R. Taylor Williamson, Vivian Fiscian, Ryan Ubuntu Olson, Fred Nana Poku, and Joseph Whittal
Abstract
People living with HIV and key populations face human rights violations that affect their access to health services, relationships in their communities, housing options, and employment. To address these violations, government and civil society organizations in Ghana developed a discrimination reporting system managed by the Commission on Human Rights and Administrative Justice that links people living with HIV and key populations to legal services. This article presents findings on how Ghanaian stakeholders built this reporting system and discusses preliminary data on its impact. To organize our analysis, we used a conceptual framework that outlines the legal frameworks that protect human rights, the institutions that promote access to justice, and the mechanisms that link people living with HIV and key populations to legal services. Using in-depth interviews, we show that targeted technical assistance increased stakeholders’ knowledge of issues that affect people living with HIV and key populations, strengthened these stakeholders’ commitment to address discrimination, streamlined case management systems, and improved relationships between civil society and the government. Through case review, we find that most discrimination happens when accessing government services, inside communities and families, and in the workplace. Finally, we describe implications for other human rights commissions that are considering using a reporting system to protect human rights, including using legal frameworks, developing case management systems, and working with civil society.
Introduction
People living with HIV and key populations, including men who have sex with men, sex workers, and people who inject drugs, commonly experience human rights violations, such as community or family exclusion, police or vigilante assault, the denial of basic services, and the non-consensual disclosure of sensitive health information. As a result, they are often unable to access critical services, including health, education, security, and employment. These human rights violations are the result of stigmatizing behaviors and discriminatory actions on the part of families, communities, employers, and government institutions, and they contribute to poor uptake of health services by people living with HIV and key populations.