US: Identical bills filed in Florida Senate and House of Representatives to bring outdated criminal law in line with science

Florida Lawmakers Introduce Bills to Modernize HIV Criminal Law on World AIDS Day

Coinciding with World AIDS Day, Senator Jason Pizzo (D-Miami) and Representative Felicia Robinson (D-Miami Gardens) have introduced identical bills in the Senate (SB 1074) and House of Representatives (HB 813) to bring an outdated criminal law in line with the contemporary understanding of HIV. Florida’s laws written at the height of the HIV/AIDS epidemic makes it a felony punishable by up to 30 years in prison for a person living with HIV to have sexual contact without first disclosing the diagnosis to their potential sexual partner, regardless of whether the contact presents any risk of transmission. The bills limit criminal liability to situations in which the person living with HIV intends to cause harm and engages in conduct that can transmit HIV.

“This modernization of Florida’s HIV-focused criminal laws is long overdue,” said Rep. Robinson upon filing the bill in the House. “Today, people living with HIV who are receiving appropriate treatment live long, healthy lives—and those same treatments make it impossible to transmit HIV sexually. Given these advances, the criminal law should stop treating HIV differently from any other transmissible infection.”

Advocates view the prospects for these bills as good given how COVID-19 has changed public perceptions regarding transmissible disease and the appropriate role of the government in controlling choices about the risks that people take, particularly in the privacy of their own homes.

“Imposing criminal penalties to attempt to control a transmissible disease was never sound public policy—and COVID-19 has made that clear to more people,” said Sen. Pizzo. “We hope to see bipartisan support this session for fixing these laws that turn law-abiding citizens into criminals based on the fact that they are living with a manageable, transmissible disease and choose to live their lives like anyone else.”

Kamaria Laffrey, who leads the Florida HIV Justice Coalition, noted the benefits to public health and efforts to end the HIV epidemic in Florida: “We want people to get tested for HIV and to remain engaged in care and treatment if they test positive, but the threat of criminal prosecution under the current law is a barrier to these things,” said Laffrey. “By eliminating criminal penalties and reducing the intense stigma associated with HIV, we make it easier for people to seek the testing and care they need and for everyone to have frank conversations about the risks involved in any sexual encounter.”

States including Virginia, Nevada, Colorado, Iowa, and Michigan have recently revised similar HIV criminalization laws, recognizing the significant advances in science for treatment and prevention from the laws’ original enactments.

Since 1988, World AIDS Day has been observed on December 1, and is a time to raise awareness of the HIV/AIDS Epidemic and remember those lost to AIDS.

Equality Florida is the largest civil rights organization dedicated to securing full equality for Florida’s LGBTQ community. Through education, grassroots organizing, coalition building, and lobbying, we are changing Florida so that no one suffers harassment or discrimination on the basis of their sexual orientation or gender identity. www.equalityflorida.org 

El Salvador: Stigma Index reports that 23 women were sterilised without their knowledge or consent in the past year

El Salvador forced sterilisation of HIV-positive women

Translated via Deepl.com – For original article in Spanish, please scroll down –

Written by Fátima Escobar

When Lizz found out she was pregnant, she was also told she had HIV. When she gave birth to her only daughter, at the age of 17, she was forcibly sterilised by medical staff at one of El Salvador’s main public hospitals. The Constitutional Chamber of the Supreme Court of the Central American country only recognised that her right to reproductive health was violated. Eleven years later, she still wants to become a mother again. This text is part of the collaborative journalism project #ChangeTheStory, supported by the Deutsche Welle Akademie.

Months earlier, Lizz had received the news of her pregnancy and the positive test result for human immunodeficiency virus (HIV) at the same time. She says she was more concerned about the news of her pregnancy than the HIV diagnosis.

One morning in December 2010, Lizz* felt her baby kicking loudly in her belly and demanding to come into the world. Her pregnancy, marked by the despair of an unforeseen diagnosis, was nearing full term.

Upon her arrival at the National Women’s Hospital “Dr. María Isabel Rodríguez”, the most important women’s hospital in El Salvador, medical staff asked her if she wanted to be sterilised, but Lizz said no. Because of her HIV status, she had to be sterilised. Because of her HIV status, she had to have a caesarean section and was taken to the operating room that night.

Minutes before she was to be anaesthetised for the caesarean section, a nurse asked her again if she was going to be sterilised and handed her a form to authorise the procedure. Lizz signed without being fully informed of the consequences.

Eleven years later, she talks about that day via video call. She pauses, takes her eyes off the screen and says: “They were practically going to let me die, they told me that if I didn’t sign they wouldn’t treat me. I signed because I couldn’t stand the pain.

After giving birth to her only daughter, Lizz had part of her reproductive organ mutilated in surgery to prevent her from having children again when she was only 17.

Four years later, Lizz’s case was taken to the Constitutional Chamber of the Supreme Court of El Salvador, where it was found that she did not have full capacity to give informed consent to be sterilised because she was a minor.

I A pillar of support
When Lizz was just 16, she had a relationship with a man eight years her senior. A few months later, she began to feel sick and had severe headaches. She went to the doctor in the community of Cojutepeque, less than an hour from the capital, and after tests she was told that she was pregnant and that she was also HIV-positive.

“At that moment, what worried me most was that I was pregnant. I didn’t think about the HIV diagnosis,” she says.

When she told her partner the news, he was not surprised. He already knew he was HIV-positive and offered to live with her as a couple. Lizz moved out of her parents’ house and stopped her studies. Today she believes that she became pregnant as a result of rape because she was still a minor.

For the next few months, she had to go to the Women’s Hospital, the only one in the country for maternal care, where she received a course of retrovirals. At birth, her baby was born with a negative diagnosis. She was free of the virus.

The human immunodeficiency virus attacks the immune system and weakens defence systems against infections and certain cancers. It is transmitted through the exchange of body fluids from an infected person, such as blood, breast milk, semen or vaginal secretions.

State data show that the chances of a child being infected with HIV at birth are very low. According to the Ministry of Health of El Salvador (MINSAL), one in every 100 babies born to mothers with HIV are diagnosed with the virus. These figures are consistent with those reported by the Joint United Nations Programme on HIV/AIDS (UNAIDS), which states that the risk of a woman with HIV transmitting the virus to her child is reduced to 5% or less with effective treatment.

Lizz received the treatment stipulated by MINSAL. Indeed, the same report states that by 2010, 100% of known HIV-positive pregnant women in the country received antiretroviral drugs to reduce the risk of infant transmission. These figures reflect that Lizz could safely have more children.

In 2019, El Salvador’s Ministry of Health reported 26,893 people living with HIV in the country, 34% of whom were women.

Lizz followed her and her baby’s health status at her local hospital, some 18 km south of the country’s capital, and there she was connected to HIV support organisations when she went to her medical appointments.

“I used to go for check-ups at Cojutepeque Hospital, where I joined a support group and feminist non-governmental organisations. He (her ex-partner) was an alcoholic and beat me. I suffered a lot of physical abuse. But by joining these groups I became empowered. I became very empowered,” she says in an energetic tone. When her baby was three months old, she decided to separate and returned to her parents’ home.

At the hospital she met members of the Asociación Atlacatl Vivo Positivo, which works for the rights of people living with HIV. They provided her with a scholarship to finish high school. Psychological therapies and group sessions contributed to her education and empowerment. And she says that after a very difficult healing process, she can now talk more easily about it.

II More women with HIV sterilised

Lizz’s case is not unique. Other HIV-positive women and minors have been systematically sterilised in El Salvador.

In her amparo lawsuit, it was found that “in hospital practice, girls and adolescents are sterilised with the sole requirement that they sign an authorisation form to that effect”. In the ruling to which Alharaca had access, it is documented that one of the doctors questioned in the process said that “a minor under twelve years of age can be sterilised according to family planning regulations”.

The Technical Guide for Family Planning Care (GTAPF), mentioned in the amparo, does not stipulate that sterilisations of certain patients on the basis of age are allowed, but only requires the patient’s informed consent.

Lizz’s case was brought to the judiciary thanks to the Asociación Nacional de Personas Positivas Vida Nueva (ANP+VN), which focuses on reducing HIV disease in El Salvador.

Together with other civil society organisations and authorities, they participated in conducting the People Living with HIV Stigma Index (INDEX) 2019, interviewing patients in 19 hospitals of the public health system.

The report documented that 23 out of 514 people surveyed were sterilised without their knowledge or consent in the past year. All of those who said they had been sterilised were women. Most of them are poor and have little access to education, says Catherine Serpas, executive director of ANP+VN.

The same study found that 7.2 per cent of respondents were advised not to have children and 5.6 per cent said they were pressured, encouraged or induced to become permanently sterilised through tubal ligation or vasectomy.

Serpas added that the study also found three more cases of minors recounting their experience.

“It was alarming to come across cases of forced sterilisation. The first case we collected was from a woman who experienced this in 1998. Also, here we found cases of girls, minors,” says Serpas. She says that the association did not keep records of all of them, but after contacting some women, many decided not to participate in legal proceedings for fear of stigma.

One of those who did manage to follow up was Lizz, after conducting the INDEX 1.0 study. “The case happened in 2010, but she only spoke about it in 2014,” she explained.

III The legal battle
Organisations protecting the rights of people with HIV are often part of support groups like the one Lizz attended. There she met peers who had gone through the same thing and were persuaded by medical staff to be sterilised. This motivated her to speak out and start a legal process with the support of ANP+VN.

In 2014, they filed an injunction seeking recognition of the violation of Lizz’s reproductive health rights and HIV-related discrimination by medical staff at the National Women’s Hospital “Dr. María Isabel Rodríguez”.

A key element in bringing the case was to have the medical file, which they requested from the hospital through the Institute for Access to Public Information (IAIP), but were denied. Until they were taken to the amparo trial, the hospital authorities handed over the file, which had no evidence to justify the sterilisation.

Lizz’s defence had access to statements from some of the medical staff that it made “no sense” for people with HIV to continue having babies.

The hospital director denied before the Chamber any act of HIV discrimination or that the patient was forced to undergo sterilization.

The Constitutional Chamber declared in 2015 that there had been “violation of her fundamental rights to reproductive health, reproductive self-determination and personal integrity – in relation to the fact that, being a minor, and therefore not having full capacity to give her informed consent to be sterilised”.

“We did manage to prove that there was discrimination (on the grounds of HIV), but the Court did not admit it,” said Crissia Pérez, her lawyer and legal representative.

The Chamber’s ruling ordered the promotion of a process for material and moral damages and guaranteed adequate psychological treatment to overcome the consequences of the act of sterilisation.

IV Maternity. A right denied

Lizz suffered from recurrent bouts of depression. After the trial she wanted to regain her fertility.

Surgical sterilisation is a procedure in which the fallopian tubes, which carry the egg from the ovary to the uterus, are blocked. This can be by tying and cutting the tubes, by cauterisation, or closure with a ring or clamp.

About 20% of sterilised women regret their decision, but there are cases that cannot be reversed. One of them was Lizz’s.

“There are different ways of cutting the tubes, but the cut the doctor made was flush. There was no way to reconstruct the tubes. We interpret this as a practice of violence and an act against humanity,” says Catherine Serpas.

Between January 2013 and July 2021, 36 sterilisations were performed on women who verified delivery with a primary diagnosis of HIV out of a total of 280 deliveries in the country’s public hospitals, according to MINSAL data provided through the Institute for Access to Public Information (Instituto de Acceso a la Información Pública).

***

A gynaecologist working for the public health system, whose name she wishes to withhold for her own safety, warns that it is a moot point to recommend that a woman with HIV should not have children.

“If you go back to the 1980s, a diagnosis of HIV infection was practically a death foretold. Today we have the facility that there are various support programmes for these patients, including antiretroviral therapy, screening tests and social and psychological support groups,” she explains.

She says that if the patient is responsible for her health and her medication, she can become pregnant and have her pregnancy monitored regularly.

“Now, if the situation is different with a patient who has had poor adherence to her treatment or is irresponsible in her controls, who has uncontrolled secondary diseases or a poor prognosis,” she warns, “it becomes necessary to avoid pregnancy to prevent maternal or foetal complications.

Serpas explains that reproductive health issues are not seen as a problem. “This happens because we live in a world that is seen as totally masculine, especially on issues such as HIV,” she says.

ANP+VN often receives complaints about the lack of support in terms of family planning, she adds. “There is still a belief that the person is diagnosed and forgets about their sex life… We have found that when it comes to cytology (testing for the human papillomavirus, which causes cervical cancer) they have been mistreated by health staff, always with the interpretation ‘why are you still having sex’. The HIV response has evolved, but the thinking is still poor.

IV Migration
Lizz not only faced obstetric violence in her home country, during the trial she also received anonymous phone calls threatening her life. During her visits to the hospital for psychological treatment, medical staff tried to persuade her to drop her lawsuit.

The Head of the HIV and Human Rights Department of the Human Rights Ombudsman’s Office, Jaime Argueta, acknowledged that “there is no system of protection that can give guarantees to the person who has had the courage to file a complaint, to protect her against the state itself. She even began to be questioned when she received her treatment”.

Stigma is becoming less and less common in the health and workplace, she says, but “HIV testing is still required for employment as part of a battery of tests”.

At the community level, he warns that there is still a lot of discrimination and people’s diagnoses are disclosed in the places where they live.

“Maybe they work in a beauty salon and someone starts spreading the diagnosis and they lose their customers. Or they sell any kind of ready-made food for consumption and their livelihoods are also affected,” she said.

Lizz lived in an area declared to be at high risk of gang violence. This became another reason for her to migrate to the United States with her daughter and her current partner. There, more than 10,000 kilometres away from the country that expelled her, she is now trying to rebuild her life.

“I wanted a better life for my daughter. Fear also played a part in my decision to migrate,” she said.

V A new life
Despite her irregular migration status, Lizz has managed to access retroviral treatment through a protocol at a research centre in the United States, which she accessed through a hospital.

For now she is working, studying English and wants to go back to university to study law to help others: “My dream is to work in an organisation that helps with human rights or migration”.

According to the International Community of Women Living with HIV and AIDS (ICW Latina), in El Salvador the legal framework that establishes sanctions for health personnel in the case of forced sterilisation of women with HIV has a positive rating, that is, according to this organisation, doctors do receive penalties in these cases. However, those who attended Lizz’s case did not receive any penalty.

At the close of this investigation, an interview was requested with the head of the National STI/HIV/AIDS Programme, Dr Ana Isabel Nieto Gómez, to find out her position on Lizz’s case, but no response was received. Dr. Nieto was in the same position in 2010, when Lizz was forcibly sterilised.

Nieto is now an official in the government of President Nayib Bukele. His regime has been criticised for lacking accountability, giving little access to the press and declaring public information “confidential”.

ANP+VN currently works to provide legal support, training, psychological care, job reinsertion and alternative income generation for people living with HIV. It also has a close relationship with support groups for people with HIV in the national hospital network. Hundreds of people have benefited from its projects. Their lawyer shared that when the press covered Lizz’s case, they became aware of more cases that they could follow up and bring to justice if they had the funds.

El Salvador forzó la esterilización de mujeres con VIH

Cuando Lizz se enteró de que estaba embarazada, también le informaron que tenía VIH. Al momento de parir a su única hija, a la edad de 17 años, fue esterilizada de manera forzada por el personal médico de uno de los principales hospitales públicos de El Salvador. La Sala de lo Constitucional en la Corte Suprema del país centroamericano solo reconoció que se violó su derecho de salud reproductiva. A once años de lo ocurrido, mantiene el deseo de volver a ser madre.

Lizz había recibido meses antes de forma simultánea la noticia de su embarazo y el resultado positivo a la prueba del virus de inmunodeficiencia humana (VIH). Asegura que le preocupaba más la noticia de su embarazo que el diagnóstico del virus

Una mañana de diciembre de 2010, Lizz* sintió en su vientre que su bebé pateaba fuerte y con ello exigía su llegada al mundo. Su embarazo, marcado por la desesperanza de un diagnóstico imprevisto, estaba por llegar a término.

Desde su llegada al Hospital Nacional de la Mujer “Dra. María Isabel Rodríguez”, el más importante para la atención de la mujer en El Salvador, personal médico le preguntó si quería ser esterilizada, pero Lizz respondió que no. Por su condición de VIH le tenían que hacer una cesárea y en la noche fue llevada a la sala de operaciones.

Minutos antes de que se le aplicara la anestesia para practicarle la cesárea, una enfermera le preguntó de nuevo si se iba a esterilizar y le entregó un formulario para autorizar el procedimiento. Lizz firmó sin haber sido informada plenamente de las consecuencias.

A once años de lo ocurrido, habla sobre ese día a través de una videollamada. Hace una pausa, quita la mirada de la pantalla y dice: «prácticamente me iban a dejar morir, me dijeron que si no firmaba no me iban a atender. Yo firmé porque no soportaba el dolor».

Después de dar a luz a su única hija, a Lizz le fue mutilada una parte de su órgano reproductivo en una intervención quirúrgica para impedir que volviera a tener hijos cuando sólo tenía 17 años.

Cuatro años después, el caso de Lizz fue llevado a la Sala de lo Constitucional de la Corte Suprema de El Salvador, donde se comprobó que no tenía la capacidad plena para otorgar su consentimiento informado para ser esterilizada por el hecho de ser menor de edad.

I Un pilar de apoyo

Cuando Lizz tenía apenas 16 años, tuvo una relación con un hombre ocho años mayor que ella. A los pocos meses, comenzó a sentir malestar y dolores de cabeza intensos. Fue al médico en la comunidad de Cojutepeque, a menos de una hora de la capital, y después de hacer estudios le dijeron que estaba embarazada y que también era portadora de VIH.

“En ese momento lo que más me preocupó fue estar embarazada. No dimensioné el diagnóstico de VIH”, relata.

Cuando le dio la noticia a su pareja, él no se sorprendió. Ya sabía que era portador del virus y le ofreció vivir en pareja. Lizz salió de la casa de sus padres y suspendió sus estudios. Hoy considera que quedó embarazada por un acto de violación porque aún era menor de edad.

De su comunidad tuvo que ir los siguientes meses al Hospital de la Mujer, el único para atención materna en el país, donde recibió un tratamiento de retrovirales. Al nacer, su bebé nació con diagnóstico negativo. Estaba libre del virus.

El virus de la inmunodeficiencia humana ataca al sistema inmunitario y debilita los sistemas de defensa contra las infecciones y contra determinados tipos de cáncer. Se transmite a través del intercambio de líquidos corporales de la persona infectada, como la sangre, la leche materna, el semen o las secreciones vaginales.

Los datos del Estado reflejan que las probabilidades de que un menor se infecte de VIH al momento de su nacimiento son muy bajos. Según el Ministerio de Salud de El Salvador (MINSAL) uno de cada 100 bebés nacidos de madres con VIH son diagnosticados con el virus. Estos datos coinciden con los reflejados en el Programa Conjunto de las Naciones Unidas sobre el VIH/Sida ONUSIDA, donde se asegura que el riesgo de que una mujer con VIH le transmita el virus a su hijo se reduce a un 5 % o menos con un tratamiento eficaz.

Lizz recibió el tratamiento estipulado por el MINSAL. Incluso, el mismo informe asegura que para el año 2010 el 100 % de embarazadas con VIH conocidas en el país, recibieron medicamentos antirretrovirales para reducir el riesgo de transmisión infantil. Estas cifras reflejan que Lizz podía tener más hijos de forma segura.

En 2019, el Ministerio de Salud de El Salvador reportó 26,893 personas vivas con VIH en el país, de ellas el 34 % eran mujeres.

Lizz dio seguimiento a su estado de salud y el de su bebé en su hospital local, unos 18 km al sur de la capital del país, y ahí tuvo conexión con organizaciones de apoyo a personas con VIH cuando iba a sus citas médicas.

“Yo iba a controles al Hospital de Cojutepeque, ahí me uní a un grupo de apoyo y a organizaciones feministas no gubernamentales. Él (su expareja) era un hombre alcohólico y me golpeaba. Sufrí mucho abuso físico. Pero al unirme a estos grupos me empoderé. Me empoderé muchísimo”, dice en tono enérgico. Cuando su bebé cumplió tres meses, decidió separarse y volvió a casa de sus padres.

En el hospital conoció a integrantes de la Asociación Atlacatl Vivo Positivo, que trabaja a favor de los derechos de las personas con VIH. Ellos le brindaron una beca para terminar sus estudios de educación media. Las terapias psicológicas y las sesiones grupales contribuyeron a su formación y empoderamiento. Y asegura que después de un proceso de sanación muy difícil, ahora puede hablar con mayor facilidad sobre el tema.

II Más mujeres con VIH esterilizadas

El caso de Lizz no ha sido el único. Otras mujeres con VIH y menores de edad han sido esterilizadas de forma sistemática en El Salvador.

En su juicio de amparo, se comprobó que “en la práctica hospitalaria se esteriliza a niñas y adolescentes con el único requisito que estas suscriban un formulario de autorización para tal efecto”. En el fallo al que tuvo acceso Alharaca, se documenta que una de las doctoras interrogadas en el proceso dijo que «una menor de doce años de edad puede ser esterilizada según la normativa de planificación familiar».

La Guía Técnica de Atención en Planificación Familiar (GTAPF), mencionada en el amparo, no estipula que exista esterilizaciones a ciertos pacientes en razón de edad, únicamente exige que haya un consentimiento informado del paciente.

El caso de Lizz fue llevado al Poder Judicial gracias a la Asociación Nacional de Personas Positivas Vida Nueva (ANP+VN), enfocada en la reducción de la morbilidad del VIH en El Salvador.

Junto con otras organizaciones de la sociedad civil y autoridades, participaron en la realización del Índice de Estigma en Personas con VIH (INDEX) 2019, haciendo entrevistas a pacientes en 19 hospitales del sistema público de salud.

En el Informe se documentó que 23 de 514 personas encuestadas fueron esterilizadas sin su conocimiento o su consentimiento en el último año. Todas las que afirmaron este hecho eran mujeres. La mayoría de ellas son de escasos recursos económicos y tienen poco acceso a educación, señala Catherine Serpas, directora ejecutiva de ANP+VN.

El mismo estudio reflejó que a un 7.2 % de las personas encuestadas le aconsejaron no tener hijos y un 5.6 % menciona que fue presionado, motivado o inducido para esterilizarse de forma permanente por medio de ligadura de trompas o vasectomía.

Serpas añadió que en el estudio también encontraron tres casos más de menores de edad que contaban su experiencia.

“Fue alarmante encontrarnos con casos de esterilizaciones forzadas. El primer caso que recolectamos fue de una mujer que vivió esto en 1998. Además, aquí encontramos casos de niñas, menores de edad”, expresa Serpas. Ella dice que la asociación no guardó registro de todos, sin embargo, al realizar contacto con algunas mujeres, muchas decidieron no participar en procesos legales por miedo al estigma.

Una de las que sí lograron dar seguimiento fue Lizz, luego de realizar el estudio INDEX 1.0. “El caso ocurrió en 2010, pero ella habló de este hecho hasta 2014”, explicó.

III La batalla legal

Las organizaciones de protección de los derechos de personas con VIH suelen formar parte de los grupos de ayuda como a los que asistía Lizz. Ahí conoció a compañeras que pasaron por lo mismo y que fueron persuadidas por el personal médico para ser esterilizadas. Eso la motivó a hablar e iniciar un proceso legal con el acompañamiento de ANP+VN.

En 2014 promovieron un amparo para que se reconociera la violación de los derechos de salud reproductiva de Lizz y discriminación en razón del VIH por parte del personal médico del Hospital Nacional de la Mujer «Dra. María Isabel Rodríguez».

Un elemento clave para llevar el caso era tener el expediente médico, el cual solicitaron al hospital por medio del Instituto de Acceso a la Información Pública (IAIP), pero les fue negado. Hasta que fueron llevadas al juicio de amparo, las autoridades del hospital entregaron el expediente, el cual no tenía pruebas que justificaran la esterilización.

La defensa de Lizz tuvo acceso a declaraciones de parte del equipo médico que señalaban que “no tenía sentido” que las personas con VIH siguieran teniendo bebés.

El director del hospital negó ante la Sala cualquier acto de discriminación por VIH o que se haya forzado a la paciente para ser sometida a esterilización.

La Sala de lo Constitucional declaró en 2015 que sí hubo «vulneración de sus derechos fundamentales a la salud reproductiva, a la autodeterminación reproductiva y a la integridad personal —con relación al hecho de que, siendo menor de edad, y por lo tanto no teniendo la capacidad plena para otorgar su consentimiento informado para ser esterilizada».

“Sí logramos probar que hubo discriminación (en razón de VIH), pero la Sala no lo admitió”, lamentó su abogada y apoderada legal Crissia Pérez.

En el fallo de la Sala se ordenó la promoción de un proceso por los daños materiales y morales y garantizar un tratamiento psicológico adecuado para superar las secuelas por el acto de esterilización.

IV Maternidad. Un derecho negado

Lizz sufrió cuadros de depresión recurrentes. Después del juicio quiso recuperar su fertilidad.

La esterilización quirúrgica es un procedimiento en el que las trompas de Falopio, que transportan el óvulo desde el ovario hasta el útero, se bloquean. Esto puede ser por atadura y corte de los conductos, por cauterización, o cierre con un anillo o grapa.

Un 20 % de las mujeres esterilizadas se arrepiente de su decisión, pero hay casos que no se pueden revertir. Uno de ellos fue el de Lizz.

«Hay diferentes tipos de cortar las trompas, pero el corte que le hizo el médico era al ras. No había forma de reconstruir las trompas. Nosotros interpretamos esto como una práctica de violencia y un acto de lesa humanidad», señala Catherine Serpas.

Entre enero de 2013 hasta julio de 2021 se realizaron 36 esterilizaciones en mujeres que verificaron parto con un diagnóstico principal VIH de un total de 280 partos en los hospitales públicos del país, según datos del MINSAL brindados por medio del Instituto de Acceso a la Información Pública.

***

Una ginecóloga que trabaja para el sistema de salud público, cuyo nombre desea omitir para resguardar su seguridad, advierte que es una temática discutible el recomendar a una mujer con VIH no tener hijos.

“Si nos remontamos a los años ochenta, el diagnóstico de infección por VIH era prácticamente una muerte anunciada. Hoy tenemos la facilidad de que hay diversos programas de apoyo para estos pacientes, que incluyen la terapia antirretroviral, exámenes de control y grupos de apoyo social y psicológico”, explica.

La médica asegura que si la paciente es responsable de su salud y sus medicamentos, puede embarazarse y llevar el control periódico de su embarazo.

“Ahora, si el panorama es diferente con una paciente que ha tenido poca adherencia a su tratamiento o sea irresponsable en sus controles, que tenga enfermedades secundarias no controladas o de mal pronóstico», advierte, «se vuelve necesario evitar el embarazo para evitar complicaciones maternas o fetales”.

Serpas explica que los temas de salud reproductiva no son vistos como un problema. “Eso pasa porque vivimos en un mundo que se ve totalmente masculino, y más, en temas como el VIH”, dice.

ANP+VN recibe con frecuencia reclamos sobre la falta de apoyo en términos de planificación familiar, agrega. “Todavía se cree que la persona recibe el diagnóstico y se olvida de su vida sexual… Hemos detectado que a la hora que se les hace la citología (prueba de detección del virus del papiloma humano, que causa el cáncer de cérvix) han recibido maltrato por parte del personal de salud, siempre con la interpretación de ‘¿por qué sigue teniendo relaciones sexuales?’. La respuesta del VIH ha evolucionado, pero el pensamiento sigue siendo mediocre”.

IV Migración

Lizz no solo enfrentó la violencia obstétrica en su país, durante el juicio también recibió llamadas anónimas donde la amenazaban con atentar contra su vida. En sus visitas al hospital para recibir tratamiento psicológico, hubo personal médico que la intentó persuadir para que desistiera en su demanda.

El Jefe Departamento de VIH y Derechos Humanos de la Procuraduría General de Derechos Humanos, Jaime Argueta, reconoció que “no existe un sistema de protección que pueda dar garantías a la persona que ha tenido el valor de presentar la denuncia, para protegerla contra el mismo estado. Incluso, ella empezó a ser cuestionada al momento de recibir su tratamiento».

Cada vez es menos frecuente es el estigma en ámbito de salud o en el ámbito laboral, dice, pero aún se pide la “prueba de VIH para el ingreso a un empleo como parte de la batería de exámenes”.

En el ámbito comunitario, advierte que todavía hay mucha discriminación y se divulgan los diagnósticos de personas en los lugares donde ellos viven.

“Tal vez trabajan en una sala de belleza y alguien empieza a divulgar el diagnóstico y pierden sus clientes. O venden cualquier tipo de alimentos ya preparados para el consumo y también son afectadas en sus formas de vida”, expuso.

Lizz vivía en una zona declarada de alto riesgo de violencia por pandillas. Esto se convirtió en una razón más que la llevó a migrar a Estados Unidos junto con su hija y su actual pareja. Allá, a más de 10 mil kilómetros del país que la expulsó, ahora intenta rehacer su vida.

“Quería una vida mejor para mi hija. El miedo también tuvo que ver en mi decisión de migrar”, expresó.

V Una nueva vida

A pesar de su condición migratoria irregular, Lizz ha logrado tener acceso a un tratamiento de retrovirales a través de un protocolo en un Centro de Investigación en Estados Unidos, al cual accedió por medio de un hospital.

Por ahora trabaja, estudia inglés y desea regresar a la Universidad a estudiar leyes para ayudar a otras personas: “Mi sueño es trabajar en una organización que ayude en los derechos humanos o migración”.

Según la Comunidad Internacional de Mujeres viviendo con VIH Sida (ICW Latina), en El Salvador el marco legal que establece sanciones para el personal sanitario en el caso de la esterilización forzada a las mujeres con VIH tiene una calificación positiva, es decir, según esta organización los médicos sí reciben penalidad ante estos casos. Sin embargo, los que atendieron el caso de Lizz no recibieron ninguna penalidad.

Al cierre de esta investigación se solicitó una entrevista con la jefa del Programa Nacional de ITS/VIH/SIDA, Dra. Ana Isabel Nieto Gómez, para conocer su postura respecto al caso de Lizz, sin embargo no se recibió respuesta. La doctora Nieto fungía en ese mismo cargo en 2010, cuando Lizz fue esterilizada de forma forzosa.

En la actualidad Nieto es funcionaria del Gobierno del presidente Nayib Bukele. Su régimen ha sido señalado por nula rendición de cuentas, dar poco acceso a la prensa y por declarar “confidencial” información pública.

En la actualidad ANP+VN trabaja para brindar apoyo legal, capacitaciones, atención psicológica, reinserción laboral y generación de alternativas de ingresos para personas con VIH. Además, tiene estrecha relación con los grupos de apoyo de personas con VIH de la red hospitalaria nacional. Cientos de personas se han visto beneficiadas por sus proyectos. Su abogada compartió que cuando la prensa cubrió el caso de Lizz, tuvieron conocimiento de más casos a los que podrían dar más seguimiento y llevar a la justicia si contaran con los fondos.

 

Russia: Medical documents showing negative HIV status and no drug addiction required for stays over 90 days

Migrants may be required to provide the Ministry of Internal Affairs with a certificate of the absence of HIV infection

Automated translation – For original article in Russian, please scroll down

MOSCOW, November 19. / TASS /. Labor migrants and foreign citizens who have arrived in Russia for a period of more than 90 days may be obliged to provide the Ministry of Internal Affairs with medical documents showing the absence of drug addiction and HIV infection from December 29. This follows from the draft order prepared by the Ministry of Internal Affairs of the Russian Federation, which was reviewed by TASS.

“To approve the procedure for submission by foreign citizens and stateless persons who arrived in the Russian Federation for purposes not related to the implementation of labor activities, for a period exceeding 90 calendar days, or for the purpose of labor activity, to the territorial body of the Ministry of Internal Affairs of the Russian Federation <…> documents confirming the passage of a medical examination for the presence or absence of the fact of their use of narcotic drugs or psychotropic substances without a doctor’s prescription or new potentially dangerous psychoactive substances, infectious diseases that pose a danger to others, <…> and a disease caused by the human immunodeficiency virus (HIV -infection) “, – the document says. At the same time, it is noted that “this order comes into force on December 29, 2021”.

As follows from the document, foreigners must submit medical documents to the Ministry of Internal Affairs within 30 days from the date of expiration of the previously issued medical documents confirming that they have passed a medical examination. In the event that a foreign citizen has not reached the age of 18 or is recognized by a court as incompetent, documents can be submitted by one of his parents, guardians or trustees.

“Medical documents can be submitted at the place of residence of a foreign citizen on paper – directly to the migration department of the territorial body of the Ministry of Internal Affairs of Russia, or to an enterprise or an authorized organization, or in the form of an electronic document signed with an enhanced qualified electronic signature, using the federal state information the system “A single portal of state and municipal services (functions)” to the territorial body of the Ministry of Internal Affairs of Russia, “the draft order says.

In the event that the documents are drawn up in a foreign language, then they must be translated into Russian, the correctness of which must be notarized. Upon admission, the authorized person must check the full compliance of the documents with the established standards, and then issue a certificate of receipt. At the same time, if a migrant submits medical documents in electronic form, then an electronic message is sent to him about their acceptance no later than the working day following the day they were received. Subsequently, information about the receipt of medical documents is entered into the information system of the Ministry of Internal Affairs of Russia, intended for the provision of public services, within three working days from the date of their receipt.

Мигрантов могут обязать предоставлять в МВД справки об отсутствии ВИЧ-инфекции

Приказ может вступить в силу 29 декабря
МОСКВА, 19 ноября. /ТАСС/. Трудовых мигрантов и иностранных граждан, прибывших в Россию на срок более 90 дней, могут обязать с 29 декабря предоставлять в МВД медицинские документы об отсутствии у них наркозависимости и ВИЧ-инфекции. Это следует из подготовленного МВД РФ проекта приказа, с которым ознакомился ТАСС.

“Утвердить порядок представления иностранными гражданами и лицами без гражданства, прибывшими в РФ в целях, не связанных с осуществлением трудовой деятельности, на срок, превышающий 90 календарных дней, либо в целях осуществления трудовой деятельности, в территориальный орган МВД РФ <…> медицинских документов, подтверждающих прохождение медицинского освидетельствования на наличие или отсутствие факта употребления ими наркотических средств или психотропных веществ без назначения врача либо новых потенциально опасных психоактивных веществ, инфекционных заболеваний, представляющих опасность для окружающих, <…> и заболевания, вызываемого вирусом иммунодефицита человека (ВИЧ-инфекции)”, – говорится в документе. При этом отмечается, что “настоящий приказ вступает в силу с 29 декабря 2021 года”.

Как следует из документа, представить медицинские документы в МВД иностранцы должны в течение 30 дней со дня истечения срока действия ранее выданных медицинских документов, подтверждающих прохождение ими медицинского освидетельствования. В случае, если иностранный гражданин не достиг 18 лет или признан судом недееспособным, документы может представить один из его родителей, опекунов или попечителей.

“Медицинские документы могут быть представлены по месту пребывания иностранного гражданина на бумажном носителе – непосредственно в подразделение по вопросам миграции территориального органа МВД России, либо в предприятие или уполномоченную организацию, либо в форме электронного документа, подписанного усиленной квалифицированной электронной подписью, с использованием федеральной государственной информационной системы “Единый портал государственных и муниципальных услуг (функций)” в территориальный орган МВД России”, – отмечается в проекте приказа.

В том случае, если документы составлены на иностранном языке, то они подлежат переводу на русский язык, верность которого должна быть нотариально засвидетельствована. Уполномоченное лицо при приеме должно проверить полное соответствии документов установленным нормам, после чего выдать справку об их получении. При этом, если мигрант подает медицинские документы в электронном виде, то ему направляется электронное сообщение об их приеме не позднее рабочего дня, следующего за днем их получения. В последующем сведения о получении медицинских документов вносятся в информационную систему МВД России, предназначенную для предоставления государственных услуг, в течение трех рабочих дней с даты их получения.

US: Supreme Court agrees that sex offender law struck down by Louisiana Supreme Court is unconstitutional

Supreme Court Declines To Hear Louisiana’s Defense of a Law That Stamped ‘SEX OFFENDER’ on Driver’s Licenses

The policy imposed an additional form of ritual humiliation on a reviled category of people without any plausible public-safety justification.

The U.S. Supreme Court today declined to hear Louisiana’s appeal of a decision against its 2006 law requiring that people on the state’s sex offender registry carry IDs or driver’s licenses that say “SEX OFFENDER” in orange capital letters. A year ago, the Louisiana Supreme Court concluded that the requirement amounted to compelled speech and could not be justified by the state’s legitimate interest in protecting public safety. In addition to raising First Amendment issues, Louisiana’s now-moribund law illustrates the longstanding tendency to impose additional punishment on people convicted of sex offenses in the guise of regulation.

The registries themselves, which require sex offenders to regularly report their addresses to local law enforcement agencies so that information can be made publicly available in online databases that also include their names, photographs, and physical descriptions, are primarily punitive, exposing registrants to ostracism, harassment, and violence while impeding their rehabilitation by making it difficult to find employment and housing. There is little evidence that the sort of public notification practiced by every state delivers benefits that outweigh those costs. Louisiana’s experiment in ritual humiliation, which branded registrants with orange letters they had to display in every transaction that required producing a government-issued ID, compounded those costs without offering any plausible benefits.

One problem with sex offender registries is that they cover a wide range of crimes, including many that do not involve violence, force, or physical contact. While people tend to imagine rapists or child molesters when they hear the term sex offender, the reality can be quite different, in ways that are important in assessing the danger that a person might pose to the general public or to people in particular age groups.

In Louisiana, for example, mandatory registration applies not only to crimes like rape and sexual assault but also to nonviolent offenses, such as voyeurism, possession of child pornography, consensual sex between adults who are closely related, sex between high school teachers and students (even when the student has reached the age of consent), and employment of a minor in “any practice, exhibition, or place, dangerous or injurious to the life, limbs, health, or morals of the minor.” Robert Suttle, who posted the picture of his driver’s license shown above, was forced to register because he was convicted of intentionally exposing someone to HIV, which resulted in a six-month prison sentence. After a bad breakup, he says, his former partner told the police he had not been informed of Suttle’s HIV status.

The second line of each record in the state’s registry shows the offender’s “tier,” which corresponds to various crimes classified by severity, ranging from Tier 1 (least serious, requiring registration for 15 years) to Tier 3 (most serious, requiring lifetime registration). Further down in the record, you can see the statute under which the registrant was convicted (e.g., “carnal knowledge of a juvenile”), which still omits potentially important details.

The driver’s license warning required by Louisiana’s law did not provide even that much information, meaning that anyone who saw it was invited to assume the worst. Tazin Hill, the man who challenged the law, completed his prison sentence in 2013. He was convicted of having sex with a 14-year-old when he was 32, which placed him in Tier 1. But anyone who saw his license had no way of knowing the nature or severity of his offense. Rebelling at this government-imposed badge of shame, Hill excised the “SEX OFFENDER” label from his license and covered the gap with clear tape, which resulted in the criminal charges that gave rise to this case.

Another problem with sex offender registries is the mistaken assumption that people who fall into this broad category are more likely to commit additional crimes than, say, robbers, burglars, or arsonists. When it upheld mandatory “treatment” of sex offenders in prison, for example, the Supreme Court relied on a highly dubious recidivism estimate that was repudiated by its original source but has nevertheless been cited repeatedly by lower courts. The “SEX OFFENDER” stamp on Louisiana driver’s licenses, even more than the registry, promoted such erroneous fears by implying that the bearer posed an ongoing threat, no matter the details of his crime, how long ago it occurred, or how he had behaved since he completed his sentence.

The empirically unjustified belief that sex offenders are highly prone to recidivism is especially inaccurate and damaging when applied to people convicted as minors, who are included in Louisiana’s registry and therefore had to carry “SEX OFFENDER” IDs or driver’s licenses. Judy Mantin, who this year testified before a state legislative committee that was considering revisions to Louisiana’s law in light of the state Supreme Court’s ruling, said her son “made a mistake” when he was 14 but today is “a very productive citizen.” She argued that “our children deserve a second chance in life.”

Legislators ostensibly have made the same judgment regarding adults convicted of sex offenses, who have notionally paid their debt to society once they complete their criminal sentences. Yet legislators imply otherwise by imposing additional burdens on those people for decades after their official punishment. In this case, any interaction involving a driver’s license—e.g., with cashiers, hotel clerks, bank tellers, employers, landlords, election officials, or airport security screeners—became a new invitation to close-range fear and loathing.

What was the justification for this requirement, which added to the burdens imposed by registration, public notification, and residence restrictions? The state argued that the “SEX OFFENDER” label facilitated law enforcement by alerting police officers to a person’s status. But police already could readily check that by consulting the state’s database. And as the Louisiana Supreme Court noted, the state could have eliminated even that slight inconvenience with a more discreet label: “A symbol, code, or a letter designation would inform law enforcement that they are dealing with a sex offender and thereby reduce the unnecessary disclosure to others during everyday tasks.”

Such a solution would not be adequate, the state argued in its petition to the U.S. Supreme Court, because “the Louisiana Legislature concluded that the public, and not merely law enforcement, needs to know of a sex offender’s status under limited circumstances.” Such as?

“A property manager needs to know a sex offender’s status when leasing an apartment—or the manager might incur liability if a tenant is raped on the premises,” the petition said. “A church or Red Cross facility may need to know a person’s status as a sex offender when providing shelter from a storm. People trick or-treating on Halloween may need a quick way to verify that their children are safe from predators.”

During a lower-court hearing, one of the state’s lawyers offered another example:

If I’m deciding who I want to be my babysitter and I know that I don’t want a sex offender to babysit my children, I say, “OK. I’d like to see your ID before I allow you to babysit my children.” And, “Oh, it says ‘sex offender.’ I’m not going to hire you.”

The Halloween scenario suggests the state’s desperation, not only because this particular hazard is an urban legend but also because it is difficult to imagine a situation in which parents would demand to see the driver’s licenses of neighbors handing out candy to trick-or-treaters. Even when the concerns are more reasonable, the public registry, for better or worse, already allowed anyone to look up an individual and see if he was listed; that was supposedly the whole purpose of creating a publicly accessible database in the first place.

“Louisiana’s branded-identification regime was an outlier in singling registrants out for public opprobrium,” Hill’s lawyers noted in their brief urging the Supreme Court not to consider the state’s appeal. “Just two other States require identification cards to display phrases like ‘SEX OFFENDER,’ while only six States have laws that require identification cards to include other types of sexual offense disclosure—typically a symbol or statute number recognizable only to law enforcement.”

Even as an outlier, Louisiana’s law suggests how ready politicians are to support practically any burden on sex offenders, whether or not it makes sense as a tool to promote public safety. Policies like these serve no useful purpose, but they do make life harder for a reviled category of people whose punishment never ends.

Russia: Over the past five years, Russian courts have acquitted only one defendant under Article 122 of the Criminal Code

Going to prison for the virus: No acquittals for HIV infection in Russia in three years

Translated with www.DeepL.com/Translator, please scroll down for original article in Russian.

Human rights activists, the WHO and the UN all oppose this provision in the Russian Criminal Code.

No chance of acquittal

In one of the most controversial articles of the Russian Criminal Code, the chances of an acquittal are 0 per cent. Cases are heard behind closed doors and verdicts are almost never published. The practice has been opposed by respected global organisations, and even the Russian government has proposed amendments. But for now, the case stands still and the defendants are sent to penal colonies. Where they will not receive proper treatment. We are talking about Article 122 of the Criminal Code of the Russian Federation (HIV infection).

According to the Judicial Department, it is virtually impossible to obtain acquittal for crimes related to HIV transmission. Over the past five years, Russian courts have acquitted only one defendant under Article 122 of the Criminal Code. And from 2018 to 2020, the statistics are quite depressing – all the defendants in such cases have only heard guilty verdicts. Even in cases of treason and espionage, courts acquit more often, Supreme Court documents show (in 3 years, courts have released as many as 5 defendants accused of crimes against state security).

Word and deed

In the winter of 2011, Samara resident Evgeny Kovalev (hereafter the names are changed – ed.) ended up in a drug treatment clinic. The young man had been addicted to illegal substances shortly before, but decided to get rid of his addiction and got registered at the clinic. During the process, they started taking various tests for Yevgeniy, including HIV tests. One of them showed that Kovalev’s organism had antibodies to the infection (they are present at any stage of the disease including asymptomatic stage). He had no symptoms of HIV but was diagnosed with HIV.

At that time Kovalev was dating a girl and was periodically having intimate relations with her. As he will later prove in court, the doctors did not tell him about the positive diagnosis. He only found out about it when he and his girlfriend visited the social centre where they were tested. Although the results of the tests were negative, the couple broke up after the unpleasant news and maintained their friendship. A few months later, however, the girl felt ill and went to the health centre, where the doctor gave her a number of referrals. This is how she found out that she was also infected.

The victim went to the police and Kovalev was detained. He was charged with intentional transmission of HIV (part 2 of article 122 of the Criminal Code). During the hearing, Evgeniy put forward the version that his ex-girlfriend could have been infected by another person, as they always used protection during sex. But the court sided with the victim, who claimed that she had never slept with anyone else. No other evidence was cited in the verdict.

In August 2011, the Kuibyshev District Court of Samara sentenced Kovalev to a real sentence (not specified in the text of the sentence) in a penal colony. Despite having a wife and an underage child, as well as a serious illness, the young man was taken into custody right in the courtroom. He was also charged with moral damages.

In September 2017, a resident of Feodosia (Crimea) reported her mobile phone missing to the police. Her acquaintance Oleg Osipov was suspected. He was summoned to the police station. During the interrogation, there was a conflict between him and an operative named Chudak. After a verbal altercation Oleg suddenly grabbed a decanter from the policeman’s desk, smashed it on a safe and started cutting his hands with broken shards (before that Osipov had not been found guilty of any offence: he had no criminal record, was not registered at a drug treatment facility or a psychiatric clinic). The operative tried to take away the glass, but was struck in the thigh during the scuffle.

After a few minutes, Osipov was restrained and taken to his cell. The man cleaned the wound, the cleaner was scrubbing the blood off the floor. They never found evidence that it was Oleg who had stolen the ill-fated smartphone.

But he was charged with other crimes. For assaulting a police officer in the line of duty (part 2 of article 318 of the Criminal Code). And of knowingly putting another person at risk of HIV infection (part 1 of article 122 of the Criminal Code). It turned out that in December 2012, Osipov learned about his disease and the dispensary took a receipt from him saying that he was warned about the need to comply with sanitary and hygiene standards to avoid infecting other people. This fact was considered by the Investigative Committee to be sufficient for the prosecution.

At trial, Oleg pleaded guilty and repented of what he had done. But the court decided that his correction is possible only in isolation from society and sentenced the man to two years and two months in a penal colony.

Osipov’s appointed lawyer, Oksana Pasichenko, told Sobesednik that she does not know the fate of her former client, but he is “most likely already at large”.

Incidentally, sometimes law enforcers themselves are prosecuted for deliberate HIV infection. In 2015, a police officer was detained in Kaliningrad who had infected nine women.

Despite Osipov’s unfortunate experience, often those accused under Article 122 of the Criminal Code who plead guilty still avoid real sentences. This happened, for example, to Alexey Lozhkin, a resident of Udmurtia who infected his girlfriend with HIV back in 2008. He repented in court and received a one-year suspended sentence.

Fear of confession

The first case of HIV in the USSR was registered in 1987. Lawmakers almost immediately criminalised intentional transmission of HIV; article 115.2 was added to the Criminal Code of the USSR, which later became article 122 of the Russian Criminal Code.

Russian law still does not clearly describe the circumstances under which criminal liability for HIV-positive individuals arises.

The law puts HIV-positive people before other citizens, says Mariya Godlevskaya, peer counselor of the E.V.A. association (she herself found out about her infection in 1999).

– That`s why many HIV-positive people are afraid to tell their environment about their status”, Godlevskaya says. – Article 122 of the Criminal Code puts people in a corner, criminalising anyone who has HIV. The sole responsibility for his or her health shifts to the individual. And yet there are cases when HIV-positive people are simply blackmailed by their former partners. Although it is known that a person on antiretrovirals cannot infect another person, the judicial practice simply does not take this into account.

WHO and the UN have long called for the decriminalisation of HIV infection. And in a number of countries the situation, albeit slowly, is beginning to change. For example, this year, the state of Illinois (USA) decriminalised HIV transmission. A similar proposal back in 2017 was put forward by the Russian government, but it was never approved.

“Contagious” Article

Article 122 of the Russian Criminal Code punishes both HIV infection itself and “knowingly putting another person at risk of infection”. It can be punishable by imprisonment for up to one year. If the defendant knew he or she had the disease, he or she could be sent to prison for five years. If the victim is a minor or two or more people, the perpetrator faces up to 8 years in prison.

In the statistics of the Supreme Court, cases under Art. 122 are combined with cases under Art. 121 (infection with a sexually transmitted disease), so it is impossible to draw an exact conclusion about what kind of punishment the courts are choosing. It is known that in 2020, the number of actual and suspended sentences were about the same – 28 people went to prison and 29 remained free. Ten received restriction of liberty (unable to travel abroad) and one received compulsory labour.

Human rights activists believe that such measures do not work, although they are used in many countries around the world. The list of such measures does not include those countries which are considered to be developed.

Myths

Society is still full of myths about HIV and its terminal stage, AIDS. One of the main ones is the supposedly high mortality rate of the disease.

In reality, HIV-positive people live as long as the average person. As long as they take antiretroviral medication. In this case the person is not contagious. However, the Russian code makes no distinction between those who take medication and those who refuse treatment.

В тюрьму за вирус: В России за три года нет ни одного оправдательного приговора по статье о заражении ВИЧ

Против этой нормы в УК РФ выступают и правозащитники, и ВОЗ, и ООН.

Без шанса на оправдание

0% – таковы шансы, что обвиняемого оправдают по одной из самых спорных статей Уголовного кодекса России. Дела по ней рассматриваются в закрытом режиме, тексты приговоров практически никогда не публикуются. Против этой практики выступают авторитетные всемирные организации, свои поправки предлагало даже российское правительство. Но пока дело стоит на месте, а подсудимых отправляют в колонии. Где они не смогут получить надлежащего лечения. Речь идет о ст. 122 УК РФ (заражение ВИЧ-инфекцией).

Согласно данным судебного департамента, за преступления, связанные с передачей ВИЧ-инфекции, практически невозможно добиться оправдательного приговора. За последние 5 лет российские суды освободили всего одного обвиняемого по ст. 122 УК РФ. А с 2018-го по 2020-ый статистика совсем удручающая – все фигуранты подобных дел слышали лишь обвинительные вердикты. Даже по делам о госизмене и шпионаже суды оправдывают чаще, следует из документов Верховного суда (за 3 года суды освободили целых 5 обвиняемых в преступлениях против безопасности государства).

Слова и дело

Зимой 2011-го житель Самары Евгений Ковалев (здесь и далее имена изменены – ред.) оказался в наркологическом диспансере. Молодой человек незадолго до этого пристрастился к запрещенным веществам, но решил избавиться от пагубной зависимости и встал на динамический учет. В процессе у Евгения стали брать различные анализы, в том числе и на ВИЧ. Один из них показал: в организме Ковалева есть антитела к инфекции (они присутствуют на любой стадии заболевания, в т.ч. и на бессимптомной). Никаких симптомов ВИЧ у пациента не было, но по результатам анализа ему поставили диагноз – ВИЧ (Z-21).

В то время Ковалев встречался с девушкой и периодически вступал с ней в интимные отношения. Как впоследствии будет доказывать молодой человек суду, врачи не рассказали ему о положительном диагнозе. Он узнал об этом только во время совместного с подругой визита в социальный центр, где они сдали анализы. И хотя результаты анализа девушки были отрицательными, после неприятного известия пара рассталась, сохранив дружеские отношения. Впрочем, через несколько месяцев девушке стало плохо, она пришла в поликлинику, где врач ей выписал ряд направлений. Так она узнала, что тоже заражена.

Потерпевшая обратилась в полицию и Ковалева задержали. Ему предъявили обвинение в умышленном заражении ВИЧ-инфекцией (ч.2 ст.122 УК). В ходе слушаний Евгений выдвинул версию, что его бывшая девушка могла быть заражена другим человеком, поскольку они всегда предохранялись во время секса. Но суд встал на сторону потерпевшей, которая утверждала, что больше ни с кем не спала. Других доказательств в приговоре не приводится.

В августе 2011-года Куйбышевский районный суд Самары приговорил Ковалева к реальному сроку (в тексте приговора он не указан) в колонии. Несмотря на наличие жены и несовершеннолетнего ребенка, а также тяжелого заболевания, молодого человека взяли под стражу прямо в зале суда. Кроме того, с него взыскали моральный ущерб.

Срок за графин

В сентябре 2017-го жительница Феодосии (Крым) сообщила в полицию о пропаже мобильного телефона. Подозрение пало на ее знакомого Олега Осипова. Его вызвали в отдел полиции. В ходе допроса между ним и опером по фамилии Чудак произошел конфликт. После словесной перебранки Олег внезапно схватил со стола полицейского графин, разбил его о сейф и осколками начал резать себе руки (до того Осипов не был замечен ни в каких правонарушениях: судимостей не имел, на учете в нарко- и психдиспансере не состоял). Чудак попытался отнять стекло, но во время потасовки получил удар в бедро.

Через несколько минут Осипова удалось скрутить и отвести в камеру. Чудак зализывал рану, уборщица отмывала кровь с пола. Доказательств того, что именно Олег украл тот злосчастный смартфон, так и на нашли.

Но его обвинили в других преступлениях. В нападении на полицейского при исполнении (ч.2 ст.318 УК). И в заведомом поставлении другого лица в опасность заражения ВИЧ-инфекцией (ч.1 ст.122 УК). Выяснилось, что в декабре 2012-го Осипов узнал о своем заболевании и в диспансере у него взяли расписку о том, что он предупрежден о необходимости соблюдения санитарно-гигиенических норм для избежания заражения других людей. Этого факта СК посчитал достаточным для обвинения.

На суде Олег признал свою вину и раскаялся в содеянном. Но суд решил, что его исправление возможно лишь в условиях изоляции от общества и приговорил мужчину к 2 годам 2 месяцам колонии общего режима.

Адвокат Осипова по назначению Оксана Пасиченко сказала «Собеседнику», что не знает о судьбе своего бывшего подзащитного, но он, “скорее всего, уже на свободе”.

Кстати, иногда за умышленное заражение ВИЧ судят и самих стражей порядка. В 2015-м в Калининграде задержали полицейского, который заразил девятерых женщин.

Несмотря на печальный опыт Осипова, зачастую обвиняемые по 122 ст. УК, которые идут на признание вины, все же избегают реальных сроков. Так случилось, например, с жителем Удмуртии Алексеем Ложкиным, который еще в 2008-м заразил ВИЧ свою девушку. Он раскаялся в суде и получил 1 год условно.

Боязнь признаться

Первый случай заболевания ВИЧ в СССР был зарегистрирован в 1987-м. Законодатели практически сразу криминализировали его умышленную передачу – так в УК РСФСР появилась ст. 115.2, позже превратившаяся в 122 ст. УК РФ.

В российском законодательстве до сих пор нет четкого описания обстоятельств, при которых наступает уголовная ответственность для ВИЧ-положительных.

Законодательство ставит ВИЧ-положительного человека ниже остальных граждан, считает равный консультант ассоциации «Е.В.А» Мария Годлевская (сама она узнала о том, что заражена, в 1999-м).

– Поэтому многие ВИЧ-положительные боятся рассказать окружению о своем статусе, – уверяет Годлевская. – Ст. 122 УК загоняет человека в угол, криминализируя любого, у которого есть ВИЧ-инфекция. Вся ответственность за здоровье ложится исключительно на него. А ведь есть случаи, когда ВИЧ-положительных просто начинают шантажировать их бывшие партнеры. И хотя известно, что находящийся на антиретровирусных препаратах не способен заразить другого, судебная практика данный момент попросту не учитывает.

ВОЗ и ООН давно требуют декриминализации заражения ВИЧ-инфекцией. И в ряде стран ситуация, хотя медленно, но начинает меняться. Так, в этом году штат Иллинойс (США) отменил уголовную ответственность за передачу ВИЧ. Аналогичное предложение еще в 2017-м выдвигало и правительстве России, но оно так и не было одобрено.

«Заразная» статья

Ст. 122 УК РФ карает как за само заражение ВИЧ-инфекцией, так и за «заведомое поставление другого лица в опасность заражения». Может наказываться лишением свободы на срок до одного года. Если обвиняемый знал о наличии у него заболевания, его могут отправить в колонию на 5 лет. Если потерпевшим является несовершеннолетний, либо два и более лица, виновнику грозит до 8 лет лишения свободы.

В статистике ВС дела по 122 ст. объединены с делами по ст. 121 (заражение венерическим заболеванием), поэтому нельзя сделать точный вывод о том, какие наказания избирают суды. Известно, что в 2020-м число реальных и условных сроков было примерно одинаковым – 28 человек отправились в колонию, 29 остались на свободе. 10 получили ограничение свободы (не смогут выезжать за границу), один – обязательные работы.

Правозащитники же считают, что такие меры не работают, хотя применяются во многих странах мира. В том числе и тех, кого принято считать развитыми.

Мифы

В обществе до сих пор есть много мифов вокруг ВИЧ и его терминальной стадии – СПИД. Один из главных – в якобы высокой смертности от этого заболевания.

На деле ВИЧ-положительные люди живут столько же, сколько в среднем обычный человек. При условии приема антиретровирусных препаратов. В этом случае человек не является заразным. Однако российский УК не делает разницы между теми, кто принимает препараты, и теми, кто отказался от лечения.

 

 

Uganda to re-consider problematic HIV law provisions

After five years of waiting, the Constitutional Court of Uganda has finally begun to hear a landmark case challenging the overly broad and draconian provisions of the HIV and AIDS Prevention and Control Act of 2014.

Constitutional Court Judge Christopher Izama Madrama has instructed the Attorney General of the Government of Uganda to submit a formal reply to the HIV Constitutional Petition No. 4 of 2016, after it came up for mention in the Court on August 12th, 2021.

The petition, by a coalition of HIV, human rights, and LGBTQ organisations, seeks for the removal of three problematic clauses in the HIV Prevention and Control Act which was passed on May 13, 2014 by the Ugandan Parliament.

The Act allows for stringent punishments for the vague ‘crimes’ of attempted and intentional HIV transmission. The other problematic provisions in the Act are mandatory HIV testing for pregnant women and their partners and allowing medical providers to disclose a patient’s HIV status to others without consent.

The Act’s problematic provisions have been known to have been used in a broad range of circumstances, including the arrest, conviction, and acquittal of a nurse wrongfully convicted of injecting a baby with HIV-infected blood and the charging of two different women for exposing an infant to HIV via breastfeeding.

This is the one of three pieces of good news from Uganda this week.

Earlier this year, HJN joined other civil society and human rights organisations in condemning the passage of Uganda’s Sexual Offences Bill which would have negatively impacted sex workers, the LGBTQ communities, and people living with HIV.

The Bill defined rape as ‘misrepresentation’, running the very real risk of being interpreted by the criminal legal system as HIV status non-disclosure. If the accused was found to be living with HIV, this would have resulted in the death penalty.

However, last week it was reported that President Museveni declined to sign the Bill into law, saying many provisions are redundant and already provided for in other laws.

In addition, last week Uganda’s Constitutional Court scrapped a controversial anti-pornography law whose provisions included a ban on women wearing miniskirts in public saying the law was “inconsistent with or in contravention of the constitution of the Republic of Uganda.”

Russia: Law prohibiting migrants living with HIV from staying in the country does not just legalise discrimination, it also endangers their lives

“You have HIV, you have to leave”

Automated Google translation – For original article in Russian, please scroll down

Russia still has a law prohibiting HIV-infected migrants from staying in the country. This norm does not just legalise discrimination – it puts people in mortal danger who could receive treatment and live a normal life.

In the SIZO “Kresty” a “feeding trough” was opened – a hole through which food is passed to the arrested. A woman looked through the window and shouted: “Ramis – who?”

Ramis went to the “trough”.

– Congratulations, you have HIV. Come on, sign. If you infect someone, imprisonment for up to three years.

The woman left, the trough closed. Ramis turned and looked at the inmates:

– What was it?

Ramis came to St. Petersburg from Kyrgyzstan, worked as a driver. Ten years ago, he came home from work late at night, fell asleep at the wheel and got into a traffic accident. Ramis could not compensate for the damage for the wrecked car.

“The company has disclaimed responsibility: I had to work eight hours, but it turned out thirteen,” Ramis says. – I was delayed because the car needed to be repaired. I could have left it [at the car service], but there was a product inside it, [so] I waited for the repair, took the product, and on the way back it happened.

Ramis spent five months in a pre-trial detention center, he was sentenced to two years in a penal colony. At home, the man has a wife and son.

All this time, Ramis did not receive antiretroviral (ARV) therapy, despite his positive HIV status. Migrants in Russia do not have the right to this treatment, and even more so in prisons there is no access to the necessary medicines. The man did not know anything about the disease, his cellmates had already told him something about the virus.

Ramis was released in 2013. Of the documents, he only had a certificate of release. He was stopped immediately on the way from the colony to St. Petersburg, detained and sent to the center for those who are awaiting deportation.

Ramis spent another six months there, during which he became ill and developed tuberculosis of the lymph nodes. The man was taken to the hospital and again confirmed to be HIV positive. After that, the deportation process accelerated: there was another trial, and the employees of the migration service took Ramis to the airport.

Ramis recalls that before the deportation he was directly told:

– As we enter the airport, you take off your mask, do not talk about the temperature or tuberculosis, otherwise you will be returned again, they will not be allowed on the plane.

– The doctor told me to return to my homeland, I had to start taking ARV therapy, otherwise I would not have cured tuberculosis. I had to take off my mask and say that everything is fine with me, ”Ramis says. – As soon as they took off, I got dizzy. This five-hour flight seemed like an eternity to me. Honestly, I thought I was going to die.

Come and get infected here

In Russia, there is a law according to which migrants with HIV are denied treatment and deported to their homeland. The norm appeared in the country in 1995 as a fight against the spread of the virus. Initially, the law was passed in an environment when HIV was not yet a widespread disease.

The authorities believed that the epidemic in Russia could be prevented by limiting the flow of people with HIV, says Daniil Kashnitsky, junior researcher at the Institute for Social Policy at the Higher School of Economics. But by the end of the nineties, HIV still spread throughout Russia, including through injecting drug use, because people shared syringes.

Daniel emphasizes that now in the countries from which migrants most often come to Russia – Uzbekistan, Tajikistan, Ukraine, Kyrgyzstan and Moldova – the level of HIV prevalence is lower than in Russia.

– In Ukraine, it is slightly lower, and in other countries – significantly, four to five times. Today we are not talking about the fact that someone comes to Russia en masse with HIV, but rather the opposite: they come and get infected with HIV here, ” says Kashnitsky. – This is evidenced by the data of epidemiological surveillance among migrants who returned to Uzbekistan and Tajikistan. Again, this is not due to the fact that they have come to a country with a high prevalence of the disease, but because they have an increased risk of life.

Daniel considers a break with his family, a lack of help and older relatives to watch over those who left, as an increased risk of his life. As a result, migrants have more freedom to engage in sexual relations and may start using drugs.

“I lived without a wife for three years,” Ramis says. – Conducted, as they say, promiscuous sex. I got HIV through the bed.

You must pay back your debts first

When obtaining or renewing a patent, as well as a residence permit in Russia, people need to take an HIV test. The procedure usually takes place at migration centers. There is a large flow of people there, and if someone finds a virus, as a rule, no one advises him or explains anything. They just say, “You have HIV, you have to leave.”

“This news hits a man on the head like a sack,” says Kashnitsky. – In rural areas of Tajikistan, for example, the average salary is $ 100, which is enough only for food. To come to Russia and pay for a patent, people borrow money from relatives, friends, and banks. First, you have to repay these debts, and then only start working as a plus for yourself.

Migrants who came to Russia to work do not want to deceive the expectations of their relatives. In addition, HIV is a stigma, so migrants are the last to want to talk about the disease to their loved ones. Therefore, they hide their status and start working illegally, especially in Russia there is still the possibility of working in the gray zone.

Thus, the prohibition of migrants with HIV to stay in Russia has many negative consequences. A person who has been diagnosed with a virus is literally pushed into the illegal sphere. Not only does he not receive the necessary treatment, – being left without a patent and a residence permit, the migrant is not protected by the law in any way, at any moment he risks losing his job and salary, becomes especially vulnerable to the police: if he is stopped on the street, he will have to give a bribe.

Ilgiz decided to work in the gray zone. In 2019, he came to Moscow from Uzbekistan to work in his specialty. But it didn’t work out. Through a mobile application, Ilgiz met a young man who offered him to “work as an escort.”

– After he told me this, we had a fight, it even came to a fight. But I had to send home a serious amount, and it was impossible to achieve this with my earnings in Moscow.

Ilgiz went home and, as he says, “thought hard.” The apartment in which his parents lived was put up for auction for debts on utility bills. They were given sixty days to pay the fines.

The young man returned to Moscow and agreed to work.

– I deceived myself, reassured myself that it was temporary, that I would think of something and return back to normal life. But I went into this more and more. I started dating serious, big people. They asked for proof that I was healthy – every three months I was checked. And something suddenly told me that something was wrong with me.

The very bottom

At the state medical center, Ilgiz’s fears were confirmed. The doctor told him that he had a huge viral load and had HIV.

– I decided: I must kill myself. He worked out various options: jump off the floor, hang himself, get poisoned, throw himself under the car. But I realized that dead will bring more problems to my family than alive. It is very difficult to take a corpse from Russia home.

The young man was not provided with psychological support at the medical center, but the specialist immediately began to insist that Ilgiz provide his passport data, convincing him that he would not transfer them anywhere.

“I knew that as soon as I provided them, I would be deported. I was not afraid of being deported to my homeland, but the very reason – because of HIV – scared me. I didn’t want anyone to know about this, ”Ilgiz says. – I value my parents very much, I am afraid to shock them with such news – they may even abandon me. I have not received anything in this life, the most precious thing in it is my mom and dad, I cannot lose them.

Ilgiz did not disclose his personal data, did not tell his relatives about the disease and stayed to work in Russia. But he decided to lead a different way of life and tries not to return to the past.

In addition to difficulties with work, foreigners with HIV cannot receive education in Russia, even for a fee. Four years ago, Amir came from Uzbekistan to study dentistry in Tver. He was in his last year of college when he found out that he was ill.

Like Ilgiz, no one consulted Amir about the disease. Instead, doctors began to insist that he should be registered – as if then he would be able to receive therapy free of charge, like other foreigners.

– Of course, it was a hoax, – Amir is indignant. – Only after they took my data, they told me about the deportation. The state then was … the very bottom. What deportation? I cannot quit my studies, I have already studied to be a dentist for seven years. Plus, I belong to the MSM community (men who have sex with men. The term is adopted in organizations helping people with HIV. – Approx. TD ). Coming back would have ended very badly.

Amir learned of his status in January 2020. He still hasn’t told anyone about it. The young man just wanted to tell the guy about it, who most likely infected him. But they did not see each other for a year, and Amir could not find him and talk to him.

– In my homeland, everyone thinks that only sinners are sick with HIV. I myself was brought up with such convictions. They do not know that there is therapy, that those who are being treated are not contagious, everyone thinks that if you have HIV, you are doomed. But now I have been living for a year, and everything is in order.

It just needs to be done, and that’s it.

Migrants with HIV who remain illegally in Russia do not have access to routine healthcare. They can only rely on emergency medical assistance.

Due to the fact that migrants cannot take ARV therapy, their immunity decreases, the viral load grows, and complications begin. By the time they get to the hospital, they already need long-term treatment, which the Russian state is obliged to provide them.

But even access to emergency medicine can be difficult. In anticipation of deportation, Ramis spent several months in the temporary detention center for foreign citizens, for a long time he kept a temperature of forty degrees. He started treating tuberculosis only in Kyrgyzstan.

– I was in the hospital for four months. It was very bad without money. I was operated there: without anesthesia – “without shit” – they cut me.

Unfavorable discrimination

The Regional Expert Group on the Health of Migrants in the EECA region calculated that hospitalization and inpatient treatment of migrants with HIV costs Russia more than providing them with ARV therapy. Thus, the country spends more than 220 thousand rubles per person with an advanced HIV case in a hospital, and a course of an annual ARV therapy would cost about 85 thousand.

If Russia legalizes people with HIV, they will be able to return to their homeland, register with an AIDS center, receive treatment and continue working in Russia.

“We don’t even require today to set a budget for the treatment of migrants with HIV – it’s enough just to remove the rule on expulsion,” says Daniil Kashnitsky. – For some reason, doctors and officials believe that the abolition of deportation will necessarily lead to an increase in costs, but this is not so. Absolutely no one will suffer from this, and there will be many advantages. It just needs to be done, and that’s it.

Many countries abolished similar deportation rules 10-15 years ago. According to Daniil Kashnitsky, HIV is a pandemic and the closure of borders does not help the fight against the spread of the virus. The European Court of Human Rights demanded from Russia a complete refusal to discriminate against HIV-positive foreigners back in 2016, but during this time the legislation has not changed in any way.

In April, State Duma deputy Fedot Tumusov submitted to the Russian government a bill proposing to abolish the mandatory deportation of migrants with HIV if they receive ARV therapy. Denis Kamaldinov, chairman of the board of the non-profit organization Humanitarian Project, is confident that the initiative will improve the situation with the disease.

– The person who is on therapy will not transmit the virus to others. This will partly solve the problem of prevention, says Kamaldinov. – If labor migrants are in the country legally, then the country needs them. This means that it is important to verify all the mechanisms for legalizing these people, regardless of their HIV status.

According to Kamaldinov, if the countries where migrants come from agree to provide them with therapy, then it will be necessary to decide who will control the treatment. He believes that adherence to therapy should be monitored in the health care system, and not in the migration service.

– It is important to calculate the capacity of the health care system to monitor and accompany migrants, or to work out the mechanisms that are associated with the fact that a person provides analyzes for local health care.

Tumusov hoped that the initiative would be successful:

– At least if you look at things objectively.

But in mid-July, the government received a negative response to the bill. The response (available to the editorial office) specifies that there are no legal grounds for providing migrants with therapy at the expense of foreign states. Bans on the entry and residence of foreign citizens and stateless persons with HIV, according to the document, were established “in order to prevent the spread of HIV infection in the territory of the Russian Federation”. The only exceptions are people who have family members, children or parents who have citizenship or permanently reside in the territory of the Russian Federation.

Never ask for help

Traditionally, it is believed that HIV is spread only in certain groups: among homosexuals, injecting drug users. Their risk of infection is indeed higher, but, according to official data, the main route of transmission of the virus in Russia is through sex with heterosexual partners. Because of prejudice about the spread of the virus, people with HIV do not get tested, are unaware of their status, infect partners and exacerbate the pandemic. In 2019, 1,068,839 people were registered in Russia living with HIV.

According to Kashnitsky, there is no data that would indicate that HIV prevalence trends among migrants differ. Throughout the EECA region, the proportion of sexual transmission is increasing and the proportion of HIV transmission through injecting drug use is decreasing.

To combat the epidemic, every HIV-positive person must have access to ARV therapy. On average, over three months of treatment, the viral load decreases so much that a person cannot infect other people, even his sexual partner, with unprotected sex.

According to the research platform “To be precise,” only 44% of people living with HIV were receiving antiretroviral therapy in Russia in 2019. This is due to underfunding of AIDS centers, outdated treatment protocols, as well as stigma around the disease – people are afraid to seek help. Someone is worried that acquaintances will find out that difficulties may arise at work; migrants also fear expulsion from the country.

“Migrants with HIV will never seek help,” Ramis says. – They know: they will be deported for life.

Visitors with HIV not only do not go to doctors, but also do not undergo official testing for the presence of the disease due to fear of expulsion. Therefore, there is no complete epidemiological picture of the number of HIV-positive migrants. According to official data, in 2019, 97 thousand Russians and only 2 thousand newcomers were diagnosed with HIV.

“Official testing data is the tip of the iceberg,” says Daniel. – We have no way of believing that HIV-positive migrants pose any risk for Russians.

***

All the heroes of this article have achieved zero viral load. Ilgiz, with the help of the foundation, contacted the doctor, who wrote out a treatment plan for him, and he himself buys the medicines at the pharmacy. Amir is receiving therapy at a non-profit organization. Both remain in Russia for the time being illegally. Ramis has been receiving medicines at the AIDS Center in Kyrgyzstan for six years.

“Deportation is wrong,” Ilgiz believes. – Every person is wrong – you do not know what will happen tomorrow. So I didn’t know. I was sure, not one hundred, but a thousand percent that this would not happen to me, I protected myself, took pre-exposure and post-exposure therapy, passed tests. But I got sick anyway. But the main thing is that I know about my status and I am undergoing treatment.

Ramis did not see his wife and son for two years after returning to his homeland – he communicated with them only by phone. He believed that with so many problems and HIV-positive status, he could no longer have a family. Then Ramis started working in an organization that helps people with HIV and tuberculosis.

– Doctors from the center asked me why I didn’t invite my wife and son to my place. I laughed: “Why are you driving? I have so many problems. ” And then I decided to call them. For another two years, under various pretexts, I had sex with my wife with a condom. But then I realized that with therapy I could have a healthy child and not infect my wife. Our daughter is eight months old.

«У вас ВИЧ, вы должны уехать»

В России до сих пор действует закон, запрещающий находиться на территории страны мигрантам с ВИЧ-инфекцией. Эта норма не просто легализует дискриминацию — она подвергает смертельной опасности людей, которые могли бы получать лечение и жить самой обычной жизнью

В СИЗО «Кресты» открылась «кормушка» — отверстие, через которое арестованным передают еду. В окошко заглянула женщина и крикнула: «Рамис — кто?»

Рамис подошел к «кормушке».

— Поздравляю, у вас ВИЧ. Давайте, расписывайтесь. Если кого-то заразите, лишение свободы до трех лет.

Женщина ушла, кормушка закрылась. Рамис повернулся, посмотрел на сокамерников:

— Че это было-то?

Рамис приехал в Санкт-Петербург из Кыргызстана, работал водителем. Десять лет назад он поздно ночью возвращался с работы, уснул за рулем и попал в дорожно-транспортное происшествие. Возместить ущерб за разбитую машину Рамис не смог.

— Компания сняла с себя ответственность: я должен был работать восемь часов, а вышло тринадцать, — говорит Рамис. — Я задержался из-за того, что машину нужно было ремонтировать. Я мог бы ее оставить [в автосервисе], но внутри нее был товар, [поэтому] я дождался ремонта, отвез товар, и по пути назад это случилось.

Пять месяцев Рамис провел в СИЗО, его приговорили к двум годам колонии-поселения. На родине у мужчины остались жена и сын.

Все это время Рамис не получал антиретровирусную (АРВ) терапию, несмотря на положительный ВИЧ-статус. У мигрантов в России нет права на это лечение, а в тюрьмах тем более нет доступа к необходимым медикаментам. О заболевании мужчина ничего не знал, что-то о вирусе рассказали ему уже сокамерники.

Рамис вышел на свободу в 2013 году. Из документов у него была только справка об освобождении. Его остановили сразу по пути из колонии в Санкт-Петербург, задержали и отправили в центр для тех, кого ждет депортация.

Там Рамис провел еще шесть месяцев, во время которых ему стало плохо, развился туберкулез лимфатических узлов. Мужчину отвезли в больницу и снова подтвердили, что у него ВИЧ. После этого процесс депортации ускорился: прошел еще один суд, и сотрудники миграционной службы доставили Рамиса в аэропорт.

Рамис вспоминает, что перед депортацией ему прямо сказали:

— Как в аэропорт зайдем, ты сними маску, не говори про температуру или туберкулез, а то тебя опять вернут, в самолет не пустят.

— Мне врач велела вернуться на родину, нужно было начать принимать АРВ-терапию, иначе я не вылечил бы туберкулез. Пришлось мне маску снять и сказать, что у меня все хорошо, — говорит Рамис. — Как только взлетели, у меня головокружение началось. Этот пятичасовой перелет мне показался вечностью. Честно скажу, я думал, что сдохну.

Приезжают и здесь заражаются

В России действует закон, по которому мигрантам с ВИЧ отказывают в лечении и депортируют их на родину. Норма появилась в стране в 1995 году в качестве борьбы с распространением вируса. Изначально закон принимали в условиях, когда ВИЧ еще не был повсеместным заболеванием.

Власти считали, что эпидемию в России можно предотвратить, если ограничить поток людей с ВИЧ, рассказывает младший научный сотрудник Института социальной политики НИУ ВШЭ Даниил Кашницкий. Но уже к концу девяностых ВИЧ все равно распространился по всей России, в том числе из-за употребления инъекционных наркотиков, потому что люди пользовались общими шприцами.

Даниил подчеркивает, что сейчас в странах, откуда чаще всего приезжают мигранты в Россию, — Узбекистане, Таджикистане, Украине, Кыргызстане и Молдове — уровень распространения ВИЧ ниже, чем в России.

— На Украине немного ниже, а в остальных странах — значительно, в четыре-пять раз. Сегодня речь не идет о том, что кто-то в Россию приезжает массово с ВИЧ, а, скорее, наоборот: они приезжают и здесь заражаются ВИЧ-инфекцией, — говорит Кашницкий. — Об этом свидетельствуют данные эпидемиологического надзора среди мигрантов, вернувшихся в Узбекистан и Таджикистан. И опять же это происходит не из-за того, что они приехали в страну с высокой распространенностью заболевания, а потому, что у них повышенный риск жизни.

К повышенному риску жизни Даниил относит разрыв с семьей, отсутствие помощи и старших родственников, которые бы следили за уехавшими. В результате мигранты свободнее вступают в сексуальные отношения, могут начать употреблять наркотики.

— Я без жены три года жил, — рассказывает Рамис. — Вел, как это говорится, беспорядочные половые связи. Через постель у меня появился ВИЧ.

Сначала ты должен вернуть долги

При получении или продлении патента, а также вида на жительство в России людям необходимо сдать тест на ВИЧ. Процедура обычно проходит в миграционных центрах. Там большой поток людей, и если у кого-то находят вирус, его, как правило, никто не консультирует и ничего не объясняет. Просто говорят: «У вас ВИЧ, вы должны уехать».

— Эта новость как мешком ударяет человека по голове, — говорит Кашницкий. — В сельской местности Таджикистана, например, средняя зарплата — 100 долларов, ее хватает только на еду. Люди, чтобы приехать в Россию и оплатить патент, одалживают деньги у родных, друзей, в банках. Сначала ты должен вернуть эти долги, а потом уже только начать работать в плюс для себя.

Мигранты, приехавшие в Россию на заработки, не хотят обманывать ожидания родных. Кроме того, ВИЧ — это стигма, поэтому мигранты в последнюю очередь хотят рассказывать о заболевании своим близким. Поэтому они скрывают свой статус и начинают работать нелегально, тем более в России до сих пор сохраняется возможность работы в серой зоне.

Таким образом, запрет мигрантам с ВИЧ находиться в России имеет множество негативных последствий. Человека, у которого выявили вирус, буквально выталкивают в нелегальную сферу. Он не только не получает необходимого лечения, — оставаясь без патента и вида на жительство, мигрант никак не защищен законом, в любой момент рискует лишиться работы и зарплаты, становится особенно уязвимым перед полицией: если остановят на улице, придется давать взятку.

Работать в серой зоне решил Ильгиз. Он в 2019 году приехал в Москву из Узбекистана работать по специальности. Но не вышло. Через мобильное приложение Ильгиз познакомился с молодым человеком, который предложил ему «работать эскортом».

— После того как он это мне сказал, мы с ним поругались, дошло даже до драки. Но мне нужно было отправить домой серьезную сумму, а моими заработками в Москве этого добиться было невозможно.

Ильгиз уехал домой и, как он говорит, «подумал хорошенько». Квартиру, в которой жили его родители, выставили на аукцион за долги по коммунальным счетам. Им дали шестьдесят дней, чтобы оплатить штрафы.

Молодой человек вернулся в Москву и согласился на работу.

— Я обманывал себя, успокаивал, что это временно, что я что-то придумаю и вернусь обратно к нормальной жизни. Но я уходил в это все сильнее. Я начал встречаться с серьезными, большими людьми. Они просили доказательства, что я здоров, — каждые три месяца я проверялся. И что-то мне вдруг подсказало, что со мной что-то не так.

Самое дно

В государственном медицинском центре опасения Ильгиза подтвердились. Врач сказал ему, что у него огромная вирусная нагрузка и он болен ВИЧ.

— Я решил: надо убить себя. Прорабатывал разные варианты: спрыгнуть с этажа, повеситься, отравиться, броситься под машину. Но я понял, что мертвый принесу своей семье больше проблем, чем живой. Вывезти труп из России на родину очень сложно.

Психологической поддержки в медцентре молодому человеку не оказали, но специалист сразу начал настаивать на том, чтобы Ильгиз предоставил свои паспортные данные, убеждая, что никуда не будет их передавать.

— Я знал, что, как только предоставлю их, меня депортируют. Я не боялся выдворения на родину, но сам повод — из-за ВИЧ — меня пугал. Я не хотел, чтобы об этом кто-то узнал, — говорит Ильгиз. — Я очень дорожу родителями, такими новостями я боюсь их шокировать — они могут даже отказаться от меня. Я в этой жизни ничего не получил, самое дорогое в ней — мои мама и папа, их я не могу потерять.

Ильгиз не раскрыл свои личные данные, не рассказал о заболевании родным и остался работать в России. Но решил вести другой образ жизни и старается не возвращаться к прошлому.

Помимо трудностей с работой, иностранцы с ВИЧ не могут в России получать образование, даже платно. Четыре года назад учиться на стоматолога в Тверь из Узбекистана приехал Амир. Он был на последнем курсе института, когда узнал, что болен.

Так же как и Ильгиза, Амира никто не проконсультировал о заболевании. Вместо этого врачи стали настаивать, что ему надо встать на учет — якобы тогда он сможет бесплатно получать терапию, как и другие иностранцы.

— Конечно, это было обманом, — возмущается Амир. — Только после того, как они забрали мои данные, мне сказали о депортации. Состояние тогда было… самое дно. Какая депортация? Я не могу бросить учебу, я семь лет уже проучился на стоматолога. Плюс я отношусь к сообществу МСМ (мужчины, занимающиеся сексом с мужчинами. Термин принят в организациях, помогающих людям с ВИЧ. — Прим. ТД). Возвращение обратно закончилось бы очень плохо.

Амир узнал о своем статусе в январе 2020 года. Он до сих пор об этом никому не сказал. Молодой человек только хотел рассказать об этом парню, который, скорее всего, его заразил. Но они не виделись год, и Амир не смог его найти и поговорить с ним.

— На моей родине все считают, что ВИЧ болеют только грешники. Я сам был воспитан в таких убеждениях. Там не знают, что есть терапия, что те, кто лечится, не заразны, все думают, что если у тебя ВИЧ, то ты обречен. Но вот я уже год живу, и все в порядке.

Это просто надо сделать, и все

У мигрантов с ВИЧ, которые остаются нелегально в России, нет доступа к плановой медицине. Они могут рассчитывать только на экстренную помощь врачей.

Из-за того что мигранты не могут принимать АРВ-терапию, их иммунитет снижается, вирусная нагрузка растет, начинаются осложнения. К тому моменту, когда они попадают в больницу, им уже требуется длительное лечение, которое российское государство им обязано предоставить.

Но даже с доступом к экстренной медицине могут возникнуть трудности. В ожидании депортации Рамис провел в центре временного содержания иностранных граждан несколько месяцев, долгое время у него держалась температура сорок градусов. Лечить туберкулез он начал только в Кыргызстане.

— Четыре месяца я был в больнице. Без денег было очень плохо. Мне операцию там делали: без наркоза — «без ни хрена» — они меня резали.

Невыгодная дискриминация

В Региональной экспертной группе по здоровью мигрантов в регионе ВЕЦА подсчитали, что госпитализация и стационарное лечение мигрантов с ВИЧ обходятся России дороже, чем их обеспечение АРВ-терапией. Так, страна тратит больше 220 тысяч рублей на одного человека с запущенным случаем ВИЧ в больнице, а курс годовой АРВ-терапии стоил бы около 85 тысяч.

Если Россия легализует людей с ВИЧ, они смогут вернуться на родину, встать на учет в СПИД-центре, получить лечение и продолжить работать в России.

— Мы даже не требуем сегодня закладывать бюджет на лечение мигрантов с ВИЧ — достаточно просто убрать норму о выдворении, — говорит Даниил Кашницкий. — Врачи, чиновники почему-то считают, что отмена депортации обязательно повлечет за собой рост расходов, но это не так. От этого абсолютно никто не пострадает, а плюсов будет много. Это просто надо сделать, и все.

Многие страны отменили схожие нормы о депортации 10—15 лет назад. По словам Даниила Кашницкого, ВИЧ — это пандемия и закрытие границ не помогает борьбе с распространением вируса. Европейский суд по правам человека требовал от России полного отказа от дискриминации ВИЧ-положительных иностранцев еще в 2016 году, но за это время законодательство никак не изменилось.

В апреле депутат Государственной Думы Федот Тумусов направил на рассмотрение правительства России законопроект, предлагающий отменить обязательную депортацию мигрантов с ВИЧ, если они получают АРВ-терапию. Председатель правления некоммерческой организации «Гуманитарный проект» Денис Камалдинов уверен, что инициатива улучшит ситуацию с заболеваемостью.

— Человек, который принимает терапию, не будет передавать вирус другим. Отчасти это решит проблему профилактики, — говорит Камалдинов. — Если трудовые мигранты находятся в стране легально, значит они нужны стране. Значит, важно верифицировать все механизмы легализации этих людей вне зависимости от ВИЧ-статуса.

По мнению Камалдинова, если страны, откуда мигранты приезжают, согласятся обеспечивать их терапией, дальше нужно будет решить, кто станет контролировать лечение. Он считает, что за приверженностью к терапии должны следить в системе здравоохранения, а не в миграционной службе.

— Важно рассчитать возможности системы здравоохранения по наблюдению и сопровождению мигрантов либо отработать механизмы, которые связаны с тем, что человек предоставляет анализы для местного здравоохранения.

Тумусов рассчитывал, что инициатива будет успешна:

— По крайней мере, если смотреть на вещи объективно.

Но в середине июля от правительства пришел отрицательный отзыв на законопроект. В отзыве (есть в распоряжении редакции) уточняется, что нет правовых оснований для обеспечения мигрантов терапией за счет средств иностранных государств. Запреты на въезд и проживание иностранных граждан и лиц без гражданства с ВИЧ, согласно документу, установлены «в целях предупреждения распространения ВИЧ-инфекции на территории Российской Федерации». Исключение составляют только люди, у которых есть члены семьи, дети или родители, имеющие гражданство или постоянно проживающие на территории РФ.

Никогда не обратятся за помощью

Традиционно считается, что ВИЧ распространен лишь в определенных группах: среди гомосексуалов, инъекционных наркопотребителей. Риск заражения у них действительно выше, но, согласно официальным данным, основной путь передачи вируса в России — секс гетеросексуальных партнеров. Из-за предубеждений о распространении вируса люди с ВИЧ не сдают анализы, не знают о своем статусе, заражают партнеров и усугубляют пандемию. В 2019 году в России было зарегистрировано 1 068 839 человек, живущих с ВИЧ-инфекцией.

По словам Кашницкого, нет данных, которые бы говорили, что среди мигрантов тенденции распространения ВИЧ отличаются. По всему региону ВЕЦА растет доля сексуального пути передачи и сокращается доля передачи ВИЧ при употреблении инъекционных наркотиков.

Для борьбы с эпидемией доступ к АРВ-терапии должен быть у каждого ВИЧ-положительного человека. В среднем за три месяца лечения вирусная нагрузка снижается настолько, что человек не может заразить других людей, даже своего полового партнера при незащищенном сексе.

Согласно данным исследовательской платформы «Если быть точным», антиретровирусную терапию в России в 2019 году получали только 44% людей, живущих с ВИЧ. Это связано с недофинансированием центров СПИДа, с устаревшими протоколами лечения, а также со стигмой вокруг заболевания — люди боятся обращаться за помощью. Кто-то переживает, что узнают знакомые, что могут возникнуть трудности на работе; мигранты опасаются еще и выдворения из страны.

— Мигранты с ВИЧ никогда не обратятся за помощью, — говорит Рамис. — Они ведь знают: им светит пожизненная депортация.

Приезжие с ВИЧ не только не обращаются к врачам, но и не проходят официальное тестирование на наличие заболевания из-за страха выдворения. Поэтому полной эпидемиологической картины по количеству ВИЧ-положительных мигрантов нет. По официальным данным, в 2019 году ВИЧ выявили у 97 тысяч россиян и всего у 2 тысяч приезжих.

— Данные официального тестирования — это верхушка айсберга, — уточняет Даниил. — У нас нет возможности полагать, что ВИЧ-положительные мигранты представляют хоть какой-либо риск для россиян.

***

Нулевой вирусной нагрузки добились все герои этой статьи. Ильгиз с помощью фонда связался с врачом, который расписал ему план лечения, и сам покупает лекарства в аптеке. Амир получает терапию в некоммерческой организации. Оба пока что остаются в России нелегально. Рамис уже шесть лет получает лекарства в СПИД-центре Кыргызстана.

— Депортация — это неправильно, — считает Ильгиз. — Каждый человек ошибается — вы же не знаете, что будет завтра. Вот и я не знал. Я был уверен не на сто, а на тысячу процентов, что со мной этого не произойдет, я предохранялся, принимал доконтактную и постконтактную терапию, сдавал анализы. Но все равно заболел. Но главное — я знаю о своем статусе и прохожу лечение.

Рамис два года после возвращения на родину не виделся со своей женой и сыном — общался с ними лишь по телефону. Он считал, что с таким количеством проблем и ВИЧ-положительным статусом у него больше не может быть семьи. Потом Рамис начал работать в организации, которая помогает людям с ВИЧ и туберкулезом.

— Врачи из центра спрашивали меня, почему я не зову жену с сыном к себе. Я смеялся: «Вы че, гоните? У меня столько проблем». А потом решился их позвать. Еще два года я под разными предлогами занимался с женой сексом с презервативом. Но потом понял, что с терапией могу иметь здорового ребенка и не заражу жену. Нашей дочери восемь месяцев.

Russia: Migrants workers to undergo HIV testing every 3 months

Labor migrants in Russia will be obliged to take a PCR test every 72 hours and tests for HIV and other infectious diseases every three months

Automatic google translation – For original article in Russian, please scroll down

On July 1, Russian President Vladimir Putin signed a federal law on state fingerprint registration of visa-free foreign citizens in Russia.

According to the law, visa-free foreigners will now have to undergo fingerprinting, photographing and medical examination without fail within 90 calendar days from the date of entry. They will be given a corresponding document.

And labor migrants will have to go through all these procedures within 30 days. They will be required to confirm the absence of HIV infection, infectious diseases that pose a danger to others, as well as drug addiction.

Moreover, if they are diagnosed with drug addiction or HIV infection, then “a decision will be made about the undesirability of their stay in Russia.” Failure to comply with this law threatens to reduce the length of stay of foreigners in Russia.

The law will come into force in December.

Human rights activist Valentina Chupik explained that according to this law, migrants will have to take PCR tests to detect coronavirus every 72 hours, as well as do tests for other infectious diseases every three months.

“I suppose that after this story not a single legal migrant will remain in Russia. For example, I will not be able to spend 1950 rubles every three days on a PCR test. […] As far as I understand, the one who signed these laws did not even read them. Well, he hasn’t read them for years. And the one who made these laws has no idea about Russian legislation and about migration statistics, ”said the human rights activist.

She sent a letter to the President of Uzbekistan Shavkat Mirziyoyev asking for help in this situation and urged migrants from other countries to also appeal to their authorities. She believes that in this way the Russian authorities “will pay attention to what they have done in the field of migration law and get down to business.”

Трудовых мигрантов в России обяжут сдавать ПЦР-тест каждые 72 часа и тесты на ВИЧ и другие инфекционные заболевания каждые три месяца

Президент России Владимир Путин 1 июля подписал федеральный закон о государственной дактилоскопической регистрации безвизовых иностранных граждан в России.

Согласно закону, безвизовые иностранцы теперь должны будут проходить дактилоскопическую регистрацию, фотографирование и медосмотр в обязательном порядке в течение 90 календарных дней со дня въезда. Им будет выдаваться соответствующий документ.

Президент России Владимир Путин 1 июля подписал федеральный закон о государственной дактилоскопической регистрации безвизовых иностранных граждан в России.

Согласно закону, безвизовые иностранцы теперь должны будут проходить дактилоскопическую регистрацию, фотографирование и медосмотр в обязательном порядке в течение 90 календарных дней со дня въезда. Им будет выдаваться соответствующий документ.

*Дактилоскопическая регистрация — сдача отпечатков пальцев.

А трудовые мигранты должны будут пройти все эти процедуры в течение 30 дней. Они будут обязаны подтвердить отсутствие ВИЧ-инфекции, инфекционных заболеваний, которые представляют опасность для окружающих, а также наркотической зависимости.

При этом, если у них выявят наркоманию или ВИЧ-инфекцию, то «будет приниматься решение о нежелательности их пребывания на территории России». Несоблюдение этого закона грозит сокращением срока пребывания иностранцев в России.

Закон вступит в силу уже в декабре.

Правозащитница Валентина Чупик пояснила, что согласно этому закону, мигранты будут должны сдавать ПЦР-тесты на выявление коронавируса каждые 72 часа, а также каждые три месяца делать тесты на другие инфекционные заболевания.

«Я так предполагаю, что после этой истории ни одного легального мигранта в России не останется. Я, например, не потяну тратить каждые три дня 1950 рублей на ПЦР-тест. […] Я так понимаю, что тот кто подписывал эти законы, их даже не читал. Ну он их уже много лет не читает. А тот, кто производил эти законы понятия не имеет о российском законодательстве и о статистике миграции», — заявила правозащитница.

Она направила письмо к президенту Узбекистана Шавкату Мирзиееву с просьбой о помощи в этой ситуации и призвала мигрантов из других стран также обратиться к своим властям. Она считает, что таким образом власти России «обратят внимание на то, что они понаделали в сфере миграционного права и займутся делом».

Russia: Migrants are forming a “hidden epidemic” because they are afraid to seek help

Why are migrants living with HIV being deported from Russia?

Automated translation – For article in Russian, please scroll down.

Russia is one of 19 countries that deport migrants living with HIV. Migrants, in turn, prefer not to return to their homeland and remain in the country illegally. For fear of being discovered, they do not seek medical attention until they feel very sick. Experts believe that in this way migrants not only risk their health, but also exacerbate the situation with HIV in the country, writes RIA Novosti.

Where it all started

In 1995, the Law on Preventing the Spread of HIV was passed, stating that migrants who have been diagnosed with HIV should be deported. In 2015, the law was amended: it is forbidden to expel from the country foreigners whose relatives are Russian citizens.

Despite the fact that it is possible to take a status test in Russia anonymously, migrants who want to obtain citizenship or a patent in order to work officially must provide the results of an HIV test. The data is automatically sent to Rospotrebnadzor, then the relevant commission makes a decision on the “undesirability of stay”, after which the foreign citizen must leave the country within one month.

In this regard, the number of migrants who have decided to “lay low” in order not to return to their homeland is growing: many have jobs here, a stable income, families and relatives.

Hidden epidemic 

In February, Russian Deputy Prime Minister Tatyana Golikova announced that there were 1.1 million people living with HIV in Russia. According to Rospotrebnadzor, migrants, who make up almost 2 million, account for more than 39,000 cases. Most of them are citizens of Tajikistan, Ukraine and Uzbekistan. These are only official statistics. According to Vadim Pokrovsky, with existing methods of fighting infection, the number of people living with HIV by 2030 could double.

Experts believe that migrants are forming a “hidden epidemic”: many are in the country illegally, do not accept treatment, because they are afraid to seek help. They try not to leave Russia, because they will not be allowed back because of their status.

According to Vadim Pokrovsky, under current methods of combating infection the number of people living with HIV by 2030 can grow by half.

Expert opinion

Daniil Kashnitsky, Academic Relations Coordinator of the Regional Expert Group on Migrant Health, believes that the law passed in 1995 is long out of date. Over the past few decades, drugs have been developed that allow people living with HIV to live full lives, have an undetectable viral load and have healthy babies. And because of the existing discrimination, migrants “hide” and do not have access to quality medicine. Many of them are ready to purchase treatment at their own expense, but due to being on the “unwanted list”, they cannot legally stay in Russia.

Experts from the Regional Expert Group on Migrant Health are confident that this problem can be solved by refusing deportation and reaching certain agreements with the CIS countries.

Почему из России депортируют мигрантов, живущих с ВИЧ?

Россия является одной из 19 стран, которые депортируют мигрантов, живущих с ВИЧ. Мигранты, в свою очередь, предпочитают не возвращаться на родину и остаются в стране нелегально. Из страха быть обнаруженными они не обращаются за медицинской помощью до тех пор, пока не станет совсем плохо. Специалисты считают, что таким образом мигранты не только рискуют своим здоровьем, но и усугубляют ситуацию с ВИЧ в стране, пишет РИА Новости.

Откуда все началось

В 1995 году был принят закон «О предупреждении распространения ВИЧ», сообщающий, что мигранты, у которых выявили ВИЧ, должны быть депортированы. В 2015 году закон был скорректирован: запрещено высылать из страны иностранцев, у которых родственники являются гражданами России.

Несмотря на то, что пройти тест на наличие статуса в России можно анонимно, мигранты, которые хотят получить гражданство или патент, чтобы работать официально, должны предоставить результаты анализа на ВИЧ. Данные автоматически попадают в Роспотребнадзор, затем соответствующая комиссия принимает решение о «нежелательности пребывания», после чего иностранный гражданин должен покинуть страну в течение одного месяца.

В связи с этим растет количество мигрантов, которые решили «залечь на дно», чтобы не возвращаться на родину: у многих здесь работа, стабильный доход, семьи и родственники.

Скрытая эпидемия 

В феврале вице-премьер РФ Татьяна Голикова сообщила о том, что в России зафиксировано 1,1 млн людей, живущих с ВИЧ. По данным Роспотребнадзора, на мигрантов, которые составляют почти 2 млн, приходится более 39 000 случаев. Большую часть составляют граждане Таджикистана, Украины и Узбекистана. Это только официальная статистика. По словам Вадима Покровского, при существующих методах борьбы с инфекцией количество людей, живущих с ВИЧ, к 2030 году может вырасти вдвое.

Эксперты считают, что мигранты формируют «скрытую эпидемию»: многие находятся в стране нелегально, не принимают лечение, так как боятся обратиться за помощью. Они стараются не выезжать из России, потому что обратно их не пустят из-за статуса.

По словам Вадима Покровского, при существующих методах борьбы с инфекцией количество людей, живущих с ВИЧ, к 2030 году может вырасти вдвое.

Мнение экспертов

Даниил Кашницкий, координатор по академическим связям Региональной экспертной группы по здоровью мигрантов, считает, что закон, принятый в 1995 году уже давно устарел. За последние несколько десятилетий разработаны препараты, которые позволяют людям, живущим с ВИЧ, жить полноценной жизнью, иметь неопределяемую вирусную нагрузку и рожать здоровых детей. А из-за существующей дискриминации мигранты «прячутся» и не имеют доступа к качественной медицине. Многие из них готовы приобретать лечение за свой счет, но из-за попадания в «нежелательный список», они не могут легально находиться в России.

Специалисты из Региональной экспертной группы по здоровью мигрантов уверены, что эту проблему можно решить, отказавшись от депортации, и достигнув определенных договоренностей со странами СНГ.

[Update]US: Nevada Governor signs law that will modernise HIV laws in line with other communicable diseases

Governor Sisolak Signs into Law Legislation Modernizing Nevada’s HIV Laws

HENDERSON, NV – Nevada Governor Steve Sisolak today signed into law landmark legislation to reform outdated Nevada laws that criminalized and stigmatized people living with HIV. Senate Bill (SB) 275 was introduced by Senator Dallas Harris, received bipartisan support in the Senate, and it was supported by a broad alliance of advocacy groups, public health professionals, civil rights organizations and health care providers including Silver State Equality, Nevada’s statewide LGBTQ+ civil rights organization, and a partner of the Nevada HIV Modernization Coalition.

Senate Bill (SB) 275, introduced by Sen. Dallas Harris, won approval with a unanimous vote in the Nevada Senate and by a 26-15 vote in the Assembly. The bill moved to the Governor for his signature.

On the importance of signing the bill into law Governor Sisolak said:

“Nevada is known as a warm and welcoming place for all– in our State, we celebrate our diversity. I am so grateful to sign legislation to ensure that our LGBTQ+ community feels safe, protected and can continue to grow and flourish in the Silver State. Senate Bill 275, sponsored by Senator Harris and presented in partnership with André Wade and former Senator David Parks, modernizes Nevada’s HIV criminal laws and reestablishes the Advisory Task Force on HIV Exposure Modernization for the 2021-2022 Legislative Interim. We know that laws that criminalize people living with HIV don’t stop the spread, but they actually hurt our public health efforts.”

Silver State Equality released the following statement from State Director André C. Wade:

“Today, Nevada recognizes HIV as a public health issue, not a criminal one. issue. With his signature, Governor Sisolak has moved Nevada HIV laws into the 21st century by aligning them with modern science, ultimately helping to reduce stigma and discrimination against people living with HIV. When people are no longer penalized for knowing their status, it encourages them to come forward, get tested and get treatment. That’s good for all Nevadans. The HIV epidemic will end not by threatening people with criminal prosecution, but instead, by encouraging people to get tested, and by providing them access to care. Today’s signing is especially great news for Nevada communities of color and members of the LGBTQ+ community, who are disproportionately impacted by HIV.”

Senator Dallas Harris, Co-Chair of the Advisory Task Force on HIV Exposure Modernization, said:

“Nevada state law will no longer discourage Nevadans from getting tested for HIV. With the Governor’s signature today, we are helping to reduce the stigma that keeps some from learning their HIV status and getting treatment. I want to thank Governor Sisolak for his actions that are keeping Nevada at the forefront in the fight to stop the spread of HIV. Much work remains to be done, but I’m optimistic that eventually these discriminatory criminal laws targeting those living with HIV will be eliminated throughout the country.”

Statement from the Co-Chairs of the Nevada HIV Modernization Coalition – Connie Shearer, Chris Reynolds, and Stephan Page:

“The Nevada HIV Modernization Coalition members would like to thank Senators David Parks and Dallas Harris for their unwavering commitment to modernizing Nevada’s laws that were stigmatizing and harmful. The passing of SB275 is a great step forward toward ending the unwarranted criminalization of people living with HIV in Nevada and it supports science. This in turn supports and promotes public health for all Nevadans.”

A Statement from Connie Shearer, Co-Chair Nevada HIV Modernization Coalition:

“The Nevada HIV Modernization Coalition members would like to thank Senators David Parks and Dallas Harris for their unwavering commitment to modernizing Nevada’s laws that were stigmatizing and harmful. The passing of SB275 is a great step forward toward ending the unwarranted criminalization of people living with HIV in Nevada and it supports science. This in turn supports and promotes public health for all Nevadans.”

The Elizabeth Taylor AIDS Foundation issued the following statement:

“The Elizabeth Taylor AIDS Foundation salutes Governor Sisolak for signing much needed legislative reform for people living with HIV represented in SB 275. We are grateful for the leadership of Senator Harris in championing this bill. We congratulate the Nevada HIV Modernization Coalition and Silver State Equality for their hard work in achieving this long-awaited reform. With the voice of our founder, Elizabeth Taylor, we stand with all organizations throughout the country who are striving to reform these discriminatory laws. We are appreciative for the opportunity to have been of support in Nevada.”

For more information, visit www.silverstateequality.org/hiv.

Published on May 26, 2021, in GlobeNewsWire

Nevada Legislature Passes Bill to Modernize State’s HIV Laws

Garnering bipartisan support, legislation will fix Nevada’s outdated, ineffective, discriminatory HIV criminal laws.

CARSON CITY, Nev., May 26, 2021 (GLOBE NEWSWIRE) —

Silver State Equality, Nevada’s statewide LGBTQ+ civil rights organization and a partner of the Nevada HIV Modernization Coalition, praised Nevada legislators Wednesday for their bipartisan passage of legislation that modernizes Nevada’s HIV criminal laws.

Senate Bill (SB) 275, introduced by Sen. Dallas Harris, won approval with a unanimous vote in the Nevada Senate and by a 26-15 vote in the Assembly. The bill now moves to the Governor for his signature.

The bill repeals a Nevada statute that makes it a felony for someone who has tested positive for HIV to intentionally, knowingly or willfully engage in conduct that is intended or likely to transmit the disease. Repealing that statute means a person who has contracted HIV and who engaged in such behavior would instead be given a warning as their first offense and, after a second offense, would be guilty of a misdemeanor — a punishment that is consistent with the treatment of other communicable diseases.

The bipartisan show of support impressed HIV activists who have been advocating for years to reform state laws that criminalize HIV with the goal of ensuring they are sync with advances in modern medicine that make transmission of the virus impossible.

Silver State Equality released the following statement from State Director André C. Wade, who — along with Sen. Harris — serves as Co-Chair of the Nevada Department of Health and Human Services’ Advisory Task Force on HIV Exposure Modernization:

“We are extremely pleased with the passage of SB 275 via a strong bipartisan vote. This action will advance the fight against HIV transmission and help to remove HIV stigma that was perpetuated by outdated criminal laws that discouraged disclosure, and thereby testing, treatment and the use of other preventative measures. Even though changing these outdated, ineffective and discriminatory laws is simply common-sense progress, this is a huge move in the right direction. Its passage shows that the years of advocating around this issue are paying off. Our legislators and Nevada citizenry are beginning to understand that the old laws were born out of an era when evidence-based knowledge about HIV risk, transmission and treatment were exceedingly limited. Thank you to the Nevada Legislature, especially Senator Dallas Harris, who authored SB275, and for keeping Nevada at the forefront of LGBTQ+ and civil rights reform.”

Senator Harris, Co-Chair of the Advisory Task Force on HIV Exposure Modernization, said:

“The bipartisan passage of this bill reverses practices that were put in place during the 1980s AIDS epidemic and have proven ineffective and counterproductive from a public health perspective. The old laws also disproportionately affected already marginalized groups, including people of color and LGBTQ+ people. Passage of SB275 helps to remove the statutory stigma that was intentionally placed into our laws that’s done nothing but harm to those who contracted HIV.”

According to a recent report by the UCLA Williams Institute, which analyzed data from the state of Nevada, between 2011 and 2020, arrests for HIV crimes were double the amount from the previous decade and arrests for HIV crimes fell disproportionately on black Nevadans. Black people are 10 percent of Nevada’s population and 28 percent of people living with HIV in the state, but 40 percent of those who have been arrested for HIV crimes.

Connie Shearer, Co-Chair of the Nevada HIV Modernization Coalition said:

“While it’s true that the majority of arrests under HIV criminal laws are reduced or dismissed, the outdated laws continued to perpetuate misinformation and antiquated myths, fears and opinions about HIV and how it is spread. With the passage of SB275, the Nevada Legislature chose science over outdated and irrational fear.”

For more information, visit www.silverstateequality.org/hiv

Published on March 23, 2021 in The Nevada Independent

Democratic Senator seeks overhaul of HIV laws she says will help remove stigma

Sen.  (D-Las Vegas) has introduced a bill that would modernize the state’s laws on human immunodeficiency virus by treating HIV in the same way as other communicable diseases.

The bill aims to reverse practices established decades ago during the height of the AIDS epidemic — when little was known about HIV and AIDS — that have disproportionately affected already marginalized groups, including people of color and LGBTQ+ people.

“The priority for me is equality,” Harris said. “The goal is to remove the statutory stigma that was intentionally placed into our laws all the way across the country that’s done nothing but harm to those who have contracted HIV.”

The bill, SB275, would repeal a Nevada statute that makes it a felony for someone who has tested positive for HIV to intentionally, knowingly or willfully engage in conduct that is intended or likely to transmit the disease. Repealing that statute would mean a person who has contracted HIV and who engaged in such behavior would instead be given a warning as their first offense and, after a second offense, would be guilty of a misdemeanor — a punishment that is in line with the treatment of other communicable diseases, such as chlamydia and SARS.

“These laws were written back in the ‘80s and ‘90s,” said André Wade, chair of the state’s Advisory Task Force on HIV Exposure Modernization. “Whenever there’s a specific call out of HIV, instead of including it as a communicable disease … then that, in and of itself, is stigmatizing.”

Wade, who also serves as the state director for Silver State Equality, an LGBTQ+ civil rights organization, explained that modernizing the laws is important because HIV is treated as though it is different and worse than other communicable diseases, even though it is not.

In 2019, the state’s HIV/AIDS Surveillance Program found that 11,769 Nevadans were living with HIV, with 27.6 percent of that group identified as Black, even though Black Nevadans comprise just 10.3 percent of the state’s population.

Laws criminalizing HIV arose at a time when little was known about the virus and treatment of the disease. However, as medicine has advanced, prevention medications have been created that eliminate the risk of HIV transmission. And public health experts have also learned that the virus does not spread through saliva, tears or sweat, or by hugging, shaking hands, sharing toilets or sharing dishes.

Samuel Garrett-Pate, communications director for Silver State Equality, said that outdated HIV laws have actually made it more difficult to contain the spread of the virus because of the stigma associated with the laws.

“We recognize that not only have these laws not worked to protect people from the transmission of HIV,” Garrett-Pate said. “They’ve actually been counterproductive … They actually discourage testing. They discourage people from learning their status. They discourage people from disclosing their status.”

Harris said she wants to encourage more testing, and an important step in doing that is removing discriminatory language in the law. Her HIV modernization bill includes provisions to update the language around HIV and other communicable diseases and to ensure that people living with HIV are referred to more respectfully in state laws.

Harris also noted the importance of ensuring equality for all through the bill, including for sex workers and inmates. The bill would repeal a Nevada statute that allows for the segregation of inmates who have tested positive for HIV — which would codify into law a directive from a February settlement between the Department of Justice and the Nevada Department of Corrections that banned the segregation practice.

The bill is also aimed at addressing the spread of communicable diseases as a public health matter, rather than through criminalization.

Existing law allows health authorities to take certain action to investigate and control the spread of communicable disease, including ordering a person to be examined for the presence of a disease and ordering the isolation, quarantine or treatment of a person.

The bill would require any such order to include the reasons why the ordered actions are necessary to prevent, suppress or control the communicable disease.

The initiatives come largely from the work of Silver State Equality and the HIV task force.

The task force — established in the 2019 session through SB284, a bill that was sponsored by now termed-out Sen.  (D-Las Vegas) — was created to address stigma surrounding HIV and to update HIV laws in Nevada based on how the public health understanding of the virus has advanced over previous decades.

Since its commencement, the task force has worked to create a report ahead of the current session that includes many of the recommendations realized in Harris’s bill. And with a provision in the bill that would re-establish the task force for the 2021-22 legislative interim, the task force could continue its work on understanding how Nevada’s HIV laws affect those who have contracted the virus.

Wade and Harris both acknowledged that there is more work to be done beyond what made it into the bill, but Wade said he thinks that the bill does most of what he and the task force sought to accomplish.

Harris said she has another bill, SB211, that would require primary care providers to offer STD and HIV testing to anyone aged 15 and older and that would work in tandem with SB275.

“Testing, testing, testing, right. If we learned anything from coronavirus, it’s, ‘go get tested,’” Harris said. “So that’s another piece. I’m hoping that’s going to work together with this modernization bill to break down some of those barriers.”

The HIV modernization bill is scheduled for its first hearing during a meeting of the Senate Health and Human Services Committee on Thursday. Harris said she expects a positive response.

“I expect it to be well received,” Harris said. “The task force has done a lot of the groundwork on this… This is a result of months and months and multiple meetings with law enforcement, with [district attorney] aides, with communities of those who are living with HIV… with our health departments, with all of the stakeholders at the table.”

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