Assessing Changes in HIV-Related Legal and Policy Environments: Lessons Learned from A Multi-Country Evaluation

12 Pages Posted: 19 Jun 2018 Last revised: 10 Jul 2018

See all articles by Laura Ferguson

Laura Ferguson

University of Southern California - Program on Global Health and Human Ritghts

Alexandra Nicholson

University of Southern California - Program on Global Health and Human Rights

Ian Henry

University of Southern California - Program on Global Health and Human Rights

Amitrajit Saha

United Nations Development Programme - HIV, Health and Development Team

Tilly Sellers

United Nations Development Programme Regional Bureau for Africa - Health and Development Team

Sofia Gruskin

University of Southern California Keck School of Medicine; University of Southern California Gould School of Law; Harvard School of Public Health

Date Written: July 10, 2018

Abstract

Introduction: There is growing recognition in the health community that the legal environment — including laws, policies, and related procedures — impacts vulnerability to HIV and access to HIV-related services both positively and negatively. Assessing changes in the legal environment and how these affect HIV-related outcomes, however, is challenging, and understanding of appropriate methodologies nascent.

Methods: We conducted an evaluation of a UNDP project designed to strengthen legal environments to support the human rights of key populations, in particular LGBT populations, women and girls, affected by HIV in sub-Saharan Africa. We analyzed data on activities designed to improve legal environments through a systematic document review and 53 qualitative interviews.

Results: The project made substantial strides towards legal change in many places, and examples provide broader lessons for work in this area. Two core pillars appear fundamental: a government-led participatory assessment of the legal environment, and building the capacity of those impacted by and engaged in this work. Systematic attention to human rights is vital: it can help open new spaces for dialogue among diverse stakeholders, foster new collaborations, and ensure local ownership, nuanced understanding of the political landscape, attention to marginalized populations, and accountability for (in)action. Entry points for effecting legal change go beyond “HIV laws” to also include other laws, national policies and strategies.

Conclusion: Conducting legal environment assessments, multi-stakeholder dialogues, action planning and related activities, alongside capacity building, can contribute to changes in knowledge and attitudes directly relevant to reforming laws that are found to be harmful. Shorter-term goals along the causal pathway to legal change (e.g. changes in policy) can constitute interim markers of success, and recognition of these can maintain momentum. Increasing understanding of progress towards changes in the legal environment that can positively affect HIV-related outcomes is important in working to improve the health and lives of people living with HIV.

Suggested Citation

Ferguson, Laura and Nicholson, Alexandra and Henry, Ian and Saha, Amitrajit and Sellers, Tilly and Gruskin, Sofia, Assessing Changes in HIV-Related Legal and Policy Environments: Lessons Learned from A Multi-Country Evaluation (July 10, 2018). USC CLASS Research Paper No. CLASS 18-15; USC Law Legal Studies Paper No. 18-17. Available at SSRN: https://ssrn.com/abstract=3188246 or http://dx.doi.org/10.2139/ssrn.3188246

Laura Ferguson (Contact Author)

University of Southern California - Program on Global Health and Human Ritghts ( email )

2250 Alcazar Street
Los Angeles, CA 90089
United States

Alexandra Nicholson

University of Southern California - Program on Global Health and Human Rights ( email )

2001 N Soto St
Los Angeles
CA
United States

Ian Henry

University of Southern California - Program on Global Health and Human Rights

2001 N Soto St
Los Angeles
CA
United States

Amitrajit Saha

United Nations Development Programme - HIV, Health and Development Team ( email )

UNDP Regional Bureau for Europe and the Commonweal
One United Nations Plaza 16th Floor
New York, NY 10017
United States

Tilly Sellers

United Nations Development Programme Regional Bureau for Africa - Health and Development Team ( email )

Addis Ababa
Ethiopia

Sofia Gruskin

University of Southern California Keck School of Medicine ( email )

2001 N. Soto Street
Los Angeles, CA 90089
United States

HOME PAGE: http://globalhealth.usc.edu/ghhr

University of Southern California Gould School of Law ( email )

699 Exposition Boulevard
Los Angeles, CA 90089
United States

Harvard School of Public Health ( email )

677 Huntington Avenue
Boston, MA MA 02115
United States

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