• preventing HIV infection in adolescent girls, focusing on better reproductive health care

• reducing violence against women

• protecting property and inheritance rights of women and girls

• ensuring equal access to care, treatment and support

• supporting improved community-based care, focusing on women and girls

• promoting access to prevention options for women, including female condoms and microbicides

• supporting ongoing efforts towards universal education for girls.

HIV/AIDS is one of the most serious human rights issues of this century, and must be tackled with human rights values and a gender-sensitive approach. Those living with it know the extent of the discrimination. I heard it from so many of them during my term as United Nations High Commissioner for Human Rights and since, including from women in rural areas in Africa who feared losing their homes and being rejected by their families. I heard it over and over again from women living with AIDS during the Bangkok conference.

Human rights response
We know that placing human rights at the centre of the response to AIDS is an effective strategy. Non-discrimination, legal protection and equal access to services are critical. Constitutional and national protection of the rights of those infected and affected by HIV/AIDS is still lacking in most countries. States have a particular responsibility to meet their human rights commitments, and they have the mechanisms to do so.

For a long time most countries have recognized that it is wrong to discriminate on the basis of gender, race or religious beliefs. Over time we have realized that it is also wrong to discriminate on the basis of physical ability or sexual orientation. It may now be time to realize that discrimination based on health or serostatus also has no place in our societies.

Gender equality is at the core of a human rights approach to HIV/AIDS, and forms the basis of our work in the project I now head, Realizing Rights: The Ethical Globalization Initiative. We must have a gendered response, sensitive to the needs and multiple vulnerabilities of women while recognizing and strengthening their own agency.

When women lack social and economic power, their ability to negotiate relationships is compromised. While more injecting drug users are male, female drug users remain marginalized and unlikely to access services. Women are at higher risk of sexual transmission, which can occur with a drug-using partner.

HIV/AIDS is one of the most serious human rights issues of this century, and must be tackled with human rights values and a gender-sensitive approach

Women make up an increasing proportion of those newly infected with HIV. Violence against them fuels the epidemic and enables their exploitation, including trafficking and prostitution. Minority women, refugees and migrants are particularly at risk.

Mother-to-child transmission must be addressed, but the well-being of women in their own right must also be protected through anti-retroviral treatment provision to adults. It is a human rights imperative that prevention information, confidential counselling and testing, treatment for sexually transmitted diseases, and comprehensive drug and anti-retroviral treatment be available to men and women equally.

Brave actions
We know what works. We need to adopt comprehensive programmes, rather than piecemeal prevention projects. We need outspoken leaders and brave actions. We need insightful, accurate and sensitive media awareness campaigns, in every medium and every language.

We need data disaggregated by both age and gender to address this epidemic adequately, and prevention interventions targeted in a gender-aware and youth-friendly way. We must have effective treatment of sexually transmitted infections, available in contexts that are appropriate for men, women and young people.

We need confidential sexual and reproductive health information and services – including testing and counselling. We need many and well-run needle exchanges, needle availability, drug treatment programmes and outreach by and to injecting drug users. Effective strategies for young people include peer-led programmes, school interventions and adolescent-friendly health services.

We must work together to form effective partnerships – within nations between government, civil society, private sector and academic participants, and between nations regionally and globally. We need structural interventions and long-term, sustainable investment and development to tackle the structural factors that fuel HIV/AIDS risk behaviours, such as unemployment, poverty, gender inequality, drug use, prostitution and violence.

Action on prevention now will save millions of lives and billions in investment later. Effective prevention rarely makes headlines. It is not easy to engage people on what doesn’t happen, on the lives saved, the people who do not get sick, the families and societies that are not destroyed by AIDS, because effective HIV prevention was implemented in time.