Consolidated guidelines: HIV prevention, diagnosis, treatment and care for key populations

Laws and policies can help to protect the human rights of key populations – both those living with HIV and those at risk for HIV. Legal reforms, such as decriminalizing sexual behaviours and drug use, legal recognition of transgender status, and lowering the age of consent and considering exceptions to a standard age of consent policy (such as nature minors), are critical enablers that can change a hostile environment for key populations to a supportive environment (8). Specific consideration should be given to such legal reforms as part of any revision of policies or programmes for key populations. For example, in many countries possession, use and sale of clean needles and syringes or of condoms remains justification for arrest. If so, this warrants review.

Supporting the health and well-being of key populations whose sexual behaviours, drug use, gender expression or perceived sexual orientation are currently criminalized may require changing legislation and adopting new policies and protective laws in accordance with international human rights standards. Without protective policies and decriminalization of the behaviour of key populations, barriers to essential health services will remain; many people from key populations may fear that seeking health care will expose them to adverse legal consequences.

Countries should work toward developing policies and laws that decriminalize injection and other use of drugs and, thereby, reduce incarceration.

Countries should work toward developing policies and laws that decriminalize the use of clean needles and syringes (and that permit NSPs) and that legalize OST for people who are opioid-dependent.

Countries should ban compulsory treatment for people who use and/or inject drugs