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 Maryland has an outdated law from 1989 that makes it a misdemeanor for a person living with HIV who is aware of their HIV-positive status to “knowingly transfer or attempt to transfer”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.

 

UK Parliament Commemorates HIV Is Not A Crime Day

On Tuesday 5th March the HIV Justice Network hosted a reception with the All Party Parliamentary Group for HIV and AIDS (APPGA) to mark the first global HIV Is Not A Crime Awareness Day.

Baroness Barker, co-chair of the APPGA, Lisa Power former Policy Director at the Terrence Higgins Trust and the first chair of the HIV Justice Network’s Supervisory Board, spoke alongside our Executive Director, Edwin J Bernard.  The SERO Project’s, Kerry Thomas, an HIV criminalisation survivor, appeared via video.

The event was attended by MPs and members of the House of Lords, as well as representatives of the UK and US governments, the Global Fund, UNAIDS, HIV philanthropic funders, and UK and international HIV policy organisations.

Edwin presented global and Commonwealth data, based on a briefing paper especially undertaken for the event by our policy analyst, Elliot Hatt, which demonstrated that the Commonwealth is far behind global HIV criminalisation law reform trends.

In the past five years, there were more adoptions of HIV criminalisation laws than there were repeals or reforms in the Commonwealth, whilst globally this was reversed.  Notably, the United States – formerly a world leader and exporter of HIV criminalisation – was now a world leader in ending it.

“It’s time for the UK to do the same, domestically, and throughout the Commonwealth,” he said.

Mexico: Activists call for congress to repeal HIV Criminalisation statute in Tlaxcala

Activists urge the decriminalisation of “danger of contagion” for HIV and other diseases in Tlaxcala

Translated from Spanish with Deepl.com – Scroll down for original article

Activists and defenders of the human rights of people living with HIV have urged the Congress of Tlaxcala to pass an initiative to eliminate the crime of “danger of contagion” from the local Penal Code as soon as possible.

Antonio Escobar Muñoz, director of the HIV and Human Rights programme of the LGBTTTQI+ collective, argued that it is essential to eliminate any discriminatory treatment based on health status.

According to the activist, cases of discrimination and stigmatisation based on health status persist in Tlaxcala, especially in school, work and governmental environments, mainly in the health sector.

Escobar Muñoz pointed out that people with HIV face criminalisation based on their HIV status, but often choose not to report it for fear of stigma and re-victimisation.

She emphasised that in Tlaxcala more work is needed on awareness raising, sensitisation and education, although the decriminalisation initiative represents an important step towards ensuring safe and discrimination-free environments.

This day, the initiative was presented in the plenary of the Local Congress with a draft decree proposing to repeal the denomination of Chapter I of the Eleventh Title with its respective article 302; section V of article 434, both of the Penal Code for the Free and Sovereign State of Tlaxcala.

This initiative seeks to recognise the need to promote public policies that encourage prevention, education and support for people living with HIV, thus contributing to the fight against stigmatisation and discrimination, as well as highlighting the need to update legislation in Tlaxcala.


Urgen activistas despenalización de “peligro de contagio” por VIH y otras enfermedades en Tlaxcala

Activistas y defensores de los derechos humanos de personas que viven con VIH han urgido al Congreso de Tlaxcala a dictaminar cuanto antes la iniciativa para eliminar del Código Penal local el delito de “peligro de contagio”.

Antonio Escobar Muñoz, director del programa de VIH y Derechos Humanos del colectivo LGBTTTQI+, argumentó que es indispensable eliminar cualquier trato discriminatorio por condición de salud.

Según el activista, en Tlaxcala persisten casos de discriminación y estigmatización por condición de salud, especialmente en entornos escolares, laborales y gubernamentales, principalmente en el sector salud.

Escobar Muñoz señaló que las personas con VIH enfrentan situaciones de criminalización basadas en su estatus serológico, pero muchas veces optan por no denunciar por miedo al estigma y la revictimización.

Enfatizó que en Tlaxcala se necesita más trabajo en concientización, sensibilización y educación, aunque la iniciativa de despenalización representa un paso importante para garantizar entornos seguros y libres de discriminación.

Este día, se presentó en el pleno del Congreso Local la iniciativa con proyecto de decreto por el cual se propone derogar la denominación del Capítulo I del Título Décimo Primero con su respectivo artículo 302; la fracción V del artículo 434, ambos del Código Penal para el Estado Libre y Soberano de Tlaxcala.

En esta iniciativa, se busca reconocer la necesidad de promover políticas públicas que fomenten la prevención, la educación y el apoyo a las personas que viven con VIH, contribuyendo así a la lucha contra la estigmatización y la discriminación, además de destacar la necesidad de actualizar la legislación en Tlaxcala.

US: New report published on the enforcement of HIV criminalisation in Ohio

‘Antiquated’ and unscientific laws enforced against Ohioans living with HIV: Report

Across the country, a growing coalition of advocates is pushing to repeal or update state laws that criminalize people living with HIV or AIDS.

In Ohio, six laws on the books either criminalize certain acts – including sex – for people living with HIV or substantially increase sentences for them compared to people who do not have the virus.

Most of the laws were passed decades ago, fueled by fear, absent scientific understanding about how HIV is transmitted and before advancements in HIV-related treatment were widely introduced. Laws still remain in place in 34 states.

There are no national reporting requirements that track arrests or prosecutions under the laws. Until now, it was unclear how frequently Ohio prosecutors have charged people under the laws, which also apply to people living with hepatitis or tuberculosis.

A report released today by Equality Ohio and the Ohio Health Modernization Movement (OHMM), two groups pushing for legal reform, reveals that more than half of the prosecutions over a six-year period were for acts – such as spitting or throwing bodily fluids – that were unlikely to transmit HIV. It also found a disproportionate number of people charged were Black compared to Ohio’s overall population of Black residents.

“Ohio is unique in that these antiquated laws are actually being utilized and enforced against everyday Ohioans who are living with HIV,” Kate Mozynski, an attorney with Equality Ohio and one of the co-authors of the report told the Buckeye Flame.

In 2022, about 25,000 people in Ohio had an HIV diagnosis. The rate of Black residents diagnosed with HIV was more than six times the rate of white residents.

The groups spent three years gathering information from prosecutors and courts in all 88 Ohio counties and identified 214 cases charged under the six laws. Often, the records lacked or had conflicting information on race or ethnicity, and the gender captured in law enforcement records didn’t always reflect a person’s gender identity.

That prevents researchers from fully understanding the impact that these laws are having on some of the most vulnerable populations in Ohio, including LQBTQ+ people, people experiencing incarceration and people of color, according to the report. The federal Centers for Disease Control and Prevention has warned that laws criminalizing HIV exposure are outdated and may discourage testing, increase stigma and exacerbate disparities in Black and Latino communities.

Cuyahoga County had the highest number of charges

 The report found that:

  • Prosecutions are concentrated in Ohio’s more populous counties, including Cuyahoga, Hamilton, Franklin and Lucas counties.
  • Cuyahoga County charged four times the number of people under the six laws than Franklin County, which has a higher population and more people living with HIV and AIDS. Cuyahoga County accounted for 26% of the cases identified.
  • The largest share of prosecutions involved Black men, based on recorded race and gender included in records.

A separate Marshall Project review of prosecutions under the six laws in Cuyahoga County from 2016 through 2022 examined 36 charges involving 35 defendants. That doesn’t didn’t include charges for solicitation, prostitution or loitering, which are generally misdemeanor crimes.

The cases involved 18 law enforcement agencies, including three hospital police departments and public transit police.

The Cuyahoga County Prosecutor’s office, which decides whether to prosecute felony cases under Ohio’s laws, said these charges are determined on a “case-by-case basis” after considering input from victims, according to Lexi Bauer, communications manager. Bauer noted that the majority of the “harassment by bodily fluid” charges in recent years were related to hepatitis and not HIV.

Ohio penalties among the harshest

Ohio’s laws remain among the harshest when it comes to HIV criminalization, not just based on the conduct that is criminalized but also the penalties, said Jada Hicks, staff attorney for The Center for HIV Law and Policy.

In Ohio, people living with HIV (or viral hepatitis or tuberculosis) can be charged whether or not they:

  • Engaged in sex practices or other acts that could transmit the virus.
  • Transmitted HIV.
  • Used protection, such as condoms and/or dental dams.
  • Had an undetectable level of virus in their blood and were unable to transmit HIV.

Most of the charges examined in the report fall under two Ohio laws.

One law makes it a crime for a person living with HIV (or hepatitis or tuberculosis) to “harass” someone with their bodily fluids. That would include spitting or throwing urine, feces or blood at another person.

Under the other law, a person can be charged with felonious assault if they have sex with another person without telling them that they are living with HIV.

The penalties for failing to disclose HIV status in Ohio are stiff regardless of whether the virus was actually transmitted or whether it was even possible for a person to transmit the virus. Possible sentences for individuals living with HIV can be anywhere from two to 29 times longer than those for Ohioans who are HIV-negative.

Ohio is also one of six states that require individuals convicted under one of these statutes to register as a sex offender.

“Ohio’s HIV laws don’t require actual transmission or even the intent to transmit,” said Nathan Cisneros, a researcher with the Williams Institute, which does legal and public policy research on sexual orientation and gender identity. “Conduct that couldn’t transmit HIV – like spitting and biting, loitering while having a conversation about sex work – can land you in prison.”

The Williams Institute also published a report today that looked at arrests under Ohio’s six laws over two decades and felony prosecutions in Cuyahoga County from 2009 to 2022. Researchers identified at least 530 separate allegations under the six laws since 2000. Having consensual sex without disclosing an HIV-positive status made up nearly half of the total cases. Incidents related to sex work and bodily fluid exposure each accounted for nearly one-fifth of the total.

Changing legal landscape

Thirteen states have either repealed or modernized their HIV laws, according to the Center for HIV Law and Policy, including Illinois in 2021 and New Jersey in 2022.

Ohio advocates have been at the forefront of efforts to challenge the laws as discriminatory. In 2022, the Center for HIV Law and Policy filed a complaint with the Department of Justice on behalf of people living with HIV in Ohio and Tennessee.

In December, the DOJ notified Tennessee it was violating the Americans with Disabilities Act (ADA) by enforcing the state law that increases penalties for people convicted of prostitution if they also have HIV. On Feb. 15, the Justice Department filed charges against the state in federal court..

Combing state records for HIV-related charges

OHMM researchers gathered information from county-level online court records and local county clerk and prosecutors’ offices in Ohio’s 88 counties for a six-year period ending in 2020. The project identified 214 cases prosecuted under the six laws.

Behind each one of the cases, there is a “real, everyday Ohioan who happens to have a medical condition,” Mozynski said.

Where in Ohio are people being charged?

The highest concentration of charges are in the state’s larger metropolitan areas.

  • 26% in Cuyahoga County (Cleveland)
  • 12% in Hamilton County (Cincinnati)
  • 7% in Lucas County (Toledo)
  • 7% in Franklin County (Columbus)
  • Montgomery (Dayton) and Warren (Lebanon) counties, about 5% each.

What charges are most common?

More than half of the cases identified were for the charge of “harassment with a bodily substance,” which carries with it a penalty of up to 5 years in prison and a $10,000 fine. Cases with this charge are often related to acts against law enforcement or corrections officers or healthcare workers.

Charges don’t distinguish between bodily fluids that can transmit HIV, such as blood, and those that do not, such as saliva, urine or feces. People can also be charged if they are living with hepatitis, regardless of whether it is transmitted.

Prosecutors also don’t have to prove whether a person is capable of transmitting the virus or determine whether it is scientifically impossible to transmit the virusdue to prescription-drug treatments that have reduced the presence of the virus in a person’s blood – called a viral load – to undetectable levels.

A third of the cases were for “felonious assault,” which carries the most severe penalty of any HIV-related charge – up to eight years of incarceration and a $15,000 fine. Each sexual act can be charged separately. It also doesn’t require that the virus be transmitted.

OHMM found no cases where people were charged with “selling or donating contaminated blood.” The Williams Institute found six arrests over a 20 year period related to blood donation.

Read the OHMM (“Enforcement of HIV Criminalization in Ohio: Analysis of Court Cases from 2014 to 2020”) report here.

Read the Williams report (“Enforcement of HIV Criminalization in Ohio HIV-related criminal incidents from 2000 to 2022”) here.

Global Statement on HIV Is Not A Crime Awareness Day

Download this statement as a pdf

This year, on February 28th, the HIV JUSTICE WORLDWIDE coalition commemorate HIV is Not A Crime Awareness Day as a Global Awareness Day for the first time, under the theme: “You care about ending HIV criminalisation, you just don’t know it yet”. We invite you to stand with us in solidarity and action as we strive to eliminate the unjust criminalisation of people based on their HIV-positive status.

HIV Is Not A Crime Awareness Day was launched in the United States two years ago by HIVJUSTICE WORLDWIDE founding partner, the SERO Project, in collaboration with the Elizabeth Taylor AIDS Foundation, and has grown in size and prominence ever since.

HIV criminalisation laws and prosecutions persist in many parts of the world* perpetuating stigma, discrimination, and human rights violations against people living with HIV. These laws reinforce misconceptions, fuel fear and prejudice instead of fostering empathy and understanding. They undermine public health efforts by deterring people living with HIV from seeking testing, treatment, and support, ultimately hindering progress in HIV prevention and care and reaching targets set to end AIDS by 2030.

The impact of HIV criminalisation extends beyond legal consequences, affecting the social, economic, and emotional well-being of those affected. It breeds shame and secrecy, hindering open communication about HIV and perpetuating a cycle of silence and isolation.HIV criminalisation disproportionately impacts marginalized communities most affected by HIV,exacerbating existing inequalities and injustices as seen in recent years.

We believe that everyone has a role to play in ending HIV criminalisation, marked by our theme this year: “You care about ending HIV criminalisation, you just don’t know it yet,”

We as the HIV JUSTICE WORLDWIDE coalition partners are raising awareness, challenging stigma, and advocating for policy reform and HIV decriminalisation. We want to create a more just and compassionate society for all. It begins with education, empathy, and a commitment to upholding the rights and dignity of every individual, regardless of their HIV status. It’s time for change. It’s time to dismantle the legal barriers that perpetuate stigma and discrimination against people living with HIV. It’s time to shift the narrative from fear and punishment to compassion and support. It’s time to recognise that HIV criminalisation not only affects individuals but also our communities, as it undermines public health efforts and human rights principles.

On this HIV Is Not A Crime Awareness Day, we call upon governments, policymakers, advocates, healthcare providers, and communities worldwide to take action:

  • Reform Legal Frameworks: Advocate for the repeal or reform of laws and policies that
    criminalise HIV non-disclosure, exposure or non-intentional transmission. Replace
    punitive measures with evidence-based approaches grounded in public health and
    human rights.
  • Promote Education and Awareness: Raise awareness about the impact of HIV
    criminalisation on individuals, families, and communities. Foster empathy,
    understanding, and support for people living with HIV.
  • Ensure Access to Justice: Ensure that individuals living with HIV have access to legal
    support and representation to challenge unjust prosecutions and discriminatory
    practices.
  • Foster Inclusive Policies: Advocate for policies that promote inclusivity, dignity, and
    respect for the rights of people living with HIV, including access to comprehensive
    healthcare, prevention, and support services.
  • Empower Communities: Empower communities affected by HIV to advocate for their
    rights, including for HIV decriminalisation, challenge criminal laws and policies and
    demand accountability from policymakers and institutions.

Together, we can create a future where no one faces criminal legal system discrimination or prosecution simply because they are living with HIV. Join us in saying no to HIV criminalisation and yes to justice, compassion, and solidarity. #HINACDay 2024.

* The HIV Justice Network’s Global HIV Criminalisation Database counts 109 jurisdictions in 80 countries with HIV-specific criminal laws, including 23 jurisdictions in the United States, two in Mexico, and three in Nigeria, together with a federal HIV law in each country. The Database includes individual case reports of HIV criminalisation in 161 jurisdictions in 90 countries since we began monitoring HIV cases. These include cases in all eight Australian states, eight provinces and territories in Canada, seven Mexican states, two Nigerian states, 42 jurisdictions in the United States, and all four nations of the United Kingdom. We consider 89 jurisdictions in 52 countries to be ‘active’ – those which have enforced relevant laws in the past five years. A total of 39 of these jurisdictions have HIV-specific laws in place, while 50 jurisdictions applied general criminal laws, such as communicable disease or general harm provisions, to instances of alleged HIV non-disclosure, potential or perceived exposure, or non-intentional transmission.


About us

We are global coalition of community-led global and regional networks and human rights defenders working to shape the discourse on HIV criminalisation, as well as share information and resources, network, build capacity, mobilise advocacy, and cultivate a community of transparency and collaboration.

The coalition is comprised of fourteen networks and organizations. It was founded in 2016 by: the AIDS and Rights Alliance for Southern Africa (ARASA), The Global Network of People Living with HIV (GNP+), HIV Justice Network (HJN), The HIV Legal Network (Legal Network), International Community of Women Living with HIV (ICW Global), Positive Women’s Network (PWN-USA), and the Sero Project (Sero).

A further seven partners have since joined the coalition: AIDS Action Europe (AAE), Eurasian Women’s Network on AIDS (EWNA), Harm Reduction International (HRI), MENA Community, Global Action for Gay Men’s Health and Rights (MPact), Southern Africa Litigation Centre (SALC) and the Global Network of Young People Living with HIV (Y+ Global). To learn more about the HIV JUSTICE WORLDWIDE coalition please visit: www.hivjusticeworldwide.org

HIV Is Not A Crime Awareness Day goes global!

Next Wednesday 28th February is HIV Is Not A Crime Awareness Day.

For the first time, HIV Is Not A Crime Awareness Day – which began two years ago in the United States – has gone global! This year’s theme is: “You care about ending HIV criminalisation – you just don’t know it yet!”

That’s why we’ll be producing a very special episode of our webshow, HIV Justice Live! on this important new date for global HIV decriminalisation activism, where I’ll be joined on my ‘virtual sofa’ by an inspiring group of community-based expert activists – Florence Riako Anam (GNP+); HIV and human rights consultant, Michaela Clayton; Mikhail Golichenko (HIV Legal Network); and Andy Tapia and Kerry Thomas (SERO Project) – to explain why HIV criminalisation impacts us all, and what you can do about it.

We’ll be streaming live to YouTube and Facebook, so you’ll be able to interact with us during our Q&A session. By March 1st, Zero Discrimination Day, the show will also be available on our YouTube channel where it will be subtitled in English, allowing for automatic translation into any language.

HIV Is Not A Crime Awareness Day was the brainchild of our long-time HIV JUSTICE WORLDWIDE partner, the SERO Project’s co-Executive Director, Kamaria Laffrey. HIV Is Not A Crime Awareness Day was launched two years ago in collaboration with the Elizabeth Taylor AIDS Foundation, community activists and public policy organisations across the United States and grown in size and prominence ever since.

HIV Is Not A Crime Awareness Day takes place on 28th February for several reasons. It’s a date that bridges two major US awareness months – Black History Month in February and Women’s History Month in March. And it’s also a symbolic nod to the legacy of the late Hollywood icon and early AIDS activist, Elizabeth Taylor, who was born on 27th February.

HIV Is Not A Crime Awareness Day is an opportunity to amplify the voices of those who have been criminalised based on their HIV status; to remind people of the negative impacts of HIV criminalisation on health and rights; to celebrate the work of many individuals who are part of the growing global movement to end HIV criminalisation; and to recognise that there’s still much to do to achieve HIV JUSTICE WORLDWIDE.

You can find out what other events are taking place on and around HIV Is Not A Crime Awareness Day by visiting a dedicated Facebook page or by following the hashtag #HINACDay.

US: Report by the Williams Institute examines the enforcement of HIV criminalisation laws in Mississippi

HIV criminal laws lopsided impact on Black men in Mississippi

A new report by the Williams Institute at UCLA School of Law finds that at least 43 people in Mississippi were arrested for HIV-related crimes between 2004 and 2021. Half of all arrests in the state happened between 2017 and 2021.

The HIV epidemic and Mississippi’s HIV-related criminal laws disproportionately impact men, and Black men in particular. Men make up 49% of Mississippi’s population, 71% of people living with HIV (PLWH), and 72% of HIV-related arrests. Black men comprise 18% of the state’s population and 50% of PLWH. However, they make up 47% of HIV-related arrests.

Researchers analyzed data obtained from the Mississippi Department of Public Safety. Findings show that the enforcement of HIV criminal laws is concentrated around the state’s capital and most populous city, Jackson, and near the Gulf Coast. Almost 20% of arrests occurred in three counties: Harrison (15%), Hinds (13%), and Lamar (11%).

HIV criminalization is a term used to describe laws that either criminalize otherwise legal conduct or increase the penalties for illegal conduct based on a person’s HIV-positive status. Nearly two-thirds of U.S. states and territories currently have laws that criminalize people living with HIV.

Mississippi has two HIV criminal laws. The knowing exposure law makes it a felony to knowingly expose another person to HIV, hepatitis B, or hepatitis C and is punishable by up to 10 years in prison and/or a $10,000 fine. Mississippi’s endangerment by bodily substance law makes it a misdemeanor to attempt to expose or expose anyone at a correctional facility to bodily fluids. However, if someone knows their HIV or hepatitis status, the crime is upgraded to a felony punishable by 3 to 10 years in prison and/or a $10,000 fine.

“Mississippi’s criminal laws do not require the actual transmission of HIV, the intent to transmit, or even conduct that can lead to the transmission of HIV,” said lead study author Nathan Cisneros, HIV Criminalization Project Director at the Williams Institute. “We now have medical treatments that wholly eliminate the risk of transmitting HIV through sex, yet these advances are not reflected in Mississippi’s laws.”

Mississippi’s 2021 Ending the HIV Epidemic Plan called for reform of the state’s HIV criminal laws to align with modern HIV medicine.

“HIV criminal laws perpetuate stigma and can discourage testing and treatment,” said co-author Brad Sears, Founding Executive Director at the Williams Institute. “That’s why many national and state organizations, including the American Medical Association, have called for a repeal of these laws.”

This report is part of a series of reports examining the ongoing impact of state HIV criminalization laws on people living with HIV.

Read the report

US: Updated CDC guidelines on Molecular HIV Surveillance do not go far enough, believe HIV advocates

CDC updates privacy guidelines for HIV sample tracking

Guidelines relating to a controversial practice used by American state and local health departments to curb HIV infections were updated last week by the US Centres for Disease Control and Prevention – but have not gone far enough, believe some experts.

The guidelines track the genetic signatures of viruses collected from people newly diagnosed with HIV, and the updated policy encourages health officials to be more transparent about the process, one of many changes sought by HIV advocacy organisations concerned about how so-called molecular surveillance could violate patients’ privacy and civil rights.

The New York Times reports that the agency stopped short of adopting more significant changes some had been pushing for, like allowing health agencies to opt out in states where people can be prosecuted for transmitting HIV.

“We’re in a period where health data are increasingly used in criminal prosecutions, as seen in prosecutions of people seeking abortion care or who might have miscarried,” said Carmel Shachar, a professor at Harvard Law School who specialises in healthcare. The revised policy did not go far enough, she said, to protect people with HIV.

Dr Alexandra Oster, who leads the CDC’s molecular surveillance team, said the benefits of the programme far exceed the risks. “We need to do it well,” she said. “But we need to keep doing it.”

HIV has a distinctive genetic signature in each person that helps doctors decide which drugs are likely to thwart it. But the information can also be used to track its spread through a population – including identifying clusters of people who carry closely-related viruses.

The CDC has, for decades, used molecular surveillance to track flu, salmonella and, more recently, Covid.
In 2018, it began requiring health departments that received federal funding for HIV programmes to share such data gleaned from people with the virus. Patients do not have to be informed that their viral samples are tracked.

Molecular surveillance has identified more than 500 HIV clusters in the country since 2016, the CDC said.

Health officials can then interview people in the clusters to identify their sexual or drug-use partners and connect them to testing, needle exchanges and medications that block transmission.

But many HIV activists have long argued that such tracking could violate people’s rights and discourage testing and treatment.

Before the information is reported to the CDC, health departments strip it of information that could readily identify the patient. But personal data are held by state and local health departments.

In some states, people have been prosecuted for transmitting HIV or for not telling their partners that they carry it. No criminal prosecution in the United States has been known to involve molecular surveillance data, but activists remain wary of the possibility.

They also fear that advances in technology might eventually be able to determine who infected a specific person.

In October, 110 HIV and human-rights groups sent a letter to the CDC expressing “serious concerns” that molecular surveillance was carried out without the informed consent of people with HIV.

The CDC said that it had a meeting with the activist coalitions’ representatives last year and incorporated their input in the revised policy.

A similar conflict arose in the late 1990s, when the CDC pushed for states to collect names of diagnosed people in state-run databases, which the agency said would help combat a disease that by then had killed hundreds of thousands of Americans. But many activists protested the policy, delaying its rollout for a decade.

Since 2008, all states have collected the names of people diagnosed with HIV.

The CDC said the information is secure, and that it knew of only one names-related data breach – in Florida in 1996. It said it knew of no such privacy violations related to molecular surveillance data.

The new policy did not allow waivers for opting out of molecular surveillance in places where such data could be used in criminal proceedings, a change that had been recommended by the National Alliance of State and Territorial Aids Directors, a non-profit representing public health officers.

Representatives from more than 40 state or county health departments that the federal government prioritises for HIV prevention told The New York Times that the molecular surveillance policy had been generally useful in their efforts to prevent transmission. None knew of any data breaches.

Unraveling the legal challenges surrounding HIV criminalisation in russia

Russian Court Cases and HIV Transmission: What You Need to Know

Text: Alexey Semenov

Russian courts annually pronounce several dozen sentences under articles related to the transmission of HIV infection. At the same time, leading international organizations have long called for the abandonment of such articles in the Criminal Code, because they interfere with the fight against the HIV epidemic. “Such Cases” examined judicial statistics and also found out why Russians write statements against their partners.

In 2019, a documentary was released on Russian television series Anton Krasovsky’s “Epidemic” about people living with HIV. Then the co-founder of the ANO “Sibiryachki Plus” Maria Petrova, whose story was told by the documentary filmmakers, received a call from her boyfriend, whom she had been dating for three years at that time.

“He was very excited. He said: “You are so and so, they showed you on the second channel. My relatives saw it.” And it was his relatives who told him that he would not eat with them, he would not wash with them,” recalls Maria.

Read also “How many partners have you had?” Why people with HIV prefer to hide their status

The man explained that in order to be rehabilitated in front of his relatives, he must write a statement against Maria to the police about “the threat of HIV infection.” Petrova could not transmit any virus to him – she had been going to the AIDS Center for a long time and regularly took therapy.

After some time, Maria received a call from the police and invited her to talk – they told her that a man had written a statement against her. The police immediately reassured Maria, noting that they would not initiate a case.

“What saved me was that I live with an open face, write about my status on social networks and hold events. And this man is among my friends and subscribers. The police examined social networks and decided that he could not have known about my status. And if a partner knows that a person has HIV, then there is no criminal case,” explains Maria.

What we thought

We have collected all available cases under Article 122 of the Criminal Code of the Russian Federation from the state system “Justice”, as well as statistics from the judicial department at the Supreme Court. Most of the texts of the verdicts are not published, as they relate to the intimate lives of people. The Eurasian Women’s AIDS Network, which has been monitoring cases of persecution of people with HIV and their blackmail since 2017, also shared cases with us.

Since then, Petrova has been approached by people with HIV who have been subject to statements of intentional infection, by those who want to go to the police, and by investigators who receive such cases. “It’s good if you come across a competent investigator and interrogator. But basically, since there is not much practice in such cases, many investigators and interrogators, reading the statement, come across this article for the first time,” says Maria.

Po data Judicial Department of the Supreme Court, since 2015, 702 people have been convicted in Russia under the article on intentional infection with HIV or creating a threat of such infection, and another 11 were sent to compulsory psychiatric treatment.

A little more than 0.9% of cases under this article were acquitted or dismissed on exonerating grounds. 17.5% of such cases were closed for other reasons, including due to the death of the accused. Thus, in 2021 in Adygea, a woman who infected her partner with HIV died during the trial. In Kabardino-Balkaria, a prisoner died after cutting his hand and spattering blood on the eye of a prison doctor. He was also accused of attempted infection with the virus.

“Why did you do this to me?”

According to the current Russian law, everyone who registers with the AIDS Center signs a warning about criminal liability for intentional infection with HIV. Courts pay attention to this circumstance when passing sentences: if a person signed documents in an infectious disease specialist’s office, any case of infection from him is considered intentional.

“Suppose I just found out that I have HIV. I go to the doctor, I’m dumbfounded. I think I’m going to die soon. And they tell me in the doctor’s office: “Sign the document.” What is in it is not very clear. But you take and sign a document stating that you are a potential criminal without thinking. Even if the doctor explains something, the person is unlikely to remember it, because at that moment he has something completely different in his head,” explains Maria.

Ekaterina Stepanova, an infectious disease doctor at the University Clinic H-Clinic, Candidate of Medical Sciences, who acts as an expert in criminal cases of HIV infection, believes that the process of warning about liability is organized incorrectly:

“People don’t understand what they signed, they don’t understand what they were told. Of course, the moment of signing these papers should be postponed to a time when the person is sane.”

Read also “Just yell, demand and achieve.” Prisoners with HIV across Russia report being denied access to treatment

But epidemiologists are punished by their superiors if a person leaves and does not sign these papers, the doctor explains. “But you have to understand that the patient came, and instead of being supported, they interrogated him and said that he was facing a criminal case. Will he return to this wonderful place? “It’s more likely no than yes,” says Stepanova.

The victims in cases of HIV infection are often the former partners of patients, says Maria Petrova. Most often, sentences under articles of infection or threat of infection with HIV are made against men. They were convicted in 68% of cases, it follows from statistics Supreme Court of Russia since 2017.

“Mainly, the applicants are women who, out of resentment that their partner broke up with them, write a statement. He didn’t even infect them with HIV because he was taking ARV therapy, but they write a statement that he put them at risk of infection, and this is also a criminal offense,” explains Petrova.

In 2022, a resident of Novoaltaisk was sentenced to a suspended sentence for transmitting HIV to his partner as a result of a long “romantic relationship.” The couple had sex without a condom by consent, but after a while the woman discovered HIV pills on her lover and asked: “Why did you do this to me?” After this conversation, the relationship did not end and the young people continued to have sex, but broke up due to “domestic conflicts.” Some time later, the woman was diagnosed with HIV, and she wrote a statement against her former partner. He was sentenced to one year and eight months of suspended imprisonment.

Of the 17 cases of prosecution under Article 122 of the Criminal Code – about HIV infection or the threat of such infection, recorded by the Eurasian Women’s AIDS Network in 2017–2023, at least six are related to long-term, in fact, family relationships. Thus, a man from the Kurgan region was convicted in 2014 of having sex with his wife – at that time the couple was raising two children together. Maria Petrova emphasizes:

“If two consenting adults have sex, it is still a matter of two people.”

“And why is it always an HIV-positive person who is a potential criminal? After all, both are responsible for their health. And when one of the partners insists on sex without a condom or agrees to it, he is also responsible – two are to blame,” Maria is sure.

“If people decide not to use condoms, then they need to be examined together and remember the incubation window period and fidelity to each other. Such subtle issues that, it seems to me, are quite strange to regulate by criminal law,” says Natalya Sidorenko, coordinator of the working group on decriminalization of HIV transmission.

In the Joint United Nations Program on HIV/AIDS (UNAIDS) it says that any laws that criminalize HIV must be repealed because they discourage people from getting treatment and contribute to the spread of the virus.

“Punitive laws have been shown to block access to HIV services and increase the risk of HIV infection,” the organization said. It notes that criminalizing HIV transmission increases stigma against people living with the virus and creates an atmosphere of “false calm.” “People think that, on pain of criminal liability, their partner(s) will warn that they have HIV,” it says report “Eurasian Women’s Network on AIDS”.

“In order to hide his own crime”

The article on HIV transmission is redundant, because the Criminal Code already regulates all possible consequences for victims, says Natalya Sidorenko.

“If this was sexualized violence, then the article “Rape” has a separate clause that increases the punishment for contracting HIV. Simply transmitting the human immunodeficiency virus is a harm of moderate severity, because the harm occurs with the development of the disease. And now we have antiretroviral therapy, and people do not live to reach the AIDS stage, because the disease does not develop and no harm is caused,” explains the coordinator.

Of the 910 cases of HIV transmission or threat of infection, more than 27% involve sexualized violence, Takie Cases calculated. Another 6% of these cases involve sexual contact between adults and minors. Also, more than 10% of cases involve other types of physical violence: robberies, assaults and beatings. In 12 cases, the defendants were charged with murder.

Sometimes the same people become victims of sexualized violence and at the same time involved in cases of HIV transmission. In 2015, a resident of Karachay-Cherkessia reported to the police about rape in a barn on a farm. But the police decided that no one had raped the woman, and she wrote the statement “in order to hide her own crime” – the threat of infecting her partner with HIV. The woman was sentenced to two years of suspended imprisonment for false denunciation and the theoretical possibility of transmitting the virus.

When considering such cases, the courts do not examine the real possibility of the defendant infecting the victim, explains Maria Petrova.

“Nobody finds out whether a person took therapy”

“A specialist from the AIDS Center comes to court and speaks as a representative of the state, but the Russian Ministry of Health does not recognize the principle “undetectable equals non-transmitting”. That is, doctors from public hospitals claim that the likelihood of infection from a person with an undetectable viral load still exists, although all leading experts say the opposite,” says Maria.

“Those who were reported and came to us took therapy. It turns out that they could not create a threat to transmit the virus,” confirms coordinator Natalya Sidorenko.

Po opinion WHO, the risk of transmission of the virus from a person with an undetectable viral load is “virtually zero.” But the chief freelance HIV specialist of the Russian Ministry of Health, Alexey Mazus believes that the studies proving this position are based on too small a sample of patients.

“There are no specifics on this issue, only sloganeering, which ultimately allows us to speak publicly about the unlimited right of a patient with HIV infection with an abstract “undetectable” viral load to have free sexual contacts and even to conceal the diagnosis,” Mazus said.

Doctor Ekaterina Stepanova says that Rospotrebnadzor specialists already recognize people with an undetectable viral load as harmless. In the last editorial staff The SanPiN department indicates the existence of “quantitative indicators of the presence of the virus in the blood below the level that ensures the possibility of HIV transmission.”

“In fact, allegations about the possibility of transmission of the virus from people with an undetectable load are due to the insufficient education of those doctors who appear in courts. Because many experts agree with a different point of view. And science has done enough for others to stop denying the obvious,” the infectious disease specialist is sure.

At the same time, courts do not always take into account the opinions of doctors

Stepanova recalls one of the trials in which she participated as an expert – then all the experts agreed that the defendant could not transmit the virus, but the conclusions were interpreted incorrectly: “Judges often say: “We are examining the rule of law, not this infection of yours.” ” And then, when the analysis begins and they realize that they don’t understand anything, they’re like: “Okay, let’s get your experts.”

According to Stepanova, the denial of the principle “undetectable equals non-transmitting” by part of the medical community leads to a decrease in the coverage of patients with therapy. By data for 2022, only 61% of Russians with an officially established diagnosis received therapy. To defeat the epidemic, this figure must be increased to 95% worldwide, and 95% must have an undetectable viral load, believes UNAIDS.

“People who do not receive therapy are really dangerous in terms of transmitting the virus. But it is they who most often do not receive any punishment if others are infected, because they are not registered and do not sign a warning about criminal liability,” explains doctor Stepanova.

Bite danger

Russian courts consider biting, spitting and splashing of blood to be the real ways of transmitting the virus, as follows from the published verdicts. Thus, a resident of Yuzhnouralsk was convicted, among other things, of the threat of HIV infection for biting a policeman in the “right shoulder blade area.” A resident of Korolev was convicted on similar charges in 2015, and in 2018, a student who escaped from a Vologda orphanage was convicted.

“One of the cases involves an examination by an employee of the AIDS Center, who said that the possibility of transmission of the virus through a bite cannot be ruled out. But this is nonsense. WHO, UNAIDS and all other people, adequate infectious disease epidemiologists, will say that the probability of transmitting the virus through a bite is zero,” says Natalya Sidorenko.

Infectious disease doctor Ekaterina Stepanova emphasizes that during all the years of the HIV epidemic, only a few cases of transmission of the virus through a bite have been recorded: “The risk is theoretically possible with a high viral load and a sufficiently large amount of blood in the saliva. Roughly speaking, if, for example, during the detention of a suspect, his teeth were knocked out, his face was broken, and he spat at a police officer, there is some risk here.”

According to the State Automated Information Agency “Justice”, violence against police officers was charged along with the threat of HIV infection in 2.5% of cases. Often, security forces expose themselves to an additional risk of contracting HIV when they deprive detained, arrested and convicted people of access to therapy, Stepanova notes:

“Here it is in the interests of the state and its representatives that people take therapy”

“This is necessary so that even at such moments the risk of infection is minimal,” says the infectious disease specialist.

In 5% of cases of HIV infection, according to the State Automated Information System “Justice”, along with the main accusation, the courts dealt with episodes of theft and fraud; 11 cases were related to drugs, 13 – to other crimes.

In 55% of cases, according to the same data, the defendants were not charged with anything other than possible HIV transmission. Moreover, at least 14 people were convicted only for the threat of infection, which in reality did not occur.

Articles on HIV infection migrated to the Russian Criminal Code from the Soviet one, says coordinator Natalya Sidorenko. “Of course, this article is outdated – it was adopted in the late 80s in the Criminal Code of the RSFSR, then it migrated to all these criminal codes in the post-Soviet space. Then there was no information about HIV, there was no treatment and, of course, there was enough fear.”

Doctor Stepanova agrees with Sidorenko – she calls the article on HIV infection inconsistent with modern scientific knowledge. “The norm was adopted quite a long time ago, the revision was also a long time ago, and ideas about the safety of people with an undetectable load were finally approved in 2018,” she explains.

Natalya Sidorenko calls the existence of the first paragraph of Article 122 of the Criminal Code “nonsense” – about “putting another person at risk of contracting HIV infection.” According to her, this formulation creates the problem of blackmail of people with HIV from their partners.

Since 2017, the Eurasian Women’s AIDS Network has documented 15 cases of blackmail. They were mainly associated with disagreements between former partners and spouses – for example, when they could not decide with whom their common children would live.

So, a husband wanted to write a statement against a woman from the Nizhny Novgorod region, who was upset about the upcoming divorce. The woman was saved from a criminal case by the fact that he was indicated in the medical record as a proxy, was examined during his wife’s pregnancy and visited the AIDS Center with her.

This is the best way for a person with HIV to protect themselves from accusations in the event of a disagreement with their partner, says Maria Petrova. In addition to a joint visit to the doctor, she recommends telling a third person about your status, and also getting a receipt from your partner.

Pressure on people with HIV

Such strict regulation of the lives of people with HIV leads to the fact that they are simply afraid to enter into relationships, and even more so to inform their partners about their diagnosis, says project manager of the Children+ Foundation, psychologist Anna Sharabanova. Partners of people with HIV may be pressured by relatives who have misconceptions about the infection.

“There are always exceptions, and one of them is older people who grew up in a time when HIV was considered a plague and everyone avoided these three letters as much as possible. It is often difficult for such people to accept new information, it is difficult to agree that there is no danger, to get rid of beliefs that have accumulated over the years. For this reason, the relatives of someone who has chosen a person living with HIV as a partner raise this issue sharply, even to the point of ultimatums – they put pressure towards not just breaking the union, but also legal proceedings,” says Sharabanova.

If a person with HIV has difficulty disclosing the diagnosis to a partner, she advises contacting a specialized psychologist or peer consultants: “The words “I am a peer consultant, I have a husband with whom we gave birth to three healthy children, two higher educations and a very successful career.” “Coming from a living example can calm a person.”

Thank you for reading to the end!

An encouraging start to 2024

This year has begun with some really encouraging news: years of HIV criminalisation advocacy are really paying off.

First, we heard that the Congress of Mexico City completely repealed the crime of “danger of contagion” from the Penal Code. The repeal was approved with an overwhelming majority of 42 votes in favour and only two against. As per the decision, Articles 76 and 130 have been modified to eliminate the criminalisation of people with sexually transmitted infections (STIs), including HIV. This is a direct result of community activism led by the Mexican Network Against HIV Criminalisation. Congresswoman Ana Francis López noted that, with the adoption of this decision, Congress is fulfilling the demands of communities living with HIV that asked not to be discriminated against or punished.  Mexico City joins the states of Aguascalientes, Jalisco, Nayarit, San Luis Potosí and Tabasco, where their Penal Codes do not provide for a specific crime for exposure to HIV or STIs.

Then we heard that progress is being made towards HIV decriminalisation in Tajikistan. The recent Plenum of the Supreme Court marked the first step in this important process. One of the most significant changes was the recognition of the fact of placing people at risk of HIV was an unproven basis for criminal prosecution. With almost 200 known HIV criminalisation cases, this process now needs to speed up. Marginalised groups bear the brunt of the implementation of the HIV criminalisation law in Tajikistan; starting in 2014, authorities have regularly targeted sex workers and LGBT people, often under the guise of disease prevention. We remain hopeful that further progress will be made in the near future to ensure that people living with HIV are not unjustly criminalised in Tajikistan.

We also heard welcome news that another country with far too many unjust prosecutions, Singapore, is also moving towards law reform. The Singapore Ministry of Health is currently conducting a review of the law concerning HIV disclosure. This review will hopefully result in changes to current draconian practices and policies that has seen the law used to convict people – usually gay men – where condoms had been used and where the person living with HIV had an undetectable viral load.

And finally, with the support of our HIV JUSTICE WORLDWIDE Francophone Network, led by the HIV Legal Network, civil society groups are urging authorities in Burkina Faso to reconsider the HIV criminalisation provisions contained within its HIV law, Law 030. The call for action reflects a broader effort to improve the health and wellbeing of people living with HIV/AIDS in Burkina Faso and across the continent.

These are but a few examples of the hard work and dedication of so many of us. The global movement to end HIV criminalisation is making significant progress. Let’s keep up the momentum.

Together, we can make HIV JUSTICE WORLDWIDE a reality.

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