Number of people who accessed legal counsel, protection, or post-violence services

Background

Member states of the United Nations Political Declaration on HIV and AIDS committed in 2011 to “national HIV and AIDS strategies that promote and protect human rights, including programs aimed at eliminating stigma and discrimination against people living with and affected by HIV, including their families, including through sensitizing police and judges; training healthcare workers in nondiscrimination, confidentiality, and informed consent; supporting national human rights learning campaigns, legal literacy, and legal services; and monitoring the impact of the legal environment on HIV prevention, treatment, care, and support.” People affected by, vulnerable to, and living with HIV, and members of key populations, are more likely to experience discrimination, violence, exploitation, and stigma in their communities because of their HIV status, the HIV status of a family member, their occupation, their gender, or their sexuality. At times, this discrimination prevents them from accessing much-needed health services because it can be shared by health and service providers as well.

This indicator can be used by community HIV programs and governments to monitor legal, protection, and support services provided to individuals who have experienced abuse, violence, exploitation, or violations to their person or property. Adequate provision of services to victims of violence and rights abuses involves the legal, healthcare, social protection, child protection, and policing systems, among others. Coordination and cooperation among many systems, involving numerous stakeholders, is essential to the provision of efficient, high-quality, and timely services to individuals who have experienced violence or other harm.

Numerator

Community-based HIV programs targeting adults (18+ years old):

Number of men and women (18+ years old) who have accessed legal counsel, social/legal protection, or post-violence services during the reporting period

Community-based HIV programs targeting children (<18 years old):

Number of female and male children and adolescents (<18 years old) who have accessed legal counsel, social/legal protection, or post-violence services during the reporting period

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

This indicator should include individuals who have experienced sexual violence (any sexual act that is perpetrated against someone’s will), physical violence, emotional violence, threats, coercion, arbitrary deprivation of liberty, economic deprivation, stigma, and/or discrimination, and have accessed support services during the reporting period. Community-based organizations that provide support services can track this information through their program records directly. Alternatively, community health or extension workers can ask beneficiaries whether they received any legal, protection, or post-violence support services during the reporting period and the location and type of support, but with caution. Referral and assessment alone should not be counted for this indicator, because this indicator monitors service uptake.

Community-based organizations and community workers are advised to align communications and reporting procedures with national social protection and case management policies and procedures. Skilled personnel, such as social workers, health workers, and justice sector personnel, should participate in further discussion with and questioning of victims, in lieu of community health or extension workers. If a community health or extension worker becomes aware of violence or suspects violence in his or her community, it is recommended that he or she ensure that victims or potential victims are connected to the correct, trained authorities immediately. However, they should be trained on the appropriate procedures to follow if they suspect or become aware of violence, instead of handling these cases, which could lead to further harm (see related indicator definition here for guidance on effective handling by community programs when cases of violence are identified).

Regardless of when the aggression or rights violation took place, any individual who has received any of the following at least once (although this list is not exhaustive) during the reporting period should be counted once for this indicator:

• Child or adult protection services (protection against violence, abuse, exploitation, and trafficking)
• Protection of succession rights
• Training and orientation on protection of the child
• Inheritance support
• Will writing support
• Removal from dangerous situations
• Assistance to report and resolve child abuse and neglect cases
• Fostering and adoption
• Rights education
• Vital registration
• Succession planning (making wills and memory books)
• Education of individual on legal rights
• Post-violence clinical services
• Legal counsel
• Police services
• Psychosocial support for sexual, physical, or emotional violence

HIV-related legal services can be delivered through legal information and referrals, legal advice from paralegals at the community level, alternative/community forms of dispute resolution, functioning mechanisms for redress like tribunals and ombudsman offices, and engaging faith-based or traditional legal leaders or systems to resolve dispute or changing traditional norms.

Community workers interacting with victims should receive training to make them aware of relevant laws, traditional justice systems, knowledge about types of violence and exploitation, professional ethical standards, respecting patient choice and maintaining informed consent, and methods of communication with victims and that minimize further trauma during interactions. Communities should enforce survivor- centered approaches to ensure autonomy, safety, respect, and right to confidentiality.

Data sources

This information is often tracked by programs for vulnerable children through vulnerable children service delivery forms, graduation checklists, beneficiary support activity forms, home visit tools, and household assessment tools. Provision of rights-based education is also tracked during behavior change communication activities. Whether the violence was addressed through decision-making or action planning, it is also tracked through outreach peer calendars in key population programs.

Disaggregation

• Age (<1 year, 1–4 years, 5–9 years, 10–14 years, and 15–19 years for children; 20–24 years, 25–49 years, and 50+ years for adults)
• Sex
• Type of support provided (see list above)
• Type of violence (sexual, emotional, or physical)
• Key population type (sex workers, men who have sex with men, transgender people, people who inject drugs)

Data quality considerations

This indicator does not monitor the quality or safety of services provided to victims, and programs should be sure to provide serious oversight and supervision of any services provided at the community level, given the sensitivities and security considerations required. Double-counting should be avoided (such as people receiving services more than once or from numerous sources). The community worker will not be able to track whether the victim received the full package of care when referred to post-violence clinical services based on type of violence experienced. This indicator should include only individuals who accessed support services during the reporting period, though the violence or rights abuses may or may not have occurred during the reporting period.

Reporting frequency

Community workers should collect this information regularly, but they should monitor progress monthly with support from their supervisors. The indicator should be reported on a quarterly basis.

Data element

Legal, protection, or post-violence services

Category

Key Populations, Vulnerable Children

References

The United States President’s Emergency Plan for AIDS Relief (PEPFAR)PEPFAR. (2018). Monitoring, evaluation, and reporting (MER 2.0) indicator reference guide updated release (Version 2.2). Washington, DC: PEPFAR. Retrieved from https://www.pepfar.gov/documents/organization/263233.pdf

World Health Organization (WHO) & United Nations Office on Drugs and Crime (UNODC). (‎2015)‎. Strengthening the medico-legal response to sexual violence. Geneva, Switzerland: World Health Organization (WHO). Retrieved from  http://www.who.int/reproductivehealth/publications/violence/medico-legal-response/en/

The Joint United Nations Programme on HIV/AIDS (UNAIDS). (2014). Guidance note: Human rights and the law. Geneva, Switzerland: UNAIDS. Retrieved from http://www.unaids.org/en/resources/documents/2014/2014unaidsguidancenote_humanrightsandthelaw_en