Welcome to the Publication Archives of USAID-funded Health Policy Projects.

Browse POLICY Project (1995-2006) Materials

↑ top

Files will load from www.policyproject.com.

List entries are alphabetical by title and contain the title, abstract, language, and then the filename which is hyperlinked and will open in a new browser window. Many files are PDFs but some of the older ones are Word documents.

Human Rights

HP+ More recent Human Rights publications are available.

  • Internal stigma is the product of the internalization of shame, blame, hopelessness, guilt, and fear of discrimination associated with being HIV-positive. It can affect caregivers and family members, who also may internalize feelings of shame, guilt, or fear. Internal stigma can have a profound effect on HIV prevention, treatment, and care. This document explores the difference between internal and external stigma, the contributing factors, and potential ways of addressing stigma, including indicators and steps to empowerment.
    English
    Internal_Stigma.pdf

  • Around the world, in myriad ways, individuals are working to fight stigma and discrimination and promote human rights in order to combat the HIV epidemic. 'Breaking Through' highlights the contributions of people who are speaking out against stigma, discrimination, and human rights violations. Some of those profiled are people living with HIV. It is our hope that readers will be inspired by the approaches and stories presented in this booklet. The individuals profiled represent a fraction of those who are confronting stigma and discrimination and promoting human rights. Their stories reflect the dedication and spirit of countless others who are working toward enabling environments that support the inclusion of people living with HIV and vulnerable groups and that foster effective, just responses to the epidemic.
    English
    Breaking Through.pdf

  • At long last, academics, researchers, activists, service providers, and people living with HIV are beginning to understand and articulate the consequences of addressing (or not addressing) and measuring HIV-related stigma and discrimination. This paper reviews the present understanding of HIV-related stigma and discrimination as they relate to vulnerability, and suggests approaches for stigma reduction. It explores and examines what constitutes HIV-related stigma and discrimination, what effects they have on behavior and HIV responses, and what we can do to reduce them.
    English
    Breaking_the_Cycle.pdf

  • At long last, academics, researchers, activists, service providers, and people living with HIV are beginning to understand and articulate the consequences of addressing (or not addressing) and measuring HIV-related stigma and discrimination. This paper reviews the present understanding of HIV-related stigma and discrimination as they relate to vulnerability, and suggests approaches for stigma reduction. It explores and examines what constitutes HIV-related stigma and discrimination, what effects they have on behavior and HIV responses, and what we can do to reduce them.
    French
    Breaking the cycle_FR.pdf

  • HIV-related stigma and discrimination (S&D) has accompanied the AIDS epidemic from the start. Fear of and actual experience with stigma and discrimination reduce an individuals willingness to practice prevention, seek HIV testing, disclose his or her HIV status to others, ask for (or give) care and support, and begin and adhere to treatment. As efforts to address S&D increase, so does the need for a set of standard tested and validated S&D indicators. Yet measures that can both describe an existing environment, and evaluate and compare interventions, are lacking. This report suggests ways to begin the process of quantitatively measuring HIV-related stigma in an effort to help practitioners, policymakers and donors evaluate their programs.
    English
    Measure HIV Stigma.pdf

  • De Frente a la VIDA is a photojournal that features the stories of 10 people living with HIV/AIDS in Mexico. It was developed as part of POLICY's "Mo Kexteya" Project on stigma and discrimination in Mexico. Media reporting and images can profoundly influence public perceptions of HIV/AIDS. This photojournal aims to help change stereotypical portrayals of PLHAs by presenting positive images of PLHAs and their everyday experiences in a range of settings. The photojournal is being used in advocacy work and in journalist training sessions to help improve reporting on HIV/AIDS and people affected by the disease.
    Spanish
    MoKexteya.cfm

  • A report from a workshop held by the East-Central Division of the Seventh Day Adventist Church, bringing together people from five continents to put forth a united front in the battle against the spread of HIV/AIDS. The workshop sensitized church leaders to the issues of HIV/AIDS, identified priority actions and put forth policy reccomendations to the church Executive Committee.
    English
    ken_ecd_sdaps.pdf

  • This manual provides guidelines for employers and employees on issues of HIV/AIDS and Human Rights in employment. The overall objective this manual is to assist employers, employees and would be employees, to take action and make informed decisions pertaining to employment, HIV/AIDS and human rights. The manual applies both to the formal and informal sectors. Knowledge of human rights in the workplace will assist employers and employees to challenge policies and programmes that violate the rights of people living with HIV/AIDS.
    English
    ZM_EMPGUIDE.pdf

  • In less than a quarter of a century, the HIV/AIDS outbreak has become the most outstanding challenge worldwide. Over 30 million lives have been lost due to this devastating disease and about 40 million people are estimated to be living with HIV. HIV/AIDS causes unacceptable human suffering to the infected and affected individuals, their families, communities, and nations. Nepal has been affected by this complex epidemic, with an estimated 0.5 percent of the population being HIV positive (National Estimates of Adult HIV Infections–Nepal, 2003, NCASC, March 2004). Even a conservative estimate puts the number of people living with HIV or AIDS (PLWHA) in Nepal at over 61,000. Although HIV/AIDS prevalence in the Nepal Police Service is not known, it is reasonable to estimate that it is comparable with the national average of 0.5 percent. The prevalence may be even greater due to the nature of police work, which places them in vulnerable situations. An effective HIV/AIDS response requires adequately addressing the social and structural epidemics of poverty, conflict, war, gender inequality, stigma and discrimination, and human rights violations, which are fertile grounds for the spread of HIV/AIDS. These issues highlight the significant need for an educational program for the Nepal Police. This curriculum seeks to contribute to this purpose.
    English
    NEP_PoliceCurriculum.pdf

  • Describes the HRWG's purpose, activities, members, and achievements.
    English
    HRWG.pdf

  • The purpose of this paper is to outline the international and national legal instruments that apply to HIV/AIDS in Vietnam and to examine those instruments, as well as government policies, from a human rights perspective.
    English
    VIE_HumanRights_HIV.pdf

  • The support of the media is considered to be essential in strengthening the response to HIV/AIDS and addressing the human development challenges posed by the epidemic. As an influential advocate of social change, the media needs to play a positive role in preventing the spread of HIV/AIDS and in reducing its impact. In fact, it is the media’s responsibility to inform, educate, and lead. But the question is, has it been able to play this role effectively? This review analyzes the role of the media and the reporting trends on HIV/AIDS issues in Nepal in order to better understand how the media reports in order to foster effective partnership with it. This report will help in assessing the general trend of coverage on HIV/AIDS issues. It is expected to help the government and nongovernmental organizations (NGOs) working in the area of HIV/AIDS to devise more influential advocacy strategies. It is also expected to help in deciding on the choice of media for dissemination of information and messages on HIV/AIDS.
    English
    NEP_MediaReview_HIV.pdf

  • Final report of a study to investigate mechanisms to maximize the greater involvement of people living with HIV/AIDS (GIPA) within the HIV/AIDS policy and program development, implementation and evaluation process in Vietnam.
    English
    VIE_FinalGIPA.pdf

  • Armed forces, police, and other uniformed services around the world face a serious risk of HIV and other sexually transmitted infections (STIs), due to the nature and characteristics of their profession. As a civil force, the Nepal Police work closely with the population in all areas of the country and subsequently are frequently exposed to groups with increased vulnerability to HIV/AIDS. Although the risk of contracting HIV through performing the normal duties of uniformed services employees is so low as to be almost non-existent, there are other factors that can contribute to the vulnerability of uniformed services personnel. The overall objectives of the HIV/AIDS strategy for the Nepal Police are to halt the spread of the HIV/AIDS epidemic within the police force, their partners and families; to sensitize them toward the rights of vulnerable groups and their access to HIV/AIDS services, and to ensure that policing practices do not exacerbate the impact of the epidemic in Nepal through impeding HIV prevention initiatives. In order to meet these objectives, this strategy has been developed. The strategy broadly focuses on prevention as the fundamental basis for an effective response within the Nepal Police. The strategy recognizes the importance of research, accurate surveillance systems, and evaluation and monitoring of interventions. The strategy is guided by underlying principles including a rights-based approach, high-level leadership and commitment, reduction of stigma and discrimination, and greater involvement of people living with HIV/AIDS (GIPA).
    English
    NEP_PoliceStrategy.pdf

  • El SIDA ha sido uno de los mayores retos para las
    Spanish
    op-03es.pdf

  • Le SIDA représente depuis 20 ans un défi de taille
    French
    op-03fr.pdf

  • AIDS has presented a major challenge to African societies during the last two decades. Governments throughout the region have struggled to develop effective policies and programs to address the epidemic. This report presents case studies of the policy process in nine Anglophone African countries. Each country has employed a unique approach to policy development; the results are equally diverse. This report describes some of the country experiences and highlights areas of similarity and difference as well as major problems addressed by Anglophone African countries. The information has been distilled into a framework that captures key elements of the policymaking process. The major components of the framework are as follows: Problem identification and need recognition. Countries have passed through several stages in their response to the AIDS epidemic, including medical response, public health response, multisectoral response, and focused prevention and treatment. During the early phases, countries saw little need for a comprehensive AIDS policy. However, the need for a policy response grew as countries adopted multisectoral approaches to the epidemic and the broad impacts of AIDS on human rights, economic growth, society, and families emerged. Information collection. Once a decision to develop a policy is made, the next step usually is to obtain expert opinion—through consultant reports, interviews, or workshops. Drafting. Drafting is usually the task of small working committees. Some countries drafted policies quickly with a minimum of outside participation while others relied on a number of drafting committees that sought input and consensus from a range of interests. Review. In some cases, draft policies were debated widely and reviewed by thousands of people as a result of special regional meetings and dissemination efforts. In other cases, little outside review took place. As a consequence, policies often languished, with no champions pushing for review and approval. Approval. National AIDS policies have been approved at one of three levels: the minister of health, the cabinet, or Parliament. Implementation. Some policies have been implemented through operational or strategic plans or through the establishment of committees to develop operational guidelines. In many cases, elements of the policy can be implemented even before the full policy is adopted. Interest groups may be encouraged to take the lead in disseminating and implementing parts of the policy that are of particular interest to them. Most policies contain some components that can be implemented immediately though administrative actions; other components require efforts to develop specific legislation and to obtain funding. Each country policy addresses a large number of specific issues. Despite several cultural, social, and legal differences among the countries studied, the issues surrounding key policy topics show many similarities. The following are among the topics that were most difficult to resolve: HIV counseling and testing; pre-employment testing; orphans; AIDS education in schools; condom advertising; mandatory condom use in brothels; condom distribution in prisons; willful transmission of HIV; and HIV and abortion. In some instances when it was difficult to achieve consensus, policymakers simply eliminated issues from policy consideration. For example, most policies do not address willful transmission of HIV. In other cases, vague wording requires the issue to be addressed in national policy, with the exact meaning left to interpretation through implementation guidelines. The key lessons that have emerged from the case studies are summarized below. Identifying AIDS as a problem does not translate into recognition of the need for a comprehensive AIDS policy. The need for a comprehensive policy may become apparent only when the epidemic becomes so severe that a large portion of the population is affected or when the advocacy efforts of specific groups convince decision makers of the importance of a policy response. There are many approaches to drafting and review. Some countries rely on a high level of participation. Although greater participation lengthens the time required for drafting and review, it builds momentum for the policy and often shortens the time required for approval. As a result, highly participatory approaches may actually require less time for policy development than policies drafted rapidly by a small group of experts who then struggle for years to gain approval. The most participatory processes have produced the broadest policies covering a wide range of key issues. Such policies, it is expected, will prove to be the most effective, but the outcome remains to be demonstrated. Once approved, policies can be implemented in many ways. Some aspects of a policy (such as approval of condom advertising) may be implemented directly, in some cases even before the policy is formally approved. Other policy issues can be implemented only through enabling legislation, with the development of guidelines, or as part of a strategic plan. Countries may lack the resources to implement all facets of a policy at once. Interest groups may need to take the lead in advocating for the implementation of specific portions of the policy that most interest them.
    English
    op-03.pdf

  • The purpose of this report is to identify laws considered impediments to HIV/AIDS prevention and care, suggest law reforms considered necessary to advance HIV/AIDS prevention and care, and suggest enactment of laws considered necessary to advance HIV/AIDS prevention and care in Tanzania. The information in the report is presented in three parts, constituting fifteen chapters, references, and annexes.
    English
    TZlawreview.pdf

  • In 2002, the POLICY Project embarked on an HIV/AIDS stigma research project in a country that has a substantial HIV/AIDS epidemic. The POLICY Project developed HIV/AIDS indicators and guidelines for stigma mitigation through a participatory, consultative process. The project carried out a qualitative research study in three sectors that play a leadership role in South Africa: the faith-based sector, national government departments, and the media. The research was conducted in communities across South Africa, and of the focus group participants, 85 percent were black, 55 percent were women, and 43 percent were people living with HIV/AIDS. HIV/AIDS indicators were developed to assist HIV/AIDS program managers to monitor and evaluate the effectiveness of their stigma mitigation efforts. Comprehensive guidelines were also developed to guide and strengthen HIV/AIDS programs to ensure that HIV/AIDS stigma mitigation programs are mainstreamed, resulting in a comprehensive and effective response to the HIV/AIDS epidemic in South Africa. Further funding has been secured through USAID/South Africa to continue the project and ensure that the findings, tools, and documents from this research will be used, tested, and improved and that they inform training interventions in the next phase of the project.
    English
    SA_core_pkg__final_.pdf

  • This report is a result of qualitative research investigating the challenges to GIPA, conducted in Cambodia from March 2003 - March 2005, as well as outcomes from training programs conducted with HIV-positive Cambodians over the same period. The research seeks to develop a deeper understanding of the role of HIV-positive people in the Cambodian response to the HIV/AIDS epidemic. The research examined the experiences and perceptions of HIV-positive people, HIV/AIDS service providers, policy makers and programmers related to the challenges to HIV-positive people's meaningful involvement in the design and implementation of AIDS policy and programming in Cambodia. The study also gathered information from HIV-positive people and HIV/AIDS service providers, policy makers and programmers to identify the necessary mechanisms to promote and sustain involvement. The study provided an opportunity to reflect on the level of involvement of people infected and affected by HIV and AIDS and to promote dialogue amongst HIV-positive people and other stake-holders to secure their greater involvement in Cambodia's response to the epidemic.
    English
    CAM_StepsToEmpower_En.pdf

  • Recent international initiatives reflect, and are responding to, a worldwide movement for greater access and equity in HIV-related treatment. The new millennium has witnessed growing support from the global community to increase access to antiretroviral (ARV) treatment for those most in need. The global shift in support for treatment access, coupled with declining drug prices and the availability of generic drugs, has led many in the field to recognize that the barrier to treatment is no longer simply a matter of financial resources. This paper seeks to define treatment governance and address the roles that stigma and discrimination and the greater involvement of people with AIDS play in the policies and programs that are designed in response to the HIV/AIDS epidemic.
    English
    Treatment_Governance.pdf

  • The greater involvement of people living with HIV/AIDS (GIPA) is being promoted as a cornerstone of HIV/AIDS prevention and care and support. The concept of GIPA emerged as a formal statement at the Paris Summit on AIDS in 1994. However, the concept of PLHA involvement expressed by GIPA has been a feature of community responses to HIV/AIDS from very early in the epidemic. This research analyzes the perceptions of GIPA in Nepal from the perspective of policymakers, international organizations, NGOs, and people living with HIV/AIDS (PLHAs).
    English
    NEP_HeartofMatter.pdf

  • Malawi has one of the highest national HIV prevalence rates in the world. The National AIDS Commission (NAC) estimates that the country has an adult (15-49) HIV prevalence rate of 15 percent. There are about one million Malawians who are HIV positive and over 265,000 reported cumulative cases of AIDS. By 1999, approximately 250 Malawians became infected with HIV on a daily basis and 40 percent of all new reported AIDS cases occurred in people under the age of 30. Stigma and discrimination surrounding HIV/AIDS serve as barriers to the proper care, treatment, and support of people living with HIV/AIDS (PLWHA); discourage people from seeking voluntary counselling and testing (VCT) – an important aspect of prevention efforts and an entry point into care and the facilitation of positive living among PLWHA; and hinder the development of an enabling environment that promotes disclosure and living openly with HIV/AIDS. These results have consequences at the individual, family, community, and national levels as all efforts to prevent HIV transmission and mitigate the impacts of the HIV/AIDS epidemic are undermined by stigma and discrimination. This qualitative research study is based on data collected through focus group discussions (FGDs) with PLWHA in Malawi. It is part of a broader National HIV/AIDS Advocacy Project being executed by the Malawi Network of People Living with HIV/AIDS (MANET+) in fulfilment of the objective of advocating for the integration of stigma and discrimination-related issues into the National HIV/AIDS Policy. It emphasises three areas: care, treatment, and support services by PLWHA; VCT services; and disclosure of sero-status (by self and others). This report also explores the importance of greater involvement of PLWHA. The purpose of the National HIV/AIDS Advocacy Project is to catalyse the formulation of supportive HIV/AIDS policies, laws, and regulations.
    English
    MALA_MANET_FGD.pdf