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So even when an HIV-specific law is repealed, HIV exceptionalism may simply migrate into general criminal law.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