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Access To Justice To People Suffering From HIV/AIDS

"Human rights are a guiding light to the realization of the right to health, and we have to explore all possible synergies between these two areas. It is time to act!" -Regina Maria Cordeiro Dunlop, Permanent Mission Of Brazil

Abstract
Despite the knowledge that stigma is a major barrier to effective HIV/AIDS interventions, stigma reduction efforts are at the bottom of AIDS program priorities. One of the key reasons for the sluggish response to this recurrent problem is the intricacies of HIV/AIDS-related stigma.

We perform a comprehensive assessment of the scientific literature on HIV/AIDS-related stigma in order to document the current status of research, identify evidence gaps, and highlight promising stigma-reduction approaches in this paper. We focus on detecting, quantifying, and eradicating HIV/AIDS-related stigma, as well as studying the impact of stigma on HIV prevention and treatment program efficacy.

Introduction
HIV/AIDS is one of India's most serious problems. In India, around three million individuals are infected with HIV/AIDS. The country's socioeconomic situation, combined with its traditional mindset and accompanying misconceptions, has made it more prone to the disease. One of the main causes of the disease's proliferation is a lack of literacy. The condition is associated with a severe societal stigma.

HIV/AIDS patients face discrimination everywhere they go and are stigmatized in society. The workplace is the main area where people experience the disease's impacts. Although the condition is not totally curable, there are steps that may be taken to avoid it. People may be educated and made more aware of the disease, its causes, and its consequences, which can assist to prevent it from spreading further.

What Is AIDS

The term "Acquired Immune Deficiency Syndrome" refers to a set of symptoms caused by a breakdown in the immune system (AIDS). It is the most advanced stage of HIV infection, resulting in significant immune system damage as well as potentially fatal infections. This is a situation in which the human body's defense mechanisms are compromised, resulting in a variety of symptoms that can lead to a number of illnesses and diseases.

AIDS is caused by the Human Immunodeficiency Virus (HIV) (HIV). The virus assaults the immune system, leaving the body exposed to a wide range of diseases and malignancies, some of which are fatal.

The most prevalent routes for HIV to spread are through sexual contact (oral, vaginal, and anal intercourse), infected blood transfusions, the use of non-sterile, HIV-infected or contaminated syringes and needles, and transmission from an infected mother to her unborn child.

"A participatory approach to the AIDS response in the health care sector implies having the necessary mechanisms in place for users and communities to ensure access to services that are responsive to the needs of the different groups affected, be it drug users, sex workers, pregnant women or gay men."- Dainius Puras, Special Rapporteur On The Right To The Highest Health Standard Permitted By Law

Legal Provisions In International Conventions

The Union of India has signed many treaties, accords, and declarations dealing to HIV/AIDS, the protection of rights of those who are HIV positive, those who are afflicted by HIV/AIDS, and those who are most susceptible to HIV/AIDS, in order to safeguard people who are HIV positive, those who are affected by HIV/AIDS, and those who are most vulnerable to HIV/AIDS.

Both the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social, and Cultural Rights aim to eradicate discrimination based on race, gender, and creed. Nondiscrimination against HIV-positive people is also included in their scope.

According to the Universal Declaration of Human Rights, non-discrimination is a key aspect of human rights law. It also applies to those living with HIV/AIDS, who face a lot of discrimination and stigma. It sets various work-related provisions for HIV/AIDS infected persons, including the right to life, liberty, and security of person; no one should be subjected to forced testing and/or treatment or other cruel or humiliating treatment; all people, including HIV+ people, have the right to work and participate in the community's cultural life, enjoy the arts, and engage in scientific growth and its advantages; and all people, including HIV+ people, have the right to work.

HIV-positive people enjoy rights listed in Article 25(1) of the Declaration, including the right to an acceptable quality of living, support, medical care, and vital social services, as well as the right to employment security based on their requirements and treatment options.

The UNAIDS Guidelines, which were released in 1996, emphasize the need of countries participating in legislative reform. It also aids states in identifying legislative hurdles so that an effective HIV/AIDS prevention and care plan may be developed. It also asks for anti-discrimination and other protective measures to protect HIV/AIDS patients from discrimination in the public and private sectors, to preserve their privacy, confidentiality, and ethics in human subjects research, to stress education and conciliation, and to offer prompt and efficient administrative and civil remedies.

Legal Provisions In Indian Laws

In order to defend HIV/AIDS patients' rights, the Ministry of Health and Family Welfare correctly announced the adoption of the crucial Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency (AIDS) Syndrome (Prevention and Control) Act, 2017.

This was done shortly after the Supreme Court issued a landmark decision to strike down Section 377 of the Indian Penal Code (IPC), which made homosexuality illegal. This decision has reinforced the rights of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) group, which makes up a significant portion of India's HIV and AIDS-infected population.

The Act was lawfully implemented by the ministry of health and family welfare via a gazette notification, and as a result, the Act obtained presidential assent on April 20, 2017. This Act expressly and unequivocally prohibits all forms of discrimination against people living with HIV or AIDS, as well as the provision of informed consent and confidentiality in relation to their treatment, and the imposition of requirements on the institutions responsible for protecting their rights. The Act also attempted to prevent and control the spread of HIV and AIDS, as well as establish a system for resolving any disease-related issues.

No one, including shops, public restaurants, hotels, and places of public entertainment, may reject or cease access to, or supply or enjoy or utilize any products, accommodation, service, facility, advantage, privilege, or opportunity devoted to the general public or habitually available to the public, whether or not for a price.

This Act also states that no HIV test, medical treatment, or research can be performed on an individual without their informed consent, and that no one is required to disclose their HIV status in order to obtain employment or services unless they have given their informed consent or a court order requires them to do so. The law also protects HIV-positive people's property rights, stating that anybody under the age of 18 who is HIV-positive has all of the standard requirements for living in a shared home and therefore has access to all of the household's amenities without being kicked out or discriminated against.

Anyone who broadcasts or encourages hostile emotions toward HIV-positive people or those who live with them is also breaking the law. Any infringement of the Act that results in the publication of information on people living with HIV (PLHIV) or the fostering of hate toward them is punishable by a penalty of three months to two years in jail or a maximum fine of one lakh rupees, or both.


"AIDS, more than ever before, is a human rights issue. We must make human rights work for people; we must move from rhetoric to action if we want to ends the AIDS epidemic."- Luiz Loures, Unaids Deputy Executive Director

Legal Provisions Of The Indian Medical Council Act, 1956 (Professional Conduct & Ethics) Regulations, 2002)

When it comes to HIV/AIDS patients, the Medical Council of India provides certain obligations for doctors.

These Are Listed Below:
  • Obligation to use caution and get informed permission from the patient;
  • Disclosing facts and hazards to the patient
  • Providing information on potential alternatives and benefits
  • Warning obligation
  • Admitting a patient without his or her consent in an emergency
  • The physician should not neglect his responsibilities because he is afraid of catching the sickness.

Immoral Trafficking Prevention Act Of 1986 Legal Provisions

The Immoral Trafficking Prevention Act of 1986 governs sex labor in India. A obligatory medical examination for the detection of HIV/AIDS is required under the Act. There were other tests that were required.

HIV/AIDS Bill, 2007

The HIV/AIDS Bill is the result of a partnership between government and civil society. In both public and private contexts, the measure clearly prohibits discrimination against HIV/AIDS patients. The measure prohibits discrimination against HIV/AIDS patients based on their HIV status in employment, education, healthcare, travel, insurance, housing, and property, among other sectors. It includes all discriminatory acts and omissions based on HIV status, both actual and imagined.

Permission for HIV testing and research must be explicit, informed, and unrestricted, according to the measure. HIV testing, treatment, and research with informed consent. It also guarantees the privacy of an individual's HIV status and stipulates the situations under which information can be published.

HIV/AIDS patients have a responsibility to avoid HIV viral spread through several techniques. HIV/AIDS patients now have access to comprehensive HIV/AIDS treatment, as well as prevention, care, and support, at no cost. The bill specifically safeguards risk reduction techniques against civil and criminal liability, as well as law enforcement harassment.

According to the bill, everyone has a right to health-related information and education, as well as protection from the state. The Bill's primary focus is on women and young people. It assigns responsibility for implementing evidence-based, age-appropriate, gender-sensitive, non-stigmatizing, and non-discriminatory IEC programs to the state. The measure mandates that each district designate a health ombudsman to guarantee that everyone has easy and timely access to health care. Institutional internal complaints processes are also covered. The grievance readdress laws also contain special court procedures focusing on speedy trials and imaginative readdress.

The bill also acknowledges special rights for women, children, and those in the state's care and custody who are more susceptible to HIV and are disproportionately affected by the pandemic owing to social, economic, legal, and other challenges. It also recognizes the relationship between sexual violence and HIV, allows survivors of sexual assault to receive counseling and treatment, and allows for the establishment of sexual assault crisis centers.

"Law reform is a longer-term goal. Meanwhile, legal services can improve the quality of people's lives immediately." - David Patterson, International Development Law Organization


Bill To Prevent And Control Human Immunodeficiency Virus And Acquired Immune Deficiency Syndrome, 2010

The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Bill of 2010, which was signed into law in 2010, has robust safeguards to protect HIV/AIDS sufferers from discrimination. It is likely to be examined by the Cabinet. Discrimination against HIV-positive people is prohibited under the Act. It also makes disseminating any information that is intended to incite hostility against the affected persons illegal.

HIV testing cannot be required for employment, healthcare, education, or public access, according to the proposed legislation. They have the right to file a lawsuit in order to put an end to discrimination. In addition, the Bill provides that anybody afflicted with HIV/AIDS cannot be fired or denied employment unless a competent and unbiased healthcare practitioner confirms in writing that the affected individual creates a risk of transmission.

The bill includes a clause that protects people under the age of 18 and women of any age from eviction by allowing them to dwell in a shared house. Medical expenses will be reflected into any maintenance agreements. The law is intended to prevent HIV/AIDS sufferers from being victimized on a large scale.

No one may be forced to undergo an HIV test, according to the bill. For a test to be conducted, the individual affected must give their informed permission, which must be obtained after thorough counseling on all pros and downsides. Without the patient's agreement, medical treatment for HIV/AIDS cannot be administered. A person can only be forced to reveal his HIV status if the Court orders him to do so.

If a doctor feels there is a danger of infection, he might tell his partner that his patient is HIV positive. However, he would have to be cautious about disclosing information about a lady if there is a risk of her being abandoned or experiencing violence.

Policy On HIV/AIDS At The National Level And In The Workplace

The Ministry of Labor & Employment's National Policy on HIV/AIDS and the Workplace was revealed at the Standing Labor Committee's 43rd session. After negotiations with the International Labor Organization (ILO), NACO (National Aids Control Organization), and social partners, the Ministry of Labor and Employment produced the Policy.

The policy aims to raise HIV/AIDS awareness, motivate action to prevent the transmission of the disease, and strengthen and expand workplace support and care efforts. Its mission is to prevent HIV infection among workers and their families, to protect the rights of those who are infected and provide access to available care, support, and treatment facilities, to address HIV/AIDS stigma and discrimination at work by ensuring equity and dignity, and to ensure safe migration and mobility with access to HIV/AIDS information services.

According to the policy, HIV/AIDS screening should not be demanded of job candidates or employees, nor should it be used as a basis for dismissal or denial of benefits. Employers may seek to conduct anonymous, unrelated HIV prevalence surveys in their workplace in order to analyse the effect of HIV. These investigations may take place as long as they are conducted in compliance with scientific research ethics, professional ethics, and the preservation of human privacy and confidentiality.

Workers should be contacted and informed about such research when it is conducted. If there is a reasonable probability that the result may reveal a person's HIV status, the test will not be considered anonymous. It further emphasizes that being HIV-positive is not a reason for dismissal. For as long as they are medically fit, people with HIV-related conditions should be allowed to work in suitable circumstances.

The Following Legislation, Politicies, And Organizations Provide Protection To HIV/AIDS Patients:

  • Daman, Diu Public Health Act, 1985 Goa, Amended in 1986
  • Indian Penal Code, 1860
  • Drugs and Cosmetic Act, 1940
  • Juvenile Justice (Care and Protection of Children) Act, 2000 and 2006.
  • Maharashtra Protection of Commercial Sex Workers, Bill, 1994.
  • Medical Termination of Pregnancy Act, 1971
  • Narcotic Drugs and Psychotropic Substances Act, 1985
  • National AIDS Control Organization (NACO), Department of AIDS Control, Policies and Guidelines.

Post-Exposure Antiviral Therapy Guidelines For HIV-Infected Adults And Adolescents

  • SACS Condom Promotion Operational Guidelines
  • Data Sharing Policies

Nov 2006 Guidelines For AIDS Care And Treatment In Infants And Children

  • HIV Testing Guidelines, March 2007
  • Guidelines for Prevention and Management of Common Opportunistic Infections (NIHAR)
  • Guidelines for Network of Indian Institutions for HIV/AIDS Research (NIHAR)

Guidelines For Setting Up Blood Storage Centres For Infections

  • Operational Guidelines for the Link Worker Scheme (LWS)
  • NACO Ethical Guidelines for Operational Research
  • Operational Guidelines for the Link Worker Scheme (LWS)
  • NACO Research Fellowship Program (NACP-III)
  • National Reproductive Tract Infection Prevention, Management, and Control Guidelines
  • National Guidelines for RTI and STI Prevention, Management, and Control

National HIV/AIDS Policy And The Workplace

  • National AIDS Control Programme (NACP-III) Procurement ManualStandards for Blood Banks and Blood Transfusion Services
  • Operational Guidelines for Surveillance
  • Migrant Targeted Intervention as Operational Guidelines

Interventions For High-Risk Groups That Are Targeted (HRGS)

  • Operational Guidelines and Targeted Interventions for Truckers
  • An Operational Guide to Voluntary Blood Donation
  • A Policy for HIV/AIDS Control and Prevention in the United States (NACPC)
  • Blood Policy in the United States (NIHFW)
  • AIDS Control Program in the United States (NIHFW)
  • Policy for HIV/AIDS Prevention and Control in the United States
  • Suppression of Immoral Traffic in Women and Girls Act (Suppression of Immoral Traffic in Women and Girls Act) (Suppression of Immoral Traffic in Women
  • The Young Persons (Harmful Publications) Act of 1956 was enacted to protect young people from harmful publications.
  • Policy for HIV/AIDS Prevention and Control in the United States
  • The Indian Employers' HIV/AIDS Statement of Commitment
  • The Central Trade Unions of India's Joint Statement of Commitment on HIV/AIDS
  • International Labor Organization (ILO) Code of Practice on HIV/AIDS and the Workplace
  • AIDS Control Societies by State
  • National Commission on Human Rights

"Accessing lawyers and courts and the decision to seek a legal remedy is difficult for most people, and even more so for those who are stigmatized and discriminated against at every step of the process. Thus, there is an urgent and continued need for greater measures to guarantee access to justice for all within the AIDS response."-Rebecca Brown, Center For Reproductive Rights

Patients With HIV/AIDS Rights

Right To Healthcare:

A person who is suffering from any sickness has the right to receive care. A patient's treatment cannot be rejected because of his HIV/AIDS condition. Discrimination occurs when an HIV/AIDS patient is denied treatment. The Supreme Court of India has ordered that all patients who require second-line HIV/AIDS therapy be provided free of charge.

Following his release from prison in the case of LX v. Union of India, LX, an HIV-positive defendant, was denied antiviral treatment (ART) to prevent AIDS. In response to his petition, the Delhi High Court directed the government to continue supplying ART to LX. Following the government's initiation of the ARV roll-out in April 2004, the High Court ordered the government to give ART to LX under the ARV roll-out program and reimburse AIIMS for the expenditures they incurred.

In another case, the hospital refused to treat a pregnant woman who was HIV-positive. The Delhi High Court issued immediate orders to the Hospital in response to a plea filed by her husband, stating that there was an urgent need to give directions to safeguard the preservation of the women's and her foetus' right to health and life. A directive was issued to get one unit of blood, as well as any more blood that may be necessary, from any of the authorized blood banks as soon as possible.

Anonymity:
A person with HIV/AIDS who has been diagnosed has the right to remain anonymous regarding his or her HIV/AIDS status. Even the courts have decided in their favor, ruling that individuals can use a pseudonym in court to mask their genuine name if they do not want to expose their true identity.

In the case of Mr. X v. Hospital Z, the Supreme Court of India held that AIDS sufferers are entitled to full sympathy and human respect. Because of their HIV/AIDS status, they cannot be denied employment. While doctor-patient confidentiality is an important part of medical ethics enshrined in the Medical Council Act at the time, the court held that a patient's right to confidentiality was not enforceable in a situation where the patient was HIV positive and faced the risk of infecting his future spouse. Because it is unlawful to spread contagious illnesses, the hospital's failure to inform the spouse about the illness would render them criminals.

Because venereal disease is one of the leading causes of death in the United States, Because venereal illness is a cause of divorce in India, a person with the condition has no right to marry until he or she is completely recovered, and such a right must be considered a "suspended right."

In another case, Mr. X v Hospital Z, the Supreme Court found that its previous ruling in Mr. X v Hospital Z, which had suspended the right of HIV/AIDS patients to marry, was no longer sound law, and that the right of an HIV+ person to marry had been reinstated. It went on to say that this does not absolve persons who are HIV-positive of their responsibility to get informed permission from their future spouse prior to marriage.

Negligence In Blood Transfusion

In the case of P v. Union of India, an HIV patient's blood was donated to a pregnant woman who was later found to be HIV positive. The Indian Navy, which was at fault in this case, compensated the victim with a Government job in Kolkata or wherever she desired, accommodation on her appointment on the usual terms and conditions, a sum of Rs. 10 lakhs from the date of filing the writ petition @ 18 percent interest, and medical treatment at the Government's expense.

The Naco Guidelines Against Prescreening Tests On Prospective Employees Are As Follows: Informed Consent Right

A thorough HIV testing policy has been developed by the National AIDS Control Organization. According to the HIV testing policy, mandatory HIV testing shall not be imposed as a requirement for employment or providing healthcare services in private organizations. Testing should only be done with informed consent, including pre- and post-test counseling, and should be completely voluntary.

In The Event Of Discrimination Or Denied Access To Facilities, What Is The Remedy?

If a person infected with HIV/AIDS is denied treatment or any other service to which a regular person is entitled, or is discriminated against in any sector because of his or her HIV/AIDS status, the aggrieved person can submit a petition for remedy with the Court.

Conclusion
The study is the first to look at the data on the influence of human rights initiatives on HIV-related outcomes in a systematic way. Human rights initiatives as part of comprehensive HIV responses at the local, state, and national levels appear to have a lot of promise, but more data is needed to guide implementation and scale-up. To far, there have been few investments in the implementation and assessment of human rights projects.

The lack of evidence that has resulted has hampered the scaling up of initiatives to establish the enabling legal, social, political, and economic contexts required to reach and engage critical and vulnerable groups most at risk of HIV infection in care. By boosting investment in human rights programs and thorough assessment, now is the moment to guarantee that human rights are front and center in a comprehensive HIV response.

Bibliography::
  • https://www.legalserviceindia.com/legal/article-6998-legal-rights-of-hiv-aids-patients-in-india.html
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/
  • https://www.ohchr.org/sites/default/files/Documents/Publications/HIVAIDSGuidelinesen.pdf
  • https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264249#ack
  • https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3692-1#Sec4
  • https://kelinkenya.org/wp-content/uploads/2018/03/KELIN-AF-Midterm-Project-Review-Report-REVISED.pdf
  • https://www.un.org/africarenewal/web-features/human-rights-essential-fight-against-hivaids

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