Meet HJN at AIDS 2024

Starting this coming weekend, and continuing until Friday 26th, seven HJN team members will join an estimated 15,000 participants at the 25th International AIDS Conference in Munich to advocate for the rights and health equity of people living with HIV globally.

We are grateful to our scholarship providers and funders for making it possible for so many of us to attend AIDS 2024. We are mindful of the many individuals who have been unjustly denied visas to enter Germany and know we are privileged to be able to attend in person.

We’ll do our very best to make sure that everyone’s voices are heard, both at our sessions and at others’.

If you are also fortunate enough to be in Munich, please come and say hello, and tell us about your work and how we might support each other in the global struggle for HIV justice.

Sunday 21st July

11:30am-12:30pm. LIVING Pre-Conference Workshop: Everything You Ever Wanted to Know About Challenging HIV Criminalisation: The HIV Justice Academy. Room 13b/Channel 7.  This interactive session, featuring most of the HJN team, HJN’s Global Advisory Panel (GAP) member, Robert Suttle, and Sero’s Andy Tapia, covers the realities of HIV criminalisation and strategies to challenge unjust laws.

Monday 22nd July

1:00pm-2:30pm. Global Village Workshop: Denied, Discriminated Against, and Deported: The Global Realities of Migration, Mobility, and Health Equity for People Living with HIV. Global Village Session Room 2. This workshop, co-hosted by HJN, Queensland Positive People, NAPWHA and hivtravel.org addresses HIV-related travel restrictions and advocates for global change, featuring the latest status on HIV migration worldwide from HJN GAP member, David Haerry.

Tuesday 23rd July

12:00pm-1:00pm. Poster Presentation, Prepared for Action: Lessons Learned from the First Year of the HIV Justice Academy presented by HJN’s Sofia Varguez.

3:00pm-4:00pm. Symposium: Equity in Focus: Tackling Inequalities, Room 13a/Channel 6. This session highlights the role of community-led organisations in challenging criminalisation, discrimination and inequalities. HJN’s Edwin Bernard will speak on “Legal Landscapes: The Influence of Legislation on the Lives and Rights of the HIV Community”.

Wednesday 24th July

8:30am-10:00am. Plenary session: Addressing structural barriers: How can we do better? Hall C1/Channel 1. This morning plenary session includes HJN GAP member, Michaela Clayton, presenting “Breaking Barriers: Challenging HIV Criminalization to Counter Inequalities”.

[Rescheduled from Tuesday] 12:00pm-12:30pm. Discussion: U=U in HIV Decriminalisation Advocacy, U=University Networking Zone, Global Village, Featuring a conversation between HJN’s Edwin Bernard, and Kamaria Laffrey and Andy Tapia of the Sero Project.

2:30pm-4:30pm. Workshop: Getting Decriminalisation Right: What do good laws look like? Room 14a/Channel 9. This workshop from UNAIDS, UNDP and GNP+ will facilitate knowledge exchange on good practices in decriminalisation in relation to HIV outcomes and includes HJN’s Edwin Bernard and HJN GAP member, Alexander McClelland.

Thursday 25th July

12.00pm-1.00pm. Poster presentations. HJN team members Sylvie Beaumont, Elliot Hatt and Sofia Varguez will present four posters: Global Trends in HIV Criminalisation; The Relevance of Gender to Potential or Perceived HIV ‘Exposure’ Charges in HIV Criminalisation Cases; The ABCs of HIV Law Reform in Latin America and the Caribbean: Case Studies on HIV (De)criminalisation in Argentina, Belize, and Colombia; and Challenging Coercion and Misplaced Punishment: HIV and Infant Feeding Choices.

3:00pm-4:00pm: Workshop: Doing HIV Justice in Europe. Global Village 555 Zone. This workshop, led by HJN’s Julian Hows and featuring most of the HJN team, will focus on HIV decriminalisation advocacy across the WHO Europe region.

All Week (Sunday-Thursday)

Global HIV Migration, Global Village Exhibition Booth ADO4

This booth has been designed to capture a short video in a safe and secure space for anyone to tell us their story about travelling or relocating with HIV with a highly experienced film maker, HJN’s video and visuals consultant, Nicholas Feustel. Co-hosted by HJN, Queensland Positive People, NAPWHA and hivtravel.org.

US: CHLP and Oklahoma advocates successfully oppose sweeping STI criminalisation Bill

STI Criminalization Bill stopped in Oklahoma

CHLP collaborates with advocates in Oklahoma to oppose a bill that would have criminalized thousands of Oklahomans living with sexually transmitted infections.

The recent adjournment of the legislative session for the 59th Oklahoma Legislature marked the end of House Bill 3098 (HB 3098), which would have dramatically increased the number of health conditions criminalized under Oklahoma law.

The existing statute, Oklahoma Statutes Title 21 Section 1192 (Section 1192), imposes felony punishment, including a two-to-five-year prison sentence, on people living with smallpox, syphilis, or gonorrhea who intentionally or recklessly “spread or cause to be spread to any other persons . . . such infectious disease.” HB3098 would have added Hepatitis B virus, genital herpes, Human Papillomavirus (HPV), and Trichomoniasis to the list of criminalized conditions, potentially opening up more than 85% of the population to criminalization.

CHLP’s Positive Justice Project, including Staff Attorneys Jada Hicks and Sean McCormick and National Community Outreach Coordinator Kytara Epps, worked collaboratively with local and national advocates to oppose the legislation. Local efforts were led by Nicole McAfee, Executive Director of Freedom Oklahoma.

In testimony with the House Judiciary – Criminal Committee, CHLP emphasized that the bill would criminalize nearly all Oklahomans and worsen criminal legal system disparities for Black, Latine, Indigenous, and 2SLGBTQ+ Oklahomans.

CHLP also met with the National Coalition of STD Directors (NCSD) to broaden national awareness of the issue. In a state policy notice, NCSD noted the bill would potentially worsen barriers to STI testing and treatment and undermine efforts to expand expedited partner therapy. Oklahoma already has some of the highest diagnosis rates for sexually transmitted infections, including the fourth-highest rate of primary and secondary syphilis and the fifth-highest rate of congenital syphilis.

Hicks and McCormick also provided a virtual briefing to the members of the Oklahoma Senate Minority Caucus, offering talking points and countering the argument made by the bill’s sponsor Rep. Toni Hasenbeck that the legislation would reduce intimate partner violence.

“Laws that criminalize people living with STIs likely worsen the threat of intimate partner violence by providing another tool for abusers to force people to stay in abusive relationships,” observed McCormick. “We continue to hear stories from people living with STIs whose partners threaten to file a police report alleging a violation of an STI criminalization statute. The possibility of criminal prosecution and public disclosure of their status causes many survivors to stay in abusive relationships.”

Hicks addressed misinformation about the statute criminalizing only intentional transmission. “Under Section 1192 people who ‘recklessly [are] responsible’ for transmitting these conditions could face prosecution, but the term ‘recklessness’ is not defined in the statute, which poses significant risks of broad and subjective interpretations,” she explained. “Rather than promoting public health, it instills fear and discourages people from getting tested or disclosing their health status. We believe in education and support, not punishment, as the path to managing communicable diseases effectively.”

In addition to opposing HB 3098, the Oklahoma coalition worked with Rep. Mauree Turner to introduce House Bill 4139, which would have repealed four statutes that criminalize people living with certain medical conditions, including Section 1192. The bill would have also allowed individuals convicted of these offenses to apply for resentencing and records expungement.

“While the repeal legislation was unsuccessful, the defeat of HB 3098 prevented a more hostile environment for people living with or affected by stigmatized conditions,” said Epps. “The collaborative HB 3098 efforts are also a shining example of how local and national advocates come together to disrupt criminalization. We look forward to continuing to work with Oklahoma advocates and fighting against the ongoing criminalization of people living with stigmatized conditions.”

HJN’s Executive Director’s remarks at the UNAIDS Board Meeting on the sustainability of the HIV response

UNAIDS Programme Coordination Board (PCB) Thematic Meeting on the Sustainability of HIV Response

Round Table 1: The context and urgency of sustainability planning and response

Remarks from Edwin J Bernard, Executive Director, HIV Justice Network, Netherlands on community leadership to address human rights barriers

I am a gay man who acquired HIV 41 years ago in 1983. It was a significant year in other ways too:

  • HIV was first identified as the cause of AIDS
  • WHO held its first global AIDS meeting
  • Richard Berkowitz and Michael Callen published ‘how to have sex in an epidemic’ inventing condom-based safer sex
  • And a small group of people living with AIDS became the first community leaders in the HIV response, creating the Denver Principles, the blueprint for GIPA and MIPA principles now embedded in UNAIDS’ approach to community leadership to address human rights barriers.

Communities involve many different groups, working locally, nationally, regionally and globally. We are communities of women, men and youth living with HIV in all our diversities, as well as communities of gay men and other men who have sex with men, communities of sex workers, communities of transgender people, communities of people who use drugs. We are the key populations

And then there are communities of allies – human rights defenders who understand that public health is human rights and vice versa.

Despite member states committing to removing these human rights barriers in the 2021 Political Declaration – the 10-10-10 targets – we are far from getting anywhere close to achieving these targets because there are still far too many human rights barriers.

These are far too numerous to list, but they include gender inequality and gender-based violence; discrimination when receiving healthcare, in the workplace, in education, and in humanitarian settings; not being able to enter or migrate to a country of which you are not a citizen because of your HIV status; and the growing number of countries with so called ‘foreign agent’ laws that are closing civic space and stifling community leadership.

On top of these, every single member state criminalises one or more of the key populations, fully or partially, and 79 countries have HIV-specific criminal laws that unjustly criminalise HIV non-disclosure, exposure or unintentional transmission.

Ending HIV criminalisation is the focus of my organisation, the HIV Justice Network, and the global HIV JUSTICE WORLDWIDE coalition that we co-ordinate.

We can do this work thanks primarily to the Robert Carr Fund, which recognises the importance of community-led regional and global networks and our key role in addressing human rights barriers impacting the HIV response.

Dismantling discriminatory systems that have been built over decades and that oppress people living with and affected by HIV takes time and money – and needs community leadership.

So, if sustainability means a move to country-led integrated health systems, this will also mean that all the criminalised and marginalised people I’ve just mentioned will be even more left behind than they currently are.

But there’s a cheap and simple solution: decriminalisation!

A 2022 study from the Alliance for Public Health found that cost savings from decriminalisation of drug use could greatly reduce HIV transmission through increased coverage of opioid agonist therapy and antiretroviral therapy among people who use drugs in eastern Europe and central Asia.

Another 2022 study, from the Williams Institute, on the enforcement of HIV criminalisation laws in Tennessee of so called ‘aggravated prostitution’ – when a sex worker arrested for soliciting is found to be living with HIV – and criminal HIV ‘exposure’ – when a person living with HIV is prosecuted for allegedly not disclosing their HIV status before sex that may or may not risk transmission – estimated that the total cost of incarceration in prison for these unjust HIV-related crimes was $3.8 million.

And a 2021 study found that decriminalising sex work in Washington DC would generate over USD 5000 paid in income taxes by each sex worker – because sex work is work, after all! – plus more than USD20,000 in criminal legal system savings per sex worker a year.

If you decriminalise you not only save money you also ensure that every single person living with, or affected by HIV, gets the HIV services they need.

Following the science and basing laws and policies on public health and not morality or stigma saves money.

So, member states, if you just stop wasting money on ineffective, counterproductive criminalisation and invest in proven treatment and prevention programmes, sustainability of the HIV response is within sight.

To get to 2030, and beyond, to end AIDS as a public health threat, we need to ensure that we don’t forget the dignity and rights of people living with and affected by HIV  – easy to cut funding for, and hard to measure – and make sure that we include ending all of forms of HIV-related stigma, discrimination and criminalisation and strive for all forms of equality and empowerment.

In the drafting room on Tuesday, the NGO Delegation added criminalisation to the list that included stigma and discrimination, but the final draft you will vote on later today no longer includes mention of criminalisation as a barrier to testing. I implore you commit to ensure that my recommendation to decriminalise to sustain the HIV response is included in any and all decision points that will come out of this meeting.

Key messages summary

  • Human rights, gender justice and all the other10-10-10 societal enabler targets are essential, non-negotiable aspects of sustainability.
  • Community leadership is essential to reach 2030 and to sustain the HIV response beyond that date.
  • Don’t underestimate – or create more barriers for – communities. We are the experts in understanding what is needed to successfully achieve the end of AIDS.
  • Support communities by funding us, including replenishing the Robert Carr Fund.
  • The single most cost-effective intervention for every member state is to decriminalise, decriminalise, decriminalise!

Powerful and important new book, ‘Criminalized Lives’ published this week

This week sees the publication of a powerful and important new book, Criminalized Lives.

Based on 24 interviews conducted across Canada over two years with 16 people who were criminally accused of not disclosing their HIV-positive status, author Alexander McClelland, details the many complexities of disclosure, and the violence that results from being criminalised.

McClelland, who is living with HIV, works as a criminologist at Carleton University, in Ottawa, Canada. He is also a member of HJN’s Global Advisory Panel (GAP) and the Canadian Coalition to Reform HIV Criminalization.

Canada has long been a hot spot for HIV criminalisation where the act of not disclosing one’s HIV-positive status to sex partners has historically been regarded as a serious criminal offence. The book describes how this approach has disproportionately harmed Black and Indigenous people, women, gay men, and the poor.

While the book focuses on Canada, it presents lessons for those of us working around the world to end HIV criminalisation, especially in contexts where general criminal laws – like bodily harm, sexual assault and even attempted murder – are being applied to instances of alleged HIV non-disclosure.

Accompanied by a foreword by fellow HJN GAP member, US-based leading HIV criminalisation activist Robert Suttle, and portraits from queer comic artist Eric Kostiuk Williams, the book’s moving interviews illustrate that criminal legal systems are unprepared to handle the nuances and ethical dilemmas faced everyday by people living with HIV. 

By offering personal stories of people who have faced criminalisation first-hand, McClelland questions common assumptions about HIV, the role of punishment, and the violence that results from the criminal legal system’s legacy of categorising people as either victims or perpetrators, and the complicity of public health systems in processes of criminalisation.

The book is distributed internationally via Rutgers University Press where you can purchase paperback, hardback, and ebook versions.

Five things you can do to amplify Criminalized Lives:

  1. Ask your local library to carry the book.
  2. Host a conversation on the book in your community to help mobilise for change.
  3. Share your thoughts about the book on social media to generate conversations about the harms of HIV criminalisation.
  4. Review the book in a publication or online.
  5. Include the book in a course syllabus.

Civil society statement on the proposed re-criminalisation of HIV in Zimbabwe

Download this statement as a pdf

In 2022, the Government of Zimbabwe was celebrated nationally and internationally for repealing the country’s HIV-specific criminal law, Section 79 of the Criminal Code.

When announcing the repeal in Parliament, Minister Ziyambi Ziyambi, Zimbabwe’s Minister of Justice, Legal and Parliamentary Affairs noted: “…the global thinking now is that that law stigmatises people living with HIV and studies have shown that it does not produce the intended results. What the ministry is going to do is to repeal that section of the law and ensure that we keep up to speed with modern trends in the world.”

HIV JUSTICE WORLDWIDE is shocked, saddened and extremely disappointed that only two years later, the Ministry of Justice, Legal and Parliamentary Affairs is now proposing to re-criminalise HIV by adding HIV to the list of sexually transmitted infections (STIs) currently criminalised in Section 78 of the Criminal Code.

That they are proposing to do so as part of the Criminal Laws Amendment (Protection of Children and Young Persons) Bill is both cynical and unwarranted. Amendments to the Criminal Code are meant to codify the Supreme Court decision on the age of consent to sex. Amending Section 78 of the Criminal Code to re-criminalise HIV is out-of-step with the 2021 Political Declaration on HIV/AIDS agreed on by UN Member States, including Zimbabwe. Of note, Section 80 of the Criminal Code already provides for aggravated sentencing in cases of exposure to HIV during “sexual intercourse or performing an indecent act with a young person.”

Section 78, like the repealed Section 79, criminalises anyone who “does anything or causes or permits anything to be done with the intention or realising that there is a real risk or possibility of infecting any other person with” syphilis, gonorrhoea, herpes and “all other forms of sexually transmitted diseases”. It is overly broad and extremely vague. 

Adding HIV to this already problematic provision would be a retrograde and harmful step backwards for the following reasons:

  1. Criminalisation does not prevent HIV or STI transmission. Communicable diseases – including those that are sexually transmitted – are public health issues, not criminal issues and criminalisation is not an evidence-based response to public health issues. As UNAIDS noted in its 2022 press release congratulating Zimbabwe for repealing the HIV criminalisation law: “The criminalisation of HIV transmission is ineffective, discriminatory and undermines efforts to reduce new HIV infections. Such laws actively discourage people from getting tested for HIV and from being referred to the appropriate treatment and prevention services.”
  2. The criminalisation of HIV and other STIs can violate human rights. Such laws and prosecutions threaten the rights of people living with HIV, and other STIs, to equality, freedom from discrimination, privacy, human dignity, health, liberty, and the right to a fair trial, amongst others. Based on the HIV Justice Network’s monitoring of how people living with HIV were prosecuted previously under Section 79, we believe that the criminal justice system is not well equipped to understand the science of exposure and transmission of HIV or other STIs and would therefore be unable to uphold principles of legal and judicial fairness, including the key criminal law principles of legality, foreseeability, intent, causality, proportionality and proof. Overly broad criminalisation of HIV and STIs means people with HIV or STIs risk being prosecuted and sent to prison instead of receiving care for their medical condition.
  3. The criminalisation of HIV and other STIs can increase stigma and harm public health. This is particularly so because prosecutions are often accompanied by highly stigmatising and inaccurate media reporting. By increasing stigma and driving people away from testing and healthcare services, criminalisation may therefore also prevent or delay people from accessing testing and treatment. Effective HIV and/or STI treatment not only allows people living with HIV or other STIs to lead longer, healthier lives, but also prevents HIV and STI transmission. 
  4. Criminalisation harms women. In Zimbabwe, as in many African countries, HIV criminal laws have been disproportionately applied against women living with HIV. Women are usually the first to know of their HIV status, often due to accessing testing during antenatal care. Being the first to test positive, women may be vulnerable to being falsely blamed for bringing HIV into the relationship. Women living with HIV are also vulnerable to violence and abuse in intimate relationships and the threat of prosecution only increases that vulnerability.

Rather than adding HIV to Section 78, this provision should be repealed. This would contribute to enhancing Zimbabwe’s HIV and STI response in line with a human rights-affirming approach to health that is mandated by the Constitution and recommended by public health and human rights experts internationally and regionally.

The Health Law and Policy Consortium agrees with the HJWW coalition:

Reintroducing the punitive criminalisation of  HIV transmission is counterproductive as it undermines national health objectives and the global target of ending HIV and AIDS by 2030. It will be tantamount to reenacting state endorsed stigma that will inevitably flow from the criminalisation. This amendment not only jeopardises the progress made through the successful repeal of Section 79 of the Criminal Law Codification and Reform Act, it threatens current efforts underway to prevent the spread of HIV as it reintroduces a driver for new infections of HIV. The proposed amendment creates a formidable legal barrier that will severely undermine full access to essential healthcare services. It will deter individuals from seeking regular HIV testing, adhering to HIV treatment and medication, and disclosing their HIV status to enable their sexual partners to take preventive measures such as PrEP.

Sonke Gender Justice also agrees with the above and adds the following:

It is Sonke’s considered view that the reintroduction of the impugned provisions providing for the criminalisation of HIV in Zimbabwe will harm rights of women. The amendment of Section 78 of the Criminal Code on sexually transmitted diseases to include HIV will bring back the narrative of unjust arrests and prosecutions. Under this new provision, women tested as HIV-positive will face prosecution and eventual violence. Criminalisation of HIV reinforces gender barriers to accessing treatment, care and support for women who test HIV-positive, driving them underground, unable to disclose their status to the detriment of family health resulting in infant HIV acquisition, ART non-adherence for both the mother and infant. Criminalisation of HIV impairs public health goals that seek to promote health rights of women leading to poor health outcomes and HIV related health disparities.

HJWW, HLPC and Sonke conclude that re-criminalising HIV, as well the existing criminalisation of STIs, is a threat to Zimbabwe’s HIV and SRHR response and to the rights, security and dignity of people living with HIV, particularly women living with HIV.

Section 78 is vague and overly broad and risks being applied in a way that is unjust and discriminatory. It will not prevent HIV or STI transmission, instead perpetuating stigma and misinformation, risking driving people away from HIV and STI testing and treatment and filling prisons.

 


About the authors of this statement

HIV JUSTICE WORLDWIDE is a coalition of 16 global and regional civil society networks and human rights defenders working to end HIV criminalisation.

Health Law and Policy Consortium (HLPC) is a health policy advocacy organisation leveraging a network of experts across various disciplines. HLPC aims to facilitate rights-based policy formulation, implementation, and monitoring within Zimbabwe’s public health system.

Sonke Gender Justice is a South African-based non-profit organisation working throughout Africa. Sonke believes women and men, girls and boys can work together to resist patriarchy, advocate for gender justice and achieve gender transformation.

Download this statement as a pdf

Navigating injustice: the struggle for fair treatment of HIV non-disclosure in Canada

Resetting the code on HIV and crime

AIDS is not the death sentence it once was, but Canada still has strict punishments for people who don’t disclose their HIV status to sexual partners. Critics say that’s unfair and out of step with the rest of the world. What could be done differently?

Before Michelle was diagnosed with HIV, her life was marred in ways unfathomable to most.

In the home where she grew up, drugs were dealt and intoxicated men came and went. As a young child, Michelle was sexually abused by a family member.

In the years that followed, she used alcohol, cocaine and heroin to cope. She believes she was infected with HIV in 2000 through a contaminated needle.

Struggling with addiction, Michelle turned to sex work in Vancouver’s Downtown Eastside. In 2006, a man accused Michelle of having unprotected sex with him without disclosing her HIV-positive status. Michelle alleges she was in an abusive, coercive relationship with the man, a former client, and that he sexually assaulted her without a condom. (The Globe and Mail does not typically name victims of sexual assault, but Michelle consented to use her first name.)

After the man brought his story to police, Michelle was charged with aggravated sexual assault. In cases involving alleged “HIV non-disclosure,” it is the charge most often laid in Canada, and the most serious sexual offence in the Criminal Code. Fearing a lengthy prison term, Michelle pleaded guilty and was sentenced to 2½ years. Only after pleading did she learn that her name had been put on the National Sex Offender Registry, something no one discussed with her in court, she said.

“I have a life sentence tied to my name,” said Michelle, now 45. “I have a label but I’m not that person. The whole label of a sex offender – I was raped at the age of 5. I know what sexual abuse is. I’m a victim of sexual abuse.”

An estimated 62,790 people were living with HIV in Canada in late 2020. Michelle is one of hundreds who’ve been prosecuted for alleged HIV non-disclosure.

Between 1989 and 2020, approximately 206 people were prosecuted in 224 criminal cases, according to a 2022 report from the HIV Legal Network. Of 187 cases where the outcome is known, 130 cases – 70 per cent – ended in conviction, the vast majority with prison time. A significant number of those convicted prior to 2023 were also registered as sex offenders, before courts ended the practice of making this mandatory for all sex offences.

In Canada, the law focuses not on actual transmission of the virus, but on “non-disclosure” – the act of not telling a sexual partner that one is HIV-positive prior to sex that poses a “realistic possibility” of transmission. This means that people who did not pass HIV to anyone have been charged, convicted and imprisoned. Of 163 cases where complainants’ HIV status was known, 64 per cent didn’t involve actual transmission of HIV. Courts have convicted HIV-positive people who took precautions before sex, as well as those who were sexually assaulted.

It is a sweeping, punitive approach that sets Canada apart from many other jurisdictions internationally.

Now, a push to limit HIV criminalization is intensifying. For years, critics have argued the laws are discriminatory and unscientific – driven by fear, misconceptions about people living with HIV and a lack of knowledge about the basic scientific realities of this virus. Thanks to significant medical advances, HIV can be managed effectively with antiretroviral medication that makes the virus undetectable and untransmittable to others.

The Canadian Coalition to Reform HIV Criminalization – a group that includes people living with HIV, community organizations, lawyers and researchers – is pushing for amendments to the Criminal Code that would limit criminal prosecution to a measure of last resort, reserved for rare cases of intentional transmission. Among other changes, the group also wants to see an end to charging these cases under sexual assault law.

“People have been prosecuted, many of whom are still living with the consequences of that prosecution, including in cases where there never should have been a charge in the first place,” said Richard Elliott, a Halifax lawyer and former executive director of the HIV Legal Network.

While the federal government has published reports, engaged in public consultations and issued some directives on limiting HIV prosecution, some advocates fear the push for broader legal reform is stalling: to date, there remains no legislation to amend this country’s HIV non-disclosure law. In the absence of legal reform, Canadians living with HIV face a lingering threat of criminal liability as they navigate their intimate lives.

Alison Symington heard about the life-altering impact of this from HIV-positive women for two documentaries she co-produced on HIV criminalization. For many of these women, the legal perils were too high to chance relationships with partners who might later turn out to be misinformed or vindictive and take them to court.

“It’s sad,” said Ms. Symington, a senior policy analyst at the HIV Justice Network. “People used to be fearful that they might pass the virus on. But now that they know they won’t pass the virus on – and that they could have a happy, healthy relationship – there’s still this outdated criminal law hanging over their heads.”

At the height of the HIV/AIDS crisis in the early nineties in Canada, thousands were dying of AIDS-related illnesses, many not long after a diagnosis. In 1995 alone, more than 1,700 people died, according to Statistics Canada. It was a period that would usher in some of Canada’s earliest prosecutions for HIV non-disclosure.

With the virus shrouded in panic, misinformation and stigma, some grew fearful of disclosing. But as HIV prevention campaigns took hold and AIDS activism movements began educating people on safer sex, those failing to use condoms became a minority.

The advent of effective antiretroviral treatments in 1996 transformed the landscape, with deaths dropping dramatically a year later. The drugs suppress an HIV-positive person’s viral load, making the virus undetectable and untransmittable to others. By 2020, 87 per cent of those diagnosed with HIV in Canada were on treatment, with 95 per cent of them achieving viral suppression, according to the Public Health Agency of Canada.

Though the science progressed, both the law and public understanding of HIV failed to advance alongside.

Advocates argue the overreach in Canada’s HIV law stems partly from a 2012 Supreme Court of Canada decision, R. v. Mabior. The court ruled that HIV-positive people have a legal duty to disclose their status before having sex that poses a “realistic possibility” of HIV transmission – and decided that only a combination of condom use and a low viral load at the time of sex negate that possibility.

Critics say this legal stance diverges from well-established guidance from the World Health Organization and the Public Health Agency of Canada that a suppressed viral load or correct condom usage are each, on their own, highly effective methods of preventing transmission.

There is serious disconnect between science, public health and the law in Canada, said André Capretti, a Montreal policy analyst at the HIV Legal Network.

“Scientists have been saying undetectable equals untransmittable for many years now,” Mr. Capretti said. “But it takes a lot of time for that to permeate into the public consciousness, including at the prosecutorial level, police level and individual level. If a complainant isn’t aware that there wasn’t a risk in having sex with a partner who was undetectable, they’re still going to go to the police and want to press charges.”

Since being enacted, the laws have been used to prosecute HIV-positive people who used condoms properly and didn’t infect anyone, who engaged in oral sex – where the risk of spreading HIV is exceedingly low – and who unwittingly transmitted while being sexually assaulted. The net has caught people who are vulnerable, or who applied due diligence to not infecting others, and treated them the same as a smaller minority who transmitted recklessly.

While some court rulings are beginning to reflect the modern science on HIV transmission, other decisions have not kept up.

In 2009, an HIV-positive man in Hamilton was charged with aggravated sexual assault after his ex-partner alleged they had oral sex without the man disclosing his status. The ex-partner did not test positive; the charge was stayed in 2010.

Four years later, a Barrie, Ont., a woman was convicted of aggravated sexual assault, sentenced to more than three years in prison and registered as a sex offender for not disclosing her HIV-positive status before having vaginal sex without a condom. The woman was on antiretroviral medication, her viral load undetectable and untransmittable; her partner did not test positive. Nine years passed before her conviction was overturned, the Ontario Court of Appeal ruling that given the woman’s effective medical treatment, she was not legally obliged to disclose her status.

In 2020, the Ontario Appeals Court upheld three convictions of aggravated sexual assault for an Ontario man accused of having vaginal sex with three women without disclosing his status. There was no finding that the man infected any of the women; he wore condoms during each incident but didn’t have a low viral load during a number of those acts. The man was sentenced to 3½ years in prison.

For HIV-positive people, the prosecutions can be catastrophic.

Alexander McClelland, an assistant professor at the Institute of Criminology and Criminal Justice at Carleton University, spent time with people prosecuted for his forthcoming book, Criminalized Lives: HIV and Legal Violence.

The stories are disturbing: One man recalled being interrogated and beaten by police; another woman spoke of being locked in solitary confinement, naked. Others were vilified as HIV-positive “rapists” by prison guards, then brutalized by inmates. Some were denied HIV medication while incarcerated, growing seriously ill.

“The criminalization haunts every aspect of their lives,” said Prof. McClelland, chair of the coalition’s steering committee.

With their names broadcast through news stories and public safety warnings issued by police, many become alienated from family and friends. Others encounter employers unwilling to hire them and landlords refusing to rent to them, Prof. McClelland found.

“It isolates them in their community, where they face daily forms of harassment and violence,” he said. “These conditions ruin people’s lives.”

While prosecutions target Canadians of all genders and sexual orientations, 89 per cent of those charged were men, 63 per cent in relation to encounters they had with women. Black and Indigenous people have been disproportionately charged, convicted and incarcerated compared with white defendants. Numerous newcomers have also been deported following prosecution.

A significant proportion of those charged are heterosexual men from African, Caribbean and Black communities, according to Toronto’s Colin Johnson, who consults with Black Coalition for AIDS Prevention and the Prisoners with HIV/AIDS Support Action Network.

Some are newcomers or migrants who find themselves advised by duty counsel to plead guilty for the sake of a lesser sentence, not grasping the full scope of consequences – including the sex offender label that can follow them for the rest of their lives.

“Because in African, Caribbean and Black communities, homophobia, transphobia and HIV phobia are rampant, a lot of these people get ostracized by the very communities they would normally go to for help,” Mr. Johnson said, adding that the same stigmas keep people from getting tested and seeking treatment.

With little hope of reintegrating into society, many of these men follow a pattern from unemployment and halfway homes to isolation and depression, he said: “It’s not a pretty picture.”

Globally, Canada remains an outlier in criminalizing HIV non-disclosure. Most other countries focus instead on prosecuting people who knowingly, intentionally transmit the virus.

To lay a charge in California, for instance, prosecutors need to prove a person had specific intent to transmit HIV, and then actually transmitted the virus. In England and Wales, there is no legal obligation to disclose one’s HIV-positive status to a partner, although “reckless transmission” is illegal.

“In the case of a person who has no intent to transmit, it goes back to this notion of moral blameworthiness,” said Mr. Capretti, a human-rights lawyer. “Is this the kind of person we think is worthy of condemnation and punishment because they have this diagnosis – because they have an illness?”

Canada further deviates from other jurisdictions by charging these cases as sexual assaults.

A 1998 Supreme Court of Canada decision, R. v. Cuerrier, ruled that failing to disclose an HIV-positive status can amount to a fraud that invalidates consent – the idea being that a person can’t give consent if that consent isn’t informed. In this way, Canadian courts decided that the act of not telling is a deception on par with the violence and coercion that more often marks sexual assault.

By contrast, other countries apply general criminal law – including laws related to bodily harm – or have HIV-specific laws, according to the HIV Justice Network.

Canada has seen some movement in how these cases are handled. After former justice minister Jody Wilson-Raybould raised concerns about the overcriminalization of HIV non-disclosure, the Justice Department published a 2017 report that examined curbing such prosecutions.

Following that, in 2018, Ms. Wilson-Raybould directed federal prosecutors working in three territories to limit HIV criminalization. The directive stated officials should not prosecute HIV-positive people when they maintain a suppressed viral load because there is no realistic possibility of transmission, and that they should “generally” not prosecute when people use condoms or engage in oral sex only, because there is likely no risk of transmission. The directive also asked prosecutors to consider whether criminal charges are in the public interest.

Quebec, Ontario, Alberta and British Columbia have also issued instructions not to prosecute HIV-positive people who maintained a suppressed viral load at the time of sex, though there remains no clarity on condom use.

Beyond this patchwork of directives, advocates are pushing for greater uniformity in courtrooms across Canada. They argue that the Criminal Code must be reformed – and that only this avenue will prevent courts from relying on a tangle of inconsistent and unscientific past rulings.

In 2022, the government engaged in online consultations with experts, people living with HIV and others on reviewing the law.

In March, Justice Minister Arif Virani told The Globe and Mail editorial board that his office was working on a policy response.

“What we’re trying to do is ensure that current, modern science is reflected in terms of the way the Criminal Code is applied in cases of transmission of HIV/AIDS,” Mr. Virani said, though he would not provide a timeline for legal reform.

On May 15, Mr. Virani met with the coalition to discuss law reform efforts, saying the policy work was still continuing.

Paradoxically, the blunt instrument of the law makes HIV disclosure more fraught, critics say.

“You’re starting a relationship with a new partner – you might like to know if they’re living with HIV or any other sexually transmitted diseases. But that doesn’t mean an aggravated sexual assault charge is the appropriate response,” Ms. Symington said.

In her documentaries on HIV criminalization, Ms. Symington illuminated the challenges involved in disclosing a positive status. She’s seen numerous women charged after abusive ex-partners who knew the women had HIV reported them to police for non-disclosure.

“People can make those allegations whether they’re true or not,” Ms. Symington said. “People live in fear that any relationship that goes wrong, this could be a tool of revenge by a bitter ex-partner.”

Some abusive partners exploit the law while in relationships with HIV-positive people: “Sexual partners threaten to go to the police and claim that disclosure did not take place, as a way to control the relationship,” said Eric Mykhalovskiy, a York University professor who led early research on the public-health implications of HIV non-disclosure in Ontario.

Since judges and juries tasked with deciding whether disclosure occurred have little to work with beyond complainants’ and defendants’ competing accounts, Prof. Mykhalovskiy described HIV-positive people going to great lengths to document that a disclosure had taken place, getting their partners to sign documents, disclosing with a witness present, or alongside counsellors at HIV organizations.

Inserting criminal law into nuanced discussions about negotiating consent and HIV disclosure has undermined public-health efforts, experts say: It can deter some people from getting tested or seeking out treatment, fearful that information shared with social workers, nurses and doctors could be used against them.

“We’ve seen this in so many cases of criminalization where those medical notes end up as part of the evidence used to criminally convict a person,” Mr. Capretti said.

“There is no evidence that this assists public health,” he added. “Criminal law and public-health policy are not natural partners.”

Years of criminalization has left some living with HIV fearful and frequently second guessing their intimate relationships.

It’s a calculus Toronto’s Mr. Johnson navigated in his personal life, after being diagnosed with HIV in 1984.

“I remember for years, I did not have sex with anybody unless they were HIV positive,” he said.

While he came to accept these limitations, he watched others who were just coming out struggle. News of HIV-positive people being charged in the late 80s and early 90s heightened fear, he said: “It had a negative impact on our psyche in so many ways.”

Mr. Johnson said it took him close to 20 years to accept that he would not die of AIDS-related illness. The arrival of effective antiretroviral treatments greatly improved quality of life for HIV-positive people. On the prevention front, the advent of PrEP (pre-exposure prophylaxis) significantly decreased the risk of infection among the HIV-negative.

Mr. Johnson continues antiretroviral treatment, as he has for decades. The people he dates are typically on PrEP; everyone in his circles is well aware of the modern medical realities of the virus. On his positive status, he’s transparent: “I’m very open and upfront.”

It’s a contemporary experience of living with HIV that stands in stark contrast to the public’s understanding of the virus, which remains limited.

“The average person doesn’t know about undetectable equals untransmissable, and unfortunately, with sex education these days, people aren’t going to know about that,” Ms. Symington said. “People still have Philadelphia, they still have Rock Hudson in their heads. These are the images. It causes a panic.”

These erroneous, outdated ideas should be purged from Canadian law, she said.

“This is a relic from the past. We need to stop the injustice in HIV non-disclosure and start thinking about how to educate people on healthy relationships and healthy sexual lives.”

Health and the law in Canada: More reading

B.C.’s experiment in decriminalized drug use hit a big setback last month after complaints about consumption in public. Reporter Justine Hunter spoke with The Decibel about what that means for harm-reduction policies across Canada. Subscribe for more episodes.

 

US: NYCLU strongly supports the REPEAL STI Discrimination Act and encourages its expedient passage

Repeal STI Discrimination Act

While New York has made considerable progress in reducing the prevalence of HIV over the last decade, the COVID-19 pandemic exacerbated hurdles to HIV prevention, testing, and treatment. Moreover, New York continues to see stark disparities in HIV’s impact with Black, Indigenous, and other New Yorkers of color, as well as transgender New Yorkers and young men who have sex with men, bearing the brunt of the epidemic. Repealing New York’s HIV and sexually-transmitted infection (STI) criminalization law, Public Health Law § 2307, is a critical step toward ending the epidemic.

The NYCLU strongly supports the REPEAL STI Discrimination Act and encourages its expedient passage.

2023 – 2024 Legislative Memorandum

REPEAL STI Discrimination Act
S.4603-A (Hoylman-Sigal) / A.3347-A (Gonzalez-Rojas)

Position: SUPPORT

While New York has made considerable progress in reducing the prevalence of HIV over the last decade 1, the COVID-19 pandemic exacerbated hurdles to HIV prevention, testing, and treatment. Moreover, New York continues to see stark disparities in HIV’s impact with Black, Indigenous, and other New Yorkers of color, as well as transgender New Yorkers and young men who have sex with men, bearing the brunt of the epidemic.2

Repealing New York’s HIV and sexually-transmitted infection (STI) criminalization law, Public Health Law § 2307, is a critical step toward ending the epidemic.

Laws that criminalize people living with HIV/AIDS and STIs discourage people from learning and disclosing their status, ignore science, harm patient relationships with counselors and doctors, and perpetuate stigma. Recognizing these realities, 12 states have amended or repealed their laws criminalizing HIV/AIDS since 2014. New York must join them by passing the REPEAL STI Discrimination Act, S.4603-A (Hoylman-Sigal) / A.3347-A (Gonzalez-Rojas), which would repeal Public Health Law § 2307 and expunge past convictions under the law. The NYCLU strongly supports this bill and urges its immediate passage.

At present, New York criminalizes people for having sex if they have an STI. This crime carries no intent requirement and no transmission requirement, and open disclosure to one’s partners is no defense. Defense attorneys report that New York prosecutors have weaponized this statute to prosecute people living with HIV who have sex.

This is bad public policy. STI criminalization undermines public health and disproportionately impacts communities of color, particularly LGBTQ+ communities of color. For these reasons, the NYCLU strongly supports the REPEAL STI Discrimination Act and encourages its expedient passage.

1 New York State Budget and Policy Priorities NYS Fiscal Year 2025, Ending the Epidemic 2 (Nov. 2023).
2 Id.

Turkmenistan: UNAIDS launches campaign “Decriminalize” aiming to reduce punitive legal environments affecting key populations

Turkmenistan’s HIV/AIDS Challenges: Silence, Stigma, and Criminalization

UNAIDS launched a campaign “Decriminalize” aimed at raising awareness on issues surrounding HIV/AIDs on institutionalized levels across the world.

UNAIDS is the Joint United Nations Programme on HIV/AIDS. It aims at achieving zero new HIV infections, zero discrimination and zero AIDS-related deaths, working alongside its global and national partners to end the AIDS epidemic by 2030 as part of the SDGs.

The campaign highlights  2021-2026 Global AIDS Strategy, directed towards reforming laws that hinder the HIV response, aiming to reduce punitive legal environments affecting key populations. By 2025, the goal is for less than 10% of countries to criminalize activities such as sex work, drug possession, same-sex activity, and HIV-related behaviors.

The UNAIDS campaign underlines that criminal laws target key populations, among them are people who inject drugs, sex workers, gay men and other men who have sex with men, transgender people, and people living with HIV. Such restrictive laws violate people’s human rights. In addition, criminalizing certain activities pushes people away from the support and services they need, exposing them to harm.

Below are the highlights from the campaign focusing on Turkmenistan and its neighboring countries’ data and laws, as well as major global statistics from 2021-2022 years.

As of today, there is no data on Turkmenistan on UNAIDS website (or other sources) on such aspects as:

  • Rates of HIV among adults and children;
  • New HIV-infections and AIDS-related deaths;
  • Number of AIDS-related orphans;
  • Phases of the HIV epidemic;
  • Rates of testing, Antiretroviral Therapy (ART) coverage, and viral load suppression;
  • Coverage and numbers receiving ART;
  • Elimination of vertical transmission.

Data on combination prevention, such as condom use at last high-risk sex is only available for 2000. The only recent data available is on stigma and discrimination and only based on women’s responses from 2019 MICS.

Laws across countries in Eastern Europe and Central Asia

Source: UNAIDS Laws and Policies Analytics, 2021-2022

  • 94 countries in the world criminalized HIV: Turkmenistan and other Central Asian countries are in this list. In the meantime, the migration crisis in Eastern Europe and Central Asia, spurred by conflicts like the war in Ukraine, has led to an urgent need for HIV services among displaced populations. Central Asian nations have experienced its largest influx since independence. Simultaneously, the HIV epidemic is worsening, with Russia, Ukraine, Uzbekistan, and Kazakhstan collectively responsible for 93% of new infections in the area.
  • The Criminal Code of Turkmenistan, Article 116 on HIV Infection, punishes for knowingly putting someone at risk of HIV infection with imprisonment for up to three years. Deliberately infecting another person with HIV, knowing one has the disease, carries a penalty of up to five years’ imprisonment. These penalties escalate if the acts involve multiple individuals or minors, punishable by up to eight years’ imprisonment. Additionally, medical or pharmaceutical workers who infect someone due to negligence in their duties face imprisonment for up to five years, possibly with the loss of professional privileges for up to three years.
  • 125 countries criminalize drug use or possession for personal use. There is no data for Turkmenistan, and with exception to Tajikistan where drug possession is not an offense, in other Central Asia countries, possession of any or all drugs is a criminal offense. According to the campaign, ​​decriminalizing drug use and possession for personal use leads to substantial reductions in HIV incidence among people who inject drugs. This is facilitated by improved access to harm reduction services, decreased violence, and reduced harassment by law enforcement. Repressive policing of drug use has been linked to increased HIV infection, needle sharing, and avoidance of harm reduction programs. Hence, law reform is essential to achieve the goal of ending AIDS as a public health threat by 2030.
  • 67 countries criminalize same-sex relations. In Turkmenistan and Uzbekistan same-sex relations are penalized with imprisonment for up to 14 years. Article 133 of the Criminal Code of Turkmenistan, defines sexual intercourse between men as sodomy, and punishes with a penalty of up to two years’ imprisonment, with or without residency restrictions. Repeat offenses or causing the victim to contract sexually transmitted diseases (STDs) can lead to imprisonment for five to ten years. Negligence resulting in death, serious harm, or HIV infection incurs a sentence of ten to twenty years in prison, possibly with residency restrictions. In Kazakhstan, Kyrgyzstan, and Tajikistan same-sex relations are decriminalized. The UNAIDS campaign notes that countries that criminalize same-sex sexual activity have a significantly higher HIV prevalence among gay and bisexual men – up to 5 times more. Moreover, recent prosecutions amplify this risk even further, with rates up to 12 times higher.
  • 167 countries criminalize some aspects of sex work and 153 criminalize sex work. In Turkmenistan and Uzbekistan, the law encompasses other punitive and/or administrative regulation of sex work. Yet repeated sex work within a year after an administrative penalty is charged with a fine ranging from twenty to forty times the basic amount, or compulsory labor up to four hundred and eighty hours, or correctional labor up to two years, or imprisonment for up to two years, according to the Article 136 of the Criminal Code, while profiting from organizing and/or managing sexual services is criminalized (in the Criminal Code of Turkmenistan, these are reflected in the articles 137, 138, 139, 140). In Kazakhstan, Tajikistan and Kyrgyzstan, both are applied, however in Kazakhstan and Tajikistan there is partial criminalization of sex work, whereas in Kyrgyzstan sex work is not subject to punitive regulations and is not criminalized.
  • The campaign highlights that criminalizing sex work increases the likelihood of sex workers contracting HIV and exposes them to violence from clients, police, and others. Targeting clients worsens sex workers’ safety and health, diminishing condom access, increasing violence, and deteriorating overall well-being.

The campaign underlines that criminalization of key populations decreases their access to HIV prevention services. Criminalization also drives discrimination and structural inequalities and robs people of the prospect of healthy and fulfilling lives.

The campaign highlights progress: Belgium and Australia decriminalized sex work; Zimbabwe decriminalized HIV exposure, non-disclosure, and transmission; Central Africa Republic revised its HIV laws; and Antigua & Barbuda, St Kitts & Nevis, Singapore, and Barbados repealed colonial laws against same-sex activity. Kuwait ended laws targeting transgender individuals, and New Zealand lifted HIV-related travel restrictions. However, challenges remain: 134 explicitly countries criminalize HIV exposure; 20 criminalize and/or prosecute transgender persons; 67 criminalize consensual same-sex activity. Additionally, 48 restrict entry for people with HIV, 53 mandate HIV testing, and 106 require parental consent for adolescent HIV testing.

The campaign also provides additional resources on the topic, such as factsheets, maps, and reports, as well as offers a thematic quiz on awareness on the criminalization of key populations with additional information on the relevant subjects.

Photo: © UN Turkmenistan / 2018 / Eyeberdiyeva
Photo caption: The UN Turkmenistan celebrated

World AIDS Day to raise awareness of
the importance of getting tested for HIV

Death penalty for unintentional HIV transmission via same-sex sex struck down by Uganda’s Constitutional Court

The recent (April 3rd) ruling by Uganda’s Constitutional Court declaring that the Anti Homosexuality Act of 2023 complies with the Constitution of Uganda – except in only four aspects – was quite rightly roundly condemned by Amnesty International, the Global Fund, Human Rights Watch, International AIDS Society, and UNAIDS, as well as the US Department of State, amongst many others.

Rather than strike down every section of this heinous, draconian anti-gay law, the Court was unanimous in ruling that most of its dangerous, overly broad, and problematic provisions remain in place. 

However, in its 200+ page ruling, the Court did find that Sections 3(2)(c), 9, 11(2d) and 14 did not “pass constitutional muster” and were struck down.

Sections 9 and 11(2d) refer to landlords allowing homosexuality to take place on their premises, and section 14 refers to a “duty to report acts of homosexuality” to the police.

But section 3(2)(c) was one of the most heinous of all of the Act’s horrendous provisions, proscribing the death penalty for someone living with HIV who engaged in same-sex sex and where HIV is allegedly passed on.

  1. Aggravated homosexuality (1) A person who commits the offence of homosexuality in any of the circumstances specified in subsection (2) commits the offence of aggravated homosexuality and is liable, on conviction, to suffer death. (2) (c) the person against whom the offence is committed contracts a terminal illness as a result of the sexual act.

Read the full text of the law here

Both the Court, several petitioners, and UNAIDS – who provided an amicus brief to the Court – correctly interpreted this section as criminalising unintentional HIV transmission when two people of the same sex had sex.

In paragraphs 510-512, the Court referred to several key documents – including the 2011 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and UNAIDS 2013 Guidance Note, Ending overly broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations – and were persuaded that the section did not provide for “the element of criminal intent or mens rea, which is a vital component of the concept of crime.”

The Constitutional Court ruling went on to say:

“This indeed is the approach that was adopted in section 43 of the HIV and AIDS Prevention and Control Act, 2015, which criminalizes the intentional transmission of HIV as follows: ‘a person who wilfully and intentionally transmits HIV to another person commits an offence.’

“Finding no justification for the criminalization of the unintentional transmission of HIV under section 3(2)(c) of the Anti-Homosexuality Act we take the view that it compounds the susceptibility of persons that are HIV+ to mental health issues and thus impedes their right to enjoy the highest attainable standard of mental health, with potential ramifications to their physical health as well. This is a violation of the right to health as envisaged under Article 12(1) of the ICESCR and is inconsistent with Articles 45 and 287 of the Uganda Constitution.”

 

However, people living with HIV are already over-criminalised in Uganda by various sections of the HIV and AIDS Prevention and Control Act, as summarised in our Global HIV Criminalisation Database.

What is termed as “wilful and intentional” transmission of HIV is punishable by a fine and/or up to ten years’ imprisonment. Section 43 provides a defence if the accused’s partner was aware of, and accepted, the risk of transmission, or transmission occurred during sexual intercourse and protective measures were used. Attempted transmission is punishable by a fine and/or up to five years’ imprisonment. The scope of section 41 is undefined, but cases demonstrate that the law criminalises perceived HIV ‘exposure’ broadly.

Both Section 41 and 43 are known to have been used in a broad range of circumstances, including prosecution of a man for ‘defilement’ (2013), prosecution of a teacher for alleged transmission to his student (2013), the alleged injection of a toddler/needle stick injury (2014), alleged transmission by a woman to a number of young men (2014), alleged breastfeeding of an employer’s child (2018), the arrest, conviction and acquittal of a nurse wrongfully convicted of injecting a baby with HIV-infected blood (2018), and the alleged defilement of a boy by a woman (2019). An earlier prosecution from 2008 involved a man charged with alleged transmission. In the most recent case in 2023, a woman living with HIV pled guilty to charges under section 43 after injecting her 5-year-old son with her blood and was sentenced to seven years’ imprisonment. Cases have generally not used scientific evidence to prove allegations, with convictions at lower-level courts relying only on testimony.

Nevertheless, the recognition of key legal and rights-based arguments against punishing unintentional HIV transmission with the death penalty(!) as part of an otherwise anti-rights, morality-based ruling should be seen as a small but welcome victory. Although this might be seen as similar to the 2022 Lesotho High Court decision on the unconstitutionality of the death penalty in the context of HIV transmission following rape, the difference of course is that that rape is an act of violence that should be criminalised regardless of any other circumstances, whereas consensual sex between two men or two women should never, ever be a crime.

US: Maryland lawmakers sponsor bill aiming to repeal HIV criminalisation law

Commentary: Maryland must stop criminalizing people living with HIV

State lawmakers moving to repeal law that stigmatizes people living with HIV, increases public health risk

Having a virus should not be a crime. Yet, in Maryland, people living with HIV can face prosecution and criminal penalties even when we have disclosed our status, used condoms or are virally suppressed through medication. Maryland has an outdated law from 1989 that makes it a misdemeanor for a person living with HIV who is aware of their HIV-positive status to “knowingly transfer or attempt to transfer” HIV to another person. A conviction under this law can carry a punishment of up to three years in prison, and the law has been used to charge people for behaviors that do not transmit HIV, such as spitting and biting.

As people who have lived with HIV for decades, we know firsthand that Maryland’s HIV criminalization law discourages people from knowing their status, fosters stigma and creates barriers to lifesaving health care. It’s time for lawmakers to repeal this deeply unjust law.

Legislation (HB 485/SB 1165) sponsored by Del. Kris Fair (D) and Sen. Sen. Karen Lewis Young (D), both from Frederick County, aims to repeal this law that punishes people living with HIV. It is a law enforced on deeply racist lines. A recent analysis by the Williams Institute revealed our HIV criminalization law is used disproportionately against Black Marylanders and Black men in particular, driving increased incarceration rates and fostering stigma and shame around HIV and knowing one’s status. People living with HIV need health care, not the threat of prison cells.

This law was passed 35 years ago, when little was known about the virus. If that seems long ago, it was: George H.W. Bush was president, cellphones were the size of bricks, and Janet Jackson and Paula Abdul topped the music charts. At that time, there was little hope for people living with HIV. Thankfully, much has changed since then.

Today, we are just some of the many people with HIV who are living long and fulfilling lives. Those of us living with HIV who achieve and maintain an undetectable viral load — the amount of HIV in our blood — by taking medication as prescribed cannot sexually transmit HIV to our partners. Furthermore, people who don’t have HIV have even more effective prevention tools and can take medications such as PrEP and PEP. All of these advancements were unheard of in 1989, when lawmakers responded with fear by criminalizing HIV.

If you are surprised to learn about the incredible medical advancements in the treatment and prevention of HIV, you are not alone. Stigma and racism around the virus run so deep that many people have an outdated understanding of HIV. In fact, today our goal of ending the epidemic of HIV is achievable in the coming years if we focus on expanding access to testing, prevention and treatment.

All of us should know our HIV status, but stigma, lack of access to health care and fear of criminal penalties under Maryland law are barriers to testing for many. Our state laws and policies should remove barriers to health care and encourage Marylanders to know their status. The compounding tragedy of our HIV criminalization law is it deters people from seeking testing and treatment, thus prolonging the HIV epidemic and its toll on our communities.

Repealing the HIV criminalization law would make it safer for people unknowingly living with HIV to get tested and access needed treatment. Nationally, a recent study showed that approximately 80% of new HIV transmissions were from people who do not know their HIV status or are not receiving regular care. Expanding access to testing could have a profound effect in our state. The Maryland Department of Health estimates over 34% of young people living with HIV in the state remain undiagnosed. It is clear we cannot meet our public health goals without repealing this law.

As community caretakers in the movement, we are committed to doing everything we can to reduce stigma around HIV and increase access to care for all Marylanders. For years, we have joined other people living with HIV to share our personal stories with legislators in support of updating our law. HIV is preventable and treatable, and we hope one day to end the epidemic. However, to achieve that goal, we must first end the criminalization of HIV in the state we call home. Removing harmful, stigmatizing criminal punishments for knowing your HIV status is a commonsense update that is long overdue for the great state of Maryland.

 

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