A/HRC/22/53 institutionalization of individuals may amount to torture or ill-treatment as use of force beyond that which is strictly necessary.92 E. Marginalized groups 1. Persons living with HIV/AIDS 71. Numerous reports have documented mistreatment of or denial of treatment to people living with HIV/AIDS by health providers.93 They are reportedly turned away from hospitals, summarily discharged, denied access to medical services unless they consent to sterilization,94 and provided poor quality care that is both dehumanizing and damaging to their already fragile health status. 95 Forced or compulsory HIV testing is also a common abuse that may constitute degrading treatment if it is “done on a discriminatory basis without respecting consent and necessity requirements” (A/HRC/10/44 and Corr.1, para. 65). Unauthorized disclosure of HIV status to sexual partners, family members, employers and other health workers is a frequent abuse against people living with HIV that may lead to physical violence. 2. Persons who use drugs 72. People who use drugs are a highly stigmatized and criminalized population whose experience of health-care is often one of humiliation, punishment and cruelty. Drug users living with HIV are often denied emergency medical treatment.96 In some cases the laws specifically single out the status of a drug user as a stand-alone basis for depriving someone of custody or other parental rights. Use of drug registries – where people who use drugs are identified and listed by police and health-care workers, and their civil rights curtailed – are violations of patient confidentiality97 that lead to further ill-treatment by health providers. 73. A particular form of ill-treatment and possibly torture of drug users is the denial of opiate substitution treatment, including as a way of eliciting criminal confessions through inducing painful withdrawal symptoms (A/HRC/10/44 and Corr.1, para. 57). The denial of methadone treatment in custodial settings has been declared to be a violation of the right to be free from torture and ill-treatment in certain circumstances (ibid., para. 71). Similar reasoning should apply to the non-custodial context, particularly in instances where Governments impose a complete ban on substitution treatment and harm reduction measures.98 The common practice of withholding anti-retroviral treatment from HIVpositive people who use drugs, on the assumption that they will not be capable of adhering to treatment, amounts to cruel and inhuman treatment, given the physical and psychological suffering as the disease progresses; it also constitutes abusive treatment based on unjustified discrimination solely related to health status. 92 93 94 95 96 97 98 ECHR, Mouisel v. France, Application No. 67263/01 (2002), para. 48; see also Nell Monroe, “Define acceptable: how can we ensure that treatment for mental disorder in detention is consistent with the UN Convention on the Rights of Persons with Disabilities?”, The International Journal of Human Rights, vol. 16, No. 6 (2012). Campaign to Stop Torture in Health Care, “Torture and ill-treatment in health settings: a failure of accountability”, Interights Bulletin, vol. 16, No. 4 (2011), p. 162. Open Society Foundations, Against Her Will (footnote 43 above). See HRW, Rhetoric and Risk: Human Rights Abuses Impeding Ukraine’s Fight against HIV/AIDS (2006). Ibid., p. 44. A/65/255, para. 20. See HRW, Lessons Not Learned: Human Rights Abuses and HIV/AIDS in the Russian Federation (2004). 17