Leading health experts on Monday called for repeal of outdated laws criminalising prostitution and homosexuality so that people suffering from HIV/Aids or at risk from the disease could get medical treatment.
"The main challenge is overcoming the whole issue of stigma and discrimination, repealing of outdated laws and legislation that countries have got," Prasada Rao, director of UNAIDS Asia Pacific regional support team, said on the margins of an HIV/Aids conference.
Rao and other experts, kicking off a four-day meeting, said that while progress has been made in research and getting people treated for Aids, huge challenges lie ahead and much more needs to be done.
Address stigma and discrimination
"All this progress is not meaningful if we don't address the stigma and discrimination in this region. Young children (whether infected themselves or have family members who are infected) or are still being evicted from schools," Rao told the conference.
"This must change. Without this, progress is not possible," he added.
After HIV/Aids was first identified in the early 1980s it unleashed fear and a strong wave of prejudice against high-risk groups such as gay and bisexual men and prostitutes, but little appears to have changed after more than 20 years.
Everywhere around the world, criminalisation of behaviour involving illicit drug use, sex work and sex between men is seriously hampering effective prevention and support programs, according to experts working to help these people.
"For gay men, we need to reach out to these people but if their behaviour is criminalised, they are not going to come to you and say hey I need help. This is a classic case of a clash between public health and public security," said Loretta Wong, who heads the Hong Kong-based help group Aids Concern.
"If they don't get access to services and treatment, their health cant be monitored, they wont get tested. They will instead be driven underground and there will be the risk of infections increasing," she added.
More treatment, money needed
The conference also heard strong calls for more access to treatment. Women and children were particularly left out of the loop, experts said.
"We are supposed to be achieving universal access by 2010. We are not going to make these goals particularly in treatment, said David Cooper, professor of medicine and director at the National Centre in HIV Epidemiology and Clinical Research in Sydney, Australia.
Although about 3 million people were receiving drugs to control HIV by the end of 2007, or nearly 950,000 more compared with the end of 2006, only 31% of people who were in need of drugs were getting them.
Cooper said children and pregnant women in low and middle-income countries need better and adequate drugs.
"There is incontrovertible new evidence that treating women with antiretroviral therapy in pregnancy and during their breastfeeding period will almost eliminate HIV infection in their infants."
"But we are not getting access to these women and we are not treating them with proper antiretroviral therapy. We are just giving them single-dose drugs," Cooper said. - (Tan Ee Lyn/Reuters Health, August 2009)
Sex work and the law