Brazil: Instead of criminalising people living with HIV, strengthening health services would promote prevention and care

Living with HIV is not a crime. People living with the AIDS virus should have peace of mind like everyone else.

Google translation – For the original article in Portuguese, please scroll down.

By Esper Kallás

A few years ago, I was consulted about the case of a person who was allegedly trying to transmit HIV sexually. This happened because it was discovered that he was living with the virus after medical pre­scrip­tions were found in his drawer, which contained the medications for the treatment cocktail. The del­egate responsible for investigating the complaint, until then, tended to accept the opening of the process.

Criminalizing someone for being infected with HIV is still a serious problem in several countries around the world, including Brazil. At least 92 countries have specific or sufficiently vague laws that allow a person living with the virus to be held liable for having sex. The situation becomes even more serious as the ma­jority of people living with HIV belong to more socially vulnerable population groups.

In consensual sex, does a person living with HIV necessarily need to disclose their HIV status to their part­ner? The answer is “no”. In support of this position, here are some considerations.

Regarding the prevention of sexually transmitted infections, having a consensual sexual relationship brings responsibilities to everyone who takes part in it.

Treatment with the antiretroviral cocktail is highly effective in controlling the spread of HIV, allowing peo­ple to keep HIV undetectable in their blood. As a result, they stop transmitting HIV sexually. In several, extensive and repeated studies, the results are striking: persons who are part of couples with a sexual partner who lives with HIV and has an undetectable virus did not become infected, even with sexual rela­tions without protection of a male or female condom. As a result, a person who is living with HIV and is unde­tectable is a safer sexual partner in unprotected sex than someone who does not know if they have the virus. Hence the concept of “undetectable = untransmissible”.

The recommendation is shared by the Joint United Nations Program on HIV/AIDS (UNAIDS), which also suggests that countries respect the confidentiality of people living with the virus, helping to combat prej­u­dice and favoring access to health services. Continuing to criminalize people just because they are living with HIV takes the opposite path.

Comparing HIV to other agents of sexually transmitted infections, it is noted that these can also lead to potentially serious consequences. For example, syphilis, in its tertiary form, can compromise organs and systems, including neurological functions. Gonorrhea can lead to infertility. HPV can lead to genital cancer, especially in women. In these circumstances, there is not the same movement of attribution of guilt for having occurred by sexual transmission.

After a few days, the case presented at the beginning of the text was clarified by the delegate: the accused was undergoing treatment regularly and had an undetectable viral load, while the accuser, in bad faith, sought an opportunity for extortion.

Instead of criminalizing people living with HIV, it is necessary to strengthen health services to promote the prevention of sexually transmitted infections, facilitate access to tests for sexually transmitted agents and ensure treatment with antiretroviral cocktail drugs for those living with HIV. It is worth discussing here a campaign that better clarifies the concept “undetectable = non-transmitter” to society.

The time has passed already to resolve this public health and, also, human rights problem.


Viver com HIV não é crime. Pessoas que vivem com vírus da Aids devem ter tranquilidade como todos.

Por Esper Kallás

Há alguns anos, fui consultado sobre um caso de uma pessoa que, supostamente, tentava transmitir se­xual­mente o HIV. Isso aconteceu pois descobriu-se que vivia com o vírus, depois de terem sido encontra­das receitas médicas em sua gaveta, nas quais constavam os remédios do coquetel de tratamento. O de­legado responsável por investigar a denúncia, até então, tendia a aceitar a abertura do processo.

Criminalizar alguém por estar infectado pelo HIV ainda é um grave problema em vários países do mundo, incluindo o Brasil. Ao menos 92 países têm leis específicas ou suficientemente vagas que permitem res­ponsabilizar judicialmente uma pessoa que vive com o vírus por manter relações sexuais. A situação torna-se ainda mais grave pois a maioria das pessoas vivendo com HIV pertence a grupos populacionais social­mente mais vulneráveis.

Em relações sexuais consensuais, uma pessoa que vive com HIV precisa, obrigatoriamente, revelar seu status sorológico para o parceiro? A resposta é “não”. Sustentando esta posição, seguem algumas ponde­ra­ções.

Em relação à prevenção de infecções sexualmente transmissíveis, ter uma relação sexual consensual traz responsabilidades para todos que dela tomam parte.

O tratamento com o coquetel de antirretrovirais é altamente eficaz no controle da multiplicação do HIV, permitindo que as pessoas consigam manter o HIV indetectável no sangue. Como consequência, deixam de transmitir o HIV por via sexual. Em diversos, extensos e repetidos estudos, os resultados são contun­dentes: pessoas que compõem casais cujo parceiro sexual vive com HIV e tem vírus indetectável não se infectaram, mesmo com relações sexuais sem proteção por camisinha masculina ou feminina. Como re­sultado, uma pessoa que vive com o HIV e está indetectável é um parceiro sexual mais seguro em uma relação sexual desprotegida do que alguém que não sabe se tem o vírus. Daí o conceito de “indetectável = não transmissor”.

A recomendação é partilhada pelo Programa Conjunto das Nações Unidas para HIV/Aids (UNAIDS), que também sugere aos países respeito à confidencialidade das pessoas que vivem com o vírus, auxiliando no combate ao preconceito e favorecendo o acesso aos serviços de saúde. Continuar criminalizando pessoas somente porque vivem com o HIV trilha o caminho inverso.

Comparando HIV aos demais agentes de infecções sexualmente transmissíveis, nota-se que estes também podem levar a consequências potencialmente graves. Por exemplo, a sífilis, na forma terciária, pode com­prometer órgãos e sistemas, inclusive as funções neurológicas. A gonorréia pode levar à infertilidade. O HPV pode levar a câncer genital, especialmente em mulheres. Não há, nestas circunstâncias, o mesmo movimento de imputação de culpa por ter ocorrido transmissão por sexo.

Passados alguns dias, o caso apresentado no começo do texto foi esclarecido pelo delegado: o acusado fazia seu tratamento regularmente e tinha carga viral indetectável, enquanto quem acusou, por má fé, buscava uma oportunidade de extorsão.

Ao contrário de criminalizar as pessoas que vivem com HIV, é preciso fortalecer os serviços de saúde para promoção da prevenção de infecções sexualmente transmissíveis, facilitar acesso a testes para agentes trans­missíveis por via sexual e assegurar tratamento com remédios do coquetel antirretroviral aos que vivem com o HIV. Cabe, aqui, discutir uma campanha que esclareça melhor à sociedade o conceito “inde­tectável = não transmissor”.

Já passou a hora de resolver esse problema de saúde pública e, também, de direitos humanos.

Molecular HIV Surveillance “a perfect storm” in the context of HIV-related criminalisation

A new briefing paper published today by Positive Women’s Network-USA on behalf of the HIV JUSTICE WORLDWIDE coalition aims to support people living with HIV, activists, legal experts, and human rights campaigners in understanding the complexities and consequences of molecular HIV surveillance (MHS). 

Molecular HIV Surveillance: A global review of human rights implicationsprovides a detailed explanation of what MHS is and how it is used across the globe, including how the technology works, where it is being conducted, and by whom. The paper describes growing human rights concerns relating to the use of this technology and goes on to list a number of recommendations for the use of MHS which were gathered from an international literature review and from members of the Expert Advisory Group.*

Molecular HIV surveillance (MHS) is an umbrella term that describes a wide range of practices focused on the monitoring of HIV variants and the differences and similarities between them for scientific research, public health surveillance, and intervention.

To conduct MHS, scientists rely on the results of HIV genetic sequencing tests taken from people living with HIV – these tests are often done before prescribing HIV medication to determine if the individual has a strain of HIV that is resistant to certain treatments. Interest in, and use of, MHS for reasons other than tailoring treatment regimens is increasing globally, however. Of particular concern, in some regions, MHS is being conducted and HIV data is being shared in ways that put the rights and safety of people living with HIV in jeopardy. 

“HIV is highly stigmatised and communities that are most vulnerable to acquiring HIV are already highly policed and at risk for violence” said Naina Khanna, co-executive director of Positive Women’s Network-USA, a US-based membership organisation led by women and people of transgender experience living with HIV. “In more than 30 states in the US alone, and over 100 countries around the world, people with HIV can be criminalised on the basis of their health condition. Taking this kind of data from people without their consent or knowledge and storing or sharing it without adequate protections is extremely risky and could come at the cost of someone’s personal safety, their livelihood, and in the case of HIV criminalisation, their freedom.”

The paper highlights how HIV experts and advocates have raised a range of human rights concerns about this technology. These include: 

  • Consent and autonomy; 
  • Lack of community consultation; 
  • Increased stigma on targeted communities; 
  • Privacy and data protections; 
  • Whether or not the technology can be used to “prove” direct transmission; and,
  •  How MHS may intensify HIV criminalisation within communities who are already marginalised and oppressed.

Edwin J Bernard, Executive Director of the HIV Justice Network and global co-ordinator of the HIV JUSTICE WORLDWIDE coalition added: “MHS treats people living with HIV as ‘clusters’ and targets of public health interventions, rather than the beneficiaries of public health. When you combine MHS with HIV criminalisation it’s a perfect storm. That’s why I commissioned PWN-USA to produce this briefing paper as a first step to understand the problems and to suggest a range of possible solutions. With increased knowledge on the practices of MHS, individuals and organisations can be better equipped to advocate for ending research and surveillance practices that have the potential to harm the rights, autonomy, and well-being of people living with HIV.”

The paper provides wide-ranging recommendations for change aimed at various stakeholders, highlighting five key areas of action:

  1.   Take seriously and act upon community concerns about MHS.
  2.   Respect the bodily autonomy and integrity of people living with HIV in all our diversity.
  3.   MHS implementers must demonstrate a clear public health benefit that outweighs the potential harms of MHS, including by ensuring protections (i.e., data privacy, legal protections, social harms prevention, etc). These demonstrated benefits of MHS must measurably include people living with HIV.
  4.   Providers ordering HIV sequencing must inform people living with HIV about how their blood and data are being used for MHS purposes and be allowed to withdraw the consent if they so wish, without fear of negative consequences to their HIV treatment and care.
  5.   Implementers of MHS should publicly advocate against punitive or coercive laws and policies aimed at people living with HIV and ensure that MHS is never used in criminal, civil, or immigration investigations or prosecutions.

The paper is available to download now in English at https://www.hivjusticeworldwide.org/en/mhs/ 

It will be available soon in French, Russian and Spanish. 

Watch the launch video below:

Follow the online conversation on Twitter by using the hashtags #EndMHS #DataPrivacy #DataProtection #HIVJustice and by following @HIVJusticeNet @uspwn

We gratefully acknowledge the financial contribution of the Robert Carr Fund to this report.

*MHS Expert Advisory Group

  • Naina Khanna & Breanna Diaz, Positive Women’s Network-USA
  • Edwin J. Bernard, HIV Justice Network
  • Marco Castro-Bojorquez, HIV Racial Justice Now (in memoriam)
  • Brian Minalga, Legacy Project
  • Andrew Spieldenner, US People Living with HIV Caucus
  • Sean Strub, Sero Project

Report: End HIV criminalisation to address LGBT+ inequities

A new report published by the Global Equality Caucus examines what elected officials can do to ensure LGBT+ people receive equitable access to HIV healthcare.

The report titled Breaking barriers in HIV: Action for legislators to address LGBT+ inequities, includes ten recommendations for legislators and others to take forward, including repealing or modernising outdated HIV criminalisation laws, and doing more to safeguard health data privacy.

The report notes that HIV criminalisation laws are “out of step with modern scientific understanding and perpetuate outdated HIV stigmas.” Removing such laws would help to tackle prejudice and refocus HIV as a public health crisis.

Also relevant to our ongoing work on molecular HIV surveillance, the report further recommends that where data is collected, anonymity should always be assured, and “this applies to HIV testing, immigration status, or whatever other circumstances that may place LGBT+ people in danger should their health data be shared with other government authorities.”

Parliamentarians have a responsibility to ensure government departments respect the privacy of citizens and that health data is not being shared with agencies that could present additional barriers to the lives of LGBT+ people, such as immigration authorities or justice departments.

Singapore: Do HIV Non-Disclosure Laws in Singapore Still Make Sense Today?

by Daniel Ho, Rayner Tan and Daryl Yang

It has been almost forty years since the human immunodeficiency virus (HIV) was first discovered in 1983. HIV is the virus that leads to acquired immune deficiency syndrome (AIDS), which is also commonly known as late-stage HIV.

While HIV was viewed as a death sentence at the beginning of the pandemic decades ago, the picture today is a far cry from that. Thanks to medical advances, HIV is now understood and treated as a chronic disease. Individuals living with HIV who receive treatment enjoy the same life expectancies compared to people without HIV.

Furthermore, individuals who have achieved viral suppression as a result of medication cannot transmit HIV sexually. Three recent, large observational cohort studies produced zero cases of transmission in spite of approximately 125,000 unprotected sex acts between couples of differing HIV status, without the use of any HIV prevention methods like condoms or HIV pre-exposure prophylaxis.

Viral suppression is often also known as achieving an ‘undetectable’ viral load, and these two terms are used interchangeably. Viral loads are ‘undetectable’ because the equipment used to ‘count’ such viral loads does not detect the virus’s presence below specific thresholds.

The origins of HIV non-disclosure laws in Singapore

Like the ongoing COVID-19 pandemic, the early years of HIV were characterised by fear and panic due to a lack of information on how the virus would spread between individuals.

As a result, heavy-handed and sweeping legal reforms were undertaken to keep Singaporeans safe from the virus.

In 1992, the Infectious Diseases Act was amended to ban people living with HIV from engaging in sexual activity unless they have informed their sexual partner of the risk of contracting HIV/AIDS from them and that sexual partner has voluntarily agreed to accept that risk.

In 1998, non-Singaporeans living with HIV were prohibited from entering Singapore, regardless of their immigration status.

However, while the ban on foreigners with HIV was partially lifted in 2015 to allow short-term visitors, laws criminalizing HIV non-disclosure have not only remained in the books but were expanded in scope and severity.

In 2008, Parliament amended the law such that anyone who has “reason to believe” that he has or “has been exposed to a significant risk” of contracting HIV/AIDS must also disclose to his sexual partners the risk of contracting HIV/AIDS from him.

Alternatively, suppose he chooses not to disclose such risk. In that case, he must have either tested negative for HIV or take reasonable precautions to ensure that he does not expose his sexual partner to the risk of contracting HIV.

The punishment for failing to do so was also increased five-fold with a fine of up to S$50,000 or 10 years’ imprisonment.

HIV non-disclosure laws are counterproductive to public health

While these laws were passed to protect you from HIV, scientists working in the field of HIV would confidently tell you that they are more likely to exacerbate the spread of HIV today.

A global expert panel of more than 20 HIV scientists and experts was convened in 2018 to publish a consensus statement on the science of HIV in the context of criminal law and called for “legal and judicial systems to pay close attention to the significant advances in HIV science that have occurred over the last three decades to ensure current scientific knowledge informs application of the law in cases related to HIV”.

This is because such laws are ineffective and create a false sense of security and perpetuate stigma and discrimination, which can deter many from getting tested or seeking treatment for HIV.

When HIV non-disclosure was criminalised in 1992, then Minister for Health Yeo Cheow Tong said that this was meant to address the “irresponsible and dangerous behaviour” of HIV-positive individuals.

Subsequently, when expanding the offence to those at significant risk of contracting HIV, then Minister for Health Khaw Boon Wan explained that these laws are necessary because “for every known HIV case, there could be another one to two cases who are infected but remain undiagnosed until the symptoms appear”.

While Khaw is correct that a key problem with ending the HIV epidemic in Singapore is late diagnosis, these laws do not encourage people to get tested regularly. Instead, they create a climate of fear, stigma and shame around HIV.

The existence of these laws runs contrary to the Ministry of Health’s own strategy of “destigmatising HIV infection and getting more people at-risk to come forward to get tested”.

Living with HIV non-disclosure laws

Yes I know who I got it from. After that I actually got tested and then I Informed some of my friends, who then agreed to go to Bangkok with me, because I didn’t want to get registered in Singapore. But after a year or so I decided to come back to Singapore to seek treatment because it was… Very troublesome for me to go back and forth.” 

Apart from disincentivising linkage to the healthcare system, as explained by a participant above from a past study on living with HIV, such laws possibly maintain stigma and discrimination of already vulnerable communities of people living with HIV.

Because of this legal obligation to disclose the risk of contracting HIV to sexual partners, people living with HIV live in fear of having their HIV-positive statuses “outed” to others who may know them in various capacities, be it their employers, friends, family, or other loved ones.

The pain of rejection is very real. The fear of alienation from others may also implicate not just people living with HIV but also those who might avoid going for sexual health testing for fear of finding out that they may be HIV-positive.

This is also exacerbated by the fact that there is no legal protection for people living with HIV from discrimination, nor is there any law prohibiting their sexual partners from disclosing their HIV status to third parties.

Beyond its direct impact on the fear of having their statuses disclosed, what we know about stigma, and in particular concealed stigma (not visible or immediately obvious, such as hidden disabilities, being a sexual minority or having a mental illness) is that it places considerable psychological stress on the individual.

Living with concealed stigma

Given the ever-looming threat of discovery and possible alienation, people living with HIV may report a sense of shame and demoralisation, particularly in instances where the threat of discovery is higher or more salient, such as during job interviews or health screenings.

For example, during Chinese New Year when we are having a steamboat. You know right, after my first round of helpings, I will not use the same utensils. Or even, even during meals, I  wouldn’t use… unless they are scraps… or there are tongs or whatever. If not, then I usually will not help myself to a second round of food.”

As shared by another participant above, people living with concealed stigma may also find themselves being on a near-constant vigilance toward their interactions with others and even those who already know about their status, as a result of shame and self-stigma.

Other implications may also involve the preoccupation of having to ‘keep a secret’ due to the risks of disclosure, adding to the cognitive burden that these individuals face in their daily interactions with others.

Coupled with feelings of shame and demoralisation, the fear that people they know may shun them because of their HIV status may affect their overall behaviour. It can also lead to increased social isolation, impaired relational functioning, and excessive impression management.

These challenges stemming from stigma and discrimination may further heighten the sense of despair and exclusion that people living with HIV experience as vulnerable members of society.

What will happen without HIV non-disclosure laws?

We now know that removing HIV non-disclosure laws will help us reduce stigma and get more people to access the care they need. But what happens without such laws? Are we at greater risk of contracting HIV from someone who is living with HIV?

No, we are not, and here are three reasons why.

First, there is no evidence that such laws actually reduce HIV transmission (in fact, the opposite is more likely to be true). Furthermore, the burden of sexual health should not fall only on one party in sexual partnerships.

The removal of this law also ensures that we do not remain complacent around one’s risk of acquiring sexually transmitted infections in general and will create opportunities for more equitable, comprehensive sexual health education.

Second, it is a fact that a majority of people in Singapore who are living with HIV cannot transmit HIV sexually. The Ministry of Health has estimated that in 2018, 80% of individuals living with HIV in Singapore knew about their own status, of whom 91% had initiated treatment, and 91% of those who initiated treatment had achieved viral suppression or an undetectable viral load.

This means that based on the science of viral suppression, an estimated 66% of all people living with HIV in Singapore cannot transmit HIV through sex. While the risk will always remain at the individual level, removing such laws will get more people tested for HIV, lead to an increase in the proportion of people who start treatment, get virally suppressed, and therefore cannot transmit HIV through sex at a population level.

Third, even if someone had intentionally or recklessly put you at risk of HIV, HIV non-disclosure laws are unnecessary because existing criminal legislation already addresses this.

For example, Section 376H of the Penal Code criminalizes deception or false representation in the context of being a carrier of a sexually transmitted disease, which includes HIV. Still, it does not single out HIV as uniquely or more dangerous than other diseases.

Law enforcement may also arguably prosecute the intentional transmission of HIV as a form of grievous hurt by “means of any substance which it is harmful to the human body to… receive into the blood” under Section 326 of the Penal Code.

Ending AIDS and onward transmission of HIV by 2030

The Joint Declaration of the United Nations on HIV/AIDS (UNAIDS) adopts the ‘90-90-90’ goal, also known as the ‘HIV treatment cascade’, to track countries’ progress in the fight against HIV and AIDS.

The first 90 refers to having 90% of people living with HIV know their status, the second 90 refers to having 90% of those who know their status initiating medication, and the third 90 refers to having 90% of those on medication who have achieved viral suppression.

Earlier, we shared that Singapore’s cascade in 2018 was estimated to be 80-91-91.

Repealing laws that criminalize HIV non-disclosure will help end the present climate of fear and stigma around HIV and encourage more people to get tested for HIV and start treatment. The impact on HIV transmission would be immense.

For example, improving our estimates from 80-91-91 to 90-91-91 would mean 74.5% of people living with HIV not being able to transmit HIV sexually, up from 66%, as shared earlier. The reduced number of HIV cases would be beneficial for society without any adverse knock-on effects.

The impact on the quality of life among people living with HIV would also be significant. Reducing stigma associated with HIV will empower individuals to lead full, productive lives. HIV can finally be treated socially—as it has clinically—like any other chronic disease.

Community groups in Singapore, alongside UNAIDS, have called for the end of AIDS and onward transmission of HIV by the year 2030. We are getting close to that goal, but such laws remain a hurdle. Guided by medical advancements and public health research, it is time to repeal HIV non-disclosure laws so that they may no longer hinder Singapore’s efforts to end the HIV epidemic.

[Feature] It Takes More Than A Village to End HIV Criminalisation

The proverb says, “It takes a village to raise a child”. But what if a mother in the village is living with HIV, and some of the villagers stigmatise her? What if that stigma creates a situation where the mother living with HIV is unjustly criminalised because of her HIV status? Then it takes more than a village to get justice for that woman. It takes a global movement to end HIV criminalisation to sensitise and train lawyers and expert witnesses.  It takes national communities of women living with HIV to support that woman following her release, and to educate the community in which she lives about HIV.

Introduction

In 2016, a Malawi court convicted a woman living with HIV of “negligently and recklessly doing an act likely to spread the infection of any disease which is dangerous to life” under section 192 of the Malawi Penal Code. She had attended a village meeting with her baby which she breastfed as usual before passing the child to her grandmother. Another woman then asked her to hold her baby. It was alleged that this child began breastfeeding briefly before the woman realised what was happening. The child’s mother then reported the incident to the police. The woman was arrested and without legal advice or representation, pleaded guilty, was convicted, and sentenced to nine months’ imprisonment with hard labour.

The circumstances of the case are all the more shocking because women living with HIV are encouraged to breastfeed in Malawi (and in other countries with high HIV prevalence and settings in which diarrhoea, pneumonia and undernutrition are common causes of infant and child deaths) and because HIV-related prosecutions involving breastfeeding are exceedingly rare. Unfortunately, we have seen an increase in the number of such cases since 2016. HJN is working to address this in a number of ways because we believe there should never be prosecutions of women living with HIV for breastfeeding.

In addition, the accused woman was taking antiretroviral therapy. The chances of HIV transmission through even long-term breastfeeding are very low (which is why WHO guidelines recommend it when access to infant formula and clean water are limited) and the chances of transmission during the brief period the baby allegedly fed were infinitesimally small. In fact, the accused woman’s own child, who was routinely breastfed, has not acquired HIV, calling into question any suggestion that she intended to cause harm to the other woman’s child. Perversely, for a system that unjustly condemned her for risking harm to the other woman’s child, her own baby was imprisoned with her, without any arrangements for appropriate feeding and care, negating any notion that the legal system’s purpose was to protect children.

Following media reports of her initial conviction, numerous individuals and organisations – including HJN and our HIV JUSTICE WORLDWIDE partners, ARASA and SALC – became involved in the case, ultimately changing the outcome for the woman and her family, and laying the groundwork for further anti-HIV stigma advocacy and education in the region. Her story demonstrates the vital role that education, training, strong networks, and community play in the pursuit of HIV justice.

Living with HIV-related stigma

When interviewed at her home in 2019, the woman referred to as “EL” talked about her life:[1]

[1] The initials EL are used instead of her full name following a court order of anonymity to protect her privacy. The interview took place in 2019, during the village visit described later in this article.

“As kids, there were the two of us — me and my brother. My parents faced challenges raising us. Finding the basic necessities like soap and food was a tall order, let alone talking about going to school. It was difficult to get learning materials as well as proper clothes to wear at school. I worked hard in class but couldn’t get past Standard 5 at primary school. Eventually I dropped out, and my brother did the same, … My daily life was taken up doing house chores just like any other girl in the village, as well as helping my parents with farming. At 16, I got married.”

EL further described how she was diagnosed HIV-positive in 2015 after a de facto compulsory HIV test at an antenatal visit. She already had two children and was pregnant with her third. She had heard about HIV but did not know much about it. EL said that the healthcare workers provided a lot of assistance, giving her accurate information about HIV, including the importance of adhering to her antiretroviral treatment (ARVs).

EL and two of her children. Photo: Amos Gumulira/UNDP Malawi

EL said that she generally enjoyed life in her village, although at times she was subject to stigma and discrimination:

“When I went to fetch water at the community borehole, people would laugh at me, and whenever I wanted to participate in community work, you would find pockets of community members talking ill about me. Some people used to insult me, calling me names. But I persevered because my relatives, including the Village Headman himself, gave me support and always stood by my side.”

Members of EL’s family also faced discrimination. “Due to lack of information, a lot of people thought HIV was hereditary and because I was diagnosed HIV-positive, this meant that all my family members had HIV, and they were discriminated against,” EL said.

EL wonders if more could have been done to help her fight stigma. In particular, EL gained a lot of knowledge about HIV from the counselling she got when diagnosed, but perhaps she could have been better equipped with information to share with people in her community:

“A lot of people don’t know that if you adhere to ARVs, you reduce the risk of transmitting HIV to others. This information needs to be passed on to many people. There are also other issues to do with ARVs. A lot of people don’t have adequate information on the effects of ARVs and at the end of the day, they start pointing fingers at each other, giving people room to start speculating about issues to do with witchcraft.”

EL’s prosecution had repercussions for her whole village. One woman from the community explained:

“I was there and very close to where EL was sitting. Yes, she was carrying another woman’s child. This other woman had given the child to EL for safe keeping while she went to stand in a queue, but honestly speaking, I didn’t see EL breastfeed the child. I just heard some people who were sitting a distance from where we were sitting, as they started pointing accusing fingers at her.”

She said that things moved so fast that before they could think of anything to stop what she called “the rumour.” It had gotten out of hand and people started saying that EL had intentionally breastfed the child to transmit HIV.

After receiving a summons, EL voluntarily turned herself in at the police station. She was accompanied by the Village Headman (her grandfather) who wanted first-hand information about what crime she was alleged to have committed. That same day, police transferred EL to a larger town, where she was remanded for three days. At the age of 29, this was the first time that EL had ever left her village.

Days later, she appeared in court and the charge sheet was read out. EL recounted that she had not understood what was happening and could not make arguments because she had no legal representation. EL agreed with the summary of events as they were described, so she was found guilty and was imprisoned together with her youngest child.

She described life in prison as “hell”:

“After a week, my brother showed up to give me my ARVs. All this talk about a woman with HIV breastfeeding. I breastfed but I also found it tough to feed my baby while in prison because there was no provision of special food for babies. We were eating nandolo (pigeon peas) almost every day with Msima ya Mgaiwa (maize meal). And there was only one toilet for a cell of more than 50 people.”

After some time, relatives and other members of her community started visiting, giving her money she could use to buy soap and food for her baby. “When we heard from our Village Headman that she had been arrested, we were so devastated”, a woman from EL’s village explained. “We raised funds for some members to go and give her support only to learn that she had been transferred to one town, then another, but some of us did manage on several occasions to visit her and offer our support when she was in prison.”

Then, out of the blue, EL received a message that some people had come looking for her. She went to meet them: a lawyer, Wesley Mwafulirwa, and his paralegal. They explained why they were there and asked if she would like them to appeal on her behalf. She accepted enthusiastically. “I was excited but at the same time I was confused because I could not believe that I could be so lucky to have these people come to help me.”

Fighting the charges

Solicitor Wesley Mwafulirwa had volunteered to attend training to address legal barriers to prison health and human rights presented by the Southern African Litigation Centre (SALC). He travelled from Malawi to South Africa to attend the training which addressed useful regional and international mechanisms, and presented insights about legal practice and strategic litigation to support prison health and human rights, particularly for those facing heightened vulnerability to HIV and TB.

Wesley Mwafulirwa Photo: Amos Gumulira/UNDP Malawi

At the training, two lawyers spoke about their pro bono work. Wesley remembers one of them, Allan Maleche (Executive Director of KELIN), saying that each participant should take at least one case when they go back to their country. It was a turning point in Wesley’s career.

He had not been home long when he saw an article in the newspaper about an HIV-positive person convicted for trying to spread HIV. That person was EL.

Wesley, who lives in a small town in northern Malawi, drove for more than ten hours to get to the jail where EL was incarcerated. He explained his determination, saying “I was so fired up! I’d just come from SALC’s training … and I said, ‘I want to take up this case’.”

Wesley interviewed EL and offered to take her case pro bono. Wesley contacted SALC, who offered technical support. Their first step was to get an order for anonymity to protect EL’s identity and gain greater control over media reporting. Next, they faced an ethical question. They wanted to challenge the constitutionality of the law but that would take a long time. Because EL was in prison, they decided to undertake a criminal appeal instead. They applied for EL to be let out of custody on bail pending appeal. This is usually a difficult application to win, but they were successful and EL was released from prison.

In the appeal, the court was asked to consider whether the conviction could be justified, whether the penal provision was constitutional (arguing it was overly broad and vague), and whether the sentence was manifestly unjust. Wesley used his learnings from the SALC training to raise international principles and instruments relating to sentencing, which the court referenced and upheld. Michaela Clayton, then Executive Director of the AIDS and Rights Alliance for southern Africa (ARASA), and now a member of HJN’s Supervisory Board, provided expert testimony. Another expert witness, Dr Ruth Brand, identified through HJN’s global network, gave expert scientific evidence to show the risk of HIV transmission had been “infinitesimally small.”

The case was heard by Honourable Justice Zione Ntaba, who held that the proceedings in the trial court were irregular and “blatantly bias” against EL, compromising her right to a fair trial. Justice Ntaba found the charge sheet had been defective and therefore EL’s plea should not have been recorded as guilty. She noted the law must be sensitive to the accused’s knowledge or belief (or lack of) that HIV would be transmitted. Justice Ntaba decided the conviction could not be justified, acknowledging human rights principles against the overly broad criminalisation of HIV non-disclosure, exposure, or transmission. EL’s sentence was set aside. (The Constitutional challenge was referred to a full-member panel of the Constitutional Court although the case was not pursued.)

Notably, Justice Ntaba was a member of the African Regional Judges Forum to discuss HIV, TB and Human Rights (a process which is owned and planned by the judges and run with support from UNDP and funding from the Global Fund).

Fighting the stigma

Shortly after EL’s arrest, the Coalition of Women and Girls Living with HIV and AIDS in Malawi (COWLHA) and the Malawi branch of the International Community of Women Living with HIV/AIDS (ICW-Malawi) discussed the case at a roundtable meeting. At first, everyone was surprised and even laughed, questioning how she could have breastfed someone else’s child. They had never heard of a criminal case involving infant feeding and did not understand what they were dealing with.

During their discussions, COWLHA and ICW-Malawi agreed that the prosecution of EL was a manifestation of stigma and misinformation about HIV in the community. They learned more about the unjust measures that EL had experienced, like being imprisoned without being given a chance to be heard and not being given the chance to prepare and take her medication and things she needed to care for her child. COWLHA and ICW decided to get involved.

Representatives from COWLHA and ICW meet with members of EL’s village. Photo: COWLHA/ICW

Concerned that EL could face social and community hostility after her release, COWHLA and ICW planned a visit to the village to provide psychosocial support to EL and to work with traditional community leaders to provide community sensitisation on HIV, addressing issues of stigma and discrimination. Their efforts helped change some community members’ ideas about HIV.

The community formed two support groups— one for youth and another for adults (notably both were predominantly female groups). They have conducted numerous activities, including home visits, supporting children to go to school, helping the elderly with house chores, and they have a garden where they grow vegetables and rice. They hoped to access loans to become self-reliant. They also had a list of issues they wanted to learn more about, including preventing mother-to-child transmission, sexual and reproductive health, positive living, stigma and discrimination, and treatment literacy.

Visiting EL at home

In September 2019, a three-member team comprising Edna Tembo (Executive Director of COWLHA), Charity Mkona (ICW Board Chair), and Peter Gwazayani (media consultant), set out for EL’s village.

The team was welcomed by the Group Village Headman, who took them to EL’s house. EL recognised Edna from the work COWLHA and ICW-Malawi had done in the community previously. EL welcomed the team with a big smile.

EL and her husband looked cheerful as they laid a mat on the veranda of their house for the visitors. Her mother later joined the discussion.

EL was interested to learn that HJN wanted to write about her case and the type of interventions that had been helpful, to share the story with advocates for HIV justice around the world.

EL recounted that when she returned to the village, “most members of my community received me with happiness, particularly my relatives. The day I arrived, they were jubilant. They celebrated with songs that we normally sing during special occasions in the village.”

COWLHA ED Edna Tembo and Charity Mkona of ICW chat with EL, her husband and her mother (at far distance). Photo: COWLHA/ICW

EL lives with her husband, five children and her mother in a compound made up of three grass thatched houses. She introduced her children:

“The oldest is 13 and she goes to school, as do the second and third. The fourth, a little girl, is the child I was with in prison. She has not yet started school. And then there is this one, who I am breastfeeding. She is the fifth one. She has been tested for HIV on two occasions and will be going for the last test soon. The other two tests have come back HIV-negative.”

EL’s accuser and her family still lives in the same village which has presented some difficulties. EL said that on several occasions she had tried to greet them when they passed each other, but she had been ignored. “They don’t talk to me but from deep down in my heart, I have no grudges against them,” EL said.  “I am just living my normal life,” EL says, although now she says that she would never agree to carry anybody else’s child, for any reason.

Moving beyond criminalisation

With respect to the community-level interventions, lawyer Annabel Raw, who worked at SALC during the time they supported the EL case said:

“As lawyers, we would never have thought to consider such an intervention had ICW-Malawi and COWLHA not shared their insights and been willing to support the client and her community. Their work has been so important to ensuring that meaningful justice was done to combat the actual root cause of the prosecution — stigma and discrimination — and to reconcile EL with her community.”

Engaging with the community also influenced ICW-Malawi and COWLHA’s thinking about HIV criminalisation. COWLHA’s Edna Tembo noted that:

Supporting people who have been prosecuted, particularly women, gives them power, … However, it is very important to stress that psychological support is absolutely vital for those who have been prosecuted. That includes family support, and a supportive community environment enabling acceptance of an individual accused.”

Tembo was also quick to emphasise that there is more work to be done. That work includes awareness raising and ongoing support to the community, especially to identify and train volunteers, empowering them to provide services at community level and to link them to health facilities and district offices for continued support and mentorship.

EL carries her youngest child home. Photo: Amos Gumulira/UNDP Malawi

EL described her dreams for the future:

“My wish now is to see my children progress in school so that they become productive citizens in this community and help it grow. That’s my dream. If they get educated, they will be able to stand on their own and support others. My husband is not employed and it is a challenge to get money for school fees for our children. We would love to get a loan or training to have greater knowledge of economic empowerment because we want to be self-reliant. We would then love to lease some land to grow rice to sell to pay back the loan.

“It’s also my wish to see the lives of all people in the community uplifted. We farm but on a small-scale. If we were to be supported with funds, I’d love to see the community establish big rice farms, working in groups, harvesting for consumption and for sale. In so doing, we would be able to uplift our lives for the better.”

Further Information

Learn more about Wesley’s experiences in EL’s case here and here.

Learn more about the African Regional Judges Forum here.

The full High Court judgement is available here, with a summary included here.

Read more about the successful HIV and AIDS Management Act community advocacy here.


This article is based on information provided by ICW-Malawi and COWLHA following their visits to EL’s village, and an interview with Wesley Mwafulirwa published by UNDP. HJN provided financial and logistical support for the village visits thanks to a grant provided to the HIV Justice Global Consortium from the Robert Carr Fund for civil society networks.     

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

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

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

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

No chance of acquittal

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

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

Word and deed

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

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

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

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

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

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

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

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

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

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

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

Fear of confession

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

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

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

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

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

“Contagious” Article

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

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

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

Myths

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

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


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

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

Без шанса на оправдание

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

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

Слова и дело

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

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

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

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

Срок за графин

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

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

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

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

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

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

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

Боязнь признаться

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

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

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

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

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

«Заразная» статья

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

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

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

Мифы

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

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

 

 

Colombia: Constitutional court condemns restaurant for not hiring a young man with HIV

The Constitutional Court condemned a well-known restaurant chain in the country for having discriminated against a citizen who applied for a job within said chain.  It stopped the hiring process when it found out that the man was HIV positive. Due to this situation, the Court urged the Ministry of Labor to promptly address complaints in job selection processes for discrimination and establish guidelines for employers.According to the Constitutional Court In Judgment T-031/21, the young man whose identity was protected as a protection measure, filed a reference guardianship on October 22, 2019 by the First Civil Municipal Court of Cali, considering that he was a victim of discrimination by of ‘Mr. Wok ‘, because of being HIV positive, diagnosed since 2016 as an asymptomatic carrier.

According to the young man, the company did not take into account his cognitive ability, academic training and work experience, only his pathology. The Court ruled in favour of the young man and pointed out that they found irregularities in the actions of the IPS and the company.

The Court ruled in favour of the young man and noted that it found irregularities in the actions of the IPS and the company. Regarding the former, it noted that “it evaded the constitutional and legal guidelines that govern it and failed to comply with the duties that frame the ethical conduct of its activity by revealing confidential information related to the applicant’s serological status”.

On the other hand, the restaurant ignored the limits that demarcate the principles of the autonomy of private will and freedom of enterprise, in accordance with the general rules governing due process in relations between private individuals, in the context of a labour selection process”.

The case will now be brought to the attention of the National Superintendence of Health so that it can establish the respective sanction.


Corte condena a restaurante por no contratar a un joven portador de VIH

La Corte Constitucional condenó a una reconocida cadena de restaurantes del país por haber discriminado a un ciudadano que aplicó a un puesto de trabajo dentro de dicha cadena, la cual detuvo el proceso de contratación al conocer que el hombre era VIH positivo.

Por esta situación la Corte exhortó al Ministerio del Trabajo para que atienda oportunamente las quejas en procesos de selección laboral por discriminación y establezca lineamientos para los empleadores.

Según lo relató la Corte Constitucional en la Sentencia T-031/21, el joven al que protegieron su identidad como medida de protección, interpuso una tutela de referencia el 22 de octubre de 2019 por el Juzgado Primero Civil Municipal de Cali, al considerar que fue víctima de discriminación por parte de ‘Sr. Wok’, a causa de ser VIH positivo, diagnosticado desde 2016 como portador asintomático.

Según el joven, la empresa, no tuvo en cuenta su capacidad cognitiva, formación académica y experiencia laboral, únicamente su patología.

La Corte falló a favor del joven y señaló que encontró irregularidades en el accionar de la IPS y de la empresa. Sobre la primera señaló que “evadió los lineamientos constitucionales y legales que la rigen e incumplió los deberes que enmarcan la conducta ética de su actividad al revelar información confidencial relacionada con el estado serológico del accionante”.

Por otro lado, el restaurante desconoció los límites que demarcan los principios de la autonomía de la voluntad privada y la libertad de empresa, de conformidad con las reglas generales que rigen el debido proceso en las relaciones entre particulares, en el contexto de un proceso de selección laboral”.

El caso, ahora será puesto en conocimiento de la Superintendencia Nacional de Salud para que esta establezca la sanción respectiva.

September 14 is Sex Worker Pride!

HJN stands in solidarity with sex workers and asks everyone to support the upcoming Sex Worker Pride Day (September 14) that aims to increase the visibility of sex workers and their activism.

Sex Worker Pride is an opportunity to celebrate and share stories of sex workers’ self-determination and the achievements of the sex worker rights movement, according to the Global Network of Sex Work Projects (NSWP) which began the day in 2019. NSWP upholds the voice of sex workers globally and connects regional networks advocating for the rights of female, male, and transgender sex workers.

NSWP states that Sex Worker Pride “extends to all marginalised by criminalisation, discrimination, and stigma across the sex worker movement and celebrates the diversity within our community during International Sex Worker Pride.”

Edwin J Bernard, HJN’s Executive Director says: “We stand in solidarity with all sex workers. Sex work is work. We oppose all forms of criminalisation and other legal oppression of sex work, including sex workers, clients, third parties, families, partners, and friends.”

Sex Worker Pride is one of four international sex worker rights days observed every year: 3rd March (International Sex Workers Rights Day), 2nd June (International Sex Workers Day), and 17th December (International Day to end violence against sex workers)

To show solidarity, please join the conversation and organising on social media using the hashtag #SexWorkerPride.

Argentina: Organisations call for Congress to start discussing new HIV, STIs and Hepatits bill

They demand that the HIV and STI bill be dealt with

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

The new proposal was presented on October 26, 2020. It is the third time it reaches Congress, and different organizations demand that it be debated.

The current HIV regulation (regulation 23.798) dates back to 1990. With the change of contexts and perspectives, it is understandable that it is now outdated and insufficient to guarantee rights.

To reverse this situation, the new bill on HIV, Hepatitis, Tuberculosis and STIs is waiting to be discussed in Congress. As already mentioned, the 24-page document was presented at the end of October and is the result of a network of 40 organizations.

With respect to the current regulation, it establishes a change of perspective: the 1990 regulation has a biomedical approach, while the current draft establishes a gender and human rights approach. It seeks to focus on the social determinants of health and the elimination of stigma.

“It is urgent the treatment because we have a law in force from 1990 that may not be a long time for other laws but for an issue such as HIV or other viral pathologies, taking into account the progress in recent years of science and social behavior in relation to these pathologies, it is necessary to update this purely biomedical character and move to a regulation that is a comprehensive response, with a Human Rights approach,” said Matías Muñoz, president of the Ciclo Positivo Association.

In relation to the previous point, the interviewee commented that although HIV is a virus that runs through people’s blood, it not only has consequences on physical health, but there is a social problem around HIV that is related to stigma and discrimination.

“Currently, a person with HIV has the possibility of accessing treatment free of charge, but there are other social barriers that prevent them from having a good quality of life, such as discrimination in access to employment, job discrimination, dismissal for having HIV, problems in the educational system or with the close environment,” said Muñoz.
Is this the first time that a proposal with these characteristics has been presented? No, the National Front for People’s Health had already worked together with organizations on this project, which entered Congress in 2018, but was shelved.

Following the previous paragraph, on December 1, 2019 it lost parliamentary status. But it was not the first time it happened, in 2016 the same thing happened, despite having favorable opinion of the Social Action and Public Health Committee of the Chamber of Deputies.

It is important to highlight the support that the proposal has from different political parties. We highlight that it bears the signature of 17 deputies of the Frente de Todos, UCR, Coalición Cívica, Pro, Frente de Izquierda y los Trabajadores and Partido Socialista.

Key points of the new bill
In its article 1, it declares of public and national interest -among other things- the medicines, vaccines, procedures and medical products for the prevention, diagnosis, treatment and cure of HIV, Viral Hepatitis, Tuberculosis and STIs.

In another of its points, it establishes the integral and intersectoral response, which guarantees, for example, education and sensitization of the population, access to truthful, sufficient and updated information, and the reduction of risks and damages of stigma, discrimination and criminalization towards people with HIV, Viral Hepatitis, Tuberculosis and STIs.

It also includes palliative care and rehabilitation of these pathologies, including associated, derived and concomitant pathologies, as well as the adverse effects derived from them and/or their treatments.

This project contemplates universal and free coverage. The agents of the public health service, social security and prepaid medicine entities are obliged to provide comprehensive assistance to people affected by HIV, Viral Hepatitis, Tuberculosis and STIs.

In a clear way, the Ciclo Positivo Association highlights, among other points, the following:

– Prohibition of HIV, Hepatitis, TB and STI tests to enter a job position, in pre-employment medical examinations.
– Non-contributory pensions for people with HIV and Hepatitis B or C who have unmet needs. Provision of treatment for those who acquired the virus through vertical transmission and for other key populations such as women, transgender people, transvestites and non-binary people, etc.
– Creation of a National Commission on HIV, Hepatitis, TB and STIs integrated by different ministries, scientific societies and civil society organizations working on the issue.
– Extension of the provision of formula milk up to 18 months (previously only up to 6 months) for babies born to positive mothers.
– Creation of the National Observatory of Stigma and Discrimination within the orbit of INADI, in order to prevent the use of HIV infection, Hepatitis B or C, TB or any STI to prevent the exercise of rights.

There are expectations around this third presentation, due to the wide support of the project and the diffusion generated in the social networks in the last weeks, in order to promote its treatment in the Congress.

On this point, the president of Ciclo Positivo, said that “with the stir that has been achieved in the social networks in the last few days, the deputy Pablo Yedlin, president of the Health and Social Action Commission, told us that he is pleased with the possibility of having an opinion in the next few weeks”.

Although such a step would be taken after the primary elections, the claim must be kept in force. “We understand that we have a project supported by all the blocks, and for that reason, we consider that we can achieve the approval this year”, Muñoz concluded.


Exigen que se trate el proyecto de Ley de VIH e ITS

La nueva propuesta fue presentada el 26 de octubre del 2020. Es la tercera vez que llega al Congreso, y diferentes organizaciones reclaman que sea debatida.

La reglamentación vigente (normativa 23.798) de VIH data del año 1990. Con el cambio de contextos y perspectivas, es entedible que ahora esté desactualizada y que sea insuficiente para garantizar derechos.

Para revertir esta situación, el nuevo proyecto de Ley de VIH, Hepatitis, Tuberculosis e ITS espera ser tratado el Congreso. Como ya mencionamos, el documento de 24 páginas se presentó a fines de octubre, y es resultado de una red de trabajo con 40 organizaciones.

Respecto a la normativa vigente, establece un cambio de perspectiva, la de 1990 tiene un enfoque biomédico, en cambio, el proyecto actual fija un enfoque de género y de derechos humanos. Busca poner foco en los determinantes sociales de la salud y la eliminación del estigma.

“Es urgente el tratamiento porque contamos con una ley vigente del año 1990 que puede que para otras leyes no sea mucho tiempo pero para una cuestión como el VIH u otras patologías virales, teniendo en cuenta el avance de estos últimos años de la ciencia y el comportamiento social en relación a estas patologías, es necesario actualizar este carácter puramente biomédico y pasar a una normativa que sea de respuesta integral, con un enfoque de Derechos Humanos”, dijo Matías Muñoz, presidente de la Asociación Ciclo Positivo.

En relación al punto anterior, el entrevistado comentó que si bien, el VIH es un virus que recorre la sangre de las personas, no solamente tiene consecuencias en la salud física, sino que existe una problemática social alrededor del VIH que está relacionada con el estigma y la discriminación.

“Actualmente, una persona con VIH tiene la posibilidad de acceder a su tratamiento de manera gratuita, sin embargo hay otras barreras sociales que impiden que tenga una buena calidad de vida, como puede ser la discriminación en el acceso al empleo, la discriminación laboral, despidos por tener VIH, problemas en el sistema educativa o con el entorno cercano”, comentó Muñoz.
¿Es la primera vez que se presenta una propuesta con estas características? No, el Frente Nacional por la Salud de las Personas ya había trabajado en conjunto con las organizaciones sobre este proyecto, que ingresó al Congreso en 2018, pero fue cajoneado.

Siguiendo el párrafo anterior, el 1 de diciembre de 2019 perdió estado parlamentario. Pero no fue la primera vez que pasó, en 2016 sucedió lo mismo, a pesar de tener dictamen favorable de la Comisión de Acción Social y Salud pública de la Cámara de Diputados.

Es importante destacar el apoyo que tiene la propuesta de diferentes partidos políticos. Resaltamos que lleva la firma de 17 diputados y diputadas del Frente de Todos, UCR, Coalición Cívica, Pro, Frente de Izquierda y los Trabajadores y Partido Socialista.

Puntos claves del nuevo proyecto
En su artículo 1º, declara de interés público y nacional- entre otras cosas- los medicamentos, vacunas, procedimientos y productos médicos para la prevención, diagnóstico, tratamiento y cura del VIH, las Hepatitis Virales, la Tuberculosis y las ITS.

En otro de sus puntos, se establece la respuesta integral e intersectorial, que garantiza, por ejemplo, la educación y sensibilización de la población, un acceso a la información veraz, suficiente y actualizada, y la reducción de riesgos y daños del estigma, la discriminación y la criminalización hacia las personas con VIH, Hepatitis Virales, Tuberculosis e ITS.

Además se comprenden los cuidados paliativos y la rehabilitación de estas patologías, incluyendo las asociadas, derivadas y concomitantes, así como los efectos adversos derivados de las mismas y/o de sus tratamientos.

Este proyecto contempla la cobertura universal y gratuita. Los agentes del servicio público de salud, las obras sociales y las entidades de medicina prepaga, están obligadas a brindar asistencia integral a las personas afectadas por el VIH, las Hepatitis Virales, la Tuberculosis y las ITS.

De manera clara, la Asociación Ciclo Positivo, destaca, entre otros puntos, a los siguientes:

– Prohibición del test de VIH, Hepatitis, TBC e ITS para ingresar a un puesto de trabajo, en los exámenes médicos preocupacionales.
– Pensiones no contributivas para aquellas personas con VIH y Hepatitis B o C que tengan necesidades insatisfechas. Provisión de tratamientos para quienes adquirieron el virus por transmisión vertical y para otras poblaciones clave como mujeres, personas trans, travestis y no binaries, etc.
– Creación de una Comisión Nacional de VIH, Hepatitis, TBC e ITS integrada por distintos ministerios, sociedades científicas y organizaciones de la sociedad civil que trabajen el tema.
– Extensión de la provisión de leche de fórmula hasta los 18 meses (antes llegaba sólo a los 6 meses) para bebés de madres positivas.
– Creación del Observatorio Nacional de Estigma y discriminación en la órbita del INADI, en la búsqueda de que no se pueda utilizar la infección por VIH, Hepatitits B o C, TBC o cualquier ITS para impedir el ejercicio de los derechos.

Hay expectativas en torno a esta tercera presentación, por el amplio apoyo que tiene el proyecto y por la difusión que se generó en las redes sociales en las últimas semanas, para impulsar su tratamiento en el Congrego.

Sobre este punto, el presidente de Ciclo Positivo, dijo que “con el revuelvo que se ha logrado en las redes sociales en los últimos días, el diputado Pablo Yedlin, presidente de la Comisión de Salud y Acción Social, nos dijo que ve con beneplácito la posibilidad de tener dictamen en las próximas semanas”.

Si bien, dicho paso se daría después de las elecciones primarias, hay que mantener el reclamo vigente. “Entendemos que tenemos un proyecto apoyado por todos los bloques, y por eso, consideramos que podemos lograr la media sanción este año”, concluyó Muñoz.

Colombia: Constitutional Court rules in favour of soldier living with HIV, reaffirming his constitutional rights

The battle an active soldier diagnosed with HIV won against the Army in Colombia

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

To protect his fundamental rights to social security, the Sixth Chamber of the Constitutional Court ruled in favor of an active soldier diagnosed with HIV.

In 2015, an active soldier was evaluated by the Military Health Directorate of the National Army through a Medical Labor Board, there, he was evaluated for “the possible decrease of psychophysical aptitudes” after an HIV diagnosis, but he was not guaranteed treatment or follow-up by the institution.

That is to say, the soldier has had to comply with his treatment and all that it entails, in a private manner.

The 2015 report “was incomplete”, since it did not assign a percentage of loss of working capacity.

Nor did it establish criteria to determine the progress of his infection or the subsequent deterioration of his clinical conditions, the Constitutional Court explained.

In the tutela filed by the uniformed officer, three years later the Directorate denied him the possibility of repeating that evaluation “to determine the levels of his work reduction due to suffering from other illnesses that were aggravated as a result of HIV.”

Decision of the Court

Following the decision, the Sixth Chamber of Review, with Judge Gloria Stella Ortiz Delgado presiding, reaffirmed that persons with HIV are entitled to special constitutional protection.

In the specific case, the Constitutional Court argued: “The assessment carried out by the DISAN EJC in 2015 was incomplete, lacked motivation and did not analyze the medical history of the plaintiff in a comprehensive manner”.

Therefore, the Constitutional Court ordered the formation of a new Labor Medical Board.
It also recalled the obligation to respond in a timely manner to the requests made in this type of proceedings, especially in the case of members of the Army. Finally, the DISAN EJC was warned about the duty to provide the medicines required for the treatment of HIV.

Thus, the Chamber protected the rights to social security and administrative due process of the professional soldier on active duty.

He had been denied the procedures to monitor his disease and provide him with the necessary treatment.

This decision of the Court sets a precedent for members not only of the Army, but of the public force in the country.


Para proteger sus derechos fundamentales a la seguridad social, la Sala Sexta de la Corte Constitucional falló a favor de un soldado activo, diagnosticado con VIH.

Noticias Colombia.

En el 2015 un soldado activo fue evaluado por la Dirección de Sanidad Militar del Ejército Nacional a través de una Junta Médico Laboral, allí, se le evaluó por “la posible disminución de las aptitudes psicofísicas” tras un diagnóstico de VIH, pero no se le garantizó tratamiento ni seguimiento en la institución.

Es decir, el militar ha tenido que cumplir su tratamiento y todo lo que conlleva, de manera particular.

El dictamen del 2015 “resultó incompleto”, ya que no asignó un porcentaje de pérdida de capacidad laboral.

Tampoco estableció criterios para determinar el progreso de su infección o el posterior deterioro de sus condiciones clínicas, explicó la Corte Constitucional.

En la tutela que interpuso el uniformado, tres años después la Dirección le negó la posibilidad de repetir esa evaluación “para determinar los niveles de su disminución laboral por padecer otras enfermedades que se agravaron por consecuencia del VIH”.

Decisión de la Corte

Tras la decisión, la Sala Sexta de Revisión, con ponencia de la magistrada Gloria Stella Ortiz Delgado, reafirmó que las personas con VIH son titulares de una especial protección constitucional.

En el caso concreto, la Corte Constitucional argumentó: “La valoración efectuada por la DISAN EJC en 2015 resultó incompleta, incurrió en falta de motivación y no analizó la historia clínica del accionante de forma integral”.

Por lo tanto, la Corte Constitucional ordenó conformar una nueva Junta Médico Laboral.
También, se recordó la obligación de responder oportunamente las solicitudes elevadas en este tipo de trámites, especialmente cuando se trate de miembros del Ejército.
Finalmente, se advirtió a la DISAN EJC sobre el deber de suministrar los medicamentos que se requieran para el tratamiento del VIH.

Así la Sala protegió los derechos a la seguridad social y al debido proceso administrativo del soldado profesional en servicio activo.

Se le habían negado los procedimientos para hacerle seguimiento a su enfermedad y brindarle el tratamiento necesario.

Esta decisión de la Corte sienta un precedente para miembros no solo del Ejército, sino de la fuerza pública en el país.