POLICY AND PRACTICE REVIEWS article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
This article is part of the Research TopicWorld AIDS Day 2024: Take the Rights PathView all 6 articles
From Criminalization to Care: A Comparative Rights-Based Policy Review of HIV Responses in South Asia
Provisionally accepted
- The Apollo University, Chittoor, India
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Background: South Asia faces concentrated HIV epidemics rooted in legal and social marginalization of key populations. Laws criminalizing same-sex relations, sex work, and drug use, combined with gaps in anti-discrimination protections and funding constraints for civil society organizations, undermine progress toward the UNAIDS 95–95–95 targets. This review applies a rights-based approach (RBA) to compare national policies and outcomes across India, Nepal, Pakistan, and Sri Lanka, and offers actionable regional guidance. Methods: A comparative analysis was performed using a five-dimension RBA framework: legal decriminalization, anti-discrimination protections, service access, community participation, and HIV outcomes. Data were synthesized from national legal documents, UNAIDS and Global Fund reports, published research, and community organization perspectives. Comparative findings are presented in a cross-country table, and an RBA policy-outcome pathway diagram is used to visualize core mechanisms. Results: India and Nepal have partially decriminalized same-sex conduct, while criminalization of sex work and drug use persists in all four countries. Pakistan's progressive transgender rights legislation faces enforcement and political challenges; Sri Lanka retains colonial-era punitive statutes. Fragile enforcement, limited-service access, and structural health system stigma are common barriers. Where rights-based legal reforms have advanced, as in India and Nepal, higher diagnosis and treatment rates are seen. Four practical pillars—legal reform, health system transformation, funding equity, and regional collaboration—are proposed. Conclusions: Sustainable HIV epidemic control in South Asia depends on repealing punitive laws, enforcing anti-discrimination protections, and supporting community leadership. Rights-based governance not only drives epidemic control but advances dignity and equity.
Keywords: legal decriminalization, anti-discrimination protections, Service access, Community participation, HIV outcomes
Received: 03 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Hoogar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Praveen Hoogar, praveenhoogar@gmail.com
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