Anne Stangl, Devaki Singh, Michael Windle, Kirsty Sievwright, Katherine Footer, Alexandrina Lovita, Stella Mukasa, Stefan Baral
BMC Infectious diseases, 2019;
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Repressive legal environments and widespread human rights violations act as structural impediments to efforts to engage key populations at risk of HIV infection in HIV prevention, care, and treatment efforts. The identification and scale-up of human rights programs and rights-based interventions that enable coverage of and retention in evidence-based HIV prevention and treatment approaches is crucial for halting the epidemic.
The authors conducted a systematic review of studies that assessed the effectiveness of human rights interventions on improving HIV-related outcomes between 2003-2015. Of 31,861 peer-reviewed articles and reports identified, 23 were included in the review representing 15 different populations across 11 countries.
Findings
- 83 per cent of studies reported a positive influence of human rights interventions on HIV-related outcomes.
- The majority of studies incorporated two or more principles of the human rights-based approach, typically non-discrimination and accountability, and sought to influence two or more elements of the right to health, namely availability and acceptability.
- Outcome measures varied considerably, making comparisons between studies difficult.
Conclusion
The review revealed encouraging evidence of human rights interventions enabling a comprehensive HIV response, yet critical gaps remain. The development of a research framework with standardized indicators is needed to advance the field. Promising interventions should be implemented on a larger scale and rigorously evaluated. Funding for methodologically sound evaluations of human rights interventions should match the demand for human rights-based and structural approaches to protect those most vulnerable from HIV infection.
