Structural Interventions

Structural Interventions

Legal and human rights programmes to reduce stigma and discrimination / increase access to justice

An effective HIV response for AGYW should include programmes to address all human rights and gender equality-related barriers that increase AGYW’s vulnerability to HIV or limit their access to HIV-related health services. These may include initiatives to review and reform laws and strengthen access to justice to protect AGYW from:

  • Stigma and discrimination from health care providers, partners, families and communities
  • Breaches of the confidentiality and privacy rights of AGYW
  • Age of consent laws that make it difficult for AGYW to access sexual and reproductive health services independently of a parent or guardian
  • School policies that require pregnant girls to drop out of schools
  • Laws that criminalize consensual sexual activity amongst older adolescents
  • Laws that criminalize consensual same-sex sex
  • Laws that criminalize adult sex work
  • Laws that provide for punitive approaches to drug use
  • Laws that allow for early marriage
  • Laws and law enforcement that provides inadequate protection against gender-based violence

Young key populations are at increased risk of stigma, discrimination and human rights violations and should be targeted with specific efforts to remove policy and legal barriers to access to health care services.

Key programmes to reduce stigma and discrimination and increase access to justice include:
  • Stigma and discrimination reduction programmes
  • Training for health care workers on human rights and medical ethics
  • Sensitization of law-makers and law-enforcement agents
  • Legal Literacy (“Know Your Rights” campaigns)
  • HIV-related legal support services
  • Monitoring and reforming laws, regulations and policies relating to HIV
  • Removing gender inequality, gender-based violence and harmful gender norms in the context of HIV.
UNDP Capacity Development Toolkit: Critical Enablers: Key programmes
CASE STUDY: Kenyan sex worker legal literacy campaigns help to reduce violence and increase access to justice

In Kenya, the Bar Hostess Empowerment and Support Programme began as a group of sex workers and bar hostesses working together against HIV, violence and exploitation. The civil society organisation has grown to provide a number of services, including legal literacy and legal support services to protect and empower sex workers.  The organisation has supported increased awareness of rights and promoted access to justice through, amongst other things:

  • Training sex worker peer educators on law, human rights and access to justice, enabling them to act as paralegals to provide legal advice, counselling and support to other sex workers
  • Working with the media to raise awareness of sex workers’ rights and to reduce discrimination and violence
  • Establishing a forum to bring sex workers and police together to foster mutual understanding and respect for rights
  • Monitoring and documenting human rights violations against sex workers, particularly by health workers and police
  • Establishing a quarterly legal aid clinic where sex workers can get advice from lawyers
  • Supporting sex workers to claim redress in the courts for wrongful arrests and violations of their rights.
UNAIDS 2017 Confronting Discrimination: Overcoming HIV-Related Stigma and Discrimination in Health Care Settings and Beyond
Capacity Required

The organisation has the capacity to carry out advocacy with the government to make health facilities youth friendly, to increase access to condoms, contraceptives and HIV testing services among young people.

The organisation has the capacity to carry out advocacy to remove legal barriers to adolescents’ use of services for HIV and sexual and reproductive health, and to guarantee privacy, confidentiality and non-discrimination, to ensure that all adolescents who need services can access them.

The organisation has the capacity to campaign with policy makers to remove policy and legal barriers creating obstacles for HIV programming, such as the development and enforcement of gender-based violence legislation, legislation to end child marriage, criminalisation of key populations etc.

Critical Enablers