In just two decades, AIDS has become the leading cause of death in Africa, and now kills more people worldwide than any other infectious disease. Although current treatments are expensive, and an affordable vaccine in the developing world is many years away, HIV/AIDS prevention programs and activities often remain narrow in their scope, applicability, and impact. A human rights approach to the HIV/AIDS epidemic moves beyond a focus on the individual to address social, economic, and political factors that drive the epidemic, such as gender-based inequalities, poverty, corruption, and government inaction. A rights-based approach empowers affected individuals and communities, and challenges governments to justify their actions (or inaction) to the people they represent and, ultimately, to the global community. We reproduce a fact sheet written by David Patterson for the Interagency Coalition on AIDS and Development (ICAD). It sets out a rights-based approach to development, examines the human rights dimensions of the HIV/AIDS pandemic, and gives examples of right-based programming in the context of the developing world. It concludes with sources of further information, both in hard copy and on the web.
This paper reports on selected results from a completed study that explored sexual dynamics and decision-making among young people aged 11-24 years in KwaZulu/Natal Province. Data were collected in three phases: 1) a series of focus group discussions; 2) narrative research component; and 3) in-depth follow-up interviews with selected questionnaire participants. Two aspects of the youths' sexual behavior were discussed: condom use and abstinence as responses to HIV/AIDS. It is noted that as young people have begun to re-evaluate their beliefs and standards concerning appropriate sexual behavior for fear of HIV infection, significant barriers to behavior modification remain. Such obstacles are a reflection of an adaptation to historical, political, and sociocultural factors in their environment. Moreover, factors such as poor communication and negotiation skills, gender stereotypes, and gender power imbalances all hamper sexual dynamics of young people. In view of such, strategies for HIV intervention programs, such as: life skills improvement, acceptability and destigmatization of condom use, consistent condom use, and responsible sexual practice, should be incorporated.
Cultural taboos inhibit communication about sex, deny and stigmatize deviant sexual practices, and are incorporated into sexual cultures characterized by silence, shame and secrecy. In contemporary Indonesian societies, sex is often infused with negative connotations and referred to as taboo. Considering the threat that an AIDS pandemic poses, HIV/AIDS prevention and treatment represent a critical development issue that requires ongoing commitment from the Indonesian Government and the international donors that provide critical financial support in the health sector. These taboos that inhibit communication about sexuality clearly constrain attempts to challenge negative understandings of sexuality as inherently shameful. However, promotion of reproductive/sexual health and HIV/AIDS prevention is highly contingent upon expanded dialogue about sexuality in both private and public domains. Hence, the author emphasized the need to acknowledge the complex ways in which sexual communication is circumscribed by enduring cultural taboos, and also how sexual dialogue operates to subvert and erode those taboos.
In Indonesia, evidence indicates that HIV infections have decreased during the 1990s. Estimates by the WHO put sexually transmitted HIV infections at 25,000 among the more than 200 million population of the country. However, reports from other countries suggest that injecting drug users (IDUs) are potentially becoming a threat to the success of AIDS-preventive programs. This is because of the huge explosion of drug use among young people, which in turn has resulted in a rise in HIV infections with communal needle use in recent years. Available data suggest that Indonesia could experience an overall 50% prevalence of HIV among the over 1 million IDUs within 1 or 2 years. Although it is the responsibility of the Indonesian government to respond to this health crisis, in its bankrupt state it can only be hoped that it will be able to put into place a framework that will allow the community, nongovernmental organizations, and donors to work together with minimum restrictions.
This paper outlines some of the imperatives that should drive attention to the rights of legal and illegal migrants to health, particularly in relation to HIV/AIDS. It is noted that migrants can be especially vulnerable to HIV/AIDS/sexually transmitted diseases (STDs), but they are often excluded or simply missed in many prevention and care programs. In terms of the effects of globalization, it would seem that governments are required to ensure that this state of affairs does not continue. Evidence indicates that human rights and other ethical violations are occurring and need to be urgently addressed at local, national and international levels. In view of such, it is recommended that HIV/AIDS/STD prevention and care programs for migrant populations should be developed with and guided by migrant communities, and involving substantial community mobilization. Although some progress in preventing the spread of HIV to and from migrants have been documented, and projects addressing their needs have been made accessible, the challenge of dealing more comprehensively the complex issues involved still remains.
