What if all countries grappling with HIV worked to ensure that the most effective evidence-based prevention, healthcare and treatment measures got to everyone affected by the epidemic? What if they compared their policies and services to best practices and worked to eliminate human rights obstacles and add critical and culturally appropriate components to their responses?
It would be a first step to identifying and confronting restrictive, inadequate and absent policies affecting men who have sex with men, transgender individuals, and people who earn their livings through sex work, an analysis from the Health Policy Project and AMSHeR — African Men for Sexual Health and Rights — says. Effectively a handbook for advocates, policymakers and service providers, the Policy Analysis and Advocacy Decision Model for HIV-Related Services, Males Who Have Sex with Males, Transgender People, and Sex Workers addressing failures in HIV responses, it identifies restrictive policies — (including, for example, prohibition of condom distribution in prisons), inadequate policies — ones that don’t address the information or commodity needs — condoms and lubricants, for example — of specific populations, and absent policies — for example to actively address barriers to services, including criminalization. It includes inventory toolkits to literally take stock of responses, with boxes for a yes or no on questions that include “Policy does not mention homosexual identity or, if it is mentioned, identifies it as legal,” as opposed to “Policy classifies homosexual ideintity as illegal,” and “Policy does not punish homosexual identity by death,” as opposed to “Policy punishes homosexual identity by death.” Some are more obvious than others. It can be used, to measure progress as well as barriers, point to redresses as well as abuses.
The Health Policy Project also has released the companion Policy Analysis Decision Model for HIV-Related Services: People Who Inject Drugs in English and Russian.
On a more local scale, Ending AIDS in Uganda: What Will it Take? released by civil society organizations as a “shadow report” at the country’s Joint Annual Review of its AIDS response over the weekend, praises progress in treatment access during the last year, and examines the factors leading to failures in recent years — stockouts, failure to acknowledge risks among fishing communities, men who have sex with men, and sex workers, and a hostile policy and legal environment toward people living with HIV as well as men who have sex with men.