

But progress has been highly uneven. In some parts of the world, reform has accelerated. In others, it has barely begun. At the same time, the HIV Justice Network’s Global HIV Criminalisation Database continues to document new prosecutions around the world, suggesting that the pace of reform has slowed.

The challenge facing the HIV justice movement has therefore evolved. In many countries, the problem is no longer simply HIV-specific criminal laws. Increasingly, criminalisation is sustained through the interaction of criminal law, public health systems, policing, politics, and stigma.

Our recent research illustrates this shift. In Uzbekistan, for example, HIV criminalisation often begins long before anyone enters a courtroom. Mandatory registration, public health surveillance, referrals from healthcare providers to law enforcement, and the use of medical records as evidence all demonstrate how healthcare systems themselves can become part of the machinery of criminalisation.

Recognising this changes what justice requires. Contemporary HIV science requires greater legal precision. Non-disclosure is not the same as intent. Perceived risk is not the same as actual risk. An allegation of HIV transmission is not proof of who transmitted HIV, and establishing the direction of transmission often requires scientific evidence that courts fail to consider or misinterpret. Even where harm has occurred, criminal punishment is not automatically the appropriate response.

But science alone cannot produce these changes. Translation depends on institutions that value evidence, independent courts, governments willing to act and civil society organisations able to advocate for reform. Increasingly, these conditions are being undermined by broader attacks on public health, human rights and democratic institutions.

This is where structural violence helps explain why the translation gap persists. Scientific evidence alone is insufficient because law does not operate independently of politics or power. Organised anti-rights movements have become increasingly influential in reshaping the political environments in which legal reform takes place. As civic space shrinks and scientific expertise is challenged, translating contemporary HIV science into law becomes increasingly difficult.

Yet communities continue to create pathways to justice. Even where legal reform is blocked, advocates document prosecutions, provide legal literacy and paralegal support, engage international human rights mechanisms, influence global health policy and support those living under punitive laws. Communities do not simply wait for the law to change; they continue creating opportunities for justice despite the obstacles they face.

That is why the next phase of HIV decriminalisation is not simply about changing more laws. It is about closing the translation gap. Yesterday we launched the Guidance on Good Practices in HIV Decriminalisation. The Guidance brings together contemporary HIV science, legal expertise and the experience of communities around the world to support countries wherever they are on the journey towards HIV decriminalisation.

Closing the translation gap requires more than scientific evidence. It requires practical tools that help governments, courts, advocates and communities translate that evidence into action. The Guidance is designed to be one of those tools.

The success of “U=U” demonstrates what is possible when science is translated into practice. The persistence of HIV criminalisation demonstrates what happens when the translation of science into justice is resisted. Closing that translation gap is now the central challenge for HIV justice. The new Guidance is intended to help meet that challenge by helping ensure that science is translated into justice.

From Courtrooms to Communities:
Funding Advocacy to Sustain HIV Responses

Our Executive Director’s remarks on today’s webinar aimed at philanthropic funders, convened by Funders Concerned About AIDS.

Today, I’ll be connecting two major forces shaping the global HIV response: the wave of criminalisation targeting people living with HIV, people most vulnerable to HIV, and their advocacy organisations, as well as the expanding reach and impact of the Global Gag Order.

Both of these reflect the same problem – the use of law and policy to control bodies, silence communities, and restrict access to health and rights. By the end of this webinar, I hope it will be crystal clear why funding advocacy remains the single highest-impact investment funders can make.

The HIV Justice Network, which I lead, works to end the unjust use of criminal law against people living with HIV worldwide. We document laws and cases, support and train advocates, and co-ordinate the HIV JUSTICE WORLDWIDE coalition – connecting the global to local and back again, linking community organisations, lawyers, and human rights defenders across all regions of the world to reform laws and prosecutorial practices.

HIV criminalisation remains stubbornly and worryingly widespread. More than 130 countries have used criminal law against people living with HIV accused of non-disclosure, potential or perceived HIV exposure or unintentional HIV transmission. Currently, 83 countries have HIV-specific criminal laws. Others use general criminal laws like “bodily harm”, “endangering health,” and even “attempted murder.”

These laws, and their application, are often based on outdated science and moral panic. They make people living with HIV to be singularly responsible for HIV prevention. They punish us for transmission risks that no longer exist in the era of treatment as prevention – and consider the harm of HIV to be so exceptional they have special laws, or prosecutions, that specifically target people diagnosed HIV-positive. No other communicable disease is treated so problematically in law.

But HIV criminalisation doesn’t exist in isolation. It is part of a broader ecosystem of criminalisation that targets the very communities most affected by HIV – sex workers, migrants, people who use drugs, and LGBTQ+ people. When these populations are criminalised, they are pushed underground, excluded from health services, and made more vulnerable to violence and exploitation.

HIV criminalisation also has a gendered impact. Women are often the first to be diagnosed, especially during pregnancy, and therefore the first to face prosecution. In some countries, pregnant women living with HIV have been charged with endangering their unborn child or accused of transmission through breastfeeding.

Gender-based violence, unequal access to legal representation, and social stigma amplify these injustices. At the same time, the criminalisation of sex work and gender nonconformity exposes women – particularly trans women – to harassment and violence from authorities.

And increasingly, advocacy organisations themselves are being restricted by laws that limit freedom of association, deny foreign funding, or create a chilling effect through so-called “anti-propaganda” or “foreign agent” measures. In more and more countries, simply speaking out against criminalisation is considered to be subversive.

And then there is the Global Gag Order, reinstated and expanded in early 2025 under the Protecting Life in Global Health Assistance policy. This policy prohibits non-U.S. NGOs receiving U.S. global health funds from providing, referring for, or even discussing abortion as a method of family planning – even when using their own, non-U.S. resources. It now applies to all U.S. global health assistance, including HIV funding.

For communities and organisations already constrained by criminal laws, the gag order adds another layer of silencing.
• It disrupts integrated HIV and reproductive-health services.
• It forces organisations to choose between funding and integrity.
• It weakens partnerships built over decades of global health cooperation.
• And it amplifies the chilling effect – discouraging advocacy, speech, and even data collection on reproductive rights.

Once again, women and girls bear the brunt. When abortion access is restricted, maternal deaths rise, and the same clinics providing HIV care lose their ability to deliver comprehensive, rights-based health services.

So when we talk about decriminalisation, we’re not just talking about repealing one set of laws. We’re talking about defending the space for civil society, for public health, and for human rights to function at all.

Despite these challenges, advocacy works. Here’s some examples – with a focus on HIV decriminalisation.
• In the US, in the past year alone, Maryland and North Dakota have repealed their HIV-specific criminal laws, while Tennessee removed mandatory sex offender registration for HIV-related convictions.
• In Mexico, again thanks to community leadership, five states have repealed vague “danger of contagion” laws used for HIV criminalisation, with more to come.
• In EECA, civil society in Ukraine is working right now with parliamentary champions to remove an HIV criminalisation law from its criminal code, despite being in the middle of a war.
• In Africa, sustained community advocacy led to the repeal of Zimbabwe’s HIV-specific criminal law and the prevention of a new HIV criminalisation law in Malawi.

But these victories didn’t happen overnight. They resulted from years of partnership between communities, legal and scientific experts, and funders willing to invest in advocacy infrastructure.

Community-led organisations are the foundation of all this progress. We are the early-warning systems when new laws are proposed, and we are the first responders when individuals face charges. We mobilise people living with HIV, key population and women’s networks, and human rights defenders to speak directly with policymakers, prosecutors, and the media.

Philanthropy has a crucial role here. Advocacy funding remains a small fraction of global HIV philanthropy, yet it has exponential impact. Advocacy capacity cannot be switched on only when a law or case hits the headlines. It requires continuity, institutional memory, and relationships built over time.

Funding advocacy protects every other investment in prevention, treatment, and care. Without enabling environments – without legal and policy reform – those investments cannot succeed.

Funders can make the difference by:
• Providing core, flexible, multi-year support that allows community-led groups to stay engaged between crises.
• Investing in coalitions and regional and global networks, like HIV JUSTICE WORLDWIDE, linking legal, scientific and human rights expertise with communities.
• Supporting data, storytelling, and knowledge translation – turning lived experience and evidence into policy change.
• Protecting civil-society space, especially where advocacy itself is criminalised or restricted.

To close, I want to leave one thought: HIV justice is prevention.

Every law that criminalises people living with HIV, every law that targets LGBTQ+ people, sex workers, people who use drugs, or migrants – and every funding policy that silences reproductive rights – makes the global epidemic harder to end.

Ending AIDS requires more than medicines. It requires dismantling the legal and policy barriers that drive people away from care and from each other.

Ending HIV criminalisation is achievable. We have the science, the evidence, and the community power to do it. What we don’t always have is flexible, sustained, core funding. Advocacy is not optional; it is infrastructure – the connective tissue that holds the HIV response together.

Philanthropy has both the freedom and the responsibility to keep that justice space open – ensuring that evidence, human rights, and community leadership remain at the heart of the global HIV response.

That is how we move from courtrooms to communities – and closer to ending AIDS as a public-health and human-rights crisis.

HJN’s Executive Director remarks to the
56th UNAIDS Board (PCB)

These remarks were made during the discussion of the proposed new Global AIDS Strategy (2026-31), the outline of which can be found here.

I’m the Executive Director of the HIV Justice Network, speaking on behalf of HIV JUSTICE WORLDWIDE, a coalition of community-led and community-based organisations working to end HIV criminalisation and related injustices.

Last June, I was a panellist during the Thematic Meeting on the Sustainability of HIV Response. You may recall that I highlighted that decriminalisation not only saves lives but it also saves money.

And so we welcome the direction of the new Global AIDS Strategy – especially Priority 2: People-focused – equity, dignity, and access, and Priority 3: Powered communities leading the HIV response, and the related results areas 6: End stigma and discrimination and uphold human rights and gender equality, and 8. Ensure community leadership.

But these priorities and results will remain aspirational unless they are backed by sustained, core funding for community-led networks.

Like UNAIDS itself, the HIV justice movement was born out of crisis, but it is sustained by hope. We know change is possible because we’ve seen it, even under the most difficult conditions. In fact, in just the past five years, 25 jurisdictions in 11 countries have repealed or revised their HIV criminalisation laws – motivated by everything from the futility of enforcement to the need to uphold privacy rights, recognise up-to-date science, and avoid harm to public health.

We have been making progress. But it is patently clear we cannot take any of that progress for granted. Communities, even if they and their organisations are criminalised, will continue to do much of the heavy lifting – reaching those who are excluded, challenging stigma and discrimination, and holding legal systems and governments accountable. That work takes time, trust, and skills – and it’s only possible when core funding is available to sustain expert teams and nurture leadership.

Global networks like ours are crucial in this ecosystem. With core, flexible funding – such as that provided by the Robert Carr Fund which has supported much of our work over the past decade – we support regional and national partners, strengthen the evidence base, build local advocacy capacity, and amplify community voices, including HIV criminalisation survivors. And we complement – not duplicate – Global Fund investments at the country level.

If we want a strategy that results in HIV justice, one that prioritises decriminalisation and is powered by communities, we must also continue to fund those communities that have brought us this far.

Humanising the Law: Harnessing Science and
Community Voices to End HIV Criminalisation

Speech delivered on the final morning plenary session of the 16th AIDSImpact Conference, Casablanca, 28th May 2025

Good morning.

I am deeply honoured to stand here with you today in Casablanca – a city whose name evokes stories of resistance and solidarity – to share our own story of resistance and solidarity: the global movement to end HIV criminalisation.

It’s especially meaningful to be back at AIDSImpact. Because, you see, this is where it all began for me. Eighteen years ago, in Marseille, I stood on a stage like this one, trembling slightly, as I spoke publicly for the very first time about HIV criminalisation.

I had no idea that moment would change the course of my life – or that it would help spark a movement that continues to grow today.

Later that same year, NAM – where I worked as an HIV treatment journalist – published my first book on the subject aimed at explaining HIV science and social science to the criminal legal system, and I started a blog – Criminal HIV Transmission – as a way of documenting the mounting number of unjust prosecutions and problematic new laws taking place across the world.

What started as a mostly solitary – and primarily UK-focused – effort quickly became a shared and surprisingly international one.

By AIDS 2008 in Mexico City, I began to understand that my blog was becoming a de facto global network, and many of the cases it documented were cited by South African Justice Edwin Cameron when, during his now-legendary plenary, he called for a global movement to end HIV criminalisation.

That same year UNAIDS and UNDP released guidance opposing overly broad criminal laws, and it was clear that something was shifting.

Two years later, at AIDS 2010 in Vienna we – that is NAM, GNP+, and the Canadian HIV/AIDS Legal Network – convened the first-ever pre-conference on HIV criminalisation. It brought together scientists, advocates, lawyers, and most importantly, people living with HIV. I had planned to start the HIV Justice Network then, but a consultancy job at UNAIDS, providing scientific and legal support for clear guidance to limit the overly broad use of the criminal law, kept me busy.

So it wasn’t until 2012, when we gathered in Oslo at a UNAIDS consultation on HIV and the criminal law, that the network finally came together. On the sidelines of the consultation, key representatives of civil society worked together to draft the Oslo Declaration on HIV Criminalisation – a ten-point call to action that was endorsed by more than 1700 individuals and organisations from 130 countries and, to my astonishment, also appeared as an appendix to the official UNAIDS guidance note that was published in 2013.

The Oslo Declaration became the founding document of the HIV Justice Network. From that point on, we were no longer reacting – we were organising.

By AIDS 2014 in Melbourne, with the support of several Australian and international HIV organisations, we held the Beyond Blame pre-conference, where our first major victory was announced: the repeal of the Australian state of Victoria’s HIV-specific criminal law. We knew then that change was possible.

In 2015, we joined forces with ARASA, the HIV Legal Network, GNP+, the Sero Project, and Positive Women’s Network–USA to form a powerful global consortium. With support from the Robert Carr Fund, we launched the HIV JUSTICE WORLDWIDE coalition in 2016, committing ourselves to collective action against the unjust criminalisation of people living with HIV.

Together, we developed a range of advocacy tools and resources, including the Expert Consensus Statement on the Science of HIV in the Context of Criminal Law, launched at AIDS 2018 in Amsterdam. The Consensus Statement translated complex science – about viral load, transmission routes, treatment effectiveness, and HIV forensics – into language that courts and lawmakers could understand.

Because the truth is: the law had not kept pace with science. Outdated laws continued to criminalise people living with HIV as though it were still the ‘90s. And behind each of these prosecutions was a human life: interrupted, humiliated, punished, often for simply living with a virus.

Today we know that people living with HIV on effective treatment cannot transmit the virus. U=U is not just a slogan – it’s a scientific fact. And that message has been useful in limiting unjust prosecutions, primarily in the global North.

But HIV criminalisation is a global phenomenon, and we cannot rely on science alone as an argument against HIV criminalisation, especially in places where access to treatment or viral load testing is limited or is being taken away; nor in this brave new world of integration, where treatment or prevention is only likely to be accessed by people who are not marginalised, stigmatised, or otherwise criminalised.

That’s why our key messaging must always be that making people living with HIV solely responsible – and criminally liable – for HIV prevention is simply wrong: it’s ineffective, counterproductive, and unjust. That’s where storytelling comes in – to shine a spotlight on the human cost. So over the years we made documentaries focusing on the impact of HIV criminalisation on people.

Documentaries like More Harm Than Good – which brought to life all the social science studies that overwhelmingly found mandating disclosure, criminalising non-disclosure, and sending people to prison for potentially exposing or allegedly passing on HIV did the opposite of what lawmakers intended.

And Mwayi’s Story, about a woman in Malawi unjustly prosecuted for briefly comfort-nursing another woman’s baby and the subsequent empowered movement of women living with HIV in Malawi who spoke truth to power and persuaded their Parliament not to pass an HIV-specific criminalisation law.

We wanted to show that these laws and prosecutions do nothing to protect public health – in fact, they undermine in, and they destroy lives in the process. They increase stigma, turning vulnerable people away from prevention, treatment and care services.

And we have never stopped centring the voices of those most harmed.

People like Rosemary Namubiru, a kind, elderly nurse in Uganda, who dedicated her life to caring for others. She was falsely accused of exposing a child to HIV while administering an injection – a claim later shown to be scientifically impossible. Yet she was arrested live on TV, vilified in the press, and imprisoned. Rosemary was a survivor, but she never recovered from what was done to her. When she passed away in 2022, she left behind not only grief and anger, but also a legacy – a reminder of why we do this work. To honour her. To fight for the dignity and rights of people like her. And to ensure that no one else is ever treated the way she was.

And here in Morocco – where people living with HIV and key populations still face stigma, criminalisation, and exclusion – we must also honour the rich legacy of resistance, solidarity, and resilience that continues to inspire advocates demanding justice, dignity, and change.

Throughout this movement, it has always been communities who’ve led the way: survivors who dared to speak their truths; advocates who pushed for reform; scientists who stood up for evidence-based policy; and networks like ours, who bring it all together.

I never imagined, back in 2007, that this would become my life’s work. But here I am, 18 years later, standing before you with immense pride in what we’ve achieved – and profound concern for what we’re up against. Because the truth is: we are facing an existential moment.

Globally, we’ve witnessed the rise of authoritarianism and the anti-rights movement, which along with the funding crisis is leading to a rollback of hard-won human rights, and the erosion of multilateral cooperation.

Some governments are already doubling down on criminalisation – of people and of NGOs – using stigma and fear to justify their repression. And I worry that punitive approaches to HIV prevention will become the new normal, including policing of the bodies and lives of people living with HIV that was considered acceptable in the ‘90s.

And people living with HIV – especially those who are Black, Brown, gay or queer, trans, migrants, sex workers, people who use drugs – will be the first to be caught in the crosshairs.

The HIV justice movement was born out of crisis, but it is sustained by hope. We know change is possible – because we’ve seen it, even under the most difficult conditions. In fact, over the past five years 25 jurisdictions in 11 countries have repealed or revised their HIV criminalisation laws based on a range of reasons – from futility to privacy rights, to recognising up-to-date science, to concerns over the financial, human or public health cost.

We have been making progress. But now we cannot take any of that progress for granted.

This movement belongs to all of us. And together, even with dwindling resources and some formidable enemies, I believe we can still create a world where justice is not just a concept, but a lived reality for every person living with HIV.

Thank you.

Zimbabwe’s victory:
A beacon of hope for HIV justice amid global challenges

In a landmark victory for human rights, Zimbabwe repealed its HIV criminalisation law in 2022, marking a significant step forward in the global fight for HIV justice. This historic reform, detailed in a new case study and documentary by the HIV Justice Network (HJN), was the result of years of dedicated advocacy by Zimbabwean activists, legal experts, and community organisations. Their success serves as both an inspiration and a blueprint for other nations still grappling with punitive HIV laws.

For decades, Zimbabwe’s Section 79 of the Criminal Law Code unfairly targeted people living with HIV criminalising alleged transmission without regard for intent, transmission risk, or scientific evidence. These laws, rooted in stigma rather than science, disproportionately harmed women, but mostly deterred men from seeking testing and treatment. The repeal of Section 79 was a hard-won victory that showcased the power of coalition-building and sustained advocacy.

Yet, as we celebrate Zimbabwe’s progress, we must confront a sobering reality: the global movement for HIV decriminalisation faces an existential crisis due to dwindling funding. Many donors are shifting priorities, putting essential advocacy work at risk. The HIV response itself is in peril, making it even more critical to sustain efforts to challenge unjust laws and protect the rights of people living with HIV.

The HIV Justice Network has been at the forefront of this struggle, playing an irreplaceable role in co-ordinating the global movement against HIV criminalisation. In a recent meeting, our HIV JUSTICE WORLDWIDE coalition partners re-affirmed the immense value of our work, emphasising our deep institutional knowledge, comprehensive legal monitoring, and convening power. Our two databases – the Global HIV Criminalisation Database and Positive Destinations – are vital resources for advocates, helping to expose patterns of injustice and build evidence-based arguments for reform.

Moreover, in environments where local organisations face political or legal risks, we serve as a powerful global voice, shining a spotlight on abuses and advocating for change. The network’s ability to bring together diverse stakeholders – activists, lawyers, researchers, and policymakers – ensures that no-one is fighting this battle alone.

Despite the funding crisis, the fight for HIV justice has never been more urgent. Punitive, discriminatory, outdated laws and policies continue to undermine public health efforts, fuel stigma, and violate human rights. The repeal of Zimbabwe’s HIV criminalisation law is a powerful reminder that change is possible, but it does not happen in isolation. It requires sustained, co-ordinated efforts – exactly the kind of work that HJN has championed for years.

The Zimbabwean victory is a beacon of hope, but it also serves as a call to action. We must not allow financial constraints to derail the progress we have fought so hard to achieve. Now, more than ever, we need to stand together to ensure that HIV criminalisation becomes a relic of the past. The future of HIV justice – and, therefore, the HIV response itself – depends on it.

HIV Is Not a Crime Awareness Day:
A Call to Action in a Time of Crisis

Today, on HIV Is Not a Crime Awareness Day, we stand in solidarity with people living with HIV and our allies who not only continue to fight criminalisation, discrimination, and stigma, but also the sudden loss of funding amongst rising political opposition. This year, the urgency of our fight has never been clearer. As the devastating consequences of US policy shifts ripple across the world, we are not just advocating for change – we are fighting for our lives.

Last Wednesday, at the UK Parliament, we brought together key stakeholders to highlight how unjust HIV criminalisation laws, arrests and prosecutions persist in the UK and across the Commonwealth. Similar events are taking place globally, reinforcing that this issue transcends borders.

With Zero Discrimination Day tomorrow spotlighting the power of communities in the HIV response, #WeStandTogether – today and every day – to end the unjust laws and policies that punish people not only for living with HIV, but also because of who they are, who they love, or how they make a living. In a world where stigma still shackles and injustice still reigns, HIV Is Not a Crime Awareness Day is not just necessary – it’s urgent.

The fight for justice also brings hope. On Wednesday, 5 March at 9am EST / 3pm CET / 4pm CAT / 5pm EAT, join us for a special webinar with the International AIDS Society’s Heart of Stigma programme (register here), where we will premiere a powerful new documentary and toolkit on Zimbabwe’s successful decriminalisation of HIV. Zimbabwe’s victory proves that change is possible even in challenging political environments.

This is not just a moment. It’s a movement. The time for action is now.

HJN’s Executive Director’s remarks at the UK Parliamentary event commemorating HIV is Not a Crime Awareness Day

Today, on HIV Is Not A Crime Awareness Day, we are here to confront a grave injustice: HIV criminalisation. HIV criminalisation is not a public health tool, it is a human rights violation. It is state-sponsored stigma in its most extreme form.

We are here because people living with HIV are being jailed – even when there was no possibility of transmission – for not being able to prove they disclosed their status. We are here because women with HIV are being prosecuted for breastfeeding, simply for wanting to nourish their children. We are here because HIV criminalisation is never just about HIV.

People living with HIV are often targeted not only for their status but because of who they are, who they love, or how they survive—whether they are LGBTQ+, sex workers, migrants, or belong to other marginalised communities. HIV criminalisation is a proxy for deeper discrimination—rooted in racism, sexism, homophobia, transphobia, and xenophobia. The harshest punishments fall on those at the intersection of multiple stigmas. That’s why our fight must be intersectional and collaborative—because justice for people living with HIV is justice for all.

Our Global HIV Criminalisation Database reveals the scale of the problem:

80 countries have HIV-specific criminal laws.
90 countries have unjustly prosecuted people living with HIV, many of them applying general criminal laws.

But there is hope. Seventeen countries have repealed or reformed their HIV laws in the past decade. Change is happening. Yet, our latest analysis – undertaken by our Policy Analyst, Elliot Hatt – shows that the Commonwealth is falling behind global law reform trends. We cannot let this continue.

18 Commonwealth countries have HIV-specific laws, with four country hot-spots – Canada, the UK, India, and Singapore – accounting for nearly 80% of prosecutions across the Commonwealth.

At the HIV Justice Network, we don’t just highlight the problems – we drive solutions. We connect and support activists. We equip communities with tools, available for free in multiple languages through the HIV Justice Academy.

And we share success stories—like Zimbabwe, where we fought to repeal HIV criminalisation in 2022 and prevented its return in 2024. We will be launching our documentary and toolkit analysing how this was possible in a webinar co-hosted with the International AIDS Society next Wednesday, March 5th. (Register here)

So you see, HIV decriminalisation is possible, even in challenging political environments.

But it takes:

Community leadership—because change starts and ends with those most affected.
Parliamentary action—because laws don’t change without political will.
Global coordination—because no-one can fight this battle alone.
Sustained funding—because without resources, progress stalls.

We are deeply grateful to the Robert Carr Fund for supporting us over the past nine years, ensuring that the fight for HIV justice has borne fruit. But let me be clear—this fight is far from over.

With the United States and the Netherlands withdrawing their support, we are especially grateful to the UK government for its unwavering support of the Fund. But we are at a crossroads. The survival of the Fund, and the HIV Justice movement – of the organisations, networks, and communities working tirelessly to end HIV criminalisation – is now at risk.

This is not just a funding gap. This is a threat to progress.

Law reform does not happen overnight. It requires sustained, long-term, and flexible funding to build the momentum needed to dismantle unjust laws and systems that have oppressed people living with HIV for decades.

Without continued investment, we risk losing the gains we’ve fought so hard for. We risk silencing the voices of those on the frontlines. We risk leaving the most vulnerable people behind, afraid to access HIV services and to live fulfilling lives in dignity.

So, thank you for your support. And thank you to those funders in the room who understand that HIV is not a crime, and that real, lasting change takes time.

Advocacy, movement-building, and legal reform are not quick wins—but they are essential. If we want to achieve HIV justice worldwide then we must ensure that this work continues. The future of the HIV response – and the lives of 40 million people – depends on it.

HJN’s Executive Director’s remarks at the UNAIDS Board Meeting on the sustainability of the HIV response

UNAIDS Programme Coordination Board (PCB) Thematic Meeting on the Sustainability of HIV Response

Round Table 1: The context and urgency of sustainability planning and response

Remarks from Edwin J Bernard, Executive Director, HIV Justice Network, Netherlands on community leadership to address human rights barriers

I am a gay man who acquired HIV 41 years ago in 1983. It was a significant year in other ways too:

HIV was first identified as the cause of AIDS
WHO held its first global AIDS meeting
Richard Berkowitz and Michael Callen published ‘how to have sex in an epidemic’ inventing condom-based safer sex
And a small group of people living with AIDS became the first community leaders in the HIV response, creating the Denver Principles, the blueprint for GIPA and MIPA principles now embedded in UNAIDS’ approach to community leadership to address human rights barriers.

Communities involve many different groups, working locally, nationally, regionally and globally. We are communities of women, men and youth living with HIV in all our diversities, as well as communities of gay men and other men who have sex with men, communities of sex workers, communities of transgender people, communities of people who use drugs. We are the key populations

And then there are communities of allies – human rights defenders who understand that public health is human rights and vice versa.

Despite member states committing to removing these human rights barriers in the 2021 Political Declaration – the 10-10-10 targets – we are far from getting anywhere close to achieving these targets because there are still far too many human rights barriers.

These are far too numerous to list, but they include gender inequality and gender-based violence; discrimination when receiving healthcare, in the workplace, in education, and in humanitarian settings; not being able to enter or migrate to a country of which you are not a citizen because of your HIV status; and the growing number of countries with so called ‘foreign agent’ laws that are closing civic space and stifling community leadership.

On top of these, every single member state criminalises one or more of the key populations, fully or partially, and 79 countries have HIV-specific criminal laws that unjustly criminalise HIV non-disclosure, exposure or unintentional transmission.

Ending HIV criminalisation is the focus of my organisation, the HIV Justice Network, and the global HIV JUSTICE WORLDWIDE coalition that we co-ordinate.

We can do this work thanks primarily to the Robert Carr Fund, which recognises the importance of community-led regional and global networks and our key role in addressing human rights barriers impacting the HIV response.

Dismantling discriminatory systems that have been built over decades and that oppress people living with and affected by HIV takes time and money – and needs community leadership.

So, if sustainability means a move to country-led integrated health systems, this will also mean that all the criminalised and marginalised people I’ve just mentioned will be even more left behind than they currently are.

But there’s a cheap and simple solution: decriminalisation!

A 2022 study from the Alliance for Public Health found that cost savings from decriminalisation of drug use could greatly reduce HIV transmission through increased coverage of opioid agonist therapy and antiretroviral therapy among people who use drugs in eastern Europe and central Asia.

Another 2022 study, from the Williams Institute, on the enforcement of HIV criminalisation laws in Tennessee of so called ‘aggravated prostitution’ – when a sex worker arrested for soliciting is found to be living with HIV – and criminal HIV ‘exposure’ – when a person living with HIV is prosecuted for allegedly not disclosing their HIV status before sex that may or may not risk transmission – estimated that the total cost of incarceration in prison for these unjust HIV-related crimes was $3.8 million.

And a 2021 study found that decriminalising sex work in Washington DC would generate over USD 5000 paid in income taxes by each sex worker – because sex work is work, after all! – plus more than USD20,000 in criminal legal system savings per sex worker a year.

If you decriminalise you not only save money you also ensure that every single person living with, or affected by HIV, gets the HIV services they need.

Following the science and basing laws and policies on public health and not morality or stigma saves money.

So, member states, if you just stop wasting money on ineffective, counterproductive criminalisation and invest in proven treatment and prevention programmes, sustainability of the HIV response is within sight.

To get to 2030, and beyond, to end AIDS as a public health threat, we need to ensure that we don’t forget the dignity and rights of people living with and affected by HIV – easy to cut funding for, and hard to measure – and make sure that we include ending all of forms of HIV-related stigma, discrimination and criminalisation and strive for all forms of equality and empowerment.

In the drafting room on Tuesday, the NGO Delegation added criminalisation to the list that included stigma and discrimination, but the final draft you will vote on later today no longer includes mention of criminalisation as a barrier to testing. I implore you commit to ensure that my recommendation to decriminalise to sustain the HIV response is included in any and all decision points that will come out of this meeting.

Key messages summary

Human rights, gender justice and all the other10-10-10 societal enabler targets are essential, non-negotiable aspects of sustainability.
Community leadership is essential to reach 2030 and to sustain the HIV response beyond that date.
Don’t underestimate – or create more barriers for – communities. We are the experts in understanding what is needed to successfully achieve the end of AIDS.
Support communities by funding us, including replenishing the Robert Carr Fund.
The single most cost-effective intervention for every member state is to decriminalise, decriminalise, decriminalise!

Death penalty for unintentional HIV transmission via same-sex sex struck down by Uganda’s Constitutional Court

The recent (April 3rd) ruling by Uganda’s Constitutional Court declaring that the Anti Homosexuality Act of 2023 complies with the Constitution of Uganda – except in only four aspects – was quite rightly roundly condemned by Amnesty International, the Global Fund, Human Rights Watch, International AIDS Society, and UNAIDS, as well as the US Department of State, amongst many others.

Rather than strike down every section of this heinous, draconian anti-gay law, the Court was unanimous in ruling that most of its dangerous, overly broad, and problematic provisions remain in place.

However, in its 200+ page ruling, the Court did find that Sections 3(2)(c), 9, 11(2d) and 14 did not “pass constitutional muster” and were struck down.

Sections 9 and 11(2d) refer to landlords allowing homosexuality to take place on their premises, and section 14 refers to a “duty to report acts of homosexuality” to the police.

But section 3(2)(c) was one of the most heinous of all of the Act’s horrendous provisions, proscribing the death penalty for someone living with HIV who engaged in same-sex sex and where HIV is allegedly passed on.

Aggravated homosexuality (1) A person who commits the offence of homosexuality in any of the circumstances specified in subsection (2) commits the offence of aggravated homosexuality and is liable, on conviction, to suffer death. (2) (c) the person against whom the offence is committed contracts a terminal illness as a result of the sexual act.

Read the full text of the law here

Both the Court, several petitioners, and UNAIDS – who provided an amicus brief to the Court – correctly interpreted this section as criminalising unintentional HIV transmission when two people of the same sex had sex.

In paragraphs 510-512, the Court referred to several key documents – including the 2011 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and UNAIDS 2013 Guidance Note, Ending overly broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations – and were persuaded that the section did not provide for “the element of criminal intent or mens rea, which is a vital component of the concept of crime.”

The Constitutional Court ruling went on to say:

“This indeed is the approach that was adopted in section 43 of the HIV and AIDS Prevention and Control Act, 2015, which criminalizes the intentional transmission of HIV as follows: ‘a person who wilfully and intentionally transmits HIV to another person commits an offence.’

“Finding no justification for the criminalization of the unintentional transmission of HIV under section 3(2)(c) of the Anti-Homosexuality Act we take the view that it compounds the susceptibility of persons that are HIV+ to mental health issues and thus impedes their right to enjoy the highest attainable standard of mental health, with potential ramifications to their physical health as well. This is a violation of the right to health as envisaged under Article 12(1) of the ICESCR and is inconsistent with Articles 45 and 287 of the Uganda Constitution.”

However, people living with HIV are already over-criminalised in Uganda by various sections of the HIV and AIDS Prevention and Control Act, as summarised in our Global HIV Criminalisation Database.

What is termed as “wilful and intentional” transmission of HIV is punishable by a fine and/or up to ten years’ imprisonment. Section 43 provides a defence if the accused’s partner was aware of, and accepted, the risk of transmission, or transmission occurred during sexual intercourse and protective measures were used. Attempted transmission is punishable by a fine and/or up to five years’ imprisonment. The scope of section 41 is undefined, but cases demonstrate that the law criminalises perceived HIV ‘exposure’ broadly.

Both Section 41 and 43 are known to have been used in a broad range of circumstances, including prosecution of a man for ‘defilement’ (2013), prosecution of a teacher for alleged transmission to his student (2013), the alleged injection of a toddler/needle stick injury (2014), alleged transmission by a woman to a number of young men (2014), alleged breastfeeding of an employer’s child (2018), the arrest, conviction and acquittal of a nurse wrongfully convicted of injecting a baby with HIV-infected blood (2018), and the alleged defilement of a boy by a woman (2019). An earlier prosecution from 2008 involved a man charged with alleged transmission. In the most recent case in 2023, a woman living with HIV pled guilty to charges under section 43 after injecting her 5-year-old son with her blood and was sentenced to seven years’ imprisonment. Cases have generally not used scientific evidence to prove allegations, with convictions at lower-level courts relying only on testimony.

Nevertheless, the recognition of key legal and rights-based arguments against punishing unintentional HIV transmission with the death penalty(!) as part of an otherwise anti-rights, morality-based ruling should be seen as a small but welcome victory. Although this might be seen as similar to the 2022 Lesotho High Court decision on the unconstitutionality of the death penalty in the context of HIV transmission following rape, the difference of course is that that rape is an act of violence that should be criminalised regardless of any other circumstances, whereas consensual sex between two men or two women should never, ever be a crime.

An encouraging start to 2024

This year has begun with some really encouraging news: years of HIV criminalisation advocacy are really paying off.

First, we heard that the Congress of Mexico City completely repealed the crime of “danger of contagion” from the Penal Code. The repeal was approved with an overwhelming majority of 42 votes in favour and only two against. As per the decision, Articles 76 and 130 have been modified to eliminate the criminalisation of people with sexually transmitted infections (STIs), including HIV. This is a direct result of community activism led by the Mexican Network Against HIV Criminalisation. Congresswoman Ana Francis López noted that, with the adoption of this decision, Congress is fulfilling the demands of communities living with HIV that asked not to be discriminated against or punished. Mexico City joins the states of Aguascalientes, Jalisco, Nayarit, San Luis Potosí and Tabasco, where their Penal Codes do not provide for a specific crime for exposure to HIV or STIs.

Then we heard that progress is being made towards HIV decriminalisation in Tajikistan. The recent Plenum of the Supreme Court marked the first step in this important process. One of the most significant changes was the recognition of the fact of placing people at risk of HIV was an unproven basis for criminal prosecution. With almost 200 known HIV criminalisation cases, this process now needs to speed up. Marginalised groups bear the brunt of the implementation of the HIV criminalisation law in Tajikistan; starting in 2014, authorities have regularly targeted sex workers and LGBT people, often under the guise of disease prevention. We remain hopeful that further progress will be made in the near future to ensure that people living with HIV are not unjustly criminalised in Tajikistan.

We also heard welcome news that another country with far too many unjust prosecutions, Singapore, is also moving towards law reform. The Singapore Ministry of Health is currently conducting a review of the law concerning HIV disclosure. This review will hopefully result in changes to current draconian practices and policies that has seen the law used to convict people – usually gay men – where condoms had been used and where the person living with HIV had an undetectable viral load.

And finally, with the support of our HIV JUSTICE WORLDWIDE Francophone Network, led by the HIV Legal Network, civil society groups are urging authorities in Burkina Faso to reconsider the HIV criminalisation provisions contained within its HIV law, Law 030. The call for action reflects a broader effort to improve the health and wellbeing of people living with HIV/AIDS in Burkina Faso and across the continent.

These are but a few examples of the hard work and dedication of so many of us. The global movement to end HIV criminalisation is making significant progress. Let’s keep up the momentum.

Together, we can make HIV JUSTICE WORLDWIDE a reality.