US: Ending Criminalization of HIV is among Equality Virgina’s legislative priorities for 2021

Equality Virginia outlines 2021 legislative agenda

Equality Virginia Executive Director Vee Lamneck on Monday announced HIV decriminalization is among their organization’s legislative priorities during the 2021 legislative session that begins this week.

“Virginia is one of 37 states with outdated laws targeting and punishing people based on their HIV positive status,” they said during a Zoom call.

According to the Centers for Disease Control and Prevention, these states with laws criminalizing HIV exposure were implemented during the early years of the epidemic to discourage risky behavior leading to transmission, promote safer sex practices and in some instances receive funds to support HIV prevention. The CDC, however, states many of these laws “are now outdated and do not reflect our current understanding of HIV.”

Cedric Pulliam and Deidre Johnson, co-founders of Ending Criminalization of HIV and Over-incarceration in Virginia, support Equality Virginia’s efforts to decriminalize HIV transmission in the state.

“These laws disincentivize testing, deepen community distrust of public health institutions and put people living with HIV at heightened risk of intimate partner violence,” Pulliam told call participants. “Someone can be bit or spit on and they can go to court on that and we know that’s not how transmission occurs.”

Senate Bill 1138, the proposed HIV decriminalization law, is one of eight bills for which Equality Virginia and state legislative sponsors are encouraging public support once the General Assembly convenes on Wednesday. They include an LGBTQ panic defense ban, second-parent adoption protections and an effort to amend the state constitution to affirm marriage equality.

Virginia voters in 2006 approved an amendment to the state constitution to ban same-sex marriages and unions, though the U.S. Supreme Court’s 2015 Obergefell decision rendered the change unconstitutional.

State Sen. Adam Ebbin (D-Alexandria) and state Del. Mark Sickles (D-Alexandria), like others, are concerned with U.S. Supreme Court Justices Clarence Thomas and Samuel Alito’s comments last October that challenged the Obergefell ruling and support amending the state constitution again to affirm marriage equality.

Sickles told attendees on Monday’s call he supported the bill to repeal the marriage amendment, and the two-year amendment process it would initiate because of the conservative makeup of the U.S. Supreme Court and “we don’t know where they are going to go right now.”

However, he felt confident the legislation would pass the 2021 session and make its way to Virginia voters in 2022 when they will vote to affirm marriage equality in the state’s constitution.

“The way Americans think about this fundamental right,” Sickles said. “We should get an overwhelming majority in 2022.”

Lamneck said it was important to remove the ban on marriage equality from Virginia’s legal code and from the state constitution “which is a reflection of Virginia’s values.”

Equality Virginia and state Del. Mark Levine (D-Alexandria), who is running to be the state’s first openly LGBTQ lieutenant governor, also support repealing a “conscience clause” enabling religious-based adoption agencies to discriminate against qualified LGBTQ families.

Ted Lewis, the executive director of Side-by-Side, a Virginia organization supporting homeless LGBTQ youth, said they were excited to support Equality Virginia’s full legislative advocacy agenda. Lewis specifically looks forward to mobilizing around second-parent adoption, more LGBTQ-inclusive family life curriculum, and the repeal of the “conscience clause” exemption.

Many of the other advocates and supporters on the call used a virtual poll to signal their support for a ban on the so-called panic defense.

Sponsored by state Del. Danica Roem (D-Manassas), this legislation would prevent a defendant from blaming violence or murder on the victim’s sexual orientation or gender identity. 

“For Black or brown trans women, we know this is more likely to happen in court that the perpetrators would say the violence was okay because they were LGBTQ,” Equality Virginia Program Director Thalia Hernandez told participants. “It is unacceptable that this is still happening in Virginia and we need to make sure that it is not happening any more.”

Hernandez was pleased to see many of the measures promoted by Equality Virginia were being supported by attendees via the poll, including protections for LGBTQ seniors and Gov. Ralph Northam’s proposed expansion of Medicaid coverage to include transgender health care services.

UK: The criminal law around HIV transmission has failed to keep pace with social and scientific change

Laws around HIV transmissions need urgent update

The criminal law in relation to HIV transmission has not kept up with the science, according to a team of researchers based at Oxford Brookes, Northumbria and Kingston universities.

Alex Powell, Teaching Fellow in Law at Oxford Brookes University said: “The criminal law has continued to frame HIV in terms of personal responsibility and bodily autonomy within the dominant narratives of danger, disease, and out-dated science. Doctrinal law has failed to keep pace with social and scientific change.”

HIV and the Criminal Law

At present, there is no specific law or Act of Parliament in England and Wales that explicitly addresses the subject of HIV transmission. Nonetheless, the criminalisation of HIV has become the subject of growing academic and policy debate. Falling under the scope of the Offences Against the Person Act 1861, the criminal law has established that HIV transmission can constitute an offence of Grievous Bodily Harm (GBH). 

In the article, the researchers considered the changing social and scientific landscape associated with condomless sex, to re-evaluate the development of law in this area, concluding that:

  • The criminal law in relation to HIV transmission has not kept up with the science.
  • If the purpose of HIV transmission is to prevent or regulate ‘serious harm’ (GBH), this definition should be supported by current research rather than outdated fear. The law may be contradictory on these terms by further contributing to medical and social harms such as stigma.

Chris Ashford, Professor of Law and Society at Northumbria University also commented: “The experiences of people living with HIV have been transformed over recent years. Advances in medical science have made the virus a manageable chronic condition, while eliminating the risk of onward transmission for those with access to treatment, something referred to as TasP (treatment as prevention) or U=U (undetectable equals untransmissible).”

Max Morris, Lecturer in Criminology at Kingston University added: “Through the reframing of HIV transmission as an act of harm, criminalisation also implicates the positive partner as a ‘vector of disease’. In doing so, we argue that the language of law diminishes the humanity of HIV positive people by re-constituting them as a ‘danger’ or ‘threat’ to (‘innocent’) HIV negative people.”

The study is published in the Journal of Criminal Law, titled ‘Bareback Sex in the Age of Preventative Medication: Rethinking the “Harms” of HIV Transmission’. 

Belarus: Process to abolish HIV criminalisation statutes in Belarus criminal code has been launched

On improvement of the Criminal Code of the Republic of Belarus and the exclusion of Article 157 “HIV infection”

Translation via Deepl.com – For article in Russian, please scroll down.

People PLUS in action

The legal environment for HIV-positive people will be further improved. The process has been launched. On the eve of December 1 a letter from the Deputy Chairman of the Permanent Commission on National Security of the House of Representatives of the National Assembly of the Republic of Belarus A.V. Dubov was received by the Public Association “PLUS People”.

“I would like to inform you that the proposals to make amendments to the Criminal Code of the Republic of Belarus in the part of abolishment of articles 157 and 158 that were received from the Ministry of Health of the Republic of Belarus in my address have been considered together with interested state bodies. Proposals to repeal Articles 157 and 158 have been sent for consideration and taken into account in the course of finalizing the draft laws.

Proposals to amend the Criminal Code were formed at the Round Table “Maintenance of the status of elimination of HIV transmission from mother to child. Amendments to the Criminal Code of the Republic of Belarus in the part of abolition of articles 157 and 158”, which was held on September 28, 2020 with the participation of Deputies of the House of Representatives of the National Assembly of the Republic of Belarus, the Deputy Minister and heads of departments of the Ministry of Health of the Republic of Belarus, country offices of UNAIDS and WHO, the Republican associations of the Belarusian Red Cross Society and Public Association “PLUS People”.

In their presentation, “PLUS People” RSO told the participants of the Round Table about the benefits that the improvement of legislation will bring to society.

“The qualification of crimes related to HIV infection, not according to a special article, but according to the articles for harm to health and how the cases of private and public prosecution will develop in the society a culture of caring about each person’s own health and measures to prevent HIV infection and other diseases”.

People will no longer be afraid to know their HIV status and will be bravely tested for HIV.

People living with HIV:

After learning the diagnosis, they will not avoid being registered at the dispensary.
be able to exercise their right to establish a family and have children without fear
will not be victims of blackmail, extortion and intimidation
We express our gratitude to the brave people who dared to tell the audience of the Round Table their life stories about how they faced stigma and discrimination, thereby confirming and strengthening the arguments for the exclusion of Article 157 from the Criminal Code of RB, cited by ROO “PLUS People”.


О совершенствовании Уголовного кодекса РБ и исключении ст. 157 «Заражение ВИЧ»

Правовая среда в отношении ВИЧ-положительных людей будет дальше совершенствоваться. Процесс запущен. Накануне 1 декабря в адрес РОО “Люди ПЛЮС” пришло письмо от Заместителя председателя Постоянной комиссии по национальной безопасности  Палаты представителей Национального собрания Республики Беларусь А.В. Дубова.

«Информирую о том, что поступившие из Министерства здравоохранения Республики Беларусь в мой адрес предложения о внесении изменений в Уголовный кодекс Республики Беларусь в части отмены статей 157 и 158 рассмотрены совместно с заинтересованными государственными органами.Принимая во внимание, что в Министерстве юстиции Республики Беларусь создана межведомственная рабочая группа по подготовке проектов кодексов об уголовной ответственности, в рамках деятельности которой предполагается изучение основных направлений совершенствования Уголовного, Уголовно-процессуального и Уголовно-исполнительных кодексов. Предложения в части отмены статей 157 и 158 направлены для рассмотрения и учета их в ходе доработки законопроектов».

Предложения о внесении изменений в Уголовный кодекс были сформированы на Круглом столе «Поддержание статуса элиминации передачи ВИЧ от матери ребёнку. Внесение изменений в УК РБ в части отмены статей 157 и 158», прошедшем 28 сентября 2020 г. с участием Депутатов Палаты представителей Национального собрания Республики Беларусь , Заместителя Министра и руководителей управлений Министерства здравоохранения РБ, страновых офисов ЮНЭЙДС и ВОЗ, Республиканских объединений «Белорусского Общества Красного Креста» и РОО «Люди ПЛЮС».

РОО «Люди ПЛЮС» в своей презентации рассказывали участникам Круглого стола о том, какую пользу совершенствование законодательства принесёт обществу.

«Квалификация преступлений в связи с заражением ВИЧ , не по специально выделенной статье, а по статьям за причинение вреда здоровью и, как дела частного и частно-публичного обвинения будут развивать в обществе культуру заботы каждого человека о собственном здоровье и мерах профилактики заражения как ВИЧ-инфекции, так и других заболеваний».

Люди перестанут боятся узнать свой ВИЧ-статус и будут смело тестироваться на ВИЧ. 

Люди, живущие с ВИЧ:

  • узнав диагноз, не станут избегать постановки на диспансерный учёт
  • без страха смогут реализовывать право на создание семьи и рождение детей 
  • не станут жертвами шантажа, вымогательства и запугиваний

Выражаем благодарность смелым людям, которые решились рассказать аудитории Круглого стола свои жизненные истории, о том как они столкнулись со стигмой и дискриминацией, тем самым подтверждая и усиливая аргументы за исключение ст. 157 из УК РБ, приведённые РОО “Люди ПЛЮС”.

 

Canada: Ontario’s sex offender registry needs further amendments

How should Ontario’s sex offender registry work?

Ontario’s sex offender registry has some soul searching to do. Does it exist to punish offenders, or protect communities? And how can the framework for who goes on the list, which the Supreme Court has ruled discriminatory, support this core objective?

The government has one year to amend Christopher’s Law, named for 11-year-old Christopher Stephenson, who in 1988 was tragically abducted, assaulted and murdered by a known pedophile. A coroner’s jury recommended creating an electronic registry of sex offenders to help police target their neighbourhood searches during the critical hours after a child goes missing.

The legislation received all-party support when tabled by the Harris government in 1999. Members touted the wide net cast by the proposed registry — the first of its kind in Canada — avowing: “Even those offenders who have received absolute or conditional discharges would have to register, with no exceptions.”

That tough talk eventually gave way to reasonable “exit ramps,” providing avenues to stay off the registry if an absolute discharge is given, or to be removed if a record suspension or pardon is granted. That makes sense if the registry’s goal is protection. If it’s not in the public interest for an individual to have a criminal record, how would their presence on a registry help investigators solve any crimes?

When an offender is deemed not criminally responsible (NCR) as a result of a mental disorder, those same considerations may exist. Yet, even with an absolute discharge, these individuals have no way to get off the registry. The discrepancy amounts to discrimination, the Supreme Court ruled last week, upholding a 2019 ruling by the Ontario Court of Appeal.

The charges originated when a man experienced a single manic episode after the 9/11 terrorist attacks. He was found NCR, and received an absolute discharge, yet was placed on the sex offender registry for life. In the years since, he has managed his mental health disorder and committed no further crimes. The victim, his ex-wife, supported his bid to be removed from the registry.

The ruling doesn’t mean every NCR offender should be left off the registry; there’s no evidence suggesting that would serve public safety. But there’s equally no evidence they automatically belong on the registry, perhaps for life, with no consideration of their actual risk of reoffending.

As legislators take another pass at these “exit ramps,” they should think about another group whose presence on the sex offender registry is of questionable value to community safety.

In Canada, people can still be prosecuted for having sex without disclosing they are HIV positive, even when condoms are used diligently and there is no realistic chance of transmission. Failure to disclose invalidates consent, turning otherwise consensual encounters into sexual assault.

The law is a holdover from the days when HIV was considered a death sentence. Canadian courts are slowly recognizing a suppressed viral load makes the virus untransmissible. But they’ve been slower to accept broad scientific consensus that correct condom use also negates any realistic possibility of transmission. Federal prosecutors in the territories are no longer pursuing such cases. But the Ontario Court of Appeal upheld a conviction just this summer.

Men and women who are reluctant to disclose they have HIV, but take diligent measures to prevent transmission, are not aggressors or a threat to public safety. Placing them on a sex offender registry for life does nothing to protect communities from predatory behaviour, nor does it help police knock on the right doors when children go missing.

If the sex offender registry exists to protect, not punish, that’s how it should really work.

AFRAVIH symposium devoted to stigma and discriminatory measures in times of Covid-19 and relevant lessons from the HIV Response

No contradiction between human rights and public health

Google translated extracts from an article published in Seronet on November 11, 2020.  The full article in French can be accessed here: https://seronet.info/article/pas-de-contradiction-entre-droits-humains-et-sante-publique-88959

From November 8 to 11, 2020, Dakar hosted the tenth AFRAVIH conference. The 2020 edition, held virtually, was as rich and dense as in previous years. To return on the strengths of the second day: UNAIDS symposium devoted to discrimination, Covid-19 as a possible “chronic disease” and social sciences, societies and behaviours.

In addition to plenary sessions and numerous thematic sessions, the program for each edition of Afravih is supplemented by symposia organised by major international and non-governmental institutions. November 9 thus proposed, at the end of the day, a symposium of UNAIDS, the wing of the United Nations responsible for the fight against AIDS. This year, the UN agency has chosen to work on “stigma and discriminatory measures in times of Covid-19: the relevant lessons learned from the response to HIV”. In this case, it was not only a question of discussing the subject, but also of including recommendations and proposing “an action plan against stigma” at the end of the conference. 

Roots of stigma and discrimination

“Stigma is unfair treatment, based on negative representations based on identities and in particular the fear of death. It conveys devaluation ”, suggests the definition of Erving Goffmann, theorised in the 1960s. As Auguste Didier Blibolo (human sciences researcher) reminded us, AIDS has been presented as a disease of death and of “unsavoury” people with “socially condemned behaviour”. Initially, the vision was that of a disease of people who had deviant sexual behaviour. And this was associated with the ignorance of the modes of transmission. For the researcher, there are comparable situations between the two pandemics, but to a lesser extent with Covid-19 which is a few months old compared to the HIV pandemic which has lasted for 40 years. One of the possible levers to change this is to raise awareness through the communication of people living with HIV. That is, the public and voluntary affirmation of one’s serological status. Another is to favour the Positive Health Dignity Protection (SPDP) strategy. Its aim is to improve the dignity, quality and longevity of people living with HIV. If this principle is realised, it should have a far-reaching and beneficial impact on communities of people living with HIV, their partners and families. As it has been thought, especially by activists, “Positive Health, Dignity and Prevention” recognises and covers all issues of health and social justice for people living with HIV. It espouses the “fundamental principles that responsibility for HIV prevention should be shared and policies and programs for people living with HIV should be designed and implemented with the meaningful participation of people living with HIV”.

Measuring stigma against vulnerable people

“The fight against stigma and discrimination is a process”, immediately recalled Dr. Ramatoulie Jallow (Yaounde, Cameroon). “We must therefore recognise that social change takes time. The HIV epidemic has taught us that the responses given by communities are the most effective, in particular to fight against discrimination and the stigma experienced by populations and that these responses lack funding, ”she explained. “Today, the crisis due to Covid-19 reminds us of these phenomena of discrimination and stigmatisation of patients. As with HIV, patients with Covid-19, or those who are suspected of being ill, are kept at a distance. The difference with HIV is in the level of information. At the start of the AIDS epidemic, there was no such international dimension, this dimension of community and especially not this feeling that everywhere in the world we are affected by the same pandemic at the same time ”.

The stigmatisation of people living with HIV and people with Covid-19 (and the discrimination to which they are victims) is therefore comparable, but to a lesser extent concerning the latter. For example, the self-discrimination of people living with HIV appears to be stronger. It is true that it is still little studied for people with Covid-19. And Ramatoulie Jallow concluded that in 40 years of the HIV pandemic, it is the community response that has proven to be “the most effective”; All that remains today is to put the necessary funding to make it even more effective and not only for HIV.

It is in the field of “human rights in times of pandemic” and especially on the question of “containment, rights and lessons learned from HIV in the response to Covid-19”, that Mianko Ramaroson intervened (UNAIDS). The expert reported people stopping taking ARVs due to confinement conditions, instances of rights violation, an increase in acts of violence against women and children (+40 to 60 % depending on the situation and country). She also mentioned the loss of income for sex workers, not compensated for by government assistance. The poor consideration of people consuming psychoactive products, or even the absence thereof, in the context of the first confinements. She also mentioned police violence (depending on the country) against the general population; violence often accentuated for the most vulnerable people. She recalled this obvious fact, but which does not seem to apply to everyone: “There is no contradiction between human rights and public health”.

One of the points in common between the HIV and Covid-19 epidemics, in terms of discrimination, remains the cumulative vulnerabilities of the most exposed and vulnerable populations. A UNAIDS report shows that HIV / AIDS and Covid-19 have the particularity of weighing on health systems, especially in the South, poorly funded and ill-prepared to respond to these pandemics. They also have the particularity of revealing and exacerbating existing social inequalities. We learned with the HIV epidemic, punitive measures tend to keep vulnerable people away from care, however, the measures taken during the first confinement seem to have learned no lesson from that time with restrictive measures which harshly penalised populations already highly precarious and stigmatised (sex workers, drug users, etc.) . It is necessary to take this “intersectionality” into account to adapt responses to the health crisis but also to allow everyone access to information… and to their rights.

Recommendations for tomorrow!

At the end of the symposium, five major recommendations emerged from the discussions:

1 – Link the results on the stigma index to the Global Program to Combat All Forms of Discrimination, and make resources available to networks of people living with HIV as part of their advocacy efforts. (Dr Ramatoulie Jallow, GNP +);
2 – Strengthen the awareness of people living with HIV to help them assume their serological status, treat themselves and protect others by being part of the “Positive health, dignity prevention” program. (Auguste Didier Blibolo);
3 – Base health responses on human rights and put communities at the center of these responses. (Mianko Ramaroson, Onusida);
4 – Insist on general information to the population to guarantee the right to be informed and develop partnerships with state departments for new legal provisions. (Maria Amar, CNDH);
5 – Promote mediation approaches and set up contractual systems associating community workers and legal aid in cases of discrimination. (Patrice Sanon, lawyer and activist in the fight against AIDS).

 

 

Global networks and organisations call on the Global Fund to safeguard and support community systems strengthening

Open letter to the Global Fund to Fight AIDS, TB, and Malaria

10 November 2020

Dear Board Leadership, Board Members and Peter Sands,

Community-led and community-based health systems are essential for Resilient and Sustainable Systems for Health that are person-centred, equitable, evidence-based and inclusive

We are a group of global networks and organisations working to advance global health. We have come together to call on decision makers, civil society, technical experts, relevant private sector and other stakeholders from across the global health response to explore how vertical disease-oriented health programmes can integrate, evolve and transform in order to respond and meet the health needs of all people everywhere, and ultimately achieve the highest attainable standard of health through universal health coverage (UHC).

The COVID-19 pandemic (exacerbated by the collision of communicable and noncommunicable disease) has brought the importance of resilient and sustainable systems for health into sharp focus as the first line of defence against the outbreak of disease. 

However, not all COVID-19 responses have recognised the importance of scaling up the work on human rights, the removal of legal and other barriers that hinder access to health, and the importance of community-led and community-based health infrastructure and systems. 

The vital role of communities and civil society has been amply demonstrated in responses to COVID-19 all over the world. Communities have been at the forefront of the pandemic response, delivering life-saving and essential medication despite lockdowns and supply chain disruptions, ensuring food supplies, offering psycho-social support and housing and developing public-information campaigns. Community-led health systems are dynamic, have demonstrated ability to deliver integrated programs across disease areas, and can reach the most marginalised and vulnerable. 

A global survey by UHC2030 and the Civil Society Engagement Mechanism (CSEM) has found that many governments are making decisions without the meaningful engagement of community, people with lived experiences and civil society representatives. Without due consultation of this health expertise, including social and behavioural research and qualitative health data, national response plans will be incomplete and will inadequately reflect the pandemic’s disproportionate impacts on marginalised and at-risk populations. Moreover, the shrinking of civil society space, the persistence of laws that criminalise exposure and transmission of communicable disease, and the disproportionate use of criminal laws and regulations against key and vulnerable populations during COVID-19, all seriously threaten the attainment of the global health goals. 

We know from decades of experience that excluding civil society and community engagement from health approaches results in failure. To be effective, universal health coverage and epidemic preparedness strategies must be based on diverse and multi-sectoral systems for health that integrate and resource community responses as an essential component, rather than an ‘optional extra’. These strategies need to be person-centred and decentralised, addressing all the health needs of the community, especially when targeting communities underserved by current health systems. 

We warmly welcome the Global Fund’s commitment to reinforce systems for health by supporting urgent enhancements to community-led response systems, as part of the four-pronged response to the COVID-19 pandemic. In the 2017-2019 allocation cycle, the Global Fund invested more than US$100 million in community systems strengthening. We urge you to safeguard and build further on this strategic investment that has built resilience and sustainability, making a huge difference in the ability of communities to respond to COVID-19.

We therefore call on the Global Fund to:

  • Prioritise and proactively support community-led and person-centred health initiatives as a crucial component of Resilient and Sustainable Systems for Health
  • Ensure the active and meaningful engagement of civil society, communities and people with lived experiences at every stage of the design and implementation of universal health coverage and COVID-19 response
  • Invest in strong, locally community-driven UHC monitoring and accountability mechanisms at district and national level
  • Invest in robust public health data mechanisms that monitor accurately the response and can provide information about which communities need greater attention and enhanced access to services so that they are not left behind
  • Increase dialogue and initiatives supporting governments to ensure all UHC legislation is rights-based and inclusive, and where necessary reform and repeal laws that criminalise communicable disease

Sincerely,

Georgina Caswell, Head of Programmes, Global Network of People Living with HIV (GNP+)

Victoria Grandsoult, Executive Director a.i., UNITE Global Network of Parliamentarians to End Infectious Diseases

Cary James, Chief Executive Officer, World Hepatitis Alliance

Nina Renshaw, Policy and Advocacy Director, NCD Alliance 

Lucy Stackpool-Moore, Director, HIV Programmes and Advocacy, International AIDS Society (IAS)

Contact: Georgina Caswell, email – gcaswell@gnpplus.net

US: Council of State and Territorial Epidemiologists recommends the elimination of HIV-specific statutes criminalising HIV and the end to prosecutions

CSTE recommendations for modernization of laws to prevent HIV criminalization

I. Statement of the Problem:

The Ending the HIV Epidemic (EHE): A Plan for America initiative aims to reduce new HIV infections in the United States by 90% by 2030 through leveraging critical advances in HIV prevention, diagnosis, treatment and outbreak response. People with living with HIV (PLWH) and stakeholders continue to raise concerns about HIV criminalization as a potential barrier to achieving HIV prevention and care goals . These laws may prevent public health agencies from responding effectively to the HIV epidemic by perpetuating stigma, racism, xenophobia, social and economic injustice, and reducing willingness for people to participate in HIV prevention, testing, and care.

HIV criminalization is defined as laws and policies that are used to criminalize the transmission of or exposure to HIV, or to enhance sentencing because a person has HIV. These laws and policies put PLWH potentially at risk for prosecution in all states, with the majority of states having HIV-specific laws in place. However, state laws, and the application of these laws, vary widely. Most laws do not account for the actual scientificallybased level of risk engaged in or risk reduction measures undertaken by PLWH or persons exposed to HIV. In some states, public health officials are required by law to share protected health information with law enforcement officials.

HIV criminalization has not been shown to be an effective public health intervention. There is no association between HIV infection diagnosis rates and the presence of state laws criminalizing HIV exposure. Studies have suggested these laws are associated with decreased HIV testing and increased HIV prevalence. Surveys among PLWH have not demonstrated that these laws have an effect on sexual practices and therefore, these laws do not serve as a deterrent for potential HIV exposure. Given the punitive but ineffectual outcomes of these laws on PLWH, existing HIV-related laws must be eliminated.

II. Statement of the desired action(s) to be taken:

HIV criminalization laws and policies do not reflect the current science of HIV, but instead criminalize behaviors posing low or negligible risk for HIV transmission, stigmatize and discriminate against PLWH, and undermine national and local HIV prevention efforts. CSTE joins numerous other organizations across the globe in strongly opposing any criminalization of HIV exposure or transmission and recommends that all states, U.S. territories, and local jurisdictions:

1) Eliminate HIV-specific statutes that criminalize HIV, including HIV-specific penalties under general statutes.

2) Eliminate prosecution of HIV under general statutes (non-HIV specific criminalization).

3) Change relevant state and local statutes to specifically prohibit the use of HIV-related, public health data for uses outside of public health purposes, including law enforcement, family law, immigration, civil suits, or other legal purposes.

Public health agencies are the central authorities of the nation’s public health system and must actively inform public policy to ensure laws, regulations, and policies are data driven and scientifically sound. Local, state, and territorial public health officials can do this by engaging in the following activities.

1. Investigate their city, county, and/or state’s laws, regulations, and policies on HIV criminalization and data protection.

2. Assess the disproportionate impact of HIV criminalization laws (in their city, county, and state) on racial, ethnic, immigrant, LGBTQ and other priority populations (now referred to collectively as priority populations). Council of State and Territorial Epidemiologists Interim-20-ID-05 2

3. Engage with and educate public health legal counsel to assure they are up to date on surveillance technology and science of HIV transmission.

4. Review internal legal counsel and health department policies and practices with regard to public health data release for law enforcement purposes and prohibit or significantly limit data release or strengthen data protections when data must be released.

5. Provide unequivocal public health leadership, education, support and information to elected state and local officials, prosecutors, and law enforcement on the relative risks of transmission and the dangers of a punitive response to HIV exposure on our ability to respond to the epidemic.

6. Provide information at legislative or governmental hearings emphasizing data-driven and scientifically sound public health arguments against HIV criminalization.

7. Engage community stakeholders most affected by the epidemic on the impact of HIV criminalization on their lives. Invite them to partner with their relevant public health department to eliminate these laws.

8. Ensure states and local jurisdictions assess the impact of HIV criminalization and address action steps for HIV decriminalization in their EHE initiative implementation plans and the disproportionate impact on priority populations.

9. Identify and share best practices with elected state and local officials, law enforcement and community stakeholders related to successes in changing laws and policies to prevent HIV criminalization.

10. Provide information to the media on advances in HIV treatment and prevention and the detrimental impact of HIV criminalization and prosecution on public health efforts.

III. Public Health Impact:

Preventing HIV criminalization will diminish the burden that has been placed on priority populations and strengthen public health interventions. HIV decriminalization has the potential to engage more individuals in HIV testing and care, leading to earlier antiretroviral treatment (ART) initiation, increased viral suppression, and decreased transmission. Furthermore, prevention activities can be strengthened as more individuals become aware of their HIV status and potential risks for acquiring HIV.

1. Increase HIV testing. Studies suggest that HIV criminalization laws deter participation in HIV testing. Deterrence to HIV testing propagates HIV transmission and results in missed opportunities for HIV care and early ART initiation specifically in priority populations. Thirty-eight percent of new HIV transmissions are attributed to PLWH who are unaware of their status; therefore, HIV testing is essential to increasing awareness among PLWH.

2. Decrease stigma and discrimination related to HIV. Given the heightened community concerns regarding law enforcement actions in minority communities, it is critical that public health activities are decoupled from law enforcement. HIV criminalization perpetuates stigma and discrimination, which are significant barriers to EHE, thereby fueling the epidemic. Eliminating HIV criminalization laws will reduce stigma and may help meet EHE targets.

3. Remove a disincentive to participation in public health efforts (i.e., EHE Pillars: Prevent, Diagnose, Treat, and Respond) Trust is the cornerstone of public health, yet communities of color have a long history of systemic and institutional racism that has eroded trust in public health. Public health officials and community members have raised concerns that routinely-collected public health data can be misused for HIV criminalization and contribute to community opposition to partner services and cluster response. Removing HIV criminalization laws and securing HIV data protections will help to rebuild trust in public health and engage communities of color in critical public health services.

The full statement is available here: https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-05_HIV_Final.pdf

Uzbekistan: While people with HIV are still criminalised, there is hope for change with the the country’s entry into the UN Human Rights Council

Punishment for illness: why HIV is still a crime in Uzbekistan

Google translation. For article in Russian, please go to: https://uz.sputniknews.ru/analytics/20201028/15275804/Nakazanie-za-bolezn-pochemu-VICh-v-Uzbekistane-do-sikh-por-prestuplenie.html

Unfortunately, people living with HIV in Uzbekistan are victims of a discriminatory legal system. But there is hope that with the country’s entry into the UN Human Rights Council, the situation with obsolete norms will begin to change.

TASHKENT, October 28 – Sputnik, Anna Zhelikhovskaya. Shortly before the introduction of quarantine in Tashkent, an investigation began on the case of 52-year-old Natalya (name has been changed. – Editor’s note), a single mother who works as a hairdresser and colourist. The woman is a professional master all-rounder with over 20 years of experience in this field. She was charged under article 113, part 4 of the Criminal Code of the Republic of Uzbekistan “The spread of a venereal disease or HIV infection / AIDS” – knowingly endangering or getting infected with HIV / AIDS.  

Positive result

In 2014, the List of professional activities prohibited for persons infected with the human immunodeficiency virus was updated. It included, in particular, the profession of a hairdresser associated with cutting and shaving. Natalya’s story began in 2017, when the director of the beauty salon where she worked sent employees to undergo, as it turned out, mandatory HIV testing.   

“My test turned out to be positive. I realised that it was impossible, and retaken the analysis. I don’t know how I got through these days of waiting … The answer was again yes. The first thing I experienced was shock. Before that, I did not know anything about this disease I never came across him. Of course, the doctors talked to me, I registered at the Tashkent City AIDS Center, leaving all my data there, “the woman recalls.

She immediately started taking antiretroviral therapy (ART). This specific treatment helps patients block the virus, which means they do not put others at risk, live a full life, have a family and healthy children. For the next two years, she continued to work in the service industry, realising every day that management should know about her illness. Natalya explained the lack of a certificate to the director by the fact that she could not pay for the test at the moment.

“With the best of intentions, of course, he called the SES and asked if I could still not take the test, since I’m not a beautician, I don’t do tattoos and make-up, neither do manicure. I work with paints and cut my hair, mainly with a machine. replied that in this case, the test can not be taken, “- says the woman.

According to her, she did not report the test results to the director because she was afraid of losing her job. Raising a teenage child alone, a woman treasured her only source of income. In addition, Natalia had already learned enough about her illness and understood that with an undetectable viral load (the amount of virus in the blood), she was safe for others.

“Of course, I do not justify myself in any way. I had to report everything to the management and leave the profession. But I was scared, I was lost and did not understand what to do next, how to live now …”

In March 2020, a few days before quarantine, police officers came to the beauty salon with a purposeful check. According to the woman, one of them took her into a separate room and said that with such a diagnosis she was not allowed to work as a hairdresser. It was explained to Natalia’s colleagues and her management that the problem was in the medical book. At the same time, according to her, one of them reassured her, assuring her that there would be no trial, and she would limit herself only to a fine. However, an investigation soon began and the first court hearing was scheduled. Before the trial began, none of her colleagues and the director knew about the real reason for the audit.

“In a conversation with an operative, a doctor in the AIDS center, in the makhalla committee indirectly, not directly, but it was felt that I was suspected of indecent behaviour. To say that I was mentally and psychologically crushed is to say nothing. I am a believer, I walk to the church. For the trial, even my positive characteristics were provided from there, “recalls Natalya.

Today in the minds of people there is still a deep conviction that this is a disease of the marginalised. And if a woman has it revealed, then she will certainly receive the stigma of the fallen. Antiquated HIV legislation also hinders the fight against this stigma.

A new look at old laws

Uzbekistan’s Criminal Code was approved in 1994, and article 113 has its roots in the 1980s. Then the diagnosis was really a sentence, there was no treatment or diagnosis, and criminal prosecution was considered almost the only type of prevention. Several years ago, the World Health Organization officially recognised HIV as a chronic, not fatal, disease. People who regularly take therapy live long and healthy lives. Therefore, the list of permitted professions and the justice system for positive ones should be revised.

“To date, not only has the status of the disease changed, but there is also a lot of data that make it possible to unequivocally assert that criminal prosecution does not prevent the spread of the virus in any way. The existence of criminal liability for endangering and transmitting HIV, on the contrary, leads to the fact that people who practice risky behaviour, avoid testing. After all, while they do not know about their status, they are not subject to responsibility, “says lawyer Timur Abdullaev.

Natalia’s public defender at the trial was Evgenia Korotkova, coordinator of the Positive Women program “Ishonch va hayot”. She says that they monitored the list of prohibited professions for people with HIV in the CIS countries, and nowhere is the profession of a hairdresser.

“At the very first court session, we petitioned for the appointment of a forensic medical examination with the involvement of an experienced infectious disease expert working with HIV. The investigation established that the accused had zero viral load. danger. The indictment states that in order to prevent infection of third parties, she did not work with cutting tools, but used a typewriter. That is, by her actions, she tried to protect clients from HIV transmission, “says Evgenia.

In world medicine, the thesis “Undetectable = Untransmittable” (the principle “U = U”) has been finally proved. Experts and legislators of Uzbekistan have more than 10 years of their own observations and statistics, confirming international data. This already allows us to revise the list of prohibited professions for people with HIV, the relevant law and decriminalise Article 113.

You can already start by looking at the list of prohibited occupations that people with HIV can do.

“Amendments to this list can be achieved if the convict in question does not stop and continues to defend her rights up to the Constitutional Court and the UN Human Rights Committee,” the lawyer said.

According to him, the UN Special Rapporteur on the Right to Health and representatives of other structures of the organisation spoke about the harm of HIV criminalisation, as well as the fact that it violates a number of rights enshrined in international pacts ratified by Uzbekistan. However, so far no action has been taken in this direction.

According to human rights activists, there is a serious flaw in Article 113, which is found in almost all the criminal codes of the Central Asian countries: it contains the word “knowingly”.

“What is” knowingly “and how it relates to intent, the Code itself does not explain. As a result, such a” trifle “becomes a secondary circumstance. Whether intent or not can affect only the severity of punishment, but responsibility does not cancel out. depending on whether a person wanted to infect someone with HIV or not, the article “shines” in any case, “Timur Abdullaev explained.

Usually such inaccuracies in the legislation are eliminated either by bylaws or by Resolutions of the Plenum. But with regard to Art. 113 there is neither one nor the other. There are only Criminal and Criminal Procedure Codes, and everything else is at the discretion of the court. If the judge does not understand what HIV is and how it is transmitted, then the defendant will have a difficult time.

Moreover, even among scientists there is no consensus on whether the presence of intent is mandatory for the onset of responsibility. If so, what should this intent be? After all, it can be direct – “malicious” or indirect.

We need to talk about it

Evgenia also talks about the low level of awareness of representatives of law enforcement agencies and the judiciary about HIV transmission and treatment. She is convinced that to a greater extent this is what influences the sentencing. In her opinion, the application of modern scientific evidence in criminal cases can limit unfair prosecutions and acts of justice.

“When making a diagnosis, doctors do not tell patients about the ‘N = N’ strategy, but take a receipt of criminal responsibility for infecting others with them. Also, activists have difficulty access to the accused, and most lawyers have a prejudiced attitude towards such clients,” the human rights activist adds …

According to the law of Uzbekistan “On the protection of the health of citizens”, the patient has the right not only to keep confidential information about the diagnosis, but also to choose the persons to whom information about the patient’s health can be transferred in the interests of the patient.

Natalia and HIV activists ask themselves: where did the law enforcement agencies get the information about her diagnosis and why did they come to work, inflicting severe moral and psychological damage on the woman? Thus exposing her to the risk of disclosing the diagnosis. At the request of the editorial office, this question was answered at the Republican AIDS Center. We publish the text in full.

The Republican Council for the Coordination of Citizens’ Self-Government, the Committee on Religious Affairs and the Youth Union of Uzbekistan, the Tashkent AIDS Center provided information to the Criminal Investigation Department of the Ministry of Internal Affairs on February 10, 2020 at the request of citizens who are diagnosed with HIV and who work in salons of personal services. At the same time, the center’s specialists ensure the confidentiality of information about people living with HIV and medical secrets in accordance with Article 45 of the Law “On the Protection of Citizens’ Health” dated August 29, 1996, “the letter says. It was not possible to drop the charges against Natalia. But she escaped real imprisonment and received a two-year suspended sentence.

“A large role in our case was played by the competence and interest in the details of the case, as well as in the topic of HIV and the ways of its transmission on the part of the judge and the prosecutor. But this is more a special case than a rule. The judge gave recommendations to lobby for a revision of the list of prohibited professions for HIV – positive, to exclude the position of a hairdresser from it, “says Evgenia Korotkova.

The media should also participate in the formation of a competent public opinion about HIV, but today this topic is almost never raised in the press, and specialised structures do not interact well with journalists. 

Now Natalia has no official job. Several times the makhalla provided her with material assistance, both in connection with the pandemic and with her current situation. But there is no regular, even minimal, earnings.

On October 15, 2020, Uzbekistan adopted a law “On the Rights of Persons with Disabilities.” It lists the basic principles that ensure their rights and protection against discrimination on health grounds. People living with HIV should have similar guarantees. Uzbekistan recently joined the UN Human Rights Council. Perhaps this status will speed up the revision of Article 113 of the Criminal Code. Lawyers are convinced that the punishment should follow exclusively for willful malicious infection or its attempt. Reforms in this area will significantly strengthen the position of the republic in the field of human rights protection.

Jordan: Health professionals mandated to report individual’s HIV status to the government

Foreigners Living with HIV in Jordan Face an Impossible Choice

Government Mandates Reporting HIV Status, Deports People Living with HIV

In Jordan, medical professionals and health facilities are mandated to report an individual’s HIV status to the government. Foreign nationals found to be HIV-positive are summarily deported regardless of the consequences to their health and safety and banned for life from returning.

Earlier this year, an Iraqi gay man living with HIV fled to Jordan to escape persecution he faced at home for being gay, yet he could not access HIV treatment without being immediately deported. When his health rapidly deteriorated, he could not seek medical attention for fear of being deported. Whatever decision he made would threaten his life. 

Jordan also obliges nationals to undergo HIV testing when seeking employment in the public sector and for non-nationals obtaining work permits, and denies them jobs if they are HIV-positive. It also requires testing for non-nationals renewing residency permits. For LGBT people living with HIV, the stigma and discrimination by medical professionals and employers often bars them from accessing basic rights, without any legal recourse.

Abdallah Hanatleh, executive director of “Sawaed,” an Amman-based organization that facilitates access to HIV treatment, told Human Rights Watch that his organization documents dozens of deportations based on HIV status annually.

Jordan is not alone in this abusive practice. Gulf states including Saudi Arabia and the United Arab Emirates also deport people found to be HIV-positive without any provision for continuity of care. Worse yet, in Jordan, as in Saudi Arabia and the UAE, HIV-positive foreign nationals in the criminal justice system are denied adequate access to treatment in prison. “They are placed in solitary confinement, further isolating and stigmatizing them,” Hanatleh said.

International law prohibits deportations based solely on HIV status. Jordan should explicitly ban discrimination based on HIV status and stop deporting HIV-positive individuals under the principle of non-refoulement. This principle applies to asylum seekers and refugees, and for people with HIV, it means that governments are prohibited from returning them — depending on how advanced the disease — to places where they do not have adequate access to medical care and social support, or where they risk being subjected to persecution or degrading treatment on account of their HIV status.

Jordan should not mandate reporting of HIV status and employers should not be requiring HIV testing in the first place. People living with HIV should never be forced to forego lifesaving treatment in order to avoid deportation to danger.

 

US: To end the HIV epidemic in Nevada, laws must be based on science, not stigma and fear

Nevada’s criminalization of HIV must stop now
By Andre C Wade

According to the Center for HIV Law & Policy, 32 states have laws that criminalize behavior of people living with HIV. Nevada is one of those states. In 1993, the U.S. was grappling with HIV — how to treat it and people living with it, how to protect those not living with it — and sought to criminalize behavior of those living with it as a way to remove them from society, in a misguided attempt to decrease transmission of the virus.

During this time of heightened fear and homophobia, when we knew little about HIV, there was a concern about the knowing and intentional transmission and exposure of HIV from one person to the another. This was a concern brought up during the 1993 Nevada Legislature when discussing Senate Bill 514, which prohibits certain conduct through which human immunodeficiency virus may be transmitted after testing positive for disease. One of the villains during the session was Dr. Paul Cameron, who at the time was the Director of the Family Research Institute. The Institute’s mission was to denounce homosexuality and pathologize gay people.

Through his testimony, he likened gay people to serial killers, helping to secure passage of the bill, which stigmatized and criminalized people living with HIV for decades to come. The bill set in motion the penalty of imprisonment for up to 20 years, a fine up to $10,000, or both, for intentionally, knowingly, or willfully engaging in conduct in a manner that is likely to transmit AIDS (which should be HIV as AIDS is not transmittable).  It should be noted that in the early 1980s, the American Psychological Association discontinued Cameron’s membership for his unethical practices as did many psychological and sociological associations at the time.

Currently, in Nevada — thanks in part to Cameron’s homophobic misinformation — it is a Class B felony for a person living with HIV and who knows their status, to intentionally engage in behavior that could transmit the virus to someone else. Public health experts agree that criminalizing a health condition is not a smart strategy for preventing its transmission, but the most egregious part of Nevada’s law is that to be legally liable, the prosecutors don’t actually have to show that there was any risk of transmission or any intent to transmit the virus.

Rather, anyone living with HIV who engages in certain behaviors — regardless of whether they are detectable and transmittable, regardless of preventative measures like condom use or their HIV-negative partner taking PrEP, regardless of the outcome — can be convicted of intentionally transmitting the virus, according to Nevada’s outdated
and harmful law.

Nevada law further complicates the situation by failing to fully define any and all behaviors that could likely transmit HIV — including behaviors such as spitting and biting that public  health experts now agree pose no risk of transmission. Back in the 1980s and 1990s, these behaviors were thought to “likely transmit” HIV, which in 2020 we know is medically and scientifically impossible. Yet, these behaviors are still included in Nevada’s law and could still lead to a conviction. It’s a felony conviction if someone is charged with transmitting the virus to someone else (even if transmission doesn’t occur and even if there wasn’t intent). With other communicable diseases, the charge is a misdemeanor. So, sadly and inappropriately, an incident involving HIV would add a sentence enhancement to a felony.

As it stands, our HIV criminal laws in Nevada are based on stigma and fear, rather than modern science. They don’t take into account the fact that a person living with HIV, today, can take medication to reduce their viral load — the amount of virus present in their body — to an undetectable level, in which case there is no risk of transmission. Our laws are even more out of step given medical advancements via medications taken by HIV-negative people to prevent transmission known as PrEP (Pre-exposure prophylaxis) and PEP (Post-exposure prophylaxis).

It’s time to modernize our HIV laws in Nevada. Sen. David Parks, and the Nevada HIV Modernization Coalition, the Human Rights Campaign and Silver State Equality, amongst others agree. At the national level, the Department of Justice and the Center for Disease Control, the Center for HIV Law and Policy and The Elizabeth Taylor Foundation, to name a few, have called for the repeal or modernization of laws that criminalize HIV.

In 2019, Sen. Parks passed Senate Bill 284 that created a governor-appointed Advisory Task Force on HIV Exposure Criminalization for the state. The task force is charged with, in part, submitting a report that reviews and evaluates current statutes that criminalize exposure to HIV; identifies disparities in arrests, prosecutions and convictions under the statutes; evaluates current medical and scientific research regarding HIV transmission; and looks at what’s happening in other states regarding the modernization of HIV laws.

The Williams Institute is conducting research in Nevada as it has done in California, Florida, Georgia and Missouri to look at disparities in arrests, prosecutions and convictions.

Their current findings in other states are that these laws disproportionately impact Black and Latinx people, LGBTQ+ people, women, sex workers and young people, including minors. These are individuals who are interacting with the criminal justice system, often for the first time and when they otherwise would not have. In Missouri, the Williams Institute has found, that HIV criminalization has cost the state nearly $18 million.

Sadly, the criminalization of HIV undermines the work of public health officials charged with ending the epidemic.

When states and local jurisdictions create and implement plans for ending HIV, often they engage those living with HIV to develop a plausible plan of action.

But our laws are criminalizing those who are supposed to be engaged in plans to end HIV, thereby decreasing the likelihood that they will be able and willing to participate in a meaningful way.

Additionally, the criminalization of HIV further stigmatizes people living with HIV, which can affect overall mental health and well-being, cause someone to not disclose their status to a health care provider or to their partner, or discourage them from accessing health care altogether. Stigmatizing HIV causes people to not want to get tested in the first place, thereby decreasing the chances they will know their status.

HIV is not a crime. Here in Nevada, we need to repeal harmful statutes, reduce sentence enhancements and move some statutes from criminal codes to public health codes. Modernizing our laws based on science and what we know about our laws’ harmful impacts will help Nevada end the epidemic in the state.

André C. Wade is the state director, for Silver State Equality. He is also the chairman for the Advisory Task Force on HIV Modernization for the state of Nevada.