“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.

Senegal: Harsh penalties for same-sex relations is severely disrupting HIV services

HIV care suffers under Senegal anti-gay law

The introduction of harsh penalties for same-sex relations has created a climate of fear that is severely disrupting HIV services. Gilbert Nakweya reports.

Patients in Senegal are forgoing critical HIV care, including testing and antiretroviral drugs (ARVs), for fear of arrest or abuse following the implementation of a controversial anti-gay law. The law, which came into force at the beginning of April, 2026, has introduced harsher penalties, including doubling the maximum prison sentence to 10 years for “acts against nature“ and criminalising promotion of homosexuality. According to the HIV Justice Network, over 200 people have been arrested and dozens jailed under the law while others have been accused of deliberately transmitting HIV to others. The Network has also documented dozens of reports of forced HIV testing.

Patients have been left living in fear and others have gone to neighbouring countries such as The Gambia and Morocco. Amadu*, a gay man aged in his 30s, knew his life was in danger in March and April when arrests increased and his close gay friends were jailed. Worried about being arrested himself and running out of medication, he fled to a neighbouring country. “I was not able to access ARVs as access to clinics is dangerous. I had to leave Senegal within less than 12 hours. I couldn’t get enough ARV pills before leaving as time and risk management didn’t allow for that”, he told The Lancet.

“My economic privilege helped me escape, but I personally know of dozens of people who can’t leave for economic reasons yet they cannot access [HIV treatment] services”, said Amadu. “I rely on my network in this country to get medication, but there is always fear here as well. I know at least 20 other people who have had to leave Senegal for the same reason as me, some of them are also HIV positive and struggle to get medication”.

Speaking on condition of anonymity, one Senegalese public health expert who works with Mpact Global, a gay men’s health and rights advocacy non-governmental organisation, said that the new law is only worsening the risky environment for community health organisations helping LGBTQ+ groups access HIV preventive and treatment services. “An increase in HIV incidence among men who have sex with men should be anticipated with the legal changes and the social climate it has propagated. I haven’t seen official numbers but have heard anecdotes of people deserting HIV services facilities. There are reports of lower utilization of HIV services since the law was passed in March”, he said. There is some precedent for such an effect. The high-profile arrest of nine HIV peer educators in Senegal in 2008 had a chilling effect on LGBTQ+ organisations. Although no formal correlation has been established, HIV prevalence in gay men went from 17·8% in 2014 to 27·6% in 2024, according to CNLS (the National Council for the Fight Against HIV/AIDS), the government body responsible for coordinating efforts to combat HIV in Senegal.

The expert says that the biggest HIV service facility in the country, Fann National University Hospital, is experiencing a dearth of clients with the few who show up wearing sunglasses or hoodies to avoid being recognised and targeted. Community health workers who were engaged in HIV testing, treatment, and prevention services, such as distribution of condoms, HIV-preventive pre-exposure prophylaxis (PrEP) medication, and monitoring patients, have been arrested. “The laws are incompatible with public health and human rights. Decriminalisation, competent and adequate health services, and measures against stigma and discrimination are the only sustainable ways out”, he said.

Even health workers in government are worried. “The situation is quite complicated here. I just want to be careful to protect our patients”, said a senior public health officer who works with CNLS.

Senegal’s HIV response has already been weakened by US funding cuts on international assistance that came into force in January, 2025. The HIV prevalence among men who have sex with men is estimated to be 27·6%, compared with 0·5% in the general population.

Researchers warn that Senegal’s criminalisation of homosexuality is reversing years of gains in HIV control. “Such punitive laws [as Senegal’s] and policies have shown no evidence for effectiveness as public health approaches. They undermine both public health and human rights and have led to declines in HIV testing, use of PrEP, and support for people living with HIV infection in Uganda, Nigeria, and several other countries”, said Chris Beyrer, Professor of Medicine at Duke University, Durham, NC, USA. “This is very disappointing as Senegal had been on a path to achieving HIV control. These new policies will set the country back and only further discrimination and stigma.”

“Denying people health rights, regardless of their behaviour, drives people underground and does not improve public health”, Beyrer told The Lancet.

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

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.

Mexico: Campaigners press Baja California to vote on HIV law reform

LGBTQ+ collective seeks progress in reform to eliminate crime that criminalizes people with HIV in Baja California

The group called on the State Congress’s Diversity Committee to put the bill seeking to repeal the offence of “risk of transmission” to a vote.

Mexicali, B.C.–The reform to remove the offence of “risk of transmission” from the Baja California Penal Code has been stalled for almost a year, denounced the Arcoíris Collective, which is calling on the State Congress to put it to a vote, arguing that the current legislation criminalises people living with the human immunodeficiency virus (HIV).

Javier Russell, leader of the Colectivo Arcoíris, explained that the amendment was tabled last year and has already gone through the relevant legislative process; however, he stated that it only remains to be brought before the plenary session for a vote, and therefore called on members of the State Congress to stop keeping it “on ice”.

“It is essentially a request to the Baja California Congress’s Diversity Committee to put the bill repealing the ‘risk of contagion’ provision to a vote; this bill was tabled last year and has already gone through the legislative process; all that remains is for it to be voted on,” said the collective’s leader.

Russell pointed out that Article 160 of the State’s Criminal Code penalises people with infectious diseases, a provision which, he asserted, has been rendered obsolete by scientific advances and constitutes a form of discrimination against those living with HIV.

The group’s leader indicated that treatments are now available that enable a person with HIV to achieve an undetectable viral load, thereby reducing the risk of transmission; he therefore considered that maintaining such regulations contradicts scientific knowledge and human rights.

Similarly, Russell recalled that Mexico has made international commitments under the 2030 Agenda to achieve the 95-95-95 target, which aims for 95 per cent of people living with HIV to know their status, for 95 per cent of them to receive treatment, and for 95 per cent of those on treatment to achieve an undetectable viral load.

The activist pointed out that retaining the current laws criminalises people on the basis of their health status and runs counter to these objectives and to the national policies promoted to combat stigma and discrimination.

Finally, Javier Russell reiterated his call to the members of the Diversity Commission to ensure that the bill is debated and put to a vote, given that its approval would bring state legislation into line with scientific advances and the country’s commitments regarding health and human rights.

New data presented at AIDS 2026 reveal renewed rise in HIV criminalisation amid global anti-rights backlash

HIV criminalisation is increasing again after several years of decline, with prosecutions continuing to ignore established scientific evidence and disproportionately targeting already marginalised communities, according to new research presented today at the 26th International AIDS Conference (AIDS 2026).

The analysis examined 115 database entries covering 150 reported HIV criminalisation cases documented between 1 June 2025 and 15 June 2026. We conclude that these findings reflect not only failures to apply contemporary HIV science but also a broader global resurgence of anti-science and anti-rights politics.

The data show a clear upward trend in reported cases since 2022. By mid-June 2026, 93 reported cases had already been documented, exceeding the total annual cases recorded during both 2023 (70) and 2024 (86), although still below pre-COVID-19 pandemic levels.

“Our findings suggest that science, rights and HIV are increasingly being put on trial together,” said Edwin J Bernard, Executive Director of the HIV Justice Network, who presented the findings on behalf of his co-authors, Sylvie Beaumont, Alison Symington and Sofia Varguez. “When courts continue to prosecute people for acts that science tells us pose no possibility of HIV transmission, this is no longer a scientific problem. It is a political and legal one.”

Uzbekistan and Senegal dominate reported cases

Uzbekistan accounted for 60 of the reported cases during the study period – around 40% of all documented cases. Many involved allegations of HIV “exposure” without evidence of transmission, prosecutions involving intimate partners, and cases against women whose partners were aware of their HIV status or who were receiving effective treatment.

We also highlight a major escalation in Senegal, where a broader crackdown on LGBTIQ+ communities led to more than 200 arrests. By mid-June at least 39 people were prosecuted in relation to their HIV status, often alongside charges linked to same-sex conduct. (See this report for the most recent numbers, which increase on a daily basis.) The poster documents reports of forced HIV testing, public disclosure of HIV status, and the use of condom possession as evidence of criminal conduct.

Other countries with multiple reported cases included the United States (19), the Russian Federation (eight), France (three), the United Kingdom (three), Kazakhstan (two) and Zimbabwe (two).

Courts continue to disregard HIV science

We found that prosecutions continue to involve conduct for which there is either no possibility or only negligible possibility of HIV transmission, despite overwhelming scientific consensus.

Cases involving people with sustained undetectable viral loads continued to be prosecuted, with courts often failing even to consider viral load evidence. Prosecutions for spitting also persisted in both North America and Europe, despite scientific consensus that HIV cannot be transmitted this way.

These prosecutions stand in stark contrast to the 2018 Expert Consensus Statement on the Science of HIV in the Context of Criminal Law, which concluded that effective HIV treatment eliminates the possibility of sexual HIV transmission, condoms are highly effective prevention tools, and acts such as spitting cannot transmit HIV.

Criminalisation increasingly shifts into general criminal law

We also identified an important legal trend: HIV criminalisation increasingly continues through general criminal laws even where HIV-specific criminal statutes have been repealed or modernised.

Our data show that prosecutions increasingly rely on offences such as assault, sexual offences, public health legislation and child protection laws, suggesting that reforming HIV-specific statutes alone is insufficient unless broader criminal law and prosecutorial practices also change.

Structural inequalities reinforced

We argue that HIV criminalisation functions as a mechanism reinforcing wider systems of social control rather than protecting public health.

Women, migrants, sex workers, LGBTIQ+ people and economically marginalised communities continued to experience disproportionate enforcement. Many prosecutions occurred despite evidence of partner awareness, coercive circumstances or negligible possibility of transmission.

We conclude that HIV criminalisation increasingly operates within political environments characterised by hostility towards science, human rights, gender equality and community-led public health responses.

Positive developments offer a roadmap

Despite these concerns, we also identified encouraging developments.

Courts in Canada, France, Italy, Türkiye and the United States increasingly engaged with contemporary HIV science, while acquittals, successful legal challenges and improved judicial reasoning demonstrated that evidence-based approaches remain possible.

These examples are reflected in the newly launched Guidance on Good Practices in HIV Decriminalisation, developed by the HIV Justice Network with support from UNAIDS, which recommends:

recognising contemporary HIV science in criminal proceedings;
limiting prosecutorial discretion and overcharging;
requiring proof of actual intent and significant harm;
prohibiting criminalisation related to pregnancy, infant feeding and vertical transmission; and
strengthening community-led monitoring, legal support and accountability.

“The evidence increasingly shows what works,” Bernard said. “Where legal systems engage with science, require evidence of genuine harm and respect human rights, prosecutions decline and justice improves. But sustainable change also requires confronting the stigma and political narratives that continue to portray people living with HIV as dangerous.”

Download E J Bernard et al. WEPEF620, Science, rights, and HIV on trial: Is rising HIV criminalisation part of a global anti-science / anti-rights resurgence?

US: Pennsylvania approves bill to end HIV sentencing enhancement

Pennsylvania House unanimously passes bill ending HIV-specific criminal penalty enhancement

The Pennsylvania House voted unanimously to approve Senate Bill 45 on July 12, sending legislation that would remove an HIV-specific criminal sentencing enhancement from state law to Governor Josh Shapiro’s desk.

The bill eliminates a provision that allows people living with HIV to face more severe criminal penalties based solely on their HIV status, a policy that LGBTQ+ advocates and public health experts have long argued is outdated and unsupported by modern medical science.

Following the vote, the Pennsylvania LGBTQ+ Equality Caucus praised the legislation, calling it “an important step toward ending the criminalization of HIV status in Pennsylvania.”

The caucus also thanked Rep. Ben Waxman, who sponsored companion legislation in the House to advance the reform.

Under current Pennsylvania law, a person living with HIV can receive enhanced criminal penalties in certain cases regardless of whether HIV transmission was possible. One frequently cited example involves prostitution offenses, which are generally misdemeanors but can be elevated to felonies for someone living with HIV, even in situations involving no physical contact or conduct incapable of transmitting the virus.

Supporters of Senate Bill 45 argue those provisions reflect outdated understandings of HIV rather than current medical evidence.

Advances in HIV treatment have transformed the virus from a fatal diagnosis into a manageable chronic condition for most people with access to care. Antiretroviral therapy allows many people living with HIV to achieve an undetectable viral load, preventing sexual transmission of the virus while enabling them to live long, healthy lives.

The Equality Caucus said removing HIV-specific sentencing enhancements better aligns Pennsylvania law with contemporary science while helping reduce stigma surrounding people living with HIV.

“Senate Bill 45 brings Pennsylvania law into closer alignment with current science, reduces stigma, and creates a legal framework that can continue to evolve alongside future advances in HIV research and care,” the caucus said in a statement.

With final legislative approval complete, Senate Bill 45 now awaits Governor Josh Shapiro’s signature. If signed into law, Pennsylvania would join a growing number of states that have modernized or repealed HIV-specific criminal statutes in response to advances in HIV prevention, treatment, and scientific understanding.

US: Louisiana reform offers blueprint for ending HIV Criminalisation

Decriminalizing HIV: 3 moves that helped ETAF secure progress in Louisiana

More than 30 U.S.states still criminalize HIV under laws written decades ago, when far less was understood about how the virus is transmitted. These outdated statutes can mean prosecution or imprisonment for people living with HIV, despite scientific advances that have transformed both treatment and transmission risk.

Louisiana just took a significant step toward changing that. On May 15, 2026, Governor Jeff Landry signed House Bill 808 into law, narrowing the state’s HIV exposure statute to conduct that poses a substantial likelihood of transmission and creating new protections for people living with HIV who disclose their status and maintain an undetectable viral load. HB808 passed both chambers unanimously, a first for an HIV criminalization reform measure in the South.

The new law, which goes into effect August 1, reflects nearly a decade of work by advocates, people living with HIV, and partners across Louisiana supported in part by FCAA member Elizabeth Taylor AIDS Foundation (ETAF). The organization recognizes that criminalizing HIV impacts people’s ability to live a free and just life, find employment or housing, and stay healthy and undetectable — particularly for women, LGBTQ+ people, and the Black community. Through its HIV Is Not a Crimecampaign, ETAF is working to overturn these laws to support the freedoms of people living with HIV across the U.S.

ETAF’s Jake Arman recently shared three strategies from their work that other funders can apply to their own efforts.

Provide flexible, long-term funding.

ETAF has restructured its grantmaking to “empower states to plan strategically for the long term, beyond just the immediate year or shifting political climates,” Arman says. In an environment where meaningful change can take years or even decades, that long-range perspective is key. ETAF’s funding approach allows coalitions to wait for the right legislative moment and invest in proactive education in the meantime.

Invest in bipartisan relationship-building.

The campaign’s wins “are rooted in sustained trust-building efforts and internal strategies, enabling the community to work across political aisles to garner the support needed to change HIV laws,” Arman says. Louisiana’s unanimous vote shows what that kind of relational groundwork can produce, even on issues where consensus seems unlikely.

Celebrate incremental wins.

Big legislative wins are rare in this work. Yet even smaller legal successes can make a real difference for people living with HIV, which is why ETAF treats even smaller changes as cause for celebration. “Community input has helped us focus on deepening our impact, rather than chasing grand metrics,” Arman says. “The incremental law changes of HIV Is Not A Crime have been vital for sustaining morale and purpose, and attracting new supporters of HIV-related issues, especially at the local level.”

WHAT’S NEXT FOR THE CAMPAIGN

With outdated criminalization laws still on the books in more than 30 states, ETAF’s work is far from over. As shifting political tides create new risks for people living with HIV, ETAF sees these efforts as more urgent than ever — working toward a day where no person is subjected to unjust HIV laws.

Mexico: National HIV agency backs repeal of HIV criminalisation offence

Censida welcomes the repeal of the offence of “risk of transmission” to strengthen the strategy against HIV

Translated with Deepl. Scroll. down for article in Spanish.

The organisation argues that criminalising the disease discourages voluntary testing.

The National Centre for the Prevention and Control of HIV/AIDS and Hepatitis (CENSIDA) supported the repeal of the offence known as “risk of transmission”, considering it a step forward in terms of public health and human rights, as it removes a provision which, according to scientific evidence, fostered stigma and hindered timely access to HIV prevention, diagnosis and treatment.

The agency maintained that criminalising a health condition “does not reduce new infections or strengthen prevention strategies”.

On the contrary, it warned that the fear of legal consequences, combined with stigma and discrimination, can discourage people from undergoing voluntary diagnostic testing, limit access to preventive measures and delay people’s engagement with health services.

Recalls the work of institutions

In the statement, CENSIDA recalled that national and international bodies, including the National Council for the Prevention of Discrimination (Conapred), the National Human Rights Commission (CNDH), the UNAM Institute for Legal Research, UNAIDS, the World Health Organisation (WHO) and the Pan American Health Organisation (PAHO), have warned that the criminalisation associated with certain health conditions has adverse effects on prevention and epidemiological control strategies, by reinforcing stigma, discouraging testing and limiting access to medical care.

It also emphasised that the national HIV response policy is based on universal access to prevention, timely diagnosis and comprehensive treatment, whilst respecting people’s rights.

The agency highlighted that “the scientific evidence is conclusive: a person living with HIV who is receiving antiretroviral treatment and consistently maintains an undetectable viral load does not transmit the virus through sexual contact”, a principle recognised internationally as ‘Undetectable, Untransmittable’.

Call to provide prevention tools

The Ministry of Health stated that legal frameworks must be updated in line with scientific knowledge and not based on stigma. It added that decriminalisation will help strengthen a public health model based on shared responsibility, comprehensive sexual health education and access to prevention tools such as condoms, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), screening tests and timely treatment.

The agency, which reports to the Ministry of Health, indicated that this measure will also help more people to know their HIV status and access health services without fear of being stigmatised or criminalised, which will support the achievement of national and international targets to end HIV as a public health problem.

The agency reiterated that the response to HIV must place people at the centre of public policy, strengthen combined prevention strategies and reduce inequalities in access to health services free from discrimination.

“The protection of public health is strengthened through access to information, prevention, diagnosis, treatment and the unrestricted respect for human rights; not through the criminalisation of people on the basis of their health status.”

Censida reconoce derogación del delito de “peligro de contagio” para consolidar estrategia contra el VIH

La institución argumenta que criminalizar la enfermedad frena las pruebas voluntarias.

El Centro Nacional para la Prevención y Control del VIH/Sida y Hepatitis (CENSIDA) respaldó la derogación del delito denominado “Del peligro de contagio”, al considerar que representa un avance en materia de salud pública y derechos humanos, al eliminar una disposición que, de acuerdo con la evidencia científica, favorecía el estigma y dificultaba el acceso oportuno a la prevención, el diagnóstico y el tratamiento del VIH.

La dependencia sostuvo que penalizar una condición de salud “no reduce las nuevas infecciones ni fortalece las estrategias de prevención”.

Por el contrario, advirtió que el temor a consecuencias legales, sumado al estigma y la discriminación, puede desalentar la realización voluntaria de pruebas diagnósticas, limitar el acceso a herramientas preventivas y retrasar la vinculación de las personas con los servicios de salud.

Recuerda labor de instituciones

En el comunicado, CENSIDA recordó que organismos nacionales e internacionales, entre ellos el Consejo Nacional para Prevenir la Discriminación (Conapred), la Comisión Nacional de los Derechos Humanos (CNDH), el Instituto de Investigaciones Jurídicas de la UNAM, ONUSIDA, la Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS), han advertido que la criminalización asociada a determinadas condiciones de salud genera efectos adversos sobre las estrategias de prevención y control epidemiológico, al reforzar el estigma, desalentar la realización de pruebas y limitar el acceso a la atención médica.

Asimismo, enfatizó que la política nacional de respuesta al VIH se basa en el acceso universal a la prevención, el diagnóstico oportuno y el tratamiento integral con respeto a los derechos de las personas.

La dependencia destacó que “la evidencia científica es concluyente: una persona que vive con VIH, recibe tratamiento antirretroviral y mantiene de forma sostenida una carga viral indetectable no transmite el virus por vía sexual”, principio reconocido internacionalmente como Indetectable e Intransmisible.

Llaman a facilitar herramientas de prevención

La Secretaría de Salud señaló que los marcos jurídicos deben actualizarse conforme al conocimiento científico y no con base en el estigma. Agregó que la derogación del delito permitirá fortalecer un modelo de salud pública sustentado en la corresponsabilidad, la educación integral en salud sexual y el acceso a herramientas de prevención como el condón, la profilaxis preexposición (PrEP), la profilaxis postexposición (PEP), las pruebas de detección y el tratamiento oportuno.

El organismo, dependiente de la Secretaría de Salud, indicó que esta medida también contribuirá a que más personas conozcan su estado serológico y accedan a los servicios de salud sin temor a ser estigmatizadas o criminalizadas, lo que favorecerá el cumplimiento de las metas nacionales e internacionales para poner fin al VIH como problema de salud pública.

La dependencia reiteró que la respuesta frente al VIH debe colocar a las personas en el centro de las políticas públicas, fortalecer la prevención combinada y reducir las desigualdades en el acceso a servicios de salud libres de discriminación.

“La protección de la salud pública se fortalece mediante el acceso a la información, la prevención, el diagnóstico, el tratamiento y el respeto irrestricto de los derechos humanos; no mediante la criminalización de las personas por su condición de salud”.