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Awareness About Medico-Legal Aspects of HIV/AIDS 

Shamim Riaz Alias Anni, Hiffsa Bibi and Samia Hasnat 

Fatima Jinnah Women University, Rawalpindi, Pakistan 

ABSTRACT 

The purpose of this research is to elucidate the fact that the AIDS/HIV pandemic 
requires a unique and truly global response. The incidences of AIDS are continuously 
rising all around the world affecting both the highly developed countries like the US 
and the developing countries like India and Pakistan. Despite improvements in 
technology, the modern world is not prepared to cope with this quickly spreading 
disease the definitive cure for which is not yet known. AIDS is a serious medical issue, 
which, due to its prevalence and complexity-affects many aspects of our life, resulting 
in legal issues as well. Moreover, the discrimination against HIV patients makes the 
situation critical to such an extent that medical care and health facilities are not 
provided to them properly. The law can prevent these things by acting as a barrier to 
HIV but unfortunately the legislatures nearly around the world lag in enacting specific 
laws to prevent AIDS. 

INTRODUCTION 

Since its identification, HIV/AIDS cases have been continuously rising all around the 
world. HIV first originated when SIV, a virus closely related to HIV that attacked the 
immune system of chimpanzees and monkeys, was transferred to humans who had 
hunted and eaten those animals in the area of Kinshasa, the Democratic Republic of 
Congo, presumably in 1920. At that time HIV was unknown and did not come to the 
attention of the public (History.com 2017). The human immunodeficiency virus is a 
retrovirus that weakens the immune system of the human body. HIV causes AIDS in 
human beings. More than 40 years ago, in 1980 the first case of HIV was identified in 
the United States. Today, HIV/AIDS has attained pandemic status. Approximately 37.7 
million people were living with HIV across the world in 2020. Out of these, 36 million 
were adults and 1.7 million were children of 0-14 years and 53% were women and girls 
and 1.0 million people have died from HIV in 2020 (Doychininov 2021).  AIDS is one 
of the most serious, deadly diseases in human history and the most terrifying public 
health issue because, since the beginning of the pandemic, 55.9-110 million people 
have been infected with HIV, and 36.3 million people have died of HIV (Doychininov 
2021). 

The continuously rising numbers of HIV/AIDS cases pose serious challenges not only 
to the medical but also to the legal field. The medico-legal issues surrounding this 
disease are complex and interdisciplinary like HIV Antibody Testing, duty to warn third 
parties, charting and disclosing HIV antibody testing results, the diminishing stigma 
attached to HIV (Sahai-Srivastava 2009). Although the medical world has become 
more aware of how HIV works has been able to develop methods of its spread despite 
improvement in technology, the world is not able to cope with this deadly disease 
because of the non-availability of a definitive cure. HIV/AIDS creates legal challenges 



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as well because the emergence of the HIV epidemic has challenged the ethical values 
of the medical professionals including the infectious nature of HIV regarding the spread 
of disease, the social stigma attached to the disease, and its ethical and legal 
conundrum. AIDS will remain a disease that gives rise to stigmatization and 
discrimination regardless of how much we give awareness to the people about the 
nature and consequences of the disease but the law can its role control the disastrous 
effects of the infection by acting as a barrier to the spread of HIV by imposing sanctions 
regarding the spread of HIV. Also, the law can prohibit the discrimination faced by HIV 
patients especially in workplaces, or in hospitals, and treat HIV by effective HIV testing, 
but the law is often overlooked to deal with the complex moral and ethical issues arising 
from the HIV / AIDS epidemic and unfortunately, the legislature of the world has lagged 
in making specific law that could prevent HIV. (Pietrangelo 2020).   

1. HIV/AIDS, Stages, Symptoms and Causes 

Acquired immunodeficiency syndrome of humans is caused by two lent viruses: human 
immunodeficiency viruses of type 1 or type 2 (HIV-1 and HIV-2). They can enter the 
genome, attacking and destroying CD-4 cells. They also attack B cells and cause and 
cause macrophage dysfunction. This process finally results in acquired immune 
deficiency (AIDS). (Ellis 2020) HIV infection happens in three stages. Without 
treatment, it gets worse over time and eventually overpowers your immune system. 
Symptoms will depend on the stages. The first stage is the acute infection stage. 
During this stage, some people have no symptoms in the first month or so after 
contracting the virus, but they often realize HIV causes those symptoms. Early 
symptoms of HIV can include fever, chills, fatigue, sore throat, body pain, muscle 
aches, nausea, and upset stomach (Felman 2020). After a month or so, HIV enters the 
clinical latency stage. Some people don't have any symptoms during this time, while 
others may have minimal or nonspecific symptoms. These nonspecific systems may 
include: headaches and other aches and pain, swollen lymph nodes, recurrent fevers, 
night sweats, fatigue, nausea, vomiting, diarrhea, weight loss, skin rashes, recurrent 
oral or vaginal yeast infection, pneumonia, and shingles (Pietrangelo 2020). AIDS is 
the advanced stage of HIV infection. This is usually when your CD4-cell drops below 
200 and your immune system is badly damaged. People with AIDS who don’t take 
medication live about 3 years, or less if they get another infection. But HIV can still be 
treated at this stage. If you start on HIV drugs, stay on them, follow your doctor’s 
advice, and keep healthy habits, you can live a long life (Pathak 2021). 

The Human immunodeficiency virus (HIV) pandemic has developed as the single most 
impressive challenge to public health, Human Rights, and improvement within the 
modern thousand years. Spreading information and awareness about HIV is one of the 
key methodologies utilized within the avoidance and control of HIV/AIDS around the 
world. Lacking information and unsafe practices are major obstacles in avoiding the 
spread of HIV. Awareness about HIV, its signs and symptoms, about its modes of 
transmission is necessary because by getting awareness about HIV people will be able 
to understand how HIV and AIDS are spread and by what ways they can protect 
themselves (Alhasawi et al 2019). 

1.1. Diagnosis and HIV testing  



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HIV can be most effectively detected with the aid of HIV tests. HIV testing, also called 
HIV screening, is the only way to know if you have the virus. Several types of tests 
check your blood or other body fluid to see whether you are infected. Most cannot spot 
HIV right away, because it takes time for your body to make antibodies or for enough 
of the virus to grow inside you. Diagnoses are based on:  

1. History and essential tests CD-4 cell, diminished TLC/ DLC  

2. HIV counteracting agent in serum (agglutination, immunofluorescence, or ELISA) 
(Brouwer et al. 2000). 

1.2. Importance of HIV testing 

If you have the virus, finding out quickly means you can start treatment right away so 
you can feel better and live a long, full life. Studies show that the sooner people start 
treatment after diagnosis, the more they benefit from ART (Antiretroviral therapy). 
Treatment with ART reduces the amount of HIV in the blood (called viral load), reduces 
HIV-related illness, and helps prevent transmission to others. Pregnant women should 
get tested because early treatment means you probably won't pass it to your baby 
(Watson 2021). 

1.3. Modes of AIDS transmission 

HIV is present in certain bodily fluids. The virus is present in the blood, semen, vaginal 
fluid, milk, and other secretions. Blood and semen are not only the way of transmission 
of HIV. A person with AIDS transmits HIV through sexual contact, sharing needles and 
syringes, and the transfusion of blood. An HIV-positive pregnant woman may transmit 
HIV to her child during pregnancy or at the time of birth. Research shows that HIV 
cannot be transmitted through skin-to-skin contact, mouth-to-mouth contact (unless 
open-wound / blood are involved), sharing food, saliva, tears, sweat, sharing a toilet, 
or through insect bites (Pietrangelo 2020).  

1.4. Treatment  

There is no definitive cure for HIV/AIDS nor is there a vaccine. However, there are 
some medications that not only can slow down the progression of the infection but can 
also slow down the growth of the virus permitting the infected individual to lead a 
normal life. Antiretroviral therapy (ART) is somewhat considered a cure for HIV/AIDS. 
Antiretroviral therapy includes a combination of HIV medicines (HIV treatment regime). 
ART is suggested to everyone infected with HIV. This Therapy does not cure the HIV 
patient completely but it prevents his/her condition from becoming chronic, at the same 
time reducing the risk of virus spread. There are several types of HIV/AIDS medicines. 
Some of them block or change the protein that HIV uses for its duplication within the 
human body. This hinders HIV from replicating itself, which reduces the amount of HIV 
within the body (Kasaye and Levy 2009). 

2. Legal Point of view about HIV/AIDS 

AIDS has become an acute legal issue nowadays. HIV/AIDS cases rising daily. Given 
the fact that medical options for stopping the disease are limited, the law could also 
play an important role in controlling its spread. Many legal issues related to HIV and 



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AIDS arise in the sphere of public health, medical law, and civil rights. Both developed 
and developing countries are trying to solve these issues attempting to cope with this 
disease. Many countries particularly from Asia and the United States have introduced 
several laws to control the spread of HIV/AIDS and to protect the rights of HIV-positive 
patients since HIV patients face many problems regarding their care, treatment, and 
discrimination  (Klinck 2004).. The United States was the first country to introduce HIV-
related laws and since then approximately 75 countries have enacted criminal laws 
specifically mentioning HIV. Some are discussed below (Wasnik et al. 2018).  

2.1. Laws regarding HIV/AIDS in different countries 
 

2.1.1. AIDS related laws in Pakistan 

Pakistan has four provinces, and each of them has the authority to make its laws 
concerning various issues including health. There is no specific legislation regarding 
HIV in Pakistan on a national level but there are certain provisions of the Pakistan 
Penal Code regarding the spread of infection and there are various Acts regulating 
safe blood transfusion (UNDP 2014). At the provincial level, only Sindh has a specific 
law regarding HIV (The Sindh HIV/AIDS control treatment and protection Act, 2013; 
HIV Justice Network 2020). 

2.1.2. Provisions of Pakistan Penal Code to control the spread of HIV 

• In Pakistan Section 269 of the Pakistan Penal Code –Negligent act likely to 
spread infection of disease dangerous to life states that whoever unlawfully or 
negligently does any act which is, and which he knows or has reason to 
believe to be, likely to spread the infection of any disease which is dangerous 
to life” shall be liable for a penalty of imprisonment and /or a fine.  

• Section 270 of Pakistan Penal Code – Malignant act likely to spread infection 
dangerous to life. Whoever malignantly does any act which is, and which he 
knows or has reason to believe to be, likely to spread the infection of any 
disease dangerous to life, shall be punished with imprisonment of either 
description for a term which may extend to two years, or with fine, or with both. 
These laws could be a help to control the spread of HIV (UNDP 2014). 

2.1.3. Sindh HIV/AIDS Control treatment and protection Act 2013 

• This act provides both responsibilities and protection for HIV patients. According 
to sections 21, 22 and 24 of this Act, a person who commits any act which 
results in the transmission or spread of infection shall be punished with fines, 
imprisonment, or both. Moreover, this Act provides protection to HIV patients 
concerning HIV testing (section 14), protects them from the disclosure of HIV-
related information (section 19), and protects them against discrimination 
(section 8) (UNDP 2016). 

2.1.4. Blood Transfusion Acts 

• Blood transfusion without screening is the source of the HIV spread. Thus, to 
avoid the spread of a virus through blood transfusion there are various Acts like 



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Balochistan safe blood transfusion Act,2004, N.W.F.P Transfusion of safe blood 
Act,1999 or Sindh Transfusion of safe blood Act,1998. According to these Acts, 
blood banks should be registered with blood transfusion authorities and the 
violation of rules of the Acts will lead to imprisonment and a fine (UNDP 2014). 

Moreover, the drafts of the HIV&AIDS prevention and treatment act 2007 and the HIV 
safety bill are pending in the national assembly of Pakistan. Both support the free HIV 
testing, control of this disease by adopting effective preventive measures and 
prohibiting the discrimination against AIDS patients yet the pending of these bills 
proves that Pakistan is lagging in enacting specific laws against HIV/AIDS due to which 
the numbers of HIV cases in Pakistan are increasing. Also, the National HIV and AIDS 
Policy draft 2007 is pending in the national assembly. The policy aims at reducing 
discrimination, establishing a legislative framework regarding HIV, initiating awareness 
programs about HIV, strengthening the health system as well as insuring HIV 
prevention. (UNDP 2014: 24-25) 

3. AIDS-related laws in India 

Indian law comprises numerous provisions related both specifically to HIV and, 
generally, to the spread of life-threatening illnesses/infections.   

3.1. HIV/AIDS Prevention and Control Act 2017  

The HIV/AIDS Prevention and Control Act 2017 were implemented from September 
10 onwards, announced the Ministry of health and family welfare on Tuesday. The bill 
passed in March criminalizes the discrimination against patients suffering Acquired 
Immune Deficiency Syndrome (AIDS), a condition caused by Human 
Immunodeficiency Virus (HIV), which attacks and weakens the body's immune 
system.  

The Act makes Anti-Retroviral Treatment (ART) a legal right for all HIV/AIDS patients. 
The “test and treat” policy has been adopted, which means any person testing positive 
will be entitled to free treatment from the State and central government. It also makes 
HIV-related information confidential and makes it necessary to get informed consent 
for understanding HIV tests, medical treatment, and research (Khaire 2017).  

3.2. Section 269 and 270  

Under sections 269 and 270 a person who unlawfully or negligently commits an act of 
dissemination of a life-threatening infection shall be liable to imprisonment for any term 
of minimum for six months and maximum for two years or to a fine or to both under 
section 269 of the IPC. 

The provision of section 270 extends to cases when a person dies as a result of 
receiving infected blood from a blood bank and a latter can be sued according to the 
above-mentioned law. (Waskin et al 2018). 

3.3. Article 21: Right to life and liberty  



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Article 21 of the Constitution of India guarantees the right to life and liberty. It is a basic 
right for people with HIV to get adequate treatment provided by the government.(Yadav 
2021). 

4. AIDS-related laws in the United States 

• In 26 U.S states, you can be sent to prison if you have not informed your sexual 
partner that you are HIV positive, even if the virus wasn't transmitted In some 
states that could mean a life sentence  

• N.Y. PUB. Health Law § 2307 (2016), Venereal disease; a person who knows 
he or she is infected with an infectious venereal disease yet has sexual 
intercourse with another is guilty of a misdemeanor and may face up to one year 
in prison and a $1,000 fine.  

5. Legal rights of HIV/AIDS Patients 
 

5.1. Right to treatment 

HIV patients have the right to medical treatment.  The doctor or the hospital staff cannot 
refuse the treatment of any person with HIV/AIDS. It is unethical if the medical staff 
refuses to treat HIV patients and they will be considered guilty if they do. (Osime 
&Odigie 2006). 

5.2. Right to informed consent 

HIV patients have the right to get information about their HIV-positive status and to 
make queries before the treatment. The doctor should not perform any procedure such 
as HIV testing, discuss the nature of the disease, the results, or the treatment without 
obtaining the informed and voluntary consent of the patient. (Gupta 2015) 

5.3. Right to Confidentiality 

HIV patients have the right to confidentiality. The doctor should not disclose any 
information of the patient without his/her consent unless provided for public interest 
such as to prevent the spread of infection protecting people from getting HIV. The 
doctor would be held liable if he/she failed to respect the privacy of the patient.in other 
words, HIV-positive patients have the right to keep their medical information to 
themselves. (Gupta 2015) The right to privacy is widely recognized in Human rights 
law. 

5.4. Right against discrimination 

The most important thing is the stigma attached to HIV/AIDS and it is a major obstacle 
in treating HIV/AIDS and taking control over it. Discrimination against HIV patients 
refers to the prejudice, negative and abusive attitude towards the people infected with 
HIV. According to the available data 35% of countries, 50% of people report having 
discriminatory attitudes towards HIV patients. In 2015 70,000 people from 70 countries 
have been interviewed and around the 50 countries, showed that one in every eight 
HIV-positive people is being denied health services because of discrimination (Avert 
2020). HIV patients face discrimination more generally in workplaces, public places, 



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Hospitals, etc. All are equal before the law and they should have equal protection of 
the law without any discrimination. So, the HIV -positive patients have the right to have 
their dignity respected and protected (Thom 2003). It is widely recognized that all forms 
of Discrimination against HIV-positive people are prohibited by international Human 
rights law. 

5.5. Basic rights 

Everyone has the right to liberty, the right to life, the right to education, the right to 
work, the freedom of expression, the freedom of movement, the right to social security, 
and the right to health, etc. All the rights are protected by international Human rights 
law instruments and each country has its laws regarding such rights. No one shall be 
deprived of those basic rights to the fact that they are HIV positive. 

6. Recommendations  
 

6.1. HIV screening  

Screening for HIV is important so that everyone knows their HIV status. It should cover 
the population as widely as possible, however, within the bounds of human rights, that 
is only with the consent of the people in question.  

• People who learn that they have HIV can receive treatment that might protect 
or improve their health. Today's treatments can suppress HIV, prevent the 
progression to AIDS, and lower the risk of transmitting HIV to others.  

• Everyone between the ages of 15 and 65 and anyone pregnant should be 
screened.  

• People younger than 15 or older than 65 who are at increased risk should also 
be screened.  

• Clinicians should discuss the results with the patients. (Paltiel et al 2006). 

6.2. HIV prevention  

• When a person does not have HIV but is at high risk, clinicians offer pre-
exposure prophylaxis or PrEP. PrEP is a medication that substantially reduces 
the risk of acquiring HIV. However, as PrEP is not suitable for everyone, it 
should be taken under strict medical supervision. After a general assessment of 
whether a given patient belongs to a group at risk of HIV (through discussing 
their sexual history and HIV-risk-related behaviors), the doctor may decide 
whether the patient qualifies for PrEP. Among the behaviors putting people at 
high risk of contracting HIV the following could be mentioned:  

• having an HIV-positive sexual partner, 

• having sex without a condom with a partner who is at high risk of HIV, 

• sharing drug injection equipment 

• having sex in exchange for money, drugs, or housing, 



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• having a recent history of a sexually transmitted infection  

6.3. What do patients need to know about PrEP? 

People need to know about PrEP. PrEP reduces the risk of getting HIV by up to 99% 
when taken consistently as prescribed. There are several important issues to discuss 
with the patient while considering PrEP:  

• PrEP needs to be taken as prescribed. Otherwise, it’s much less effective. 

• People who take PrEP need to be tested for HIV regularly to confirm that they 
are HIV- negative, as PrEP is only for people who do not have HIV. 

• It's important for people who take PrEP to continue to use condoms and practice 
safer sex. 

• PrEP can cause side effects such as kidney problems or nausea though the 
benefits of taking it far outweigh the risks. 

• Far too many people continue to get HIV. We have highly effective preventive 
measures based on compelling evidence, yet too few people benefit from them. 
,  

• HIV screening and HIV prevention with PrEP reduce rates of HIV infection and 
can help toward the goal of ending HIV. 

• Clinicians should screen all patients aged 15 to 65, all pregnant women, and 
anyone at any age who is at increased risk of HIV. 

• For those who do not have HIV but are at high risk of getting it, clinicians should 
offer PrEP. (Arnold et al. 2012). 

6.4. Making specific laws regarding HIV 

Specific laws should be put into effect to reduce the spread of this fatal disease. Many 
countries have passed laws controlling the spread of AIDS but still, there is a need for 
more laws regarding different aspects of HIV like the spread of the infection, the 
treatment, protection of individual people's rights, protection against discrimination, 
etc. While enacting such laws preventing HIV one principle should be the priority, 
namely the protection of human rights and the safeguarding of human dignity.  

Following these recommendations should reduce the rate of HIV infection, help people 
with HIV maintain their health, and, ultimately, save lives. 

CONCLUSION 

AIDS is a fatal disease for which no definitive cure is known. Although there are some 
medications to treat HIV-positive patients, these medications are not 100% effective. 
AIDS is a pervasive and intensive medical and legal issue.  In the various legal systems 
of the world many laws have been made to control the spread of HIV infection but the 
legislatures around the world lag in enacting specific laws preventing the spread of 
AIDS due to which the number of HIV cases are rising day by day. 



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Author Notes 

Shamim Riaz Alias Anni has completed her intermediate in Pre-Medical from 
Government Girls Post Graduate College Kohat. Now she is studying Law at Fatima 
Jinnah Women University Rawalpindi. She is from Khyber Pakhtunkhwa province in 
Pakistan. She is interested in human welfare and she decided to study law in order to 
use it for the welfare of people, believing that lawyers can speak out when others fear 
to do so and can stand for the betterment of people and for the rights of individuals. 
That is why she participated in GIC to highlight the issues faced by AIDS patients and 
to show that this issue should be solved not only medically but also legally. Her email 
address is shamimriaz250@gmail.com  



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Hiffsa Bibi has completed her intermediate in pre-engineering. Now she is studying 
Law in Fatima Jinnah Women University. She is from Rawalpindi. She is interested in 
social welfare. She participated in many debating competitions. She also participated 
in GIC to highlight the medical and legal aspects of AIDS. She chose law for the 
betterment and welfare of society. Her email address is hiffsabibi@gmail.com  

Samia Hasnat has completed her intermediate in pre-engineering from Punjab Group 
of Colleges, Pins Dadan Khan. Now she is studying Law at Fatima Jinnah Women 
University Rawalpindi. She is from Pins Dadan District Jhelum. She is strongly 
motivated by the idea of empowering women and other vulnerable groups of society 
with the aim of contributing towards the growth of humanity. She participated in 6th 
GIC to raise awareness about medical and legal aspects of HIV/AIDS. Her email 
address is samiahasnat742@gmail.com. 


