A/79/177 mechanisms; and enacting measures that support access to comprehensive sexual education, contraception, services to address sexually transmitted infections, including prevention, screening and treatment, and wider access to health services. 167 5. Same-sex relations 77. Sexual orientation is recognized as prohibited grounds of discrimination. 168 Furthermore, “[t]he criminalization of private, consensual same -sex conduct creates an environment that is not conducive to affected individuals achieving the full realization of their right to health”. 169 In this case, harm reduction grounded on a rights-based approach therefore requires the decriminalization of same-sex relations. 170 78. Decriminalizing same-sex relations is essential to health and human rights. Yet it is important to highlight certain measures that can be adopted or implemented to reduce the health harms associated with criminalization while the fight for decriminalization persists. These include measures to reduce the discriminatory policing of LGBTIQA+ persons, and measures to prevent violence – including sexual violence – against LGBTIQA+ persons, such as in settings of incarceration. 171 Furthermore, policies can prohibit discrimination based on sexual orientation in various contexts surrounding the social determinants of health, such as with housing, employment, education and health care. 172 B. Regulation of corporate actors 79. Harm reduction for peace and sustainable development requires regulation that is cohesively developed by States in a way that is more or less restrictive depending on scientific evidence and considering power asymmetries, alongside the disparate impacts of both harm and harm reduction. 173 80. While commercial actors have long shown a preference for self -regulatory and co-regulatory approaches over direct Government regulation, 174 such measures have been shown to lead to legal gaps and inconsistencies, making them less transparent 175 and less effective, and there is a lack of mechanisms for adequate industry accountability. 176 __________________ 167 168 169 170 171 172 173 174 175 176 18/28 Shree Schwartz, Nikita Viswasam and Phelister Abdalla, “Integrated interventions to address sex workers’ needs and realities: academic and community insights on incorporating structural, behavioural, and biomedical approaches”, in Sex Work, Health, and Human Rights, Goldenberg and others, eds. Committee on Economic, Social and Cultural Rights, general comment No. 20 (2009), para. 32. A/HRC/14/20, para. 24. Ibid., para. 26. Independent Expert on sexual orientation and gender identity, “The impact of colonialism in violence and discrimination based on SOGI (sexual orientation and gender identity)”, October 2023. Living Free and Equal: What States are Doing to Tackle Violence and Discrimination against Lesbian, Gay, Bisexual, Transgender and Intersex People (United Nations publication, 2016). A/HRC/56/52, para. 56. Gilmore and others, “Defining and conceptualizing”. A/69/286, paras. 20–21 and 101. CRC/C/CHE/CO/5-6, para. 16. 24-13226