“The evidence is overwhelming: criminalisation does not prevent HIV, it fuels it”

The scourge of LGBTQ criminalisation moving across African countries – and its impact on HIV

“The evidence is overwhelming: criminalisation does not prevent HIV – it fuels it,” Immaculate Owomugisha Bazare, Director of the Centre for Women Justice, Uganda, said in a plenary presentation at the 26th International AIDS Conference (AIDS 2026) held in Rio de Janeiro recently.

The conference had a prominent focus on how criminalisation – of identities, behaviours and HIV – impacts HIV outcomes. Research presented was mostly from sub-Saharan African countries, such as Uganda and Ghana, where criminalisation of LGBTQ people has been on the rise in recent years.

Grappling with multiple forms of criminalisation and funding cuts in Uganda

In 2023, Uganda passed the Anti-Homosexuality Act, a draconian bill aimed at criminalising LGBTQ people. This law was enacted in a context where sex work and drug use are already criminalised. “All these laws and policies continue to push people away from accessing services,” Bazare said.  

Criminalisation of LGBTQ identities, behaviours such as drug use and sex work, and sex while living with HIV are intricately intertwined: key populations such as gay, bisexual and other men who have sex with men (MSM) and transgender women are at a much higher risk of contracting HIV, as are injecting drug users and sex workers. In turn, these groups can be criminalised for both how they acquired HIV and allegations of exposing others to HIV.

Bazare stated that these laws have a devastating effect on health-seeking behaviour. For a member of a key population, if any aspect of their identity is criminalised, it leads to a fear of stigma, discrimination and arrest. This results in delayed or total avoidance of HIV testing, prevention and treatment seeking. For example, if a gay man contracts HIV, any sex that he has after that is doubly criminalised: because of his identity and because he has HIV. This may be considered an act of ‘aggravated homosexuality’ according to the Ugandan Act – if the person’s sexual partner “contracts a terminal illness as a result of the sexual act.” While HIV was removed from the final wording of the Act, this clause can be left open to interpretation and likely is aimed specifically at HIV – regardless of scientific advances such as U=U – and may result in a death penalty.

The 2025 US funding freeze – which abruptly halted HIV services for key populations globally – has only added to the terror created by criminalisation in Uganda. Ruth Kikonyogo, from Save the Youth Uganda, presented research at the conference on mental health among a sample of 111 gay, bisexual and other men who have sex with men. Survey data were collected at two timepoints: after the Act was passed and after the funding freeze.

The percentage of participants reporting symptoms that matched moderate-severe depression rose by 13 percentage points, as did those reporting experiences of stigma. Exposure to violence went up by 12 percentage points, while anxiety symptoms went up by 11 percentage points and suicidal ideation by 9 percentage points. There were declines in access to both HIV services (by 14 percentage points) and psychosocial services (by 12 percentage points). Approximately 6% of the sample had fled Uganda after the Act was passed: this was reflected in the final sample size, as 142 men had initially taken the survey.

“Community-based HIV and psychosocial services serve as a critical protective factor for MSM, and their disruption magnifies the harm caused by hostile legal environments,” Kikonyogo concluded.

Ghana’s new anti-gay law

Research from other African countries showed that these negative impacts on mental health were not limited to Uganda. As Bazare put it: “The fire moves from Uganda to other countries. We’ve seen Ghana, we’ve seen Senegal now where we have specific laws that criminalise people but also criminalise HIV.”

Dr Akua Gyamerah presented research with gay and bisexual men, transgender women and gender-diverse people from Ghana, looking at whether antiretroviral therapy (ART) adherence was impacted by social stressors, such as criminalisation, through pathways such as depression, alcoholism and suicidality.

The ironically named Human Sexual Rights and Family Values Bill is considered the most restrictive anti-LGBTQ bill on the continent and was passed by Ghana’s parliament in May 2026. If signed into law by the president, John Mahama, it would criminalise LGBTQ identities, advocacy, gender-affirming care, allyship and any specific programming directed towards LGBTQ groups. As with other similar laws, it also encourages citizens to spy on each other and report any suspected homosexual behaviour.

Researchers created a scale to measure the frequency of social stressors linked to the anti-LGBTQ legislation. This included questions related to violence, arrests, discrimination and economic insecurity, for example: “Due to the anti-homosexuality bill/law in Ghana, I have been blackmailed or robbed.” ART non-adherence was measured as missing four consecutive doses at least once during the prior three months.

Among 256 participants with an average age of 31, approximately 40% identified as cisgender men, another 40% as transgender women and the remainder as gender diverse. Most of the sample reported their sexualities as gay, bisexual or queer. Monthly median income was low, at $100 for the sample.

Social stressors related to gender and sexuality were high: 68% had been asked about their sexuality, 31% had been blackmailed or robbed, while 17% had been threatened with death. Over a quarter of the sample did not report crimes because of fear of arrest (28%) and had been threatened with being reported to the police (27%). Just under 10% had been arrested. Overall, 23% stopped going to group programmes, such as health discussions for LGBTQ people, and 5% stopped seeking HIV services.

On average, the sample had been on ART for five years. Over the three months prior to the survey, 31% reported ART non-adherence. Over a quarter of the sample were at a significant risk of suicide (28%) and met the criteria for an alcohol use disorder (26%). On average, the sample displayed significant depressive symptoms.

While a direct association between criminalisation-related stressors and ART adherence was not significant, Gyamerah and colleagues found that greater social stressors were linked to higher depressive symptoms, alcohol use disorder and suicide risk. In particular, depressive symptoms were highlighted as a pathway through which social stressors impacted ART adherence.

“Proposed punitive legislation – not just laws – can undermine HIV treatment by increasing risk of mental health through exposure to social stressors,” Gyamerah concluded. “Structural harm is an HIV treatment issue. Protecting ART adherence requires affirming mental healthcare and opposition to structural criminalisation.”

Bazare summarised it as: “Laws and policies are not simply legal issues, they are public health issues, they are human rights issues, and they are gender equality issues.”

References

Bazare IO. Justice, rights and HIV: Building resilient legal frameworks. 26th International AIDS Conference, Rio de Janeiro, plenary session PL03, 2026.

View the details of this session on the conference website.

Gyamerah A et al. Anti-LGBTQ+ legislation, mental health, and ART non-adherence among sexual minority men, trans women, and gender-diverse people living with HIV in Ghana: A mediation analysis. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3906LB, 2026.

View the abstract on the conference website.

Kikonyogo R et al. One shock after another! From the anti-gay law to unexpected HIV funding cut. A comparative assessment of mental health and suicidality by men who have sex with men during these two extremes in Uganda. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3902, 2026.

View the abstract on the conference website.

Russia: New rules require health services to report HIV among foreign nationals

Medical organisations required to report foreign nationals’ HIV infections to the Ministry of the Interior

Translated with Deepl.com – Scroll down for original article in Russian.

Medical organisations will be required to provide the Ministry of the Interior and Rospotrebnadzor with information on infections among foreign nationals, including HIV, and cases of drug use, should such cases be identified whilst providing medical care. This was reported by the press office of the Russian Ministry of Health, according to ‘Interfax’.

The ministry has drawn up a draft order to this effect. The initiative is aimed at safeguarding the public health and epidemiological well-being of the Russian population and ensuring the accuracy of information regarding the medical assessments of foreign nationals, the ministry clarified.

The draft has been drawn up to implement the law requiring foreign nationals to undergo a medical examination within 30 days of entering Russia and annually thereafter. Foreign nationals themselves must pay for these examinations.

All medical certificates will be in electronic form and will be stored in the Unified State Healthcare Information System (EGISZ). Healthcare organisations will be required to transmit the information to the Ministry of the Interior and Rospotrebnadzor within 24 hours to prevent documents from circulating outside the system.

Russian President Vladimir Putin signed a law in June establishing a standard timeframe for compulsory medical examinations for foreign nationals. According to the document, migrant workers and foreign nationals planning to stay in Russia for more than 90 days must undergo a medical examination within 30 days of entering the country.

The examination includes testing for drug use, dangerous infectious diseases and HIV. The costs of the medical examination are borne by the foreign nationals themselves or their employers, and it may only be carried out by authorised medical organisations.


Медорганизации обяжут сообщать в МВД о ВИЧ-инфекциях иностранцев

Медицинские организации должны будут передать в МВД и Роспотребнадзор сведения об инфекциях иностранцев, в том числе о ВИЧ-инфекции, и случаях употребления наркотиков, если такие будут выявлены во время оказания медицинской помощи. Об этом сообщилив пресс-службе Минздрава России, передает «Интерфакс».

Ведомство разработало соответствующий проект приказа. Инициатива направлена на сохранение санитарно-эпидемического благополучия населения России и обеспечение достоверности сведений о медзаключениях граждан других стран, уточнили в министерстве.

Проект разработан для реализации закона, обязующего иностранцев проходить медосмотр в течение 30 дней с моменте въезда в Россию и далее ежегодно. При этом оплачивать прохождение осмотра должны сами граждане других стран.

Все медицинские заключения будут в электронной форме, их разместят в Единой государственной информационной системе здравоохранения (ЕГИСЗ). В течение суток медорганизации должны будут передать информацию в МВД и Роспотребнадзор, чтобы избежать оборота документов вне системы.

Президент России Владимир Путин подписал закон, устанавливающий единый срок обязательного медицинского освидетельствования для иностранных граждан, в июне. Согласно документу, проходить медосмотр в течение 30 дней после въезда в страну должны трудовые мигранты и иностранцы, планирующие находиться в России более 90 дней.

Обследование включает проверку на употребление наркотических веществ, наличие опасных инфекционных заболеваний и ВИЧ. Расходы на медосвидетельствование возлагаются на самих иностранцев или их работодателей, а проводить его смогут только уполномоченные медицинские организации.

Senegal: Harsh penalties for same-sex relations is severely disrupting HIV services

HIV care suffers under Senegal anti-gay law
The introduction of harsh penalties for same-sex relations has created a climate of fear that is severely disrupting HIV services. Gilbert Nakweya reports.
 
Patients in Senegal are forgoing critical HIV care, including testing and antiretroviral drugs (ARVs), for fear of arrest or abuse following the implementation of a controversial anti-gay law. The law, which came into force at the beginning of April, 2026, has introduced harsher penalties, including doubling the maximum prison sentence to 10 years for “acts against nature“ and criminalising promotion of homosexuality. According to the HIV Justice Network, over 200 people have been arrested and dozens jailed under the law while others have been accused of deliberately transmitting HIV to others. The Network has also documented dozens of reports of forced HIV testing.
 
Patients have been left living in fear and others have gone to neighbouring countries such as The Gambia and Morocco. Amadu*, a gay man aged in his 30s, knew his life was in danger in March and April when arrests increased and his close gay friends were jailed. Worried about being arrested himself and running out of medication, he fled to a neighbouring country. “I was not able to access ARVs as access to clinics is dangerous. I had to leave Senegal within less than 12 hours. I couldn’t get enough ARV pills before leaving as time and risk management didn’t allow for that”, he told The Lancet.
 
“My economic privilege helped me escape, but I personally know of dozens of people who can’t leave for economic reasons yet they cannot access [HIV treatment] services”, said Amadu. “I rely on my network in this country to get medication, but there is always fear here as well. I know at least 20 other people who have had to leave Senegal for the same reason as me, some of them are also HIV positive and struggle to get medication”.
 
Speaking on condition of anonymity, one Senegalese public health expert who works with Mpact Global, a gay men’s health and rights advocacy non-governmental organisation, said that the new law is only worsening the risky environment for community health organisations helping LGBTQ+ groups access HIV preventive and treatment services. “An increase in HIV incidence among men who have sex with men should be anticipated with the legal changes and the social climate it has propagated. I haven’t seen official numbers but have heard anecdotes of people deserting HIV services facilities. There are reports of lower utilization of HIV services since the law was passed in March”, he said. There is some precedent for such an effect. The high-profile arrest of nine HIV peer educators in Senegal in 2008 had a chilling effect on LGBTQ+ organisations. Although no formal correlation has been established, HIV prevalence in gay men went from 17·8% in 2014 to 27·6% in 2024, according to CNLS (the National Council for the Fight Against HIV/AIDS), the government body responsible for coordinating efforts to combat HIV in Senegal.
 
The expert says that the biggest HIV service facility in the country, Fann National University Hospital, is experiencing a dearth of clients with the few who show up wearing sunglasses or hoodies to avoid being recognised and targeted. Community health workers who were engaged in HIV testing, treatment, and prevention services, such as distribution of condoms, HIV-preventive pre-exposure prophylaxis (PrEP) medication, and monitoring patients, have been arrested. “The laws are incompatible with public health and human rights. Decriminalisation, competent and adequate health services, and measures against stigma and discrimination are the only sustainable ways out”, he said.
 
Even health workers in government are worried. “The situation is quite complicated here. I just want to be careful to protect our patients”, said a senior public health officer who works with CNLS.
 
Senegal’s HIV response has already been weakened by US funding cuts on international assistance that came into force in January, 2025. The HIV prevalence among men who have sex with men is estimated to be 27·6%, compared with 0·5% in the general population.
 
Researchers warn that Senegal’s criminalisation of homosexuality is reversing years of gains in HIV control. “Such punitive laws [as Senegal’s] and policies have shown no evidence for effectiveness as public health approaches. They undermine both public health and human rights and have led to declines in HIV testing, use of PrEP, and support for people living with HIV infection in Uganda, Nigeria, and several other countries”, said Chris Beyrer, Professor of Medicine at Duke University, Durham, NC, USA. “This is very disappointing as Senegal had been on a path to achieving HIV control. These new policies will set the country back and only further discrimination and stigma.”
“Denying people health rights, regardless of their behaviour, drives people underground and does not improve public health”, Beyrer told The Lancet.

The Anti-Rights Movement is Organised. Are We?

AIDS 2026, the biennial global conference on all things HIV, closed on July 31 after a week of presentations on scientific advances (including twice-yearly lenacapavir and long-acting cabotegravir plus rilpivirine; advances in cure and vaccine research, with reports of sustained remission in the “Kansas City Patient”) and ongoing funding crises and key populations under threat, with anti-LGBTQ legislation in Uganda, Ghana, Senegal, and Côte d’Ivoire.

During the week, I attended more than a dozen sessions. As always, the most important conversations took place not only in formal sessions, but in the Global Village, in corridors, at community events, and over coffee. By the end of the week, I realised they all revolved around the same question: How do we build a movement capable of confronting an increasingly organised anti-rights agenda?

The question first crystallised for me during Wednesday’s session, Law, Power and Access: Overcoming barriers to HIV services. During the discussion I asked how we can overcome what increasingly feels like a successful “divide and rule” strategy. Across the world, the forces seeking to roll back human rights appear remarkably coordinated. They target communities already facing marginalisation—including people living with HIV, LGBTQ+ people, women, migrants, sex workers, and people who use drugs—as they always have. Reproductive rights, civil society, and scientific evidence are under fire as well, not as separate issues, but as part of a broader political project.

Meanwhile, those of us working to defend rights too often continue to organise ourselves in silos.

The same theme emerged again later that day during a conversation between Georgetown University’s Matthew Kavanagh and Mariângela Simão, who begins her role next week as the UN Special Rapporteur on the right to health. Simão spoke of the growing cohesion of anti-rights forces internationally, while Kavanagh posed what may be the defining question for the years ahead: what would it take to build an equally effective pro-rights force?

It struck me that this wasn’t simply another conference discussion; it was the thread connecting so many conversations throughout AIDS 2026.

The HIV movement knows better than most that progress has never come from science alone. Scientific breakthroughs have transformed HIV from a life-threatening diagnosis into a manageable condition and have given us extraordinary tools to prevent transmission. But while HIV itself may no longer be life-threatening for most people with access to treatment, the political environment has become increasingly rights-threatening. Evidence alone has never guaranteed equitable access, ended stigma or repealed punitive laws. Those achievements have always depended on organised communities, strategic advocacy, political leadership, and solidarity.

Throughout AIDS 2026 there were outstanding sessions on criminalisation, gender equality, community leadership, access to medicines, funding, and shrinking civic space. Each highlighted a different piece of the puzzle. Yet we still too often approach these as separate struggles, competing for scarce funding and political attention. Our opponents do not.

Anti-rights alliances reinforce each other

The anti-rights movement has spent decades building alliances across countries and political movements. It understands that attacks on LGBTQ+ rights, sexual and reproductive health and rights, gender equality, migrant rights, civil society, and science reinforce one another. Divide and rule is effective precisely because those defending rights are so often divided.

Another session that stayed with me was No retreat, no surrender: The future of philanthropy in HIV. Richard Borain of the Children’s Investment Fund Foundation (CIFF) argued that philanthropy’s greatest contribution is not simply funding projects but strengthening the “connective tissue” that brings together governments, communities, donors, and civil society around shared goals.

That phrase resonated with me. We have become very good at investing in programs, but less intentional about investing in the relationships, trust, and collaboration that allow organisations and movements to reinforce one another.

I was reminded of this again at the Robert Carr Fund’s celebration of 15 years of supporting global HIV and health movements. At a time when the Fund has faced an uncertain future following the withdrawal of support from both the United States and the Netherlands, there was welcome news: CIFF has joined as a new donor, while ViiV Healthcare announced a further year of support.

For more than a decade, the Robert Carr Fund has demonstrated a different model of philanthropy—trust-based, multi-year, flexible core funding combined with peer learning and movement building. The HIV Justice Global Consortium, which first united regional and global HIV criminalisation networks, was made possible through Robert Carr Fund support, and the HIV Justice Network remains proud to be one of its grantees.

Yet even within the Robert Carr Fund family there is greater potential to work across movements and constituencies. That is not a criticism of the Fund; rather, it reflects how deeply siloed our sector has become. If organisations already committed to rights-based approaches can collaborate more intentionally, imagine what could be achieved with greater investment in those connections.

The anti-rights movement invests in networks, long-term relationships, shared strategies, and patient coalition-building. We need to become equally serious about investing in the infrastructure of solidarity. AIDS 2026 made clear: our greatest challenge is no longer simply defending individual rights. It is building a movement capable of defending them together.

Edwin J Bernard is Executive Director of the HIV Justice Network and a global advocate for human rights and HIV justice.

Email:edwin@hivjustice.net

Image: Rogério von Krüger / IAS

The next phase of HIV decriminalisation: closing the translation gap

Last month, I wrote about the limits of relying on “U=U” as the primary message for HIV decriminalisation. In doing so, I also reflected on how “U=U” has transformed the lives of people living with HIV. Grounded in compelling science and amplified through years of advocacy, it has become a powerful message of hope, dignity and self-acceptance. Its success also demonstrates something broader: science changes lives only when it is translated into policy, practice and public understanding.

HIV criminalisation reminds us that translating science into justice remains unfinished. Forty-five years into the HIV epidemic, advances in HIV science have fundamentally transformed our understanding of transmission, treatment and prognosis. Yet people living with HIV continue to be investigated, prosecuted and imprisoned based on outdated assumptions about risk and harm.

This contradiction formed the basis of my presentation yesterday at AIDS 2026, the 26th International AIDS Conference in Rio de Janeiro. The question I posed was simple: Why does HIV criminalisation persist despite contemporary HIV science? The answer, I argued, lies in what I call the translation gap: the persistent failure – or refusal – to translate contemporary HIV science into law, policy and practice.
 
Scientific evidence does not change society on its own. It changes society only when institutions choose to translate it into legal standards, public policy and everyday practice. That process is never purely technical; it is shaped by politics, power and values.
 
The evidence for this is clear. Over the past decade, 50 jurisdictions across 28 countries have moved towards HIV decriminalisation through legislative reform, constitutional and supreme court decisions, and updated prosecutorial guidance. Together, these reforms demonstrate that when contemporary HIV science is effectively translated into law and policy, legal systems do change.
 
But progress has been highly uneven. In some parts of the world, reform has accelerated. In others, it has barely begun. At the same time, the HIV Justice Network’s Global HIV Criminalisation Database continues to document new prosecutions around the world, suggesting that the pace of reform has slowed.
 
The challenge facing the HIV justice movement has therefore evolved. In many countries, the problem is no longer simply HIV-specific criminal laws. Increasingly, criminalisation is sustained through the interaction of criminal law, public health systems, policing, politics, and stigma.
 
Our recent research illustrates this shift. In Uzbekistan, for example, HIV criminalisation often begins long before anyone enters a courtroom. Mandatory registration, public health surveillance, referrals from healthcare providers to law enforcement, and the use of medical records as evidence all demonstrate how healthcare systems themselves can become part of the machinery of criminalisation.
 
Recognising this changes what justice requires. Contemporary HIV science requires greater legal precision. Non-disclosure is not the same as intent. Perceived risk is not the same as actual risk. An allegation of HIV transmission is not proof of who transmitted HIV, and establishing the direction of transmission often requires scientific evidence that courts fail to consider or misinterpret. Even where harm has occurred, criminal punishment is not automatically the appropriate response.
 
But science alone cannot produce these changes. Translation depends on institutions that value evidence, independent courts, governments willing to act and civil society organisations able to advocate for reform. Increasingly, these conditions are being undermined by broader attacks on public health, human rights and democratic institutions.
 
This is where structural violence helps explain why the translation gap persists. Scientific evidence alone is insufficient because law does not operate independently of politics or power. Organised anti-rights movements have become increasingly influential in reshaping the political environments in which legal reform takes place. As civic space shrinks and scientific expertise is challenged, translating contemporary HIV science into law becomes increasingly difficult.
 
Yet communities continue to create pathways to justice. Even where legal reform is blocked, advocates document prosecutions, provide legal literacy and paralegal support, engage international human rights mechanisms, influence global health policy and support those living under punitive laws. Communities do not simply wait for the law to change; they continue creating opportunities for justice despite the obstacles they face.
 
That is why the next phase of HIV decriminalisation is not simply about changing more laws. It is about closing the translation gap. Yesterday we launched the Guidance on Good Practices in HIV Decriminalisation. The Guidance brings together contemporary HIV science, legal expertise and the experience of communities around the world to support countries wherever they are on the journey towards HIV decriminalisation.
 
Closing the translation gap requires more than scientific evidence. It requires practical tools that help governments, courts, advocates and communities translate that evidence into action. The Guidance is designed to be one of those tools.
 
The success of “U=U” demonstrates what is possible when science is translated into practice. The persistence of HIV criminalisation demonstrates what happens when the translation of science into justice is resisted. Closing that translation gap is now the central challenge for HIV justice. The new Guidance is intended to help meet that challenge by helping ensure that science is translated into justice.

New global Guidance on HIV decriminalisation launched at AIDS 2026

Community-led resource distils more than 30 years of global experience into practical action for advocates, policymakers and justice systems

Download the Guidance here

The HIV Justice Network (HJN), on behalf of HIV JUSTICE WORLDWIDE (HJWW) and the Global Partnership for Action to Eliminate All Forms of HIV-related Stigma and Discrimination, today launched the Guidance on Good Practices in HIV Decriminalisation during a packed Global Village session at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro.

Supported by UNAIDS, the Guidance is the first practical global resource to bring together more than three decades of community leadership, human rights standards, contemporary HIV science and real-world experience of advocacy, litigation and law reform into a single framework for action.

Opening the session, HJN Executive Director Edwin J Bernard described the Guidance as “a practical resource that we hope communities, advocates, lawyers, judges, policymakers and public health officials will actually use.”

Rather than presenting the publication chapter by chapter, the session demonstrated how it can support change in diverse legal and political contexts around the world.

Speakers included Janet Butler McPhee (HIV Legal Network), Svitlana Moroz (Eurasian Women’s Network on AIDS), Immaculate Owomugisha Bazare (Centre for Women Justice Uganda) and Sofía Várguez Villanueva (HIV Justice Network), who shared examples of community advocacy, legal reform, strategic litigation, work in restrictive legal environments and practical advocacy tools.

Although more than 80 countries continue to maintain HIV-specific criminal laws and prosecutions also occur under general criminal laws, the Guidance reflects growing evidence that communities can successfully challenge punitive approaches. Around the world, advocates have helped repeal or modernise laws, influenced courts and prosecutors to apply contemporary HIV science, and promoted rights-based public health responses.

“The HIV justice movement has reached an important milestone,” Bernard said. “For the first time, we’ve accumulated enough experience from around the world to identify what good practice actually looks like. This Guidance brings together what communities have learned over decades, so others don’t have to start from scratch.”

Designed for advocates, lawyers, judges, prosecutors, policymakers, public health officials and community organisations, the Guidance recognises that every country starts from a different place and that reform is rarely linear. Rather than prescribing a single model, it offers practical approaches that can be adapted to different legal, political and cultural contexts.

 

Mexico: Campaigners press Baja California to vote on HIV law reform

LGBTQ+ collective seeks progress in reform to eliminate crime that criminalizes people with HIV in Baja California

The group called on the State Congress’s Diversity Committee to put the bill seeking to repeal the offence of “risk of transmission” to a vote.

Mexicali, B.C.–The reform to remove the offence of “risk of transmission” from the Baja California Penal Code has been stalled for almost a year, denounced the Arcoíris Collective, which is calling on the State Congress to put it to a vote, arguing that the current legislation criminalises people living with the human immunodeficiency virus (HIV).

Javier Russell, leader of the Colectivo Arcoíris, explained that the amendment was tabled last year and has already gone through the relevant legislative process; however, he stated that it only remains to be brought before the plenary session for a vote, and therefore called on members of the State Congress to stop keeping it “on ice”.

“It is essentially a request to the Baja California Congress’s Diversity Committee to put the bill repealing the ‘risk of contagion’ provision to a vote; this bill was tabled last year and has already gone through the legislative process; all that remains is for it to be voted on,” said the collective’s leader.

Russell pointed out that Article 160 of the State’s Criminal Code penalises people with infectious diseases, a provision which, he asserted, has been rendered obsolete by scientific advances and constitutes a form of discrimination against those living with HIV.

The group’s leader indicated that treatments are now available that enable a person with HIV to achieve an undetectable viral load, thereby reducing the risk of transmission; he therefore considered that maintaining such regulations contradicts scientific knowledge and human rights.

Similarly, Russell recalled that Mexico has made international commitments under the 2030 Agenda to achieve the 95-95-95 target, which aims for 95 per cent of people living with HIV to know their status, for 95 per cent of them to receive treatment, and for 95 per cent of those on treatment to achieve an undetectable viral load.

The activist pointed out that retaining the current laws criminalises people on the basis of their health status and runs counter to these objectives and to the national policies promoted to combat stigma and discrimination.

Finally, Javier Russell reiterated his call to the members of the Diversity Commission to ensure that the bill is debated and put to a vote, given that its approval would bring state legislation into line with scientific advances and the country’s commitments regarding health and human rights.

New data presented at AIDS 2026 reveal renewed rise in HIV criminalisation amid global anti-rights backlash

HIV criminalisation is increasing again after several years of decline, with prosecutions continuing to ignore established scientific evidence and disproportionately targeting already marginalised communities, according to new research presented today at the 26th International AIDS Conference (AIDS 2026).

The analysis examined 115 database entries covering 150 reported HIV criminalisation cases documented between 1 June 2025 and 15 June 2026. We conclude that these findings reflect not only failures to apply contemporary HIV science but also a broader global resurgence of anti-science and anti-rights politics.

The data show a clear upward trend in reported cases since 2022. By mid-June 2026, 93 reported cases had already been documented, exceeding the total annual cases recorded during both 2023 (70) and 2024 (86), although still below pre-COVID-19 pandemic levels.

“Our findings suggest that science, rights and HIV are increasingly being put on trial together,” said Edwin J Bernard, Executive Director of the HIV Justice Network, who presented the findings on behalf of his co-authors, Sylvie Beaumont, Alison Symington and Sofia Varguez. “When courts continue to prosecute people for acts that science tells us pose no possibility of HIV transmission, this is no longer a scientific problem. It is a political and legal one.”

Uzbekistan and Senegal dominate reported cases

Uzbekistan accounted for 60 of the reported cases during the study period – around 40% of all documented cases. Many involved allegations of HIV “exposure” without evidence of transmission, prosecutions involving intimate partners, and cases against women whose partners were aware of their HIV status or who were receiving effective treatment.

We also highlight a major escalation in Senegal, where a broader crackdown on LGBTIQ+ communities led to more than 200 arrests. By mid-June at least 39 people were prosecuted in relation to their HIV status, often alongside charges linked to same-sex conduct. (See this report for the most recent numbers, which increase on a daily basis.)  The poster documents reports of forced HIV testing, public disclosure of HIV status, and the use of condom possession as evidence of criminal conduct.

Other countries with multiple reported cases included the United States (19), the Russian Federation (eight), France (three), the United Kingdom (three), Kazakhstan (two) and Zimbabwe (two).

Courts continue to disregard HIV science

We found that prosecutions continue to involve conduct for which there is either no possibility or only negligible possibility of HIV transmission, despite overwhelming scientific consensus.

Cases involving people with sustained undetectable viral loads continued to be prosecuted, with courts often failing even to consider viral load evidence. Prosecutions for spitting also persisted in both North America and Europe, despite scientific consensus that HIV cannot be transmitted this way.

These prosecutions stand in stark contrast to the 2018 Expert Consensus Statement on the Science of HIV in the Context of Criminal Law, which concluded that effective HIV treatment eliminates the possibility of sexual HIV transmission, condoms are highly effective prevention tools, and acts such as spitting cannot transmit HIV.

Criminalisation increasingly shifts into general criminal law

We also identified an important legal trend: HIV criminalisation increasingly continues through general criminal laws even where HIV-specific criminal statutes have been repealed or modernised.

Our data show that prosecutions increasingly rely on offences such as assault, sexual offences, public health legislation and child protection laws, suggesting that reforming HIV-specific statutes alone is insufficient unless broader criminal law and prosecutorial practices also change.

Structural inequalities reinforced

We argue that HIV criminalisation functions as a mechanism reinforcing wider systems of social control rather than protecting public health.

Women, migrants, sex workers, LGBTIQ+ people and economically marginalised communities continued to experience disproportionate enforcement. Many prosecutions occurred despite evidence of partner awareness, coercive circumstances or negligible possibility of transmission.

We conclude that HIV criminalisation increasingly operates within political environments characterised by hostility towards science, human rights, gender equality and community-led public health responses.

Positive developments offer a roadmap

Despite these concerns, we also identified encouraging developments.

Courts in Canada, France, Italy, Türkiye and the United States increasingly engaged with contemporary HIV science, while acquittals, successful legal challenges and improved judicial reasoning demonstrated that evidence-based approaches remain possible.

These examples are reflected in the newly launched Guidance on Good Practices in HIV Decriminalisation, developed by the HIV Justice Network with support from UNAIDS, which recommends:

  • recognising contemporary HIV science in criminal proceedings;
  • limiting prosecutorial discretion and overcharging;
  • requiring proof of actual intent and significant harm;
  • prohibiting criminalisation related to pregnancy, infant feeding and vertical transmission; and
  • strengthening community-led monitoring, legal support and accountability.

“The evidence increasingly shows what works,” Bernard said. “Where legal systems engage with science, require evidence of genuine harm and respect human rights, prosecutions decline and justice improves. But sustainable change also requires confronting the stigma and political narratives that continue to portray people living with HIV as dangerous.”

Download E J Bernard et al. WEPEF620, Science, rights, and HIV on trial: Is rising HIV criminalisation part of a global anti-science / anti-rights resurgence?

New research identifies how healthcare systems become gateways to HIV criminalisation

Healthcare should be a place of care, trust and confidentiality. But our new research presented at the 26th International AIDS Conference (AIDS 2026) shows that, in many countries, routine interactions with healthcare providers and public health systems instead become the starting point for criminal investigations against people living with HIV.

Our poster, From the doctor’s office to the jail cell: System reforms to protect care, confidentiality, and prevention in the context of HIV criminalisation, examines how healthcare systems contribute to HIV criminalisation and identifies practical reforms that can better protect both public health and human rights.

Most discussions about HIV criminalisation focus on criminal laws themselves. We wanted to understand something that receives far less attention: how cases reach police and prosecutors in the first place.

Drawing on documented cases from our Global HIV Criminalisation Database, alongside legal and clinical guidance from multiple countries, we identified three recurring pathways through which healthcare systems contribute to criminalisation.

The first involves state-driven referral systems. In countries with centralised HIV registration, mandatory legal warnings, and ongoing monitoring of people living with HIV, health authorities can initiate criminal investigations without any complaint from a partner. Uzbekistan provides perhaps the clearest example, where HIV diagnosis, registration and routine public health monitoring create a direct pathway to prosecution.

The second pathway is discretionary reporting by healthcare workers or institutions. Our analysis documents cases where clinicians or health authorities contacted police based on misunderstanding of the law, perceived ethical obligations or concerns about risk, even where no legal duty existed. Examples include Argentina, where a clinic reported a mother living with HIV to family court for breastfeeding, and Iowa in the United States, where a hospital’s report to police led to a criminal prosecution despite the complainant later saying they had not intended to pursue charges.

The third pathway is compelled disclosure of confidential medical information. Even where healthcare providers do not initiate investigations, criminal procedures often require disclosure of medical records, compel clinicians to testify, or force HIV testing and disclosure. In one Australian case, police warrants resulted not only in the defendant’s records being released, but also the confidential records of sixteen other people living with HIV.

These pathways place healthcare professionals in an impossible position. They are expected to provide confidential, patient-centred care while simultaneously becoming part of systems of surveillance and punishment. This undermines trust in healthcare, discourages HIV testing and treatment, and ultimately weakens public health.

Importantly, our research also highlights examples of good practice. The British HIV Association’s position statement recommends strict confidentiality protections, multidisciplinary review before any disclosure without consent, and explicitly recognises that people with an undetectable viral load pose zero risk of sexual HIV transmission. We also highlight the Beyond Do No Harm initiative developed by Interrupting Criminalization, which provides healthcare workers with practical tools to minimise unnecessary criminalisation while meeting legitimate legal obligations.

Our research also reinforce the recommendations of the HIV BASIC (Building Access to Services through Improved Care) consensus statement, which calls on healthcare professionals to avoid practices that contribute to HIV criminalisation and instead promote confidential, rights-based care. 

“Our findings show that ending HIV criminalisation isn’t only about changing criminal laws,” said Sylvie Beaumont, lead author of the study. “We also need reforms that protect medical confidentiality, support healthcare workers, and clearly separate healthcare from law enforcement.”

Download WEPEF619 From the doctor’s office to the jail cell: system reforms to protect care, confidentiality, and prevention in the context of. HIV criminalisation.

US: Governor signs bill ending HIV-specific criminal penalties in Pennsylvania

The Philadelphia Department of Public Health (PDPH) applauds the passage of Senate Bill (S.B.) 45, which passed in the Pennsylvania State Assembly last week and was signed into law by Governor Josh Shapiro yesterday. The bill removes HIV from the criminal code in the Commonwealth of Pennsylvania.

For decades, people living with HIV, when charged with a crime in Pennsylvania, have faced potentially harsher penalties because of their HIV status. This disparity has particularly affected sex workers. While prostitution is normally classified as a misdemeanor, offenders who are living with HIV can be charged with a felony, even in situations in which HIV transmission is not possible.

“Living with HIV is not a crime, and HIV criminalization laws have been proven, time and again, not to work for the benefit of the community or in the service of justice,” said Dr. Kathleen A. Brady, Director of PDPH’s Division of HIV Health. “In fact, such laws prevent public health agencies from responding effectively to the HIV epidemic by perpetuating stigma, racism, xenophobia, social and economic injustice — while reducing willingness for people to participate in HIV prevention, testing, and care.”

“The signing of SB 45 is an important step toward ending outdated policies rooted in fear and stigma rather than science,” said Tito Valdes, Esq., Director of LGBTQ+ Affairs. “No one should face harsher treatment under the law because they are living with HIV. We applaud Governor Shapiro and the advocates who worked for years to make this change possible, and remain committed to advancing policies that promote dignity, equity, and public health for all Philadelphians.”

For HIV-related services within the city of Philadelphia, please visit PDPH’s HIV Resource Finder. For access to services and information on all of the Health Department’s efforts to end the HIV epidemic, visit Philly Keep on Loving.