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many public hospitals and drug treatment centres collect and share information about an
individual’s drug use with law enforcement, compound the inaccessibility of treatment. Research
from Human Rights Watch indicates that many drug users who have been subjected to drug
detoxification and re-education have been denied HIV services altogether or provided such
services in a manner that violates their fundamental right to health and to life.
41. Fifth, according to the submission of Human Rights Watch, incarceration is a critical risk
factor for HIV. In many countries, HIV prevalence in prison populations has been reported to be
several times the prevalence in the population at large. At the same time, there is also an
increased risk of exposure to other infectious diseases such as tuberculosis. Yet, prisoners and
other persons in detention have little or no access to HIV prevention, care, and treatment services
even when these are available in the general community. Sixth, despite the long-standing
recognition of heightened HIV risk faced by migrants and mobile populations, the international
community has largely ignored this call for action and has failed to establish policies or
mechanisms to provide health-care services to these populations. Seventh, more than
85 countries still uphold anti-sodomy laws that criminalize consensual homosexual contact
between men and often between women, impeding access to HIV/AIDS services by placing
people at risk of legal penalties. Finally, the fact that many countries do not recognize palliative
care and pain treatment as priorities in health care was raised as a concern, as well as the fact that
narcotic drug control regulations or enforcement practices in many countries impose unnecessary
restrictions that limit access to morphine and other opioid pain relievers.
42. In a submission by the International Association for the Study of Pain, the interface
between human rights and medical care, specifically in the context of pain management and
palliative care for patients with HIV, was reflected. They drew attention to the fact that
according to WHO, every year an estimated 1.4 million patients with end-stage HIV suffer
moderate to severe pain, but do not receive appropriate treatment and that most countries do not
have palliative care policies. This Association made the argument that palliative care and pain
management constitute important components of the right to health for persons living with HIV
and called for ensuring the provision of basic medication for symptom control and terminal care,
including analgesics; adopting and implementing national pain and palliative care policies; and
ensuring the education of health professionals in the care of patients with HIV and AIDS which
includes pain management and palliative care.
43. A number of proposals for further action were made and directed to Governments by the
International Council of AIDS Service Organizations (ICASO). They include the need to:
(a) fully implement the Declaration of Commitment and the Political Declaration, including
reaching universal access to HIV prevention, treatment, care and support by 2010, as adopted by
the General Assembly; (b) ensure legal protection against discrimination and violence against
women and girls, and decriminalizing sex work, men who have sex with men, transgender
people and people who use drugs; (c) repeal existing legislation and halt any efforts to pass
legislation criminalizing HIV transmission and exposure; (d) abolish laws that discriminate
against women and girls, or laws that contribute to human rights violations against women and
girls; (e) involve key populations such as people living with HIV, sex workers, people who use
drugs, men who have sex with men and transgender people in policy and programme design and
implementation; and (f) develop mechanisms for the redress of human rights violations. ICASO
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