CIVIL SOCIETY Perspectives on HIV/AIDS Policy in Nicaragua, Senegal, Ukraine, the United States, and Vietnam OVERVIEW ___________ PUBLIC HEALTH WATCH OPEN SOCIETY INSTITUTE Public Health Program Civil Society Perspectives on HIV/AIDS Policy in Nicaragua, Senegal, Ukraine, the United States, and Vietnam OVERVIEW PUBLIC HEALTH WATCH Copyright © 2007 by the Open Society Institute. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means without the prior permission of the publisher. ISBN: 978-1-891385-74-2 Published by Open Society Institute 400 West 59th Street New York, New York 10019 USA www.soros.org For more information: Public Health Watch Open Society Institute Email:
[email protected] Website: www.publichealthwatch.info Design by Jeanne Criscola | Criscola Design Layout by Judit Kovács | Createch Ltd. Printed in Hungary by Createch Ltd. Photography Front cover (clockwise from left) Luke Wolagiewicz, WPN: support group for people living with HIV/AIDS, Ukraine; Associated Press: a center caring for abandoned children living with HIV/AIDS, Vietnam; Donna DeCesare: 16-year-old living with HIV, and his mother, Central America. Back cover (top to bottom) Associated Press: lab assistant tests blood for HIV, Senegal; Associated Press: coordinator with ACLU National Prison Project talks with people in the HIV/AIDS Housing Unit at Mississippi State Penitentiary. Contents Preface 5 Acknowledgments 7 Executive Summary 11 Introduction 15 Vulnerability 20 Stigma and Discrimination 28 Barriers to Access 33 Accountability 42 Conclusion 46 Recommendations 47 Notes 49 3 Preface In June 2001, at the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), 189 national governments agreed to the Declaration of Commitment on HIV/AIDS.