Constitutional analysis and local governance in the protection of people living with HIV in Ecuador: towards a comprehensive reform

Abstract

The objective of this study was to analyze the gap between the protective framework of Ecuadorian constitutionalism and the persistent discrimination against people living with HIV. The research methodologically reviewed key national and international jurisprudence, including Judgment 2904-22-EP/24 of the Constitutional Court of Ecuador and rulings of the Inter-American Court of Human Rights, such as the González Lluy and Cuscul Pivaral cases. The results revealed that, although jurisprudence had advanced in the protection of rights and state responsibility, discrimination and stigma remained present in society, affecting access to health, employment, and education. The evidence showed that these obstacles were embedded in institutional decisions and in daily practice. The main conclusion is that, while judicial decisions provided important guidance, true social transformation required strengthening local governance, primarily through the active participation of Decentralized Autonomous Governments in implementing inclusive policies and monitoring the fulfillment of rights. It was emphasized that eliminating stigma and discrimination demanded not only a robust legal framework but also a profound cultural shift and a proactive commitment from all levels of government and society to make the dignity of people living with HIV a reality in Ecuador.