In the week following AIDS 2026 in Rio, seasoned HIV journalist Mia Malan asked in a Bhekisisa article what happens now that AIDS is no longer exceptional. After decades in which HIV commanded extraordinary political attention, scientific investment, activism and international funding, she wrote, the landscape has changed. Funding is shrinking, treatment has transformed HIV into a manageable condition for people with access to care, and the HIV response is increasingly expected to be integrated into broader health systems.
It is an important question. But from the perspective of HIV justice, I think there is another, more uncomfortable one: What happens now that HIV is no longer exceptional in global health, but it remains exceptional in law?
In the piece I wrote immediately after the conference for the Health and Human Rights Journal, I argued that the political environment surrounding HIV has become increasingly rights-threatening. The anti-rights movement is organised. It connects attacks on LGBTQ+ rights, gender equality, reproductive rights, migrants, civil society and science. Those of us defending rights too often continue to organise in silos.
And in my previous lead story for HIV Justice News, I argued that the next phase of HIV decriminalisation requires us to close the “translation gap”: the failure to translate four decades of advances in HIV science into law, policy and practice.
Now I think there is another piece of the puzzle. We need to ask whether HIV exceptionalism itself still makes sense.
There was a time when it clearly did. HIV was new, poorly understood and often fatal. Exceptional political attention and funding helped create the science, treatment and activism that transformed the epidemic. But the science has moved on. The law has not.
Slide from the Track F (Political science, laws, ethics, policies and human rights) rapporteur session at AIDS 2026
As of today, 83 countries continue to maintain HIV-specific criminal laws. But counting HIV-specific statutes substantially understates the reach of HIV criminalisation. Between 2013 and 2026, HJN’s Global HIV Criminalisation Database documented enforcement in 156 legal jurisdictions across 96 countries. Of these, 61 jurisdictions in 48 countries applied HIV-specific criminal laws, while 95 jurisdictions in 48 countries relied on general criminal offences such as assault, grievous bodily harm, attempted murder, and poisoning.
So even when an HIV-specific law is repealed, HIV exceptionalism may simply migrate into general criminal law.
There is another contradiction that deserves more attention. We continue to see, quite rightly, strong support for HIV-specific legislation that is primarily protective. Such laws can protect confidentiality, prohibit discrimination and guarantee access to prevention, testing and treatment. UNAIDS and others understandably celebrate progressive HIV legislation when it is adopted.
But many HIV omnibus laws combine those protections with punitive provisions. The same law can effectively say: we will protect you because you have HIV, and we will punish you because you have HIV. The problem, then, is not HIV-specific legislation per se. It is the continued assumption that HIV requires its own exceptional legal category, including a punitive one.
Nor is the problem confined to explicitly punitive HIV laws. Argentina provides an instructive example. Its 2022 HIV law, which replaced an old HIV-specific law following a decade-long advocacy campaign, was rightly praised for its human rights and public health approach. Yet it did not address HIV criminalisation, which continues today under general criminal law.
This leaves us with a difficult question: why do we need HIV-specific legislation to guarantee rights that should belong to everyone?
Why should access to healthcare depend on an HIV-specific law rather than universal access to healthcare?
Why should confidentiality of HIV status require special protection rather than comprehensive medical privacy?
Why should protection from discrimination depend upon being named in an HIV statute rather than comprehensive equality and anti-discrimination laws?
There were good reasons historically for HIV-specific legislation. Where governments failed to protect people living with HIV, activists had to demand specific protections. Specific laws could provide an important foothold for rights and accountability.
But perhaps we need to distinguish between using HIV exceptionalism as a strategy for securing rights and maintaining HIV exceptionalism as a permanent feature of law.
The latter increasingly makes little sense.
There is a cruel paradox here. Scientific progress has weakened the justification for HIV criminalisation at precisely the moment that declining political attention may make reform harder. This is why HIV decriminalisation remains important: it means ending a form of legal exceptionalism that has survived the scientific and public health exceptionalism that helped create it.
This is also why the HIV justice movement needs to think beyond HIV. If the anti-rights movement understands that attacks on different communities reinforce one another, we need to understand the connections too. HIV criminalisation is not an isolated legal problem. It sits alongside stigma, surveillance, discrimination, attacks on gender equality, shrinking civic space and the rejection of scientific evidence.
The response cannot simply be to preserve a special legal category for HIV. It should be to build systems in which everyone has access to healthcare, everyone has medical privacy, everyone is protected against discrimination, and criminal law does not single people out because of a health condition.
HIV advocacy helped establish many of those principles. Perhaps the next stage of HIV justice is to make those protections universal. That is not abandoning HIV justice. It is taking HIV justice to its logical conclusion.
If HIV is no longer exceptional in global health, it should not be exceptional in criminal law either.
“The evidence is overwhelming: criminalisation does not prevent HIV, it fuels it”
The scourge of LGBTQ criminalisation moving across African countries – and its impact on HIV
“The evidence is overwhelming: criminalisation does not prevent HIV – it fuels it,” Immaculate Owomugisha Bazare, Director of the Centre for Women Justice, Uganda, said in a plenary presentation at the 26th International AIDS Conference (AIDS 2026) held in Rio de Janeiro recently.
The conference had a prominent focus on how criminalisation – of identities, behaviours and HIV – impacts HIV outcomes. Research presented was mostly from sub-Saharan African countries, such as Uganda and Ghana, where criminalisation of LGBTQ people has been on the rise in recent years.
Grappling with multiple forms of criminalisation and funding cuts in Uganda
In 2023, Uganda passed the Anti-Homosexuality Act, a draconian bill aimed at criminalising LGBTQ people. This law was enacted in a context where sex work and drug use are already criminalised. “All these laws and policies continue to push people away from accessing services,” Bazare said.
Criminalisation of LGBTQ identities, behaviours such as drug use and sex work, and sex while living with HIV are intricately intertwined: key populations such as gay, bisexual and other men who have sex with men (MSM) and transgender women are at a much higher risk of contracting HIV, as are injecting drug users and sex workers. In turn, these groups can be criminalised for both how they acquired HIV and allegations of exposing others to HIV.
Bazare stated that these laws have a devastating effect on health-seeking behaviour. For a member of a key population, if any aspect of their identity is criminalised, it leads to a fear of stigma, discrimination and arrest. This results in delayed or total avoidance of HIV testing, prevention and treatment seeking. For example, if a gay man contracts HIV, any sex that he has after that is doubly criminalised: because of his identity and because he has HIV. This may be considered an act of ‘aggravated homosexuality’ according to the Ugandan Act – if the person’s sexual partner “contracts a terminal illness as a result of the sexual act.” While HIV was removed from the final wording of the Act, this clause can be left open to interpretation and likely is aimed specifically at HIV – regardless of scientific advances such as U=U – and may result in a death penalty.
The 2025 US funding freeze – which abruptly halted HIV services for key populations globally – has only added to the terror created by criminalisation in Uganda. Ruth Kikonyogo, from Save the Youth Uganda, presented research at the conference on mental health among a sample of 111 gay, bisexual and other men who have sex with men. Survey data were collected at two timepoints: after the Act was passed and after the funding freeze.
The percentage of participants reporting symptoms that matched moderate-severe depression rose by 13 percentage points, as did those reporting experiences of stigma. Exposure to violence went up by 12 percentage points, while anxiety symptoms went up by 11 percentage points and suicidal ideation by 9 percentage points. There were declines in access to both HIV services (by 14 percentage points) and psychosocial services (by 12 percentage points). Approximately 6% of the sample had fled Uganda after the Act was passed: this was reflected in the final sample size, as 142 men had initially taken the survey.
“Community-based HIV and psychosocial services serve as a critical protective factor for MSM, and their disruption magnifies the harm caused by hostile legal environments,” Kikonyogo concluded.
Ghana’s new anti-gay law
Research from other African countries showed that these negative impacts on mental health were not limited to Uganda. As Bazare put it: “The fire moves from Uganda to other countries. We’ve seen Ghana, we’ve seen Senegal now where we have specific laws that criminalise people but also criminalise HIV.”
Dr Akua Gyamerah presented research with gay and bisexual men, transgender women and gender-diverse people from Ghana, looking at whether antiretroviral therapy (ART) adherence was impacted by social stressors, such as criminalisation, through pathways such as depression, alcoholism and suicidality.
The ironically named Human Sexual Rights and Family Values Bill is considered the most restrictive anti-LGBTQ bill on the continent and was passed by Ghana’s parliament in May 2026. If signed into law by the president, John Mahama, it would criminalise LGBTQ identities, advocacy, gender-affirming care, allyship and any specific programming directed towards LGBTQ groups. As with other similar laws, it also encourages citizens to spy on each other and report any suspected homosexual behaviour.
Researchers created a scale to measure the frequency of social stressors linked to the anti-LGBTQ legislation. This included questions related to violence, arrests, discrimination and economic insecurity, for example: “Due to the anti-homosexuality bill/law in Ghana, I have been blackmailed or robbed.” ART non-adherence was measured as missing four consecutive doses at least once during the prior three months.
Among 256 participants with an average age of 31, approximately 40% identified as cisgender men, another 40% as transgender women and the remainder as gender diverse. Most of the sample reported their sexualities as gay, bisexual or queer. Monthly median income was low, at $100 for the sample.
Social stressors related to gender and sexuality were high: 68% had been asked about their sexuality, 31% had been blackmailed or robbed, while 17% had been threatened with death. Over a quarter of the sample did not report crimes because of fear of arrest (28%) and had been threatened with being reported to the police (27%). Just under 10% had been arrested. Overall, 23% stopped going to group programmes, such as health discussions for LGBTQ people, and 5% stopped seeking HIV services.
On average, the sample had been on ART for five years. Over the three months prior to the survey, 31% reported ART non-adherence. Over a quarter of the sample were at a significant risk of suicide (28%) and met the criteria for an alcohol use disorder (26%). On average, the sample displayed significant depressive symptoms.
While a direct association between criminalisation-related stressors and ART adherence was not significant, Gyamerah and colleagues found that greater social stressors were linked to higher depressive symptoms, alcohol use disorder and suicide risk. In particular, depressive symptoms were highlighted as a pathway through which social stressors impacted ART adherence.
“Proposed punitive legislation – not just laws – can undermine HIV treatment by increasing risk of mental health through exposure to social stressors,” Gyamerah concluded. “Structural harm is an HIV treatment issue. Protecting ART adherence requires affirming mental healthcare and opposition to structural criminalisation.”
Bazare summarised it as: “Laws and policies are not simply legal issues, they are public health issues, they are human rights issues, and they are gender equality issues.”
References
Bazare IO. Justice, rights and HIV: Building resilient legal frameworks. 26th International AIDS Conference, Rio de Janeiro, plenary session PL03, 2026.
Gyamerah A et al. Anti-LGBTQ+ legislation, mental health, and ART non-adherence among sexual minority men, trans women, and gender-diverse people living with HIV in Ghana: A mediation analysis. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3906LB, 2026.
Kikonyogo R et al. One shock after another! From the anti-gay law to unexpected HIV funding cut. A comparative assessment of mental health and suicidality by men who have sex with men during these two extremes in Uganda. 26th International AIDS Conference, Rio de Janeiro, abstract OAD3902, 2026.
AIDS 2026, the biennial global conference on all things HIV, closed on July 31 after a week of presentations on scientific advances (including twice-yearly lenacapavir and long-acting cabotegravir plus rilpivirine; advances in cure and vaccine research, with reports of sustained remission in the “Kansas City Patient”) and ongoing funding crises and key populations under threat, with anti-LGBTQ legislation in Uganda, Ghana, Senegal, and Côte d’Ivoire.
During the week, I attended more than a dozen sessions. As always, the most important conversations took place not only in formal sessions, but in the Global Village, in corridors, at community events, and over coffee. By the end of the week, I realised they all revolved around the same question: How do we build a movement capable of confronting an increasingly organised anti-rights agenda?
The question first crystallised for me during Wednesday’s session, Law, Power and Access: Overcoming barriers to HIV services. During the discussion I asked how we can overcome what increasingly feels like a successful “divide and rule” strategy. Across the world, the forces seeking to roll back human rights appear remarkably coordinated. They target communities already facing marginalisation—including people living with HIV, LGBTQ+ people, women, migrants, sex workers, and people who use drugs—as they always have. Reproductive rights, civil society, and scientific evidence are under fire as well, not as separate issues, but as part of a broader political project.
Meanwhile, those of us working to defend rights too often continue to organise ourselves in silos.
The same theme emerged again later that day during a conversation between Georgetown University’s Matthew Kavanagh and Mariângela Simão, who begins her role next week as the UN Special Rapporteur on the right to health. Simão spoke of the growing cohesion of anti-rights forces internationally, while Kavanagh posed what may be the defining question for the years ahead: what would it take to build an equally effective pro-rights force?
It struck me that this wasn’t simply another conference discussion; it was the thread connecting so many conversations throughout AIDS 2026.
The HIV movement knows better than most that progress has never come from science alone. Scientific breakthroughs have transformed HIV from a life-threatening diagnosis into a manageable condition and have given us extraordinary tools to prevent transmission. But while HIV itself may no longer be life-threatening for most people with access to treatment, the political environment has become increasingly rights-threatening. Evidence alone has never guaranteed equitable access, ended stigma or repealed punitive laws. Those achievements have always depended on organised communities, strategic advocacy, political leadership, and solidarity.
Throughout AIDS 2026 there were outstanding sessions on criminalisation, gender equality, community leadership, access to medicines, funding, and shrinking civic space. Each highlighted a different piece of the puzzle. Yet we still too often approach these as separate struggles, competing for scarce funding and political attention. Our opponents do not.
Anti-rights alliances reinforce each other
The anti-rights movement has spent decades building alliances across countries and political movements. It understands that attacks on LGBTQ+ rights, sexual and reproductive health and rights, gender equality, migrant rights, civil society, and science reinforce one another. Divide and rule is effective precisely because those defending rights are so often divided.
Another session that stayed with me was No retreat, no surrender: The future of philanthropy in HIV. Richard Borain of the Children’s Investment Fund Foundation (CIFF) argued that philanthropy’s greatest contribution is not simply funding projects but strengthening the “connective tissue” that brings together governments, communities, donors, and civil society around shared goals.
That phrase resonated with me. We have become very good at investing in programs, but less intentional about investing in the relationships, trust, and collaboration that allow organisations and movements to reinforce one another.
I was reminded of this again at the Robert Carr Fund’s celebration of 15 years of supporting global HIV and health movements. At a time when the Fund has faced an uncertain future following the withdrawal of support from both the United States and the Netherlands, there was welcome news: CIFF has joined as a new donor, while ViiV Healthcare announced a further year of support.
For more than a decade, the Robert Carr Fund has demonstrated a different model of philanthropy—trust-based, multi-year, flexible core funding combined with peer learning and movement building. The HIV Justice Global Consortium, which first united regional and global HIV criminalisation networks, was made possible through Robert Carr Fund support, and the HIV Justice Network remains proud to be one of its grantees.
Yet even within the Robert Carr Fund family there is greater potential to work across movements and constituencies. That is not a criticism of the Fund; rather, it reflects how deeply siloed our sector has become. If organisations already committed to rights-based approaches can collaborate more intentionally, imagine what could be achieved with greater investment in those connections.
The anti-rights movement invests in networks, long-term relationships, shared strategies, and patient coalition-building. We need to become equally serious about investing in the infrastructure of solidarity. AIDS 2026 made clear: our greatest challenge is no longer simply defending individual rights. It is building a movement capable of defending them together.
Edwin J Bernard is Executive Director of the HIV Justice Network and a global advocate for human rights and HIV justice.
Email:edwin@hivjustice.net
Image: Rogério von Krüger / IAS
US: Pennsylvania’s HIV Decriminalization Law comes under fire from activists
“Profound Disappointment” at Pennsylvania’s Updated HIV Crime Law
UPDATE: Pennsylvania just passed a law to decriminalize being HIV positive, but AIDS activists say it harms another marginalized group.
UPDATE: As we reported earlier this week, Pennsylvania Governor Josh Shapiro signed Senate Bill 45 (SB45) into law on July 20. The legislation eliminates harsher legal penalties for people simply because they are HIV positive, referred to as HIV criminalization. The law was promoted as a victory for HIV activists.
But now several HIV organizations are speaking out against aspects of the law. They point out that it targets sex workers. What’s more, the HIV advocacy groups clarify that they were not consulted in drafting the Pennsylvania legislation.
A Facebook post by HIV activist Waheeda Shabazz-El and several advocacy groups begins by stating:
The Pennsylvania HIV Justice Alliance goes on record expressing our profound disappointment with the passage of PA Senate Bill 45.
While the legislation modernizes portions of Pennsylvania’s criminal code related to HIV, it does so at the dangerously unacceptable expense of sex workers, who will face increased criminalization and harm under this law. Progress for one marginalized community should never come at the cost of another. Our celebration is tempered by the reality that this progress came at a devastating cost.
SB45 was ultimately an overhaul of the Pennsylvania criminal code pertaining to “prostitution.” It transfers most “prostitution” related offenses out of the “public indecency” section and into the “human trafficking” section of the criminal code. It also reduces some criminal charges while increasing others.…
SB45 achieves important, positive outcomes. SB45 removed the HIV felony sentence for sex workers living with HIV. Previously, if a person living with HIV was convicted of “prostitution,” their penalty was upgraded to a felony simply because of their HIV status. It was HIV discrimination written into the Pennsylvania criminal code, and we are thrilled it was removed.…
SB45 shifts prosecutorial authority and conflates sex work and trafficking.…
SB45 increases penalties for “promoters” or “patronizers,” which can harm trafficking survivors or people in the sex trades.…
Our organizations have been involved in coalitions fighting HIV criminalization in Pennsylvania for years and we support, alongside others, the standalone HIV decriminalization bills, HB632 and SB647. SB45, however, is a substantially different piece of legislation. We were not included in the legislative process nor did any of our organizations endorse SB45. Some of our organizations have, nevertheless, been associated with the bill because of the HIV decriminalization components. SB45 has also been touted as a win for the HIV decriminalization movement in the Commonwealth and in the media. For all of these reasons, it is important to make our stance public: We believe a more nuanced perspective is needed.
To reiterate and celebrate: this bill achieves hard fought wins. People living with HIV and HIV advocates have worked for years to introduce legislation that would eliminate the HIV sentence enhancement from the Pennsylvania criminal code. In the past, we have worked alongside powerful HIV decriminalization coalitions and organizations in Pennsylvania, including the Pennsylvania HIV Justice Alliance, the AIDS Law Project, Positive Women’s Network-PA, Girl U Can Do It Inc., Philadelphia FIGHT and the Elizabeth Taylor AIDS Foundation. We celebrate this legacy and work.
We remain deeply concerned, however, about how SB45 will make it harder for sex workers and trafficking survivors to survive by further criminalizing their networks of support. SB45 adopts key features associated with the End Demand model of sex work criminalization. This approach focuses on criminalizing the purchase and promotion of sex work – the “demand” side of the sex trades. It frames all people in the sex trades as “victims”, denies bodily autonomy, and ignores that people can consensually choose to engage in sex work. Ultimately, it aims to end sex work itself by policing and criminalizing people who support or pay sex workers and offers no economic alternative for sex workers. Research shows, however, criminalizing demand does not decrease demand. Instead it forces sex workers further into unsafe conditions, increasing sexual violence, exploitation, and decreasing access to support services.
Below is our original July 30 article about Governor Josh Shapiro’s signing Senate Bill 45 into law and eliminating harsher penalties for people living with HIV:
On July 20, Pennsylvania Governor Josh Shapiro signed Senate Bill 45 (SB45) into law, eliminating felony charges for people arrested for prostitution while being HIV positive and removing HIV from the criminal code in the Commonwealth of Pennsylvania.
Before the signing of SB45, when charged with a crime in Pennsylvania, people living with HIV—especially sex workers—could face harsher penalties because of their HIV status. In Pennsylvania, prostitution is classified as a misdemeanor, but people living with HIV could be charged with a felony and face up to seven years in prison, even when HIV transmission is not possible.
“Living with HIV is not a crime, and HIV criminalization laws have been proven, time and again, not to work for the benefit of the community or in the service of justice,” said Kathleen A. Brady, MD, director of the Philadelphia Department of Public Health’s Division of HIV Health, in a press release. “In fact, such laws prevent public health agencies from responding effectively to the HIV epidemic by perpetuating stigma, racism, xenophobia, social and economic injustice—while reducing willingness for people to participate in HIV prevention, testing and care.”
HIV criminalization refers to the use of unfair laws to target people who have HIV—notably, African-Americans, Latinos, LGBTQ people, and women—and to punish them because of their HIV status, not because of their actions. Under outdated laws, people with HIV can be sentenced to prison in cases where HIV was not transmitted and their only crime was allegedly not disclosing their status.
It should be noted that repealing HIV laws does not mean that people can’t be held accountable for intentionally transmitting HIV. Other laws may apply to the situation.
Many HIV laws were passed in the early days of the epidemic, when fear and lack of scientific knowledge about the virus reigned. Fast-forward four decades, and today we know, for instance, that people with HIV who take their meds and maintain an undetectable viral load do not transmit the virus sexually, a fact referred to as Undetectable Equals Untransmittable, or U=U.
“Criminal penalties for living with HIV have never served an effective law enforcement purpose,” Ronda Goldfein, executive director of the AIDS Law Project of Pennsylvania, told Pennsylvania Capital Star. “No credible research has ever linked penalties with reduction in HIV transmission.”
“The signing of SB 45 is an important step toward ending outdated policies rooted in fear and stigma rather than science,” said attorney Tito Valdes, director of LGBTQ+ Affairs for the City of Philadelphia, in a press release. “No one should face harsher treatment under the law because they are living with HIV. We applaud Governor Shapiro and the advocates who worked for years to make this change possible and remain committed to advancing policies that promote dignity, equity and public health for all Philadelphians.”
US: Arkansas’s outdated HIV laws fuel fear and deter people from getting tested and treated
Advocates call on Arkansas lawmakers to decriminalize HIV, fund treatment and prevention
As Arkansas tops another terrible list, this time as the state with the highest rate of HIV transmission, advocates are calling on Arkansas lawmakers to decriminalize the sexually transmitted disease and commit funding for prevention, treatment and education.
A coalition of people from community organizations including Central Arkansas Pride, Arkansas Rapps, Intransitive, Arkansas Black Gay Men’s Forum and Arkansas Queer Men United, along with several people living with undetectable HIV, gathered in the Old Supreme Court Room in the State Capitol before several Democratic state representatives on Monday.
Advocates argued that Arkansas’s HIV laws, which haven’t been updated since the 1980s, are outdated and create a culture of fear that prevents people from getting tested and treated for HIV. They asked lawmakers to commit $1.5 million from the state’s surplus of more than $367 million to HIV prevention, treatment and education.
Under Arkansas law, knowingly exposing another person to HIV is a Class A felony, punishable by up to 30 years in prison and a fine of up to $15,000. But critics like the Center for HIV Law and Policy say these woefully outdated laws are out of step with modern science, rooted in stigma and punish behavior that carries no or negligible risk of actually transmitting the disease.
With proper treatment, HIV can become undetectable in a person, meaning it can’t be transmitted to another person through sex, but Arkansas law doesn’t account for this.
“HIV criminalization laws like ours here in Arkansas are opposed by public health and national justice experts such as the National Alliance of State and Territorial AIDS Directors and the National Association of Criminal Defense Lawyers,” said Tian Estell, policy director of Intransitive. “We need to modernize and stop punishing people for having a virus.”
Tian added that “Black, transgender and non-binary individuals in the South are disproportionately impacted by HIV” due to other contributing factors like lack of housing, transportation and employment and limited or no access to healthcare.
“Discriminatory policies also generate and enhance stigma and fear, creating barriers to prevention and care,” Tian said. “Intransitive serves transgender people and migrants, and we’ve seen a rise in fear associated with HIV testing and disclosure of positive status”
HIV is a larger problem in Arkansas than in most states, and advocates argue our laws are only making it worse.
In 2019, the federal Health and Human Services Department started an initiative to end the HIV epidemic by 2030, identifying Arkansas as one of seven priority states where the burden of HIV is the highest.
“Arkansas continues to see new HIV diagnoses each year. In fact, Arkansas ranked number one in the highest increase of new HIV cases, seeing a roughly 67% spike since 2018,” said Raheem White, program director for Arkansas Rapps. “The burden does not fall equally. Black communities tend to carry a higher share of these diagnoses. Central Arkansas and parts of Northwest Arkansas show higher impact, while rural areas face a different challenge with fewer services and longer distances to care.”
Tommy Sproles, a community outreach organizer for Arkansas Rapps, said those numbers may not be representative of the full scope of cases in Arkansas, especially in rural areas.
“It’s a concern of ours that the numbers do not accurately reflect the real life experiences within those other parts of the state, such as the rural areas where we think that the numbers would be higher, but they’re going under-reported because of the lack of testing in those areas,” Sproles said. “As we’re talking about the data that we receive, what we’re basing our stuff on is the data that the Arkansas Department of Health actually receives, but that doesn’t even cover the full scope of everyone who is testing, if you’re not a clinic or a subcontractor for the Arkansas Department of Health, that data is not even being accumulated.”
Arkansas Rapps, for example, uses telehealth to connect people in Arkansas with testing, medication and preventative medicine like PrEP, which is up to 99% effective at preventing the transmission of HIV.
Advocates said criminalizing HIV and not funding its prevention costs Arkansas millions of dollars in both healthcare and incarceration.
“Pulaski County has the highest rate of HIV-criminalization arrests, with most other counties having only one or no arrests. This not only speaks to a disproportionate application of the law, but a significant waste of resources,” said Amber Kincade, a comprehensive prevention specialist with Engaging Arkansas Communities.
“According to data from the Arkansas Department of Corrections, from 2007 to 2023 the average sentence per count for the HIV-related convictions was 24 years. According to the fiscal year 25 Inmate Cost Report, the cost per incarcerated person a day was $74.46, which was a $4.03 increase from 2024. This means that a sentence of 24 years would cost the state roughly $652,272,” Kincade said. “The lifetime cost of treating HIV is estimated to be over $500,000. Therefore, for one case of a person living with HIV receiving such a sentencing, the cost will be over $1 million.”
Kincade added that Texas decriminalized HIV in 1994 and increased public health funding for prevention and testing.
“Texas has saved an estimated $500,000 in lifetime cost per case in HIV treatment,” Kincade said.
Sanjay Johnson, a man living with undetectable HIV, told lawmakers he was prosecuted in Pulaski County for knowingly transmitting HIV, despite the virus being undetectable in his system, in 2017.
“The language itself is damaging, because with that, people think that transmission actually occurred, which in my case was not the case. It never occurred at all,” Johnson said.
Johnson’s case lasted two years, and his lawyer got the charge reduced from a felony to aggravated assault with five years of probation. That’s despite Johnson’s medical records, which said he was undetectable, being shown in court, he said.
“You wonder why HIV is the only STD that someone can be charged for. Not gonorrhea, chlamydia, herpes, etc, etc. HIV is the only sexually transmitted disease that can be criminalized here,” Johnson said.
Senegal: Arrests and breach of medical confidentiality trigger drop in HIV testing and treatment attendance
“Violation of medical confidentiality”: in Senegal, caregivers worried about allegations against homosexuals with HIV
In Senegal, people have been incriminated for their homosexuality and accused of HIV transmission. These arrests follow the announcement by Prime Minister Ousmane Sonko of the tightening of the law penalizing “unnatural acts”. Since these arrests, the actors in the fight against AIDS have seen a decrease in attendance at screening centers.
“Arrest for homosexuality: serious cases of unnatural acts with voluntary transmission of HIV/AIDS,” headlined the Senegalese daily Les Échos, on February 9. About thirty people have been accused of transmitting HIV and incriminated for their homosexuality, which is prohibited by law. The Senegalese government has just toughened this legislation on February 24. These arrests frighten patients with the virus, who no longer go to the Dakar screening center.
“Patients are afraid of being arrested and stigmatized,” explains Dr. Rassoul Diouf, at Fane Hospital, one of Senegal’s main health centers. Usually, this facility welcomes dozens of patients daily for HIV testing and monitoring. But in recent weeks, Dr. Rassoul Diouf has seen a significant drop in consultations.”The convocations for appointments are difficult to happen. We call them but there is reluctance,” he explains to TV5MONDE.
Breach of medical confidentiality
For the actors in the fight against AIDS, this disclosure constitutes a “violation of medical confidentiality“. The National AIDS Council recalls that a law in Senegal protects the identity of people with HIV.
“On an ethical level, this is not normal, but even less on a legal level,” says Dr. Safiatou Thiam, executive secretary of the National Council for the fight against AIDS. “HIV has the particularity of being framed by a law that prohibits the disclosure of people’s status. We do not know how or by what process medical results ended up in the public square,” she explains to TV5MONDE.
Misinformation and confusion about HIV transmission
Actors in the fight against AIDS also deplore confusion about the modes of transmission of the virus. However, Senegal has long been cited as an example for the means put in place to fight HIV. Since the end of the 1990s, the country made treatments accessible. “At the beginning of the epidemic [of HIV, ed.], many countries refused to recognize its existence. But Senegal said: not only does HIV exist, but I will treat it,” explains Dr. Khoudia Sow, doctor and anthropologist.
“When a person follows his treatment properly, he becomes undetectable and can no longer transmit the virus. On the other hand, if these people interrupt their treatment for fear of stigmatization, the risk is that in the short term new transmissions will appear,” she confides. Currently, the HIV prevalence rate in Senegal is estimated at 0.3%, one of the lowest in the region. However, if patients stop taking their treatment, for fear of stigma, this rate could increase in Senegal.
US: HIV criminalisation laws expose Black Americans to disproportionate arrest and prosecution rates
“Look at who’s in political control”: How HIV disclosure laws are steeped in racial bias
HIV criminalization arose in an atmosphere of fearful ignorance, disproportionately harming Black men. But activists are fighting back.
Today, 32 states have laws that criminalize people living with HIV (PLWH). These laws expose PLWH to the risk of prosecution and incarceration for engaging in consensual sexual activity while not disclosing their status. Of those states, 28 enhance criminal penalties based on an individual’s knowledge of their HIV status. In many of these states, arrests and convictions due to HIV criminalization disproportionately impact Black populations, because HIV disproportionately impacts Black populations.
A new study of 16 states by the Williams Institute shows Black Americans are more likely than any other race to be arrested and convicted for HIV-related allegations, and were arrested for HIV-related crimes at higher rates than their overall share of the population. In 64% of the states analyzed, Black Americans faced higher rates of arrest than their share of PLWH in the state. In 75% of the states, Black Americans were convicted at higher rates than their share of PLWH in the state.
Legislation criminalizing the transmission of HIV started in the 1980s, in response to events largely fueled by fear that the AIDS epidemic — which at the time was perceived as gay men’s disease, and was originally called Gay Related Immunodeficiency Syndrome (GRID) — would spread to heterosexuals. In 1987, Ronald Reagan’s Presidential Commission on the HIV Epidemic recommended that states adopt HIV-specific laws in response to rising infection rates among gay men, based on the belief that existing assault laws were too lenient to serve as a deterrent.
In 1990, the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act was enacted, providing funding to states on the condition that their criminal laws addressed intentional HIV exposure and transmission.
Subsequently, flurries of punitive legislation arose amid highly publicized, sensationalized cases involving young Black men, such as that of Nushawn Williams in the late 1990s. Accused of having sex with younger women while HIV-positive, Williams pleaded guilty to reckless endangerment and statutory rape and was sentenced to 12 years in prison. He remains imprisoned after serving his sentence because the New York attorney general initiated involuntary civil commitment proceedings against him just days before his release.
“Available research confirms what we knew back then — criminal laws do not reduce HIV transmission or the behavior that causes it,” says Catherine Hanssens, the founding executive director of The Center for HIV Law and Policy.
Robert Suttle, an HIV criminalization policy expert, tells LGBTQ Nation that these laws became more about control than prevention. “HIV criminalization became a proxy to control certain populations — queer people, sex workers — especially to stop people diagnosed with HIV from having sex,” says Sutter. “It’s never worked.”
Not only do HIV criminalization laws, conceived at a time when an HIV diagnosis was essentially considered a death sentence, fail as preventative measures, but they also eliminate burdens of proof and intent to do harm, which are required under criminal law.
Most of these laws only require simple exposure with the failure to disclose HIV status. Most state laws don’t require evidence of transmission or intent to harm. Several target interactions in which spit and other bodily fluids come into contact with law enforcement, correctional employees, and first responders, criminalizing behavior that has no chance of transmitting HIV.
Again, these laws — which have stood for decades — reflect a time when little was known about how HIV was spread, and a diagnosis was considered fatal.
Black bodies on trial: The case of “Tiger Mandingo”
The case of Michael Johnson, also known by his screen name “Tiger Mandingo,” illustrates many of the problems with HIV-criminalization laws and how they intersect with the historic policing of Black Americans.
Johnson, a Black gay wrestler at Linwood University in St. Charles, Missouri, was arrested in 2013 for not disclosing his HIV-positive status to six former male sex partners, four of whom were white. At the time, Missouri’s law required PLWH to inform their partners of their status, regardless of safe-sex practices. The law did not require intent to transmit or actual transmission of HIV, but only that a person was aware of their status and unable to prove that they informed their partners before engaging in sex.
Johnson faced a stacked deck before his trial even started. Of the 51 potential jurors, only one was non-white. Half said they believed being gay was a choice, and two-thirds believed it was a sin. All were straight, HIV-negative, and believed that PLWH who do not disclose to their partners deserved to be prosecuted. The final jury consisted of four white men, seven white women, and one retired Black nurse. Most of the jurors appeared to be in their 50s or 60s.
Several discrepancies arose during Johnson’s trial. Johnson maintained that he disclosed his status and that all of his partners engaged in consensual sex without condoms. Each of his partners testified that they’d asked if he was “clean” or STD-free, and that he’d assured them that he was. This contradicted what they initially told police. But the jury never heard of these discrepancies, either because his defense attorney failed to raise them or because she was overruled when she did.
Telling people that they are a potential criminal based only on a diagnosed health condition is harmful, particularly to people who have been told for centuries that they are not worthy of equal treatment under the law based on race, sexual orientation, or gender identity.”
Catherine Hanssens, executive director of The Center for HIV Law and Policy.
One partner testified that Johnson had actually infected him, but told the police he’d told Johnson he was HIV-positive when he met him. No genetic evidence linked Johnson’s strain of HIV to the virus in the other men, suggesting that they may have contracted it from someone else.
The prosecution employed stereotypical tropes. Images of Johnson’s penis — from a sex video made with one of his partners — were shown to the nearly all-white, all heterosexual, HIV-negative jury, literally criminalizing his “contagious” Black body, and reducing him to his sex organ, described in graphic, lurid detail in police reports and on the witness stand as “very large” and “too tight” for condoms.
In 2015, the jury sentenced him to 30 years for transmitting HIV without disclosure to six former sexual partners, and 30.5 years for exposing four others without disclosure, for a total of 60.5 years — a longer sentence than many convicted of involuntary manslaughter. The judge ultimately reduced the sentence to 30 years.
However, Johnson served only a fraction of his sentence. His conviction was overturned in December 2016 due to egregious prosecutorial misconduct. Johnson accepted a plea deal and was released from prison on July 7, 2019.
In 2021, Missouri reformed its HIV-criminalization law, downgrading “reckless exposure” of someone to HIV from a Class B felony to a Class D felony. Moving away from the AIDS panic of the 1980s, the law applies to all “serious infections and communicable diseases,” instead of singling out HIV. Prosecutors must now prove someone “knowingly” exposed someone to HIV.
Policing Black bodies in a culture of fear
While HIV criminalization laws were originally targeted at gay men, they represent a small number of actual arrests.
“Based on the best data available, women of color who are sex workers and Black men targeted by police or those currently incarcerated make up most of the arrests and convictions,” Hanssen says.
Hanssen also describes how HIV criminalization laws don’t necessarily impact transmission, but may discourage vulnerable communities from accessing essential resources. “As I’ve suggested, laws based on myths and misconceptions surrounding HIV will perpetuate HIV stigma,” Hanssen said.
HIV-related stigma creates real obstacles for PLWH. The behaviors often associated with acquiring HIV — such as being gay or using intravenous drugs — are still stigmatized, and confirming or disclosing one’s HIV status is still widely perceived as socially dangerous. HIV-related stigma can discourage testing and prevention practices. Individuals may fear confirming their HIV status, let alone accessing education about transmission and prevention. HIV criminalization laws increase those fears.
“But look at who’s in political control — and who controls public health and the legal system. Those systems get off the hook by shifting blame to individuals. Instead of investing money into prevention, education, and awareness, they criminalize people.”
Robert Suttle, an HIV criminalization policy expert
“Telling a newly diagnosed person they will be prosecuted as a felon if they expose another person to HIV may not discourage them from having sex,” she said, “but it might discourage them from entering and staying in health care, particularly when medical mistrust is already so high among the vulnerable populations targeted by these laws.”
This is especially true for Black Americans, among whom medical mistrust may be a deeply rooted reaction to historical exploitation by incidents like the Tuskegee experiment and ongoing systemic racism.
Suttle explains how these laws cause particular harm to Black LGBTQ+ people by creating a culture of fear. “Is the public health system or legal system helping the people they claim to protect?” he asks, “The evidence shows they’re doing more harm than good.”
“For Black people — especially Black LGBTQ+ people — HIV isn’t just a medical condition,” he says. “It’s shaped by laws, policies, and institutions that operate from a culture of fear rather than science, and from control rather than care.”
Hanssen echoes Suttle, saying, “Telling people that they are a potential criminal based only on a diagnosed health condition is harmful, particularly to people who have been told for centuries that they are not worthy of equal treatment under the law based on race, sexual orientation, or gender identity.”
“There is now plenty of evidence demonstrating how HIV criminal laws increase stigma,” says Catherine Hanssens. “These laws create a uniquely harmful, un-American legal standard and produce felony penalties rooted in lack of knowledge about HIV transmission – that alone is enough to demand their repeal.”
California and Washington State have made the biggest changes. Now, both states require proof that someone intended to transmit HIV or actually did so before they can be convicted. They have also removed most laws that made exposure to HIV or other diseases a crime, except in some cases involving sex offenders. Intentional transmission is now a misdemeanor in California, with a maximum sentence of six months, or in Washington State, 30 days.
By comparison:
North Carolina still connects criminal liability to viral load and engagement in care.
Iowa eliminated its sex offender registry requirement and tightened up intent requirements, but added “recklessness” as a standard for liability.
Virginia reformed its bill, but retains felony-level offenses.
Beyond reforms to state laws, Suttle suggests a paradigm shift away from focusing on individuals and toward the legal and justice systems is necessary for effective change.
“In an individualistic society, if HIV is happening, it’s treated like we [PLWH] caused it,” he says. “But no single individual can cause an epidemic. Instead of addressing external factors — poverty, lack of education, lack of access to healthcare — systems punish individuals. Those conditions are by design, not because people ‘created’ HIV.”
“But look at who’s in political control — and who controls public health and the legal system. Those systems get off the hook by shifting blame to individuals. Instead of investing money into prevention, education, and awareness, they criminalize people.”
“For Black LGBTQ communities, this is a matter of survival,” Suttle says. “HIV in America today isn’t simply defined by medicine. It’s defined by whether laws and institutions will catch up with science, provide equity, and understand the reality we’re living in.”
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Terrance Heath is a longtime LGBT equality activist, writer, and award winning blogger. He lives in Chevy Chase, Maryland, with his two sons.
Senegal: Media frenzy meets CNLS reality check in alleged homosexuals prosecution
The CNLS warns of an offence that is difficult to substantiate
In the case known as the ‘alleged homosexuals’ case, the classification of deliberate transmission of HIV/AIDS is the subject of heated debate. However, according to a note from the National Council for the Fight against AIDS (CNLS), this offence remains one of the most complex to prove in law.
The offence of ‘deliberate transmission of HIV/AIDS’ introduces a demanding scientific dimension to the case of the ‘alleged homosexuals’. They are being prosecuted for ‘unnatural acts, criminal association, money laundering and drug trafficking’. According to the National Council for the Fight against AIDS (CNLS), the justice system must rely on precise, consistent and solidly established evidence. In a note, the entity headed by Dr Safiatou Thiam states that ‘proof of voluntary transmission of HIV is difficult’. The CNLS notes that it ‘is a particularly complex process, involving legal, scientific and medico-legal aspects’.
The 2010 Senegalese law on HIV provides for penalties against any person who, knowing that they are HIV-positive, deliberately exposes others to the risk of infection.
However, ‘the establishment of this offence is based on the cumulative evidence of several factors,’ the note specifies. The first essential element is knowledge of one’s HIV status. “It must be proven that the accused knew they were HIV-positive at the time of the offence.
Without this prior knowledge, intent or gross negligence cannot be established,” emphasises the CNLS. The second requirement is proof of risky behaviour. Thus, the analysis is not limited to the statements of the parties. ‘The risk assessment also takes into account the therapeutic situation (ARV treatment, undetectable viral load or not),’ states the text. This clarification is important because a person undergoing effective treatment, with an undetectable viral load, ‘does not transmit HIV through sexual contact (U=U: undetectable = untransmittable)’.
From a scientific point of view, proving the causal link is just as delicate. “It is not enough for two people to be living with HIV. It must be demonstrated that the transmission did indeed come from the person being prosecuted,” adds the CNLS. Moreover, the body maintains that phylogenicetic analyses have their limitations: ‘However, even in cases of high genetic proximity, this analysis alone does not prove direct transmission or the exact chronology of events.’ Finally, the element of intent remains central. ‘To qualify as deliberate transmission in the criminal sense, it must be proven that there was either a deliberate intention to transmit the virus or an awareness of the risk associated with accepting it,’ explains the CNLS.
Dans l’affaire dite des « présumés homosexuels », la qualification de transmission volontaire du Vih/Sida suscite de vifs débats. Pourtant, selon une note du Conseil national de lutte contre le Sida (Cnls), cette infraction demeure l’une des plus complexes à prouver en droit.
L’infraction « transmission volontaire du Vih/Sida » introduit une dimension scientifique exigeante dans l’affaire des « présumés homosexuels ». Ils sont poursuivis pour « actes contre nature, association de malfaiteurs, blanchiment de capitaux et trafic de drogue ». Selon le Conseil national de lutte contre le Sida (Cnls), la justice devra s’appuyer sur des preuves précises, concordantes et solidement établies. Dans une note, l’entité dirigée par le Dr Safiatou Thiam renseigne que la « preuve de la transmission volontaire du Vih est difficile ». Le Cnls relève, en effet, qu’elle « constitue une démarche particulièrement complexe, à la fois juridique, scientifique et médico-légale ». La loi sénégalaise de 2010 relative au
Vih prévoit des sanctions contre toute personne qui, en connaissance de sa séropositivité, expose délibérément autrui à un risque de contamination. Mais, « l’établissement de cette infraction repose sur la réunion cumulative de plusieurs éléments probants », précise la note. Le premier élément indispensable est la connaissance du statut sérologique. « Il doit être démontré que la personne mise en cause savait qu’elle était séropositive au moment des faits. Sans cette connaissance préalable, l’intention ou la faute caractérisée ne peut être retenue », souligne le Cnls. Deuxième exigence : la preuve d’un comportement à risque. Ainsi, l’analyse ne se limite pas aux déclarations des parties. « L’évaluation du risque tient aussi compte de la situation thérapeutique (prise d’Arv, charge virale indétectable ou non) », énonce le texte. Cette précision est majeure, car une personne sous traitement efficace, avec une charge virale indétectable, « ne transmet pas le Vih par voie sexuelle (i = i : indétectable = intransmissible) ».
Sur le plan scientifique, la démonstration du lien de causalité est tout aussi délicate. « Il ne suffit pas que deux personnes vivent avec le Vih. Il faut démontrer que la transmission provient bien de la personne poursuivie », ajoute le Cnls. D’ailleurs, soutient l’organe, les analyses phylogénétiques ont leurs limites : « Toutefois, même en cas de forte proximité génétique, cette analyse ne prouve pas à elle seule la transmission directe ni la chronologie exacte des faits ». Enfin, l’élément intentionnel reste central. « Pour qualifier la transmission volontaire au sens pénal, il faut prouver soit la volonté délibérée de transmettre le virus, soit la conscience du risque associée à son acceptation », explique le Cnls.
Senegal: Following recent arrests, the National AIDS council calls for an approach based on science and human rights
The CNLS warns against judicial and social excesses
The executive secretariat of the National Council for the fight against AIDS (CnLS) published yesterday a technical note warning of the health, legal and social consequences of recent arrests for “unnatural acts” and transmission of HIV.
The executive secretariat of the National Council for the Fight against AIDS (CNLS) published yesterday a technical note warning of the health, legal and social consequences of recent arrests for “unnatural acts” and transmission of HIV. The institution fears a decline in screening, a break in treatments and a rise in stigma, calling on the authorities to favour an approach based on science, public health and respect for human rights.
“Health, legal and social impact of the arrest of people for unnatural acts and voluntary transmission of HIV”. This is the title of the technical note published yesterday by the National Council for the Fight against AIDS (CNLS), which proposes an in-depth analysis of the potentially disastrous consequences of mismanagement of news related to HIV transmission.
According to the CNLS, the country has a concentrated HIV epidemic, characterized by a low prevalence in the general population (0.3%) and a high prevalence within some key groups: 27% in men having sex with men, 6.4% in women sex workers, 5.2% in drug users and 2% in detainees. Faced with this situation, they maintain that the national response is based on equitable access to screening, prevention means and universal antiretroviral treatment.
According to them, these approaches have reduced new infections, improved the quality of life of people living with HIV and limited transmission in the general population. However, the CNLS believes that the high media coverage of the arrests of twelve (12) people has aroused a strong reaction from public opinion and rekindled tensions around sexuality, HIV and human rights, raising major health, legal and social issues.
Blow for early screening and continuity of care
First, in terms of health, the CNLS fears that legal proceedings or the disclosure of serological status will dissuade some people, especially from the most vulnerable groups, from voluntarily using screening. “This reluctance limits the early detection of people living with HIV and their rapid access to treatment, which is essential to interrupt transmission. Nearly 90% of people with HIV are tested to date and under treatment and 92% of them no longer transmit the disease,” reads the technical note published by the CNLS.
Worse, it says, the continuity of care is also threatened. Indeed, it is noted, for fear of stigma or public exposure, some people living with HIV can discontinue their antiretroviral treatment. “These ruptures increase the risk of medical complications, resistance to treatments and transmission of the virus, with a direct impact on national health indicators,” says the CNLS. It is also established that when the possession of condoms, the use of screening or adherence to treatment are perceived as burdens in legal proceedings, it constitutes a major risk to public health.
The CNLS thus draws attention to the fact that this situation discourages prevention behaviour and promotes silent circulation of the virus, increasing the number of people unaware of their serological status and the risks of transmission among the general population.
“Unauthorised disclosure of serological status is penalised by the HIV law of 2010…”
With regard to the legal issues of arrests for unnatural acts and transmission of HIV, the CNLS recalls at first glance that the voluntary transmission of HIV is a crime under the law. However, he says, its legal qualification, as provided for by the 2010 HIV Act, presupposes the meeting of several constituent elements: proven harm, a direct causal link and a deliberate intention to harm. In practice, he says, the establishment of these elements remains complex. The demonstration of intentionality is particularly difficult and cannot be based on serological status alone. It requires proof that the person knew his status, that he voluntarily exposed others to risk without prior information and that he had the obvious will to transmit the virus,” informs the CNLS, which adds that proof of the causal link and the anteriority of the infection requires specialized medical and biological expertise, rarely available in the context of ordinary judicial proceedings, thus exposing to a risk of judicial errors.
The CNLS also reports that scientific data establish that a person living with HIV on effective antiretroviral treatment, with an undetectable viral load, does not transmit the virus. And that ignorance of these evidences can lead to misinterpretations of the facts. As a result, he argues that excessive or imprecise criminalisation of HIV transmission can produce counterproductive effects by discouraging voluntary screening, as ignorance of status is sometimes perceived as legal protection. The CNLS argues that respect for the presumption of innocence, privacy and confidentiality of medical data remains a fundamental requirement. “The unauthorised disclosure of serological status is penalised by the 2010 HIV law and can engage the responsibility of the State, with regard to Senegal’s international commitments,” he said.
Plea for a circular for judicial actors integrating current scientific data on HIV
Still in the technical note of the CNLS, it is established that on the social level, the arrests and communication that accompany them may increase the stigma and discrimination against people living with HIV. “The amalgam between sexual orientations and serological status reinforces prejudices and further marginalizes already vulnerable groups,” the document points out.
Moreover, the CNLS fears that the people concerned will be subject to social and family exclusion, and will be victims of attacks on their dignity as well as verbal, psychological or even physical violence, weakening social cohesion. Another concern for the CNLS is that community organisations and civil society actors, essential to prevention and awareness, can reduce their activities for fear of stigmatisation or reprisals, leading to a decrease in social mobilisation and a weakening of prevention mechanisms. Faced with this situation, the CNLS believes that a balanced approach, based on public health, respect for human rights and the rule of law, is essential. They also ask the Prime Minister to instruct the Keeper of the Seals to disseminate a circular to judicial actors integrating current scientific data on HIV.
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Le CNLS met en garde contre des dérives judiciaires et sociales
Le secrétariat exécutif du Conseil national de lutte contre le sida (CnLS) a publié hier une note technique alertant sur les conséquences sanitaires, juridiques et sociales des récentes arrestations pour “actes contre nature” et transmission du VIH.
Le secrétariat exécutif du Conseil national de lutte contre le sida (CNLS) a publié hier une note technique alertant sur les conséquences sanitaires, juridiques et sociales des récentes arrestations pour “actes contre nature” et transmission du VIH. L’institution redoute un recul du dépistage, une rupture des traitements et une montée de la stigmatisation, appelant les autorités à privilégier une approche fondée sur la science, la santé publique et le respect des droits humains.
«Impact sanitaire, juridique et social de l’arrestation de personnes pour actes contre nature et transmission volontaire du VIH». Tel est l’intitulé de la note technique publiée hier par le Conseil national de lutte contre le sida (CNLS), qui propose une analyse approfondie des conséquences potentiellement désastreuses d’une mauvaise gestion de l’actualité liée à la transmission du VIH.
Selon le CNLS, le pays présente une épidémie de VIH de type concentrée, caractérisée par une faible prévalence dans la population générale (0,3 %) et une prévalence élevée au sein de certains groupes clés : 27% chez les hommes ayant des relations sexuelles avec des hommes, 6,4% chez les femmes travailleuses du sexe, 5,2% chez les consommateurs de drogues et 2%chez les personnes détenues. Face à cette situation, il soutient que la riposte nationale repose sur l’accès équitable au dépistage, aux moyens de prévention et au traitement antirétroviral universel.
A l’en croire, ces approches ont permis de réduire les nouvelles infections, d’améliorer la qualité de vie des personnes vivant avec le VIH et de limiter la transmission dans la population générale. Cependant, le CNLS estime que la forte médiatisation des arrestations de douze (12) personnes a suscité une vive réaction de l’opinion publique et ravivé les tensions autour de la sexualité, du VIH et des droits humains, soulevant des enjeux sanitaires, juridiques et sociaux majeurs.
Coup porté au dépistage précoce et à la continuité des soins
D’abord, sur le plan sanitaire, le CNLS craint que les poursuites judiciaires ou la divulgation du statut sérologique dissuade certaines personnes, notamment issues des groupes les plus vulnérables, de recourir volontairement au dépistage. “Cette réticence limite le dépistage précoce des personnes vivant avec le VIH et leur accès rapide au traitement, pourtant essentiel pour interrompre la transmission. Près de 90% des personnes atteintes de VIH sont dépistées à ce jour et sous traitement et 92% d’entre elles ne transmettent plus la maladie”, lit-on dans la note technique publiée par le CNLS.
Pis, dit-il, la continuité des soins est également menacée. En effet, note-t-on, par peur de stigmatisation ou d’exposition publique, certaines personnes vivant avec le VIH peuvent interrompre leur traitement antirétroviral. “Ces ruptures augmententles risques de complications médicales, de résistance aux traitements et de transmission du virus, avec un impact direct sur les indicateurs nationaux de santé”, confie le CNLS. Il est également établi que lorsque la possession de préservatifs, le recours au dépistage ou l’adhésion au traitement sont perçus comme des éléments à charge dans des procédures judiciaires, cela constitue un risque majeur pour la santé publique.
Le CNLS attire ainsi l’attention sur le fait que cette situation décourage les comportements de prévention et favorise une circulation silencieuse du virus, augmentant le nombre de personnes ignorant leur statut sérologique et les risques de transmission au sein de la population générale.
«La divulgation non autorisée du statut sérologique est pénalisée par la loi VIH de 2010…»
En ce qui concerne les enjeux juridiques des arrestations pour actes contre nature et transmission du VIH, le CNLS rappelle de prime abord que la transmission volontaire du VIH constitue un délit au regard de la loi. Toutefois, fait-il savoir, sa qualification juridique, telle que prévue par la loi VIH de 2010, suppose la réunion de plusieurs éléments constitutifs : un préjudice avéré, un lien de causalité direct et une intention délibérée de nuire. Dans la pratique, précise-t-il, l’établissement de ces éléments demeure complexe.“La démonstration de l’intentionnalité est particulièrement difficile et ne saurait reposer sur le seul statut sérologique. Elle nécessite la preuve que la personne connaissait son statut, qu’elle a volontairement exposé autrui au risque sans information préalable et qu’elle avaitla volonté manifeste de transmettre le virus”, renseigne le CNLS qui ajoute que la preuve du lien de causalité et de l’antériorité de l’infection requiert des expertises médicales et biologiques spécialisées, rarement disponibles dans le cadre des procédures judiciaires ordinaires, exposant ainsi à un risque d’erreurs judiciaires.
Le CNLS informe également que les données scientifiques établissent qu’une personne vivant avec le VIH sous traitement antirétroviral efficace, avec une charge virale indétectable, ne transmet pas le virus. Et que la méconnaissance de ces évidences peut conduire à des interprétations erronées des faits. De ce fait, il soutient qu’une criminalisation excessive ou imprécise de la transmission du VIH peut produire des effets contreproductifs en décourageant le dépistage volontaire, l’ignorance du statut étant parfois perçue comme une protection juridique. Le CNLS soutient dans la foulée que le respect de la présomption d’innocence, de la vie privée et de la confidentialité des données médicales demeure une exigence fondamentale. “La divulgation non autorisée du statut sérologique est pénalisée par la loi VIH de 2010 et peut engager la responsabilité de l’État, au regard des engagements internationaux du Sénégal”, a-t-il fait entendre.
Plaidoyer pour une circulaire à l’attention des acteurs judiciaires intégrant les données scientifiques actuelles sur le VIH
Toujours dans la note technique du CNLS, il est établi que sur le plan social, les arrestations et la communication qui les accompagnent, risquent d’accentuer la stigmatisation et la discrimination à l’encontre des personnes vivant avec le VIH. “L’amalgame entre orientations sexuelles et statut sérologique renforce les préjugés et marginalise davantage des groupes déjà vulnérables”, souligne le document.
D’ailleurs, le CNLS craint que les personnes concernées fassent l’objet d’exclusions sociales et familiales, et soient victimes d’atteintes à leur dignité ainsi qu’à des violences verbales, psychologiques, voire physiques, fragilisant la cohésion sociale. Autre préoccupation pour le CNLS, les organisations communautaires et les acteurs de la société civile, essentiels à la prévention et à la sensibilisation, peuvent réduire leurs activités par crainte de stigmatisation ou de représailles, entraînant une baisse de la mobilisation sociale et un affaiblissement des mécanismes de prévention. Face à cette situation, le CNLS pense qu’une approche équilibrée, fondée sur la santé publique, le respect des droits humains et l’État de droit, est indispensable. Il sollicite d’ailleurs le Premier Ministre afin qu’il instruise le Garde des Sceaux de diffuser une circulaire à l’attention des acteurs judiciaires intégrant les données scientifiques actuelles sur le VIH.
Criminalization and funding cuts threaten global progress against HIV/AIDS
High-risk HIV groups facing record levels of criminalisation as countries bring in draconian laws
Curbs on LGBTQ+ rights and a halt to US funding may reverse decades of progress in fight to end Aids epidemic, warns UNAids.
People at higher risk of HIV, such as gay men and people who inject drugs, are facing record levels of criminalisation worldwide, according to UNAids.
For the first time since the joint UN programme on HIV/Aids began reporting on punitive laws a decade ago, the number of countries criminalising same-sex sexual activity and gender expression has increased.
In the past year, Mali has made homosexuality a criminal offence, where the law previously only banned “public indecency”, and has also criminalised transgender people. Trinidad and Tobago’s court of appeal has overturned a landmark 2018 ruling that decriminalised consensual same-sex relations, reinstating the colonial-era ban. In Uganda, the 2023 Anti-Homosexuality Acthas “intensified the proscription of same-sex relations”, and Ghana has moved in a similar direction with the reintroduction of legislation that would increase sentences for gay sex.
The crackdown on gay rights comes as the fight against HIV/Aids has been hit by abrupt US funding cuts, which have combined with “unprecedented” humanitarian challenges and climate crisis shocks to jeopardise hopes of ending the global epidemic this decade, UNAids said.
Several groups of people, known as “key populations”, are more likely to be infected with HIV. They include sex workers, gay men and other men who have sex with men, people who inject drugs, transgender people, and those in prisons and other enclosed settings.
In 2025, only eight of 193 countries did not criminalise any of those groups or behaviours, or criminalise non-disclosure of HIV status, exposure or transmission, according to the report.
The number of people infected by HIV or dying from Aids-related causes in 2024 was the lowest for more than 30 years, according to the UNAids annual report, at 1.3 million and 630,000 respectively.
Progress was uneven – ranging from a 56% fall in infections since 2010 in sub-Saharan Africa to a 94% increase in the Middle East and North Africa. But coupled with scientific advances – such as twice-yearly drugs to prevent infection – the world had the “means and momentum” to end Aids as a public health threat by 2030, an internationally agreed goal, it said.
The report highlights HIV-prevention services as an area of concern, with many particularly reliant on donor funding. The reported number of people receiving preventive drugs in Nigeria in November 2024 was approximately 43,000. By April 2025, that number had fallen to below 6,000.
Activists say access to prevention will be a particular issue for key populations, who may not be able to access mainstream healthcare due to factors such as stigma or fear of prosecution, but relied on donor-funded community clinics that have now closed.
Key populations were “always left behind”, said Dr Beatriz Grinsztejn, president of the International Aids Society (IAS).
The report is being released before an IAS conference next week in Kigali, Rwanda, where researchers will share data on the impact of cuts.
Modelling by Bristol University calculated that a one-year halt in US funding for preventive drugs in key populations in sub-Saharan Africa would mean roughly 700,000 people no longer used them, and lead to about 10,000 extra cases of HIV over the next five years.
UNAids modelling suggests that without any replacement for funding from US Pepfar (president’s emergency plan for Aids relief), an additional 4m deaths and 6m new infections could be expected globally by 2029.
However, Winnie Byanyima, executive director of UNAids, said 25 of the 60 low- and middle-income countries included in the report had found ways to increase HIV spending from domestic resources to 2026. “This is the future of the HIV response – nationally owned and led, sustainable, inclusive and multisectoral,” she said.
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