The Irony of HIV Exceptionalism

In the week following AIDS 2026 in Rio, seasoned HIV journalist Mia Malan asked in a Bhekisisa article what happens now that AIDS is no longer exceptional. After decades in which HIV commanded extraordinary political attention, scientific investment, activism and international funding, she wrote, the landscape has changed. Funding is shrinking, treatment has transformed HIV into a manageable condition for people with access to care, and the HIV response is increasingly expected to be integrated into broader health systems.

It is an important question. But from the perspective of HIV justice, I think there is another, more uncomfortable one: What happens now that HIV is no longer exceptional in global health, but it remains exceptional in law?

In the piece I wrote immediately after the conference for the Health and Human Rights Journal, I argued that the political environment surrounding HIV has become increasingly rights-threatening. The anti-rights movement is organised. It connects attacks on LGBTQ+ rights, gender equality, reproductive rights, migrants, civil society and science. Those of us defending rights too often continue to organise in silos.

And in my previous lead story for HIV Justice News, I argued that the next phase of HIV decriminalisation requires us to close the “translation gap”: the failure to translate four decades of advances in HIV science into law, policy and practice.

Now I think there is another piece of the puzzle. We need to ask whether HIV exceptionalism itself still makes sense.

There was a time when it clearly did. HIV was new, poorly understood and often fatal. Exceptional political attention and funding helped create the science, treatment and activism that transformed the epidemic. But the science has moved on. The law has not.

Slide from the Track F (Political science, laws, ethics, policies and human rights) rapporteur session at AIDS 2026

As of today, 83 countries continue to maintain HIV-specific criminal laws. But counting HIV-specific statutes substantially understates the reach of HIV criminalisation. Between 2013 and 2026, HJN’s Global HIV Criminalisation Database documented enforcement in 156 legal jurisdictions across 96 countries. Of these, 61 jurisdictions in 48 countries applied HIV-specific criminal laws, while 95 jurisdictions in 48 countries relied on general criminal offences such as assault, grievous bodily harm, attempted murder, and poisoning.

So even when an HIV-specific law is repealed, HIV exceptionalism may simply migrate into general criminal law.

There is another contradiction that deserves more attention. We continue to see, quite rightly, strong support for HIV-specific legislation that is primarily protective. Such laws can protect confidentiality, prohibit discrimination and guarantee access to prevention, testing and treatment. UNAIDS and others understandably celebrate progressive HIV legislation when it is adopted.

But many HIV omnibus laws combine those protections with punitive provisions. The same law can effectively say: we will protect you because you have HIV, and we will punish you because you have HIV. The problem, then, is not HIV-specific legislation per se. It is the continued assumption that HIV requires its own exceptional legal category, including a punitive one.

Nor is the problem confined to explicitly punitive HIV laws. Argentina provides an instructive example. Its 2022 HIV law, which replaced an old HIV-specific law following a decade-long advocacy campaign, was rightly praised for its human rights and public health approach. Yet it did not address HIV criminalisation, which continues today under general criminal law.

This leaves us with a difficult question: why do we need HIV-specific legislation to guarantee rights that should belong to everyone?

Why should access to healthcare depend on an HIV-specific law rather than universal access to healthcare?

Why should confidentiality of HIV status require special protection rather than comprehensive medical privacy?

Why should protection from discrimination depend upon being named in an HIV statute rather than comprehensive equality and anti-discrimination laws?

There were good reasons historically for HIV-specific legislation. Where governments failed to protect people living with HIV, activists had to demand specific protections. Specific laws could provide an important foothold for rights and accountability.

But perhaps we need to distinguish between using HIV exceptionalism as a strategy for securing rights and maintaining HIV exceptionalism as a permanent feature of law.

The latter increasingly makes little sense.

There is a cruel paradox here. Scientific progress has weakened the justification for HIV criminalisation at precisely the moment that declining political attention may make reform harder. This is why HIV decriminalisation remains important: it means ending a form of legal exceptionalism that has survived the scientific and public health exceptionalism that helped create it.

This is also why the HIV justice movement needs to think beyond HIV. If the anti-rights movement understands that attacks on different communities reinforce one another, we need to understand the connections too. HIV criminalisation is not an isolated legal problem. It sits alongside stigma, surveillance, discrimination, attacks on gender equality, shrinking civic space and the rejection of scientific evidence.

The response cannot simply be to preserve a special legal category for HIV. It should be to build systems in which everyone has access to healthcare, everyone has medical privacy, everyone is protected against discrimination, and criminal law does not single people out because of a health condition.

HIV advocacy helped establish many of those principles. Perhaps the next stage of HIV justice is to make those protections universal. That is not abandoning HIV justice. It is taking HIV justice to its logical conclusion.

If HIV is no longer exceptional in global health, it should not be exceptional in criminal law either.

“The evidence is overwhelming: criminalisation does not prevent HIV, it fuels it”

The scourge of LGBTQ criminalisation moving across African countries – and its impact on HIV

“The evidence is overwhelming: criminalisation does not prevent HIV – it fuels it,” Immaculate Owomugisha Bazare, Director of the Centre for Women Justice, Uganda, said in a plenary presentation at the 26th International AIDS Conference (AIDS 2026) held in Rio de Janeiro recently.

The conference had a prominent focus on how criminalisation – of identities, behaviours and HIV – impacts HIV outcomes. Research presented was mostly from sub-Saharan African countries, such as Uganda and Ghana, where criminalisation of LGBTQ people has been on the rise in recent years.

Grappling with multiple forms of criminalisation and funding cuts in Uganda

In 2023, Uganda passed the Anti-Homosexuality Act, a draconian bill aimed at criminalising LGBTQ people. This law was enacted in a context where sex work and drug use are already criminalised. “All these laws and policies continue to push people away from accessing services,” Bazare said.  

Criminalisation of LGBTQ identities, behaviours such as drug use and sex work, and sex while living with HIV are intricately intertwined: key populations such as gay, bisexual and other men who have sex with men (MSM) and transgender women are at a much higher risk of contracting HIV, as are injecting drug users and sex workers. In turn, these groups can be criminalised for both how they acquired HIV and allegations of exposing others to HIV.

Bazare stated that these laws have a devastating effect on health-seeking behaviour. For a member of a key population, if any aspect of their identity is criminalised, it leads to a fear of stigma, discrimination and arrest. This results in delayed or total avoidance of HIV testing, prevention and treatment seeking. For example, if a gay man contracts HIV, any sex that he has after that is doubly criminalised: because of his identity and because he has HIV. This may be considered an act of ‘aggravated homosexuality’ according to the Ugandan Act – if the person’s sexual partner “contracts a terminal illness as a result of the sexual act.” While HIV was removed from the final wording of the Act, this clause can be left open to interpretation and likely is aimed specifically at HIV – regardless of scientific advances such as U=U – and may result in a death penalty.

The 2025 US funding freeze – which abruptly halted HIV services for key populations globally – has only added to the terror created by criminalisation in Uganda. Ruth Kikonyogo, from Save the Youth Uganda, presented research at the conference on mental health among a sample of 111 gay, bisexual and other men who have sex with men. Survey data were collected at two timepoints: after the Act was passed and after the funding freeze.

The percentage of participants reporting symptoms that matched moderate-severe depression rose by 13 percentage points, as did those reporting experiences of stigma. Exposure to violence went up by 12 percentage points, while anxiety symptoms went up by 11 percentage points and suicidal ideation by 9 percentage points. There were declines in access to both HIV services (by 14 percentage points) and psychosocial services (by 12 percentage points). Approximately 6% of the sample had fled Uganda after the Act was passed: this was reflected in the final sample size, as 142 men had initially taken the survey.

“Community-based HIV and psychosocial services serve as a critical protective factor for MSM, and their disruption magnifies the harm caused by hostile legal environments,” Kikonyogo concluded.

Ghana’s new anti-gay law

Research from other African countries showed that these negative impacts on mental health were not limited to Uganda. As Bazare put it: “The fire moves from Uganda to other countries. We’ve seen Ghana, we’ve seen Senegal now where we have specific laws that criminalise people but also criminalise HIV.”

Dr Akua Gyamerah presented research with gay and bisexual men, transgender women and gender-diverse people from Ghana, looking at whether antiretroviral therapy (ART) adherence was impacted by social stressors, such as criminalisation, through pathways such as depression, alcoholism and suicidality.

The ironically named Human Sexual Rights and Family Values Bill is considered the most restrictive anti-LGBTQ bill on the continent and was passed by Ghana’s parliament in May 2026. If signed into law by the president, John Mahama, it would criminalise LGBTQ identities, advocacy, gender-affirming care, allyship and any specific programming directed towards LGBTQ groups. As with other similar laws, it also encourages citizens to spy on each other and report any suspected homosexual behaviour.

Researchers created a scale to measure the frequency of social stressors linked to the anti-LGBTQ legislation. This included questions related to violence, arrests, discrimination and economic insecurity, for example: “Due to the anti-homosexuality bill/law in Ghana, I have been blackmailed or robbed.” ART non-adherence was measured as missing four consecutive doses at least once during the prior three months.

Among 256 participants with an average age of 31, approximately 40% identified as cisgender men, another 40% as transgender women and the remainder as gender diverse. Most of the sample reported their sexualities as gay, bisexual or queer. Monthly median income was low, at $100 for the sample.

Social stressors related to gender and sexuality were high: 68% had been asked about their sexuality, 31% had been blackmailed or robbed, while 17% had been threatened with death. Over a quarter of the sample did not report crimes because of fear of arrest (28%) and had been threatened with being reported to the police (27%). Just under 10% had been arrested. Overall, 23% stopped going to group programmes, such as health discussions for LGBTQ people, and 5% stopped seeking HIV services.

On average, the sample had been on ART for five years. Over the three months prior to the survey, 31% reported ART non-adherence. Over a quarter of the sample were at a significant risk of suicide (28%) and met the criteria for an alcohol use disorder (26%). On average, the sample displayed significant depressive symptoms.

While a direct association between criminalisation-related stressors and ART adherence was not significant, Gyamerah and colleagues found that greater social stressors were linked to higher depressive symptoms, alcohol use disorder and suicide risk. In particular, depressive symptoms were highlighted as a pathway through which social stressors impacted ART adherence.

“Proposed punitive legislation – not just laws – can undermine HIV treatment by increasing risk of mental health through exposure to social stressors,” Gyamerah concluded. “Structural harm is an HIV treatment issue. Protecting ART adherence requires affirming mental healthcare and opposition to structural criminalisation.”

Bazare summarised it as: “Laws and policies are not simply legal issues, they are public health issues, they are human rights issues, and they are gender equality issues.”

References

Bazare IO. Justice, rights and HIV: Building resilient legal frameworks. 26th International AIDS Conference, Rio de Janeiro, plenary session PL03, 2026.

View the details of this session on the conference website.

Gyamerah A et al. Anti-LGBTQ+ legislation, mental health, and ART non-adherence among sexual minority men, trans women, and gender-diverse people living with HIV in Ghana: A mediation analysis. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3906LB, 2026.

View the abstract on the conference website.

Kikonyogo R et al. One shock after another! From the anti-gay law to unexpected HIV funding cut. A comparative assessment of mental health and suicidality by men who have sex with men during these two extremes in Uganda. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3902, 2026.

View the abstract on the conference website.

The Anti-Rights Movement is Organised. Are We?

AIDS 2026, the biennial global conference on all things HIV, closed on July 31 after a week of presentations on scientific advances (including twice-yearly lenacapavir and long-acting cabotegravir plus rilpivirine; advances in cure and vaccine research, with reports of sustained remission in the “Kansas City Patient”) and ongoing funding crises and key populations under threat, with anti-LGBTQ legislation in Uganda, Ghana, Senegal, and Côte d’Ivoire.

During the week, I attended more than a dozen sessions. As always, the most important conversations took place not only in formal sessions, but in the Global Village, in corridors, at community events, and over coffee. By the end of the week, I realised they all revolved around the same question: How do we build a movement capable of confronting an increasingly organised anti-rights agenda?

The question first crystallised for me during Wednesday’s session, Law, Power and Access: Overcoming barriers to HIV services. During the discussion I asked how we can overcome what increasingly feels like a successful “divide and rule” strategy. Across the world, the forces seeking to roll back human rights appear remarkably coordinated. They target communities already facing marginalisation—including people living with HIV, LGBTQ+ people, women, migrants, sex workers, and people who use drugs—as they always have. Reproductive rights, civil society, and scientific evidence are under fire as well, not as separate issues, but as part of a broader political project.

Meanwhile, those of us working to defend rights too often continue to organise ourselves in silos.

The same theme emerged again later that day during a conversation between Georgetown University’s Matthew Kavanagh and Mariângela Simão, who begins her role next week as the UN Special Rapporteur on the right to health. Simão spoke of the growing cohesion of anti-rights forces internationally, while Kavanagh posed what may be the defining question for the years ahead: what would it take to build an equally effective pro-rights force?

It struck me that this wasn’t simply another conference discussion; it was the thread connecting so many conversations throughout AIDS 2026.

The HIV movement knows better than most that progress has never come from science alone. Scientific breakthroughs have transformed HIV from a life-threatening diagnosis into a manageable condition and have given us extraordinary tools to prevent transmission. But while HIV itself may no longer be life-threatening for most people with access to treatment, the political environment has become increasingly rights-threatening. Evidence alone has never guaranteed equitable access, ended stigma or repealed punitive laws. Those achievements have always depended on organised communities, strategic advocacy, political leadership, and solidarity.

Throughout AIDS 2026 there were outstanding sessions on criminalisation, gender equality, community leadership, access to medicines, funding, and shrinking civic space. Each highlighted a different piece of the puzzle. Yet we still too often approach these as separate struggles, competing for scarce funding and political attention. Our opponents do not.

Anti-rights alliances reinforce each other

The anti-rights movement has spent decades building alliances across countries and political movements. It understands that attacks on LGBTQ+ rights, sexual and reproductive health and rights, gender equality, migrant rights, civil society, and science reinforce one another. Divide and rule is effective precisely because those defending rights are so often divided.

Another session that stayed with me was No retreat, no surrender: The future of philanthropy in HIV. Richard Borain of the Children’s Investment Fund Foundation (CIFF) argued that philanthropy’s greatest contribution is not simply funding projects but strengthening the “connective tissue” that brings together governments, communities, donors, and civil society around shared goals.

That phrase resonated with me. We have become very good at investing in programs, but less intentional about investing in the relationships, trust, and collaboration that allow organisations and movements to reinforce one another.

I was reminded of this again at the Robert Carr Fund’s celebration of 15 years of supporting global HIV and health movements. At a time when the Fund has faced an uncertain future following the withdrawal of support from both the United States and the Netherlands, there was welcome news: CIFF has joined as a new donor, while ViiV Healthcare announced a further year of support.

For more than a decade, the Robert Carr Fund has demonstrated a different model of philanthropy—trust-based, multi-year, flexible core funding combined with peer learning and movement building. The HIV Justice Global Consortium, which first united regional and global HIV criminalisation networks, was made possible through Robert Carr Fund support, and the HIV Justice Network remains proud to be one of its grantees.

Yet even within the Robert Carr Fund family there is greater potential to work across movements and constituencies. That is not a criticism of the Fund; rather, it reflects how deeply siloed our sector has become. If organisations already committed to rights-based approaches can collaborate more intentionally, imagine what could be achieved with greater investment in those connections.

The anti-rights movement invests in networks, long-term relationships, shared strategies, and patient coalition-building. We need to become equally serious about investing in the infrastructure of solidarity. AIDS 2026 made clear: our greatest challenge is no longer simply defending individual rights. It is building a movement capable of defending them together.

Edwin J Bernard is Executive Director of the HIV Justice Network and a global advocate for human rights and HIV justice.

Email:edwin@hivjustice.net

Image: Rogério von Krüger / IAS

US: Pennsylvania’s HIV Decriminalization Law comes under fire from activists

“Profound Disappointment” at Pennsylvania’s Updated HIV Crime Law

UPDATE: Pennsylvania just passed a law to decriminalize being HIV positive, but AIDS activists say it harms another marginalized group.

UPDATE: As we reported earlier this week, Pennsylvania Governor Josh Shapiro signed Senate Bill 45 (SB45) into law on July 20. The legislation eliminates harsher legal penalties for people simply because they are HIV positive, referred to as HIV criminalization. The law was promoted as a victory for HIV activists.

But now several HIV organizations are speaking out against aspects of the law. They point out that it targets sex workers. What’s more, the HIV advocacy groups clarify that they were not consulted in drafting the Pennsylvania legislation.

A Facebook post by HIV activist Waheeda Shabazz-El and several advocacy groups begins by stating:

The Pennsylvania HIV Justice Alliance goes on record expressing our profound disappointment with the passage of PA Senate Bill 45.

While the legislation modernizes portions of Pennsylvania’s criminal code related to HIV, it does so at the dangerously unacceptable expense of sex workers, who will face increased criminalization and harm under this law. Progress for one marginalized community should never come at the cost of another. Our celebration is tempered by the reality that this progress came at a devastating cost.

You can read the entire statement on Facebook:

In addition, an open letter was penned by CHLP (The Center for HIV Law and Policy), Positive Women’s Network–USA and the Sero Project. It reads in part:

SB45 was ultimately an overhaul of the Pennsylvania criminal code pertaining to “prostitution.” It transfers most “prostitution” related offenses out of the “public indecency” section and into the “human trafficking” section of the criminal code. It also reduces some criminal charges while increasing others.…

SB45 achieves important, positive outcomes. SB45 removed the HIV felony sentence for sex workers living with HIV. Previously, if a person living with HIV was convicted of “prostitution,” their penalty was upgraded to a felony simply because of their HIV status. It was HIV discrimination written into the Pennsylvania criminal code, and we are thrilled it was removed.…

SB45 shifts prosecutorial authority and conflates sex work and trafficking.…

SB45 increases penalties for “promoters” or “patronizers,” which can harm trafficking survivors or people in the sex trades.…

Our organizations have been involved in coalitions fighting HIV criminalization in Pennsylvania for years and we support, alongside others, the standalone HIV decriminalization bills, HB632 and SB647. SB45, however, is a substantially different piece of legislation. We were not included in the legislative process nor did any of our organizations endorse SB45. Some of our organizations have, nevertheless, been associated with the bill because of the HIV decriminalization components. SB45 has also been touted as a win for the HIV decriminalization movement in the Commonwealth and in the media. For all of these reasons, it is important to make our stance public: We believe a more nuanced perspective is needed.

To reiterate and celebrate: this bill achieves hard fought wins. People living with HIV and HIV advocates have worked for years to introduce legislation that would eliminate the HIV sentence enhancement from the Pennsylvania criminal code. In the past, we have worked alongside powerful HIV decriminalization coalitions and organizations in Pennsylvania, including the Pennsylvania HIV Justice Alliance, the AIDS Law Project, Positive Women’s Network-PA, Girl U Can Do It Inc., Philadelphia FIGHT and the Elizabeth Taylor AIDS Foundation. We celebrate this legacy and work.

We remain deeply concerned, however, about how SB45 will make it harder for sex workers and trafficking survivors to survive by further criminalizing their networks of support. SB45 adopts key features associated with the End Demand model of sex work criminalization. This approach focuses on criminalizing the purchase and promotion of sex work – the “demand” side of the sex trades. It frames all people in the sex trades as “victims”, denies bodily autonomy, and ignores that people can consensually choose to engage in sex work. Ultimately, it aims to end sex work itself by policing and criminalizing people who support or pay sex workers and offers no economic alternative for sex workers. Research shows, however, criminalizing demand does not decrease demand. Instead it forces sex workers further into unsafe conditions, increasing sexual violence, exploitation, and decreasing access to support services.

Below is our original July 30 article about Governor Josh Shapiro’s signing Senate Bill 45 into law and eliminating harsher penalties for people living with HIV:

On July 20, Pennsylvania Governor Josh Shapiro signed Senate Bill 45 (SB45) into law, eliminating felony charges for people arrested for prostitution while being HIV positive and removing HIV from the criminal code in the Commonwealth of Pennsylvania.

 

Before the signing of SB45, when charged with a crime in Pennsylvania, people living with HIV—especially sex workers—could face harsher penalties because of their HIV status. In Pennsylvania, prostitution is classified as a misdemeanor, but people living with HIV could be charged with a felony and face up to seven years in prison, even when HIV transmission is not possible.

“Living with HIV is not a crime, and HIV criminalization laws have been proven, time and again, not to work for the benefit of the community or in the service of justice,” said Kathleen A. Brady, MD, director of the Philadelphia Department of Public Health’s Division of HIV Health, in a press release. “In fact, such laws prevent public health agencies from responding effectively to the HIV epidemic by perpetuating stigma, racism, xenophobia, social and economic injustice—while reducing willingness for people to participate in HIV prevention, testing and care.”

HIV criminalization refers to the use of unfair laws to target people who have HIV—notably, African-Americans, Latinos, LGBTQ people, and women—and to punish them because of their HIV status, not because of their actions. Under outdated laws, people with HIV can be sentenced to prison in cases where HIV was not transmitted and their only crime was allegedly not disclosing their status.

It should be noted that repealing HIV laws does not mean that people can’t be held accountable for intentionally transmitting HIV. Other laws may apply to the situation.

Many HIV laws were passed in the early days of the epidemic, when fear and lack of scientific knowledge about the virus reigned. Fast-forward four decades, and today we know, for instance, that people with HIV who take their meds and maintain an undetectable viral load do not transmit the virus sexually, a fact referred to as Undetectable Equals Untransmittable, or U=U.

In recent years, New Jersey modernized its HIV crime laws. And in 2021, Illinois became the second state to completely repeal its discriminatory HIV crime laws (California did so in 2017). Lawmakers in Louisiana, Missouri, Nevada and Virginia have also updated similar laws. For related articles, see “Breaking HIV Laws: A Roundup of Efforts to Decriminalize HIV,” and “HIV Is Not a Crime Awareness Day 2026.”

“Criminal penalties for living with HIV have never served an effective law enforcement purpose,” Ronda Goldfein, executive director of the AIDS Law Project of Pennsylvania, told Pennsylvania Capital Star. “No credible research has ever linked penalties with reduction in HIV transmission.”

“The signing of SB 45 is an important step toward ending outdated policies rooted in fear and stigma rather than science,” said attorney Tito Valdes, director of LGBTQ+ Affairs for the City of Philadelphia, in a press release. “No one should face harsher treatment under the law because they are living with HIV. We applaud Governor Shapiro and the advocates who worked for years to make this change possible and remain committed to advancing policies that promote dignity, equity and public health for all Philadelphians.”

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.

New global Guidance on HIV decriminalisation launched at AIDS 2026

Community-led resource distils more than 30 years of global experience into practical action for advocates, policymakers and justice systems

Download the Guidance here

The HIV Justice Network (HJN), on behalf of HIV JUSTICE WORLDWIDE (HJWW) and the Global Partnership for Action to Eliminate All Forms of HIV-related Stigma and Discrimination, today launched the Guidance on Good Practices in HIV Decriminalisation during a packed Global Village session at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro.

Supported by UNAIDS, the Guidance is the first practical global resource to bring together more than three decades of community leadership, human rights standards, contemporary HIV science and real-world experience of advocacy, litigation and law reform into a single framework for action.

Opening the session, HJN Executive Director Edwin J Bernard described the Guidance as “a practical resource that we hope communities, advocates, lawyers, judges, policymakers and public health officials will actually use.”

Rather than presenting the publication chapter by chapter, the session demonstrated how it can support change in diverse legal and political contexts around the world.

Speakers included Janet Butler McPhee (HIV Legal Network), Svitlana Moroz (Eurasian Women’s Network on AIDS), Immaculate Owomugisha Bazare (Centre for Women Justice Uganda) and Sofía Várguez Villanueva (HIV Justice Network), who shared examples of community advocacy, legal reform, strategic litigation, work in restrictive legal environments and practical advocacy tools.

Although more than 80 countries continue to maintain HIV-specific criminal laws and prosecutions also occur under general criminal laws, the Guidance reflects growing evidence that communities can successfully challenge punitive approaches. Around the world, advocates have helped repeal or modernise laws, influenced courts and prosecutors to apply contemporary HIV science, and promoted rights-based public health responses.

“The HIV justice movement has reached an important milestone,” Bernard said. “For the first time, we’ve accumulated enough experience from around the world to identify what good practice actually looks like. This Guidance brings together what communities have learned over decades, so others don’t have to start from scratch.”

Designed for advocates, lawyers, judges, prosecutors, policymakers, public health officials and community organisations, the Guidance recognises that every country starts from a different place and that reform is rarely linear. Rather than prescribing a single model, it offers practical approaches that can be adapted to different legal, political and cultural contexts.

 

HIV Justice Network at AIDS 2026: new research, practical tools and global advocacy for HIV justice

The HIV Justice Network (HJN) team will be participating in the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil, where we will showcase new research, launch an important new global resource, facilitate community dialogue, and connect with partners from around the world.

Throughout the conference, visit us in the Global Village to explore our work, meet the team, and discover practical tools supporting HIV justice.

Visit the HIV Justice Network booth

Global Village | Monday 27 – Thursday 30 July

Our interactive booth will feature:

  • the Global HIV Criminalisation Database
  • the HIV Justice Academy
  • Positive Destinations, our platform addressing HIV-related travel and migration restrictions
  • practical tools and resources to support advocacy, legal reform and community action against HIV criminalisation

Meet members of the HIV Justice Network team, learn about our latest projects, and discover how you can contribute to global efforts to end HIV criminalisation and HIV-related travel restrictions.

Whether you are an activist, researcher, lawyer, healthcare provider, policymaker or funder, we would love to meet you and discuss opportunities for collaboration.

Launching the Guidance on Good Practices in HIV Decriminalisation

Thursday 30 July | 10:45–11:45 | Global Village

One of the highlights of our week will be the official launch of the Guidance on Good Practices in HIV Decriminalisation, developed by HJN on behalf of HIV JUSTICE WORLDWIDE and the Global Partnership for Action to Eliminate All Forms of HIV-Related Stigma and Discrimination, with support from UNAIDS.

This practical session will introduce advocacy resources, legal literacy tools and community-led strategies that can help challenge HIV criminalisation around the world.

Speakers include Edwin Bernard, Janet Butler McPhee, Isis Tapia, Svitlana Moroz, Sofía Várguez and Immaculate Owomugisha Bazare.

HJN represented in AIDS 2026 plenary

Thursday 30 July | Morning plenary

HIV Justice Network is also proud to see Immaculate Owomugisha Bazare, a member of our Supervisory Board and Executive Director of the Centre for Women Justice Uganda, featured in one of AIDS 2026’s flagship plenary sessions.

Immaculate will speak on “Justice, rights and HIV: Building resilient legal frameworks”, bringing her expertise as a lawyer, advocate and leader in advancing HIV justice and gender equality. Her participation highlights the growing recognition that ending HIV criminalisation and other punitive laws is essential to an effective, rights-based HIV response.

Breastfeeding is not a crime!

Wednesday 29 July | 16:30–18:00 | Global Village

HJN’s Alison Symington will lead an interactive workshop, in partnership with ICW Global, exploring criminalisation and other punitive responses to women living with HIV who breastfeed.

The workshop will bring together advocates, researchers and clinicians to contribute to a growing global consensus supporting rights-based, evidence-informed approaches grounded in bodily autonomy and informed choice.

Presenting new research

HJN team members will present four abstracts during AIDS 2026.

Oral presentation

Thursday 30 July | 16:30–17:30 | Room 203

Edwin Bernard
HIV criminalisation as structural violence: science, geopolitics and community-led pathways to justice

Drawing on new global data, this presentation argues that HIV criminalisation persists because of structural violence embedded within legal, political and funding systems. It explores how community-led advocacy is helping to close the gap between science and the law.

Poster presentations

Wednesday 29 July | 12:15–13:15

  • Sylvie Beaumont – From the doctor’s office to the jail cell: system reforms to protect care, confidentiality and prevention in the context of HIV criminalisation.
  • Edwin Bernard – Science, rights, and HIV on trial: is rising HIV criminalisation part of a global anti-science/anti-rights resurgence?

Thursday 30 July | 12:00–13:00

  • Sofía Várguez – Positive destinations or persistent barriers? Rethinking HIV-related travel restrictions.

Sofía’s poster has been selected for the Track F Featured Poster Walk, where invited presenters will give short presentations and discuss their work with conference delegates.

Follow us from Rio

We’ll be sharing highlights, photos, videos and key messages throughout the conference across our website and social media channels.

Whether you’re attending AIDS 2026 in person or following from elsewhere, we hope you’ll join us as we continue working towards a world where HIV criminalisation is consigned to history.

US: Arkansas’s outdated HIV laws fuel fear and deter people from getting tested and treated

Advocates call on Arkansas lawmakers to decriminalize HIV, fund treatment and prevention

As Arkansas tops another terrible list, this time as the state with the highest rate of HIV transmission, advocates are calling on Arkansas lawmakers to decriminalize the sexually transmitted disease and commit funding for prevention, treatment and education.

A coalition of people from community organizations including Central Arkansas Pride, Arkansas Rapps, Intransitive, Arkansas Black Gay Men’s Forum and Arkansas Queer Men United, along with several people living with undetectable HIV, gathered in the Old Supreme Court Room in the State Capitol before several Democratic state representatives on Monday.

Advocates argued that Arkansas’s HIV laws, which haven’t been updated since the 1980s, are outdated and create a culture of fear that prevents people from getting tested and treated for HIV. They asked lawmakers to commit $1.5 million from the state’s surplus of more than $367 million to HIV prevention, treatment and education.

Under Arkansas law, knowingly exposing another person to HIV is a Class A felony, punishable by up to 30 years in prison and a fine of up to $15,000. But critics like the Center for HIV Law and Policy say these woefully outdated laws are out of step with modern science, rooted in stigma and punish behavior that carries no or negligible risk of actually transmitting the disease.

With proper treatment, HIV can become undetectable in a person, meaning it can’t be transmitted to another person through sex, but Arkansas law doesn’t account for this.

“HIV criminalization laws like ours here in Arkansas are opposed by public health and national justice experts such as the National Alliance of State and Territorial AIDS Directors and the National Association of Criminal Defense Lawyers,” said Tian Estell, policy director of Intransitive. “We need to modernize and stop punishing people for having a virus.”

Tian added that “Black, transgender and non-binary individuals in the South are disproportionately impacted by HIV” due to other contributing factors like lack of housing, transportation and employment and limited or no access to healthcare.

“Discriminatory policies also generate and enhance stigma and fear, creating barriers to prevention and care,” Tian said. “Intransitive serves transgender people and migrants, and we’ve seen a rise in fear associated with HIV testing and disclosure of positive status”

HIV is a larger problem in Arkansas than in most states, and advocates argue our laws are only making it worse.

In 2019, the federal Health and Human Services Department started an initiative to end the HIV epidemic by 2030, identifying Arkansas as one of seven priority states where the burden of HIV is the highest.

“Arkansas continues to see new HIV diagnoses each year. In fact, Arkansas ranked number one in the highest increase of new HIV cases, seeing a roughly 67% spike since 2018,” said Raheem White, program director for Arkansas Rapps. “The burden does not fall equally. Black communities tend to carry a higher share of these diagnoses. Central Arkansas and parts of Northwest Arkansas show higher impact, while rural areas face a different challenge with fewer services and longer distances to care.”

Tommy Sproles, a community outreach organizer for Arkansas Rapps, said those numbers may not be representative of the full scope of cases in Arkansas, especially in rural areas.

“It’s a concern of ours that the numbers do not accurately reflect the real life experiences within those other parts of the state, such as the rural areas where we think that the numbers would be higher, but they’re going under-reported because of the lack of testing in those areas,” Sproles said. “As we’re talking about the data that we receive, what we’re basing our stuff on is the data that the Arkansas Department of Health actually receives, but that doesn’t even cover the full scope of everyone who is testing, if you’re not a clinic or a subcontractor for the Arkansas Department of Health, that data is not even being accumulated.”

Arkansas Rapps, for example, uses telehealth to connect people in Arkansas with testing, medication and preventative medicine like PrEP, which is up to 99% effective at preventing the transmission of HIV.

Advocates said criminalizing HIV and not funding its prevention costs Arkansas millions of dollars in both healthcare and incarceration.

“Pulaski County has the highest rate of HIV-criminalization arrests, with most other counties having only one or no arrests. This not only speaks to a disproportionate application of the law, but a significant waste of resources,” said Amber Kincade, a comprehensive prevention specialist with Engaging Arkansas Communities.

“According to data from the Arkansas Department of Corrections, from 2007 to 2023 the average sentence per count for the HIV-related convictions was 24 years. According to the fiscal year 25 Inmate Cost Report, the cost per incarcerated person a day was $74.46, which was a $4.03 increase from 2024. This means that a sentence of 24 years would cost the state roughly $652,272,” Kincade said. “The lifetime cost of treating HIV is estimated to be over $500,000. Therefore, for one case of a person living with HIV receiving such a sentencing, the cost will be over $1 million.”

Kincade added that Texas decriminalized HIV in 1994 and increased public health funding for prevention and testing.

“Texas has saved an estimated $500,000 in lifetime cost per case in HIV treatment,” Kincade said.

Sanjay Johnson, a man living with undetectable HIV, told lawmakers he was prosecuted in Pulaski County for knowingly transmitting HIV, despite the virus being undetectable in his system, in 2017.

“The language itself is damaging, because with that, people think that transmission actually occurred, which in my case was not the case. It never occurred at all,” Johnson said.

Johnson’s case lasted two years, and his lawyer got the charge reduced from a felony to aggravated assault with five years of probation. That’s despite Johnson’s medical records, which said he was undetectable, being shown in court, he said.

“You wonder why HIV is the only STD that someone can be charged for. Not gonorrhea, chlamydia, herpes, etc, etc. HIV is the only sexually transmitted disease that can be criminalized here,” Johnson said.

New Zealand: New research reveals how HIV criminalisation is experienced in Aotearoa

HIV decriminalisation in Aotearoa: Survey findings

For the first time in Aotearoa New Zealand, we have national evidence on how HIV criminalisation is experienced by people living with HIV.

This research captures the voices of 247 people from diverse communities across the country. It documents how criminal law, public health processes, stigma, and modern HIV science intersect in real life. The project was undertaken collaboratively by Positive Women Inc, Burnett Foundation Aotearoa, Body Positive, and Toitū te Ao, reflecting the shared commitment of all four organisations to amplifying community experiences and informing meaningful change.

The findings highlight the need for greater clarity, alignment with contemporary science, and thoughtful public conversation.

About the research

This study explores:

  • Awareness and understanding of criminal and public health law
  • Attitudes toward HIV criminalisation
  • The lived impact of legal uncertainty
  • The role of stigma in shaping legal and social outcomes
  • Recommendations informed by participant experience

Participants represented a wide range of ages, genders, sexualities, ethnicities, migration histories, and lengths of time living with HIV.

This research centers lived experience while grounding analysis in contemporary HIV science, including the evidence behind U=U (Undetectable = Untransmittable).

Key findings

1. Preference for public health management

Most participants would prefer public health manage their HIV transmission rather than the police – because HIV is a health issue, not a crime.

2. Attitudes are nuanced

Participants held diverse and layered views about criminalisation. Support was often linked to cases of intentional harm, while broader criminalisation raised concerns about fairness, stigma, and unintended consequences.

3. Impact extends beyond prosecutions

Even where prosecutions are rare, the possibility of criminalisation shapes behaviour, disclosure practices, relationships, and wellbeing.

4. Stigma remains central

Legal frameworks do not exist in isolation. Participants described how stigma around HIV influences both public perception and perceived legal risk.

Why this matters

Effective HIV responses must reflect:

  • Modern treatment science
  • Public health best practice
  • Human rights principles
  • The lived experience of people living with HIV

Clear, evidence-informed discussion is essential to ensuring legal and policy settings support – rather than undermine – public health outcomes.

Recommendations

The report identifies areas for consideration, including:

  • Clearer, accessible legal guidance
  • Greater alignment between law and contemporary HIV science
  • Stigma reduction through public education
  • Meaningful involvement of people living with HIV in future policy conversations

What happens next

Positive Women Inc, Burnett Foundation Aotearoa, Body Positive, and Toitū te Ao will:

  • Share these findings across health, legal, and policy sectors
  • Engage stakeholders in informed discussion
  • Continue centering lived experience in advocacy and education
  • Support accurate public understanding of HIV and the law

This report is a foundation for evidence-based dialogue in Aotearoa.

For media enquiries, contact Kirk Serpes at kirk.serpes@burnettfoundation.org.nz

Read the full report here

Senegal: Arrests and breach of medical confidentiality trigger drop in HIV testing and treatment attendance

“Violation of medical confidentiality”: in Senegal, caregivers worried about allegations against homosexuals with HIV

In Senegal, people have been incriminated for their homosexuality and accused of HIV transmission. These arrests follow the announcement by Prime Minister Ousmane Sonko of the tightening of the law penalizing “unnatural acts”. Since these arrests, the actors in the fight against AIDS have seen a decrease in attendance at screening centers.

“Arrest for homosexuality: serious cases of unnatural acts with voluntary transmission of HIV/AIDS,” headlined the Senegalese daily Les Échos, on February 9. About thirty people have been accused of transmitting HIV and incriminated for their homosexuality, which is prohibited by law. The Senegalese government has just toughened this legislation on February 24. These arrests frighten patients with the virus, who no longer go to the Dakar screening center.

“Patients are afraid of being arrested and stigmatized,” explains Dr. Rassoul Diouf, at Fane Hospital, one of Senegal’s main health centers. Usually, this facility welcomes dozens of patients daily for HIV testing and monitoring. But in recent weeks, Dr. Rassoul Diouf has seen a significant drop in consultations.”The convocations for appointments are difficult to happen. We call them but there is reluctance,” he explains to TV5MONDE.

Breach of medical confidentiality

For the actors in the fight against AIDS, this disclosure constitutes a “violation of medical confidentiality“. The National AIDS Council recalls that a law in Senegal protects the identity of people with HIV.

“On an ethical level, this is not normal, but even less on a legal level,” says Dr. Safiatou Thiam, executive secretary of the National Council for the fight against AIDS. “HIV has the particularity of being framed by a law that prohibits the disclosure of people’s status. We do not know how or by what process medical results ended up in the public square,” she explains to TV5MONDE.

Misinformation and confusion about HIV transmission

Actors in the fight against AIDS also deplore confusion about the modes of transmission of the virus. However, Senegal has long been cited as an example for the means put in place to fight HIV. Since the end of the 1990s, the country made treatments accessible. “At the beginning of the epidemic [of HIV, ed.], many countries refused to recognize its existence. But Senegal said: not only does HIV exist, but I will treat it,” explains Dr. Khoudia Sow, doctor and anthropologist.

“When a person follows his treatment properly, he becomes undetectable and can no longer transmit the virus. On the other hand, if these people interrupt their treatment for fear of stigmatization, the risk is that in the short term new transmissions will appear,” she confides. Currently, the HIV prevalence rate in Senegal is estimated at 0.3%, one of the lowest in the region. However, if patients stop taking their treatment, for fear of stigma, this rate could increase in Senegal.