Sexual rights

Definition

Sex­ual rights are a sub­set of human rights that impli­cate gen­der and sex­u­al­ity. Sex­ual rights include pro­tec­tions against vio­lence and dis­crim­i­na­tion in sex­ual sit­u­a­tions and based on sex­ual ori­en­ta­tion, as well as access to repro­duc­tive health infor­ma­tion, pre­ven­tive care, and treat­ment. Vio­la­tions to sex­ual rights can be direct, such as through sex­ual assault and harass­ment, or indi­rect, like in the form of anti-LGBTQIA+ laws that enable stigma and dis­crim­i­na­tion. Both the expe­ri­ence and antic­i­pa­tion of these abuses can lead to men­tal ill­ness, phys­i­cal dis­abil­ity, incar­cer­a­tion, and social ostraci­sa­tion, among other effects. These effects derived from the vio­la­tion of sex­ual rights can be uniquely trau­ma­tis­ing and con­se­quen­tial.

Sex­ual rights are fun­da­men­tal to assert­ing and main­tain­ing repro­duc­tive health. Respec­tively, these can influ­ence risks of HIV expo­sure, will­ing­ness to undergo HIV test­ing, and abil­ity to seek out and adhere to qual­ity HIV treat­ment. Unless and until peo­ple can be assured their sex­ual rights are pro­tected, HIV pro­grams and poli­cies may be unable to fully sup­port them.

Precedents

2021 Global AIDS Strategy 2021-2026

• “Repeal dis­crim­i­na­tory laws and poli­cies that increase women and girls’ vul­ner­a­bil­ity to HIV and address vio­la­tions of their sex­ual and repro­duc­tive health and rights.” (para­graph 153(h))

2021 Political declaration on HIV and AIDS

• “Rec­og­nize that sex­ual and gen­der-based vio­lence, includ­ing inti­mate part­ner vio­lence, the unequal socioe­co­nomic sta­tus of women, struc­tural bar­ri­ers to women’s eco­nomic empow­er­ment and insuf­fi­cient pro­tec­tion of the sex­ual and repro­duc­tive health and repro­duc­tive rights, in accor­dance with the Pro­gramme of Action of the Inter­na­tional Con­fer­ence on Pop­u­la­tion and Devel­op­ment, the 1995 Beijing Declaration and Platform for Action and the out­come doc­u­ments of their review con­fer­ences, of women and girls com­pro­mise their abil­ity to pro­tect them­selves from HIV infec­tion and aggra­vate the impact of AIDS.” (para­graph 29)

• “Increas­ing national lead­er­ship, resource allo­ca­tion and other evi­dence - based enabling mea­sures for proven HIV com­bi­na­tion pre­ven­tion, includ­ing con­dom pro­mo­tion and dis­tri­bu­tion, pre-expo­sure pro­phy­laxis, post-expo­sure pro­phy­laxis, vol­un­tary male med­ical cir­cum­ci­sion, harm reduc­tion, in accor­dance with national leg­is­la­tion, sex­ual and repro­duc­tive health-care ser­vices, includ­ing screen­ing and treat­ment of sex­u­ally trans­mit­ted infec­tions, enabling legal and pol­icy envi­ron­ments, full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion, in and out of school.” (para­graph 30(a))

• “Reaf­firm the com­mit­ment to sex­ual and repro­duc­tive health and repro­duc­tive rights, in accor­dance with the Pro­gramme of Action of the Inter­na­tional Con­fer­ence on Pop­u­la­tion and Devel­op­ment, the 1995 Beijing Declaration and Platform for Action and the out­come doc­u­ments of their review con­fer­ences, and reaf­firm the right of every human being to the high­est attain­able stan­dard of phys­i­cal and men­tal health, includ­ing sex­ual and repro­duc­tive health.” (para­graph 9)

2006 Political Declaration on HIV/AIDS

• “Pledge to elim­i­nate gen­der inequal­i­ties, gen­der-based abuse and vio­lence; increase the capac­ity of women and ado­les­cent girls to pro­tect them­selves from the risk of HIV infec­tion, prin­ci­pally through the pro­vi­sion of health care and ser­vices, includ­ing, inter alia, sex­ual and repro­duc­tive health, and the pro­vi­sion of full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion; ensure that women can exer­cise their right to have con­trol over, and decide freely and respon­si­bly on, mat­ters related to their sex­u­al­ity in order to increase their abil­ity to pro­tect them­selves from HIV infec­tion, includ­ing their sex­ual and repro­duc­tive health, free of coer­cion, dis­crim­i­na­tion and vio­lence; and take all nec­es­sary mea­sures to cre­ate an enabling envi­ron­ment for the empow­er­ment of women and strengthen their eco­nomic inde­pen­dence; and in this con­text, reit­er­ate the impor­tance of the role of men and boys in achiev­ing gen­der equal­ity.” (para­graph 30)

2001 Declaration of Commitment on HIV/AIDS

• “By 2005, bear­ing in mind the con­text and char­ac­ter of the epi­demic and that, glob­ally, women and girls are dis­pro­por­tion­ately affected by HIV/AIDS, develop and accel­er­ate the imple­men­ta­tion of national strate­gies that pro­mote the advance­ment of women and women’s full enjoy­ment of all human rights; pro­mote shared respon­si­bil­ity of men and women to ensure safe sex; and empower women to have con­trol over and decide freely and respon­si­bly on mat­ters related to their sex­u­al­ity to increase their abil­ity to pro­tect them­selves from HIV infec­tion.” (para­graph 59)

Expert precedents

2022 Report of the Independent Expert on SOGI: Practices of Exclusion

• “Women are tar­gets of dis­crim­i­na­tion and vio­lence around the world, and the recog­ni­tion of their sex­ual and repro­duc­tive rights–that is, their abil­ity to take deci­sions in rela­tion to their bod­ies and sex­u­al­ity–is a pre­req­ui­site for ensur­ing their full enjoy­ment of rights.” (para­graph 20)

Evidence

2022 WHO Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations

• “A mod­el­ling study esti­mated that reduced sex­ual vio­lence against sex work­ers could reduce new HIV infec­tions by 25% among sex work­ers and their clients. Women, espe­cially young women from key pop­u­la­tions, includ­ing women who use drugs, female sex work­ers, peo­ple in pris­ons and trans­gen­der women, expe­ri­ence par­tic­u­larly high rates of phys­i­cal, sex­ual and psy­cho­log­i­cal abuse.” (p. 23)

2021 State of World Population

• “Widow inher­i­tance, for exam­ple, requires a woman to engage in sex­ual rela­tions with the man who “inher­its” her, regard­less of how many sex­ual part­ners he may have had in the past, increas­ing the risk of HIV trans­mis­sion.” (p. 38)

2021 WHO Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring

• “A pack­age of inter­ven­tions includ­ing screen­ing, treat­ment and/or pro­phy­laxis for major oppor­tunis­tic infec­tions, rapid ART ini­ti­a­tion and inten­si­fied adher­ence sup­port inter­ven­tions should be offered to every­one pre­sent­ing with advanced HIV dis­ease (strong rec­om­men­da­tion, mod­er­ate-cer­tainty evi­dence).” (p.xxv)

2016 Prevention Gap Report

• “A mod­el­ling study esti­mated that elim­i­nat­ing sex­ual vio­lence against sex work­ers could avert 17% of HIV infec­tions in Kenya and 20% in Canada.” (p. 27)