“They Are Criminals”: AIDS, the Law, Harm Reduction, and the Socially Excluded

The right to the highest attainable standard of health is acknowledged universally as a fundamental human right. Unfortunately, this right seems to elude some populations referred to as key populations within the context HIV service rendition and access. They are key because they are deemed to be at higher risk of acquiring or transmitting the human immunodeficiency virus (HIV). They are men who have sex with men (MSM), sex workers (SWs), and persons who inject drugs (PWIDs). Depending on the setting, these populations face important challenges accessing HIV prevention services. For instance, in line with her half-century-old penal code, Ghana criminalizes and penalizes behaviors of MSM, SWs, and PWIDs, a practice that arguably interferes with their access to public health goods. Benefiting from a previously published work by the author, this chapter provides an analysis of how enactment and enforcement of rights-limiting policies, regulations, or legislations not only limit rights but also amplify risks and vulnerabilities to HIV in key and general populations. Drawing on prevailing rights discourses and pedagogy, the chapter offers two approaches to responding to the syndemic of HIV and rights violations. The proposed approaches are grounded in abolitionist and instrumentalist doctrines.