Law, Criminalization and HIV in the World: Have Countries That Criminalize Achieved More or Less Successful Pandemic Response?

BMJ Global Health, 2021; 6:e006315.
doi:10.1136/bmjgh-2021-006315
(2021). O'Neill Institute Papers. 96.

10 Pages Posted: 21 Sep 2021

See all articles by Matthew Kavanagh

Matthew Kavanagh

Georgetown University

Schadrac C. Agbla

University of Liverpool

Marissa Joy

Georgetown University - The O'Neill Institute for National and Global Health Law

Kashish Aneja

Georgetown University - The O'Neill Institute for National and Global Health Law

Mara Pillinger

George Washington University, Department of Political Science, Students

Alaina Case

Talus Analytics

Ngozi A. Erondu

Centre for Universal Health, Chatham House

Taavi Erkkola

UNAIDS

Ellie Graeden

Talus Analytics

Date Written: August 2, 2021

Abstract

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with HIV (PLHIV) knew their HIV status and could suppress the HIV virus through antiretroviral treatment. This article presents a cross-national ecological analysis of the relative success of national AIDS responses under this strategy, where laws were characterised by more or less criminalisation and with varying rights protections. In countries where same-sex sexual acts were criminalised, the portion of PLHIV who knew their HIV status was 11% lower and viral suppression levels 8% lower. Sex work criminalisation was associated with 10% lower knowledge of status and 6% lower viral suppression. Drug use criminalisation was associated with 14% lower levels of both. Criminalising all three of these areas was associated with approximately 18%–24% worse outcomes. Meanwhile, national laws on non-discrimination, independent human rights institutions and genderbased violence were associated with significantly higher knowledge of HIV status and higher viral suppression among PLHIV. Since most countries did not achieve 2020 HIV goals, this ecological evidence suggests that law reform may be an important tool in speeding momentum to halt the pandemic.

Note:
Funding Information: This study was funded by US Agency for International Development and Joint United Nations Programme on HIV/AIDS.

Declaration of Interests: None declared.

Keywords: HIV, pandemic, global health law, discrimination, human rights

Suggested Citation

Kavanagh, Matthew and Agbla, Schadrac C. and Joy, Marissa and Aneja, Kashish and Pillinger, Mara and Case, Alaina and Erondu, Ngozi A. and Erkkola, Taavi and Graeden, Ellie, Law, Criminalization and HIV in the World: Have Countries That Criminalize Achieved More or Less Successful Pandemic Response? (August 2, 2021). BMJ Global Health, 2021; 6:e006315.
doi:10.1136/bmjgh-2021-006315
(2021). O'Neill Institute Papers. 96., Available at SSRN: https://ssrn.com/abstract=3925649 or http://dx.doi.org/10.2139/ssrn.3925649

Matthew Kavanagh (Contact Author)

Georgetown University ( email )

Washington, DC 20057
United States

Schadrac C. Agbla

University of Liverpool

Chatham Street
Liverpool, L69 7ZA
United Kingdom

Marissa Joy

Georgetown University - The O'Neill Institute for National and Global Health Law ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
United States

Kashish Aneja

Georgetown University - The O'Neill Institute for National and Global Health Law ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
United States

Mara Pillinger

George Washington University, Department of Political Science, Students ( email )

Washington, DC
United States

Alaina Case

Talus Analytics ( email )

Boulder, CO

Ngozi A. Erondu

Centre for Universal Health, Chatham House

10 St James's Square
London, SW1Y 4LE
United Kingdom

Taavi Erkkola

UNAIDS ( email )

Geneva
Switzerland

Ellie Graeden

Talus Analytics ( email )

Boulder, CO

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