What Works for Women and Girls

is also critical to addressing the AIDS pandemic. [See also Chapter 4. Prevention for Key AffectedPopulations]Criminalization of HIV Can Hinder Prevention, Treatment and Care EffortsRecent attempts to criminalize transmission of HIV can also have adverse impacts on womenand girls. No evidence exists that HIV-specific criminal laws are effective in preventing transmissionand in fact, may be harmful. “[…] Women, who are more likely to be tested for HIVthan men...may be disproportionally exposed to the risk of criminalization…when it is preciselybecause women too often lack autonomy in their sexual relations…that they may be unableto disclose or negotiate safer sex” (Jurgens, 2007b: 53). Criminal liability may be assignedeven when safer sex was practiced, HIV status disclosed, or even when the threat of violenceprecluded disclosure (Clayton et al., 2008). Criminal penalties may create an incentive not tobe tested for HIV (Kalla and Cohen, 2007).Studies have documented discrimination based on HIV status; violations of medical privacy;forced HIV testing; HIV status as a barrier to employment and/or education and/or housing(Mukasa and Gathumbi, 2008); and discrimination in health care settings. [See also 11F. ReducingStigma and Discrimination] A 2007 review of data from 128 country reports on progress towardsfulfilling the 2001 Declaration of Commitment on HIV/AIDS found that 59% of countries reportlaws that cause obstacles for the provision of HIV prevention programs to vulnerable groups,with 42% of countries reporting barriers to accessing services for sex workers, 37% of countriesreporting barriers to accessing services for IDUs, 30% for prison inmates and 25% of countriesreporting legal barriers for young people to access services. Legal reform to ensure propersupport for vulnerable groups is necessary (Gruskin and Ferguson, 2008b).Understanding Legal Systems is Necessary to Determine Entry PointsLegal frameworks can empower women—for example through laws that ensure nondiscriminationon the basis of sex—but unfortunately laws often do not support women. “In many countries,national laws restrict women’s ability to own, inherit, or dispose of property. Women sufferinequality in access to education, credit, employment and divorce. Legal and social inequalityrenders women economically dependent on their husbands, leaving them little choice but toremain in relationships where they cannot refuse sex or insist on condom use. Women oftensink into poverty upon the death of their husband or the dissolution of their marriage, findingtheir choices and possibilities so diminished that they have to trade sex for survival or rely onsituations of lodging or work that expose them to sexual abuse or violence. Each of these factorsplaces women at a heightened risk of HIV infection” (Jurgens and Cohen, 2007: 2).It is important to understand the range of legal systems operating around the world whenconsidering promoting legal changes to protect women. Countries, or “political entities,” whichcan include political subdivisions of countries, operate under a range of legal systems, categorizedin various ways, but broadly as Civil Law, Common Law, Customary Law, Religious Law,and Socialist Law (JuriGlobe, 2009). Among these, civil law is the most prevalent system of lawin the world, and relies on written law that is codified in statutes or a constitution. Common law,310 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT