Ensuring access to justice: the need for community paralegals to end AIDS by 2030

Abstract

IntroductionThe HIV response has long recognized that certain “key populations” such as individuals in detention, adolescent girls and young women, sex workers, people who use drugs, LGBTQ individuals, migrants and others face higher barriers to access to, uptake of, and retention in HIV prevention and treatment services. One approach to addressing these barriers is the training of community paralegals to advocate for the rights of individuals and to address discrimination in health settings.DiscussionCommunity paralegal programmes have been able to successfully address rights violations that impact access to health services and underlying determinants of health across a range of countries and populations, focusing upon issues such as discrimination and the denial of health services; unlawful detention of outreach workers, sex workers, persons who use drugs and men who have sex with men; and harmful traditional practices and gender‐based violence. In addition to resolving specific cases, evaluations of paralegal programmes have found that these programmes increased legal literacy among key populations at risk of HIV and increased understanding of human rights among healthcare providers, resulting in improved access to HIV services. Some evaluations have noted challenges related to the sustainability of paralegal programmes similar to those raised with community health worker programmes more broadly.ConclusionsTo achieve global HIV goals, funding for legal literacy and paralegal programmes should be increased and interventions should be rigorously evaluated. Efforts should target discrimination in access to HIV prevention and treatment and criminalization of key populations, two key barriers to ensuring access to HIV prevention and treatment services.

Human rights and HIV: rhetoric or determinants?

“…The initiative has supported the training of sex workers and other key populations to serve as peer paralegals, to prevent police harassment and intimidation and to advocate for access to prevention and treatment as well as the right to safe labour practices and sexual health services. 41 As more international funding is placed into these types of programmes, it is critical that HIV researchers measure and report on their impact.…”

Vision 2030 and World AIDS Day 2023: Empowering Communities in HIV Research and Policy in Indonesia

“…Such an approach is aligned with the global commitment to end AIDS by 2030. 9,10 It underscores the importance of integrating diverse perspectives and methodologies to deepen our understanding and develop more effective, context-specific strategies to combat the HIV AIDS epidemic. This approach aligns with the national strategy and ensures that interventions are effective, sustainable, and inclusive.…”