A/HRC/41/27 United States of America; Michaela Clayton, Executive Director of the AIDS and Rights Alliance for Southern Africa; and Dr. Olusegun Odumosu, the Executive Director of African Men for Sexual Health and Rights. All speakers emphasized the need to respect and promote human rights for all, including key populations, in the response to HIV. Despite the advances made, including in treatment and care, the HIV epidemic continued, and the target of ending HIV by 2030 would not be achieved unless the response to HIV adopted a human rights-based approach, including in addressing structural barriers (such as stigma, discriminatory or punitive laws and policies), which underlay human rights violations, stigma and discrimination, preventing access to prevention, testing, treatment and care services, information and goods. 12. The Special Rapporteur addressed the progress made and challenges to human rights in the response to HIV. He called upon the global community, with the leadership of the United Nations, to be more active in sharing good practices to ensure their effective and sustainable replication. He highlighted the importance of a human rights-based approach in addressing non-discrimination, participation, empowerment, monitoring and accountability, and the synergy between a human rights-based approach and a modern public health approach based on scientific evidence, which were mutually reinforcing. He cautioned against the trend favouring the adoption of a selective approach to the application of human rights, including the right to health and the response to HIV. Poverty remained one of the main factors preventing an end to AIDS; he therefore reminded States to address the financial exclusion of the poor, without neglecting other forms of discrimination, in order to reach universal health coverage. 13. Dr. Baral described stigma as a barrier to access to health services and to the effectiveness and coverage of prevention and treatment programmes. He identified patterns of stigma across regions among key populations, such as men who have sex with men, and sex workers in sub-Saharan Africa and the United States of America, and the link between stigma and criminal laws. Stigma affected disclosure and access to treatment, increased vulnerability to violence and the likelihood of risky behaviour. With regard to mental health, stigma was an antecedent of depression. In Côte d’Ivoire, for instance, transgender women, who in general were subjected to more stigma than cisgender men who had sex with men, were also more vulnerable to mental health conditions. There was a strong link between criminalization, stigma and HIV; in countries where sex work was criminalized, HIV prevalence among sex workers was higher. Dr. Baral concluded that, while less research was conducted on stigma and rights violations as social determinants of health in HIV epidemiologic and prevention studies, they were quantitatively measurable and represented actionable risk factors for HIV acquisition and transmission. 14. Ms. Clayton identified human rights challenges in the response to HIV, starting with stigma and discrimination. She elaborated on other challenges, such as the drop in global funding of efforts to fight HIV, the “global gag rule”, donors transitioning out of countries or the push for more domestic funding. All of these challenges could decrease the availability of HIV services, particularly for the removal of human rights barriers or programmes for key populations. Ms. Clayton also identified the shrinking of space available for civil society and the lack of political will to address human rights barriers in the response to HIV. Cooperation at the regional level allowed for information-sharing and collaboration between civil society, judges, members of parliament and human rights mechanisms. She identified some positive examples in addressing stigma and discrimination in Malawi, based on working with a wide range of partners and stakeholders, including judges, UNDP, members of Parliament and the Southern African Development Community Parliamentary Forum. She suggested combining top-down and bottom-up approaches to bring together different stakeholders, working with both communities and lawmakers. Lastly, she stressed the importance of not sidelining HIV in definitions of universal health coverage packages at the national level. 15. Dr. Odumosu presented the work of the African Men for Sexual Health and Rights in representing African key populations in global forums, and presented examples of civil society collaboration at the regional level. He stressed the importance of ensuring that community voices were heard and had a platform, supporting the concept of the top-down, bottom-up approach. He welcomed the decriminalization in Angola of same-sex consensual 5