Sweden: Qualitative study shows inconsistencies in information given to people living with HIV pertaining to undetectability, condom use and disclosure obligations

Published in aidsmap on February 6, 2019

Navigating rules and reality: HIV disclosure, infectiousness and legal obligations in Sweden

Krishen Samuel
Published: 06 February 2019
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Despite generally positive relationships with HIV clinic staff, men living with HIV in Sweden report that when it comes to rules regarding disclosure and legal obligations, clinicians were not always clear with patients regarding the meaning of undetectability and whether or not they still needed to disclose or use condoms. Men often needed to seek out other sources in order to find this crucial information, according to a recent qualitative study published in AIDS Care by Tobias Herder and Professor Anette Agardh at Lund University.

According to the Swedish Communicable Diseases Act of 2004, HIV infection is classified as a public health hazard. It stipulates that an HIV positive individual needs to be given written rules of conduct by the treating physician after diagnosis. These standardised rules outline the patient’s obligations, including disclosure of HIV status to sexual partners and using methods to minimise transmission, such as condoms.

In 2013, in accordance with results of the HPTN 052 study, the National Board of Health and Welfare issued a clarification that allowed physicians to exempt those with an undetectable viral load from disclosing their status to sexual partners.

In June 2018 the Supreme Court acquitted an HIV-positive man who did not disclose his status to his sexual partner. He was charged with exposing his partner to the risk of serious illness. However, the Court ruled that stable HIV treatment, with a maintained undetectable viral load, leads to no risk of infection and therefore the man did not need to disclose.

The study

The main aim of this qualitative research was to explore experiences and perceptions regarding disclosure, infectiousness, undetectability, obligations and how this information was communicated to them. Researchers carried out ten in-depth interviews with men who have sex with men between November 2017 and February 2018. Median age was 43.5 (range: 25-71) with 7.5 median years since diagnosis (range: 2-27). Four men had received a disclosure exemption from their doctors, four had not and the other two were unsure. Most participants (70%) were born in Sweden.

An over-arching theme emerged from the interviews: navigating between rules and reality. This theme was identified through qualitative content analysis based on categories that emerged from the interviews. This theme — and the primary finding from the study — indicated that men living with HIV in Sweden needed to navigate the reality of living with HIV while trying to incorporate rules given to them by clinicians into their everyday lives. In certain instances, these rules were not clear or the men were given contradictory information.

Supportive clinics and clinicians

Many participants expressed that clinics were safe, supportive spaces and that they had a positive relationship with clinicians, especially nurses. The men reported that they were able to request a change in treating physician if they did not have a good relationship.

‘In that sense I think it’s great to have such a close relationship with both the physicians and nurses. Because when we meet, we have fun. And they know me, they know the way I am.’

Taking responsibility for one’s knowledge and peer support

Participants revealed that information about HIV and rules about sexual conduct were not always provided at clinics routinely. However, the men took it upon themselves to find out necessary information and felt comfortable asking clinicians when they were unsure. Some participants sensed reluctance on the part of clinic staff to fully explain that undetectability equated to uninfectiousness. The implied message was that men should continue using condoms as a precaution.

‘After multiple ifs and buts [the nurse] finally explained the thing with low infectiousness. I recently thought about this and it was very moralising. “Well, don’t forget that there is still a risk of transmission”. All I really wanted was a clear answer. (…) But she hardly wanted to give me that information.’

Men described accurate information relating to undetectability as a welcome relief; it meant that they no longer viewed themselves as infectious and could be more confident regarding sex. In many instances, this information was acquired from peers, HIV organisations or the academic literature, and not directly from clinics. The importance of peer networks for information-sharing and support was emphasised by some participants.

‘Because they are also HIV positive, they know everything, they know what you are going through, they know what you think and how you function.’

‘There was a security within myself that the virus cannot be transmitted, and reasonably I should be able to have sex on equal terms, as if I didn’t have the virus.’

Finding ways to relate to different rules

While mandatory disclosure to sexual partners and condom use were topics that all participants had discussed with their doctors at the time of diagnosis, the manner in which the rules of conduct were received, and their impact, differed among participants.

Some described it as an inherently stigmatising and negative experience, with a sense of being treated like a criminal. Others only vaguely recalled the discussion and cited their distress regarding the diagnosis as a reason for not fully processing all the information at the time.

“I believe it was more, like, how can you survive? Will I work? I mean questions about life that are bigger than the rules of conduct, more existential questions, I would say, were important at that time.’

‘I think it is really bad that they don’t tell you this. Really bad.’

Those who had received exemptions from the obligation to disclose their HIV status had generally asked their doctors directly. Some participants were not aware that they could be granted an exemption.

Due to fear of criminal charges, some men kept updated on court cases pertaining to HIV non-disclosure and based their rules of conduct on rulings from these cases.

‘As I have understood it, a prosecutor would not move on with the investigation if the person is well treated.’

Inconsistent information leads to frustration

Participants expressed frustration at receiving inconsistent information at clinics. Rules relating to condom use were particularly vague, with some physicians stating that condoms did not need to be used in long-term relationships when undetectable, while others stated that condom use was always necessary. Terms such as ‘minimal risk’ or ‘very little risk’ caused confusion and were not easily translated into real-life instances. Participants felt that younger doctors were more likely able to state unequivocally that undetectable equated to uninfectious, whereas older doctors were much more hesitant to do so.

‘There are quite different responses. Even from the same unit, institution, the response depends on who you talk to. As a person living with HIV I find this quite unpleasant.’

‘The newer ones that come (…) Well, they are more like “But, my goodness, you are not infectious anymore!”, or something like that, yes.’

Conclusion

This study highlights the importance of clear communication between healthcare providers and patients in a country where prosecution for HIV non-disclosure is still a possibility. While many participants expressed that HIV clinics were safe spaces and that they had developed good relationships with staff, they also reported that there were inconsistencies in the information they received pertaining to undetectability, condom use and their disclosure obligations. Some were not even aware that they could be exempt from disclosing.

Men needed to find ways of navigating the Swedish rules and their lived realities, often relying on knowledge gained from other, non-clinical, sources such as peers. Knowledge about being uninfectious was welcomed as a relief for the men, but needs to be communicated more directly, consistently and openly.

Reference

Herder T & Agardh A. Navigating between rules and reality: a qualitative study of HIV positive MSM’s experiences of communication at HIV clinics in 

Canada: Advocacy groups call on provinces to follow the Justice Department's directive to limit prosecutions for HIV non-disclosure

Published in The Canadian Press on February 4, 2019

Groups want provinces to have consistent policies on limiting HIV prosecutions

VANCOUVER — Advocacy groups are calling on provinces to follow the Justice Department’s directive to stop unjustly prosecuting HIV-positive people for not disclosing their status if there is no chance they could transmit the virus to their sexual partners.

The directive to limit prosecutions involving people who are on HIV treatment was issued in December but applies only to federal Crown attorneys in the three territories.
 
Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, said international scientific consensus on HIV transmission was reviewed by the Public Health Agency of Canada and informed the federal decision.
 
Ontario had already amended its policies but in a limited way to no longer prosecute people with a suppressed viral load and Elliott said Alberta has said in a letter to the network it has done the same but without stating that in a policy.

The federal directive goes further in saying people who also use a condom or engage in oral sex should generally not face serious charges such as aggravated sexual assault.

“We’ve written to all provincial attorneys general following the federal directive to say ‘Here’s the federal directive. We reiterate to you what the science is telling us and public-interest reasons for you to appropriately limit the use of criminal law.’ ”

Inconsistent policies mean that HIV-positive people in most provinces may fear being threatened with prosecution by partners who have no basis for a complaint and could even shun treatment based on stigma and discrimination, Elliott said.

In July 2018, scientists from around the world, including Canada, published a consensus statement on HIV transmission in relation to criminal law in the Journal of International AIDS Society. It said correct use of a condom prevents transmission and that possibility is further decreased or eliminated when someone has a viral load that is low or undetectable.

The Canadian HIV/AIDS Legal Network and other organizations are currently pushing Attorney General David Eby to limit HIV prosecution in British Columbia.

“There is not a single circumstance identified in the current BC Prosecution Service policy where they say we will not prosecute even though both Ontario and the feds and Alberta, in a letter, have somehow been able to clearly state that no, we will not prosecute in our jurisdiction someone who has a suppressed viral load.”

Eby was not available for comment.

Dan McLaughlin, spokesman for the prosecution service, said the province is reviewing its policy and has been considering amendments to incorporate the directive of the federal attorney general.

The review will endeavour to ensure B.C.’s policy “addresses both public safety concerns and the issues of fairness and equity in a manner consistent with the law,” he said in a statement.

Elliott, who will be one of the speakers on the issue Tuesday at Simon Fraser University, said about 210 people across the country have been prosecuted for alleged HIV non-disclosure, the second-highest number in the world, after the United States.

Valerie Nicholson of Vancouver has been HIV-positive since 2004 and said her viral load has been negligible since 2008 because of the antiretroviral medication she takes.

Nicholson, who is a member of the Canadian Coalition to Reform HIV Criminalization, said B.C. is “behind the times” with its disclosure policy.

She said she always reveals her status to sexual partners but that information was used against her by a man who informed her a year and a half after their relationship ended that she transmitted the virus to him and he would call police.

“I lived in fear for six months waiting for that knock on the door for the cops to be there,” she said. “I work in this field and if that can do that to me what does it do for someone (else)? Do they stay in an abusive relationship?”

Her big worry was that she had no way to prove she’d had a conversation with the man about her HIV status at the beginning of their relationship, Nicholson said.

Angela Kaida, a Simon Fraser University global health epidemiologist with an interest in the links between HIV and sexual and reproductive health, said the evolving conversation around the virus that is treatable needs to include the latest scientific evidence.

“People can live a normal life expectancy, they can have babies, those babies can be HIV-negative and healthy. People can have sex without a condom and not transmit HIV,” said Kaida, who will also be a featured speaker at the university on Tuesday.

“We have that science but what we haven’t resolved is the stigma, the discrimination and misinformation about HIV. What the evidence tells us that even if we criminalize people it’s not serving a public health goal.”

 

Canada: Workshops find that HIV non-disclosure laws are little known amongst women living with HIV and contribute to social injustices

Published in aidsmap on February 4th, 2019

HIV non-disclosure laws perpetuate social injustices against women in Canada

Krishen Samuel
Published: 05 February 2019
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People living with HIV in Canada can be charged with aggravated sexual assault and be registered as sexual offenders if they do not disclose their HIV status, but many HIV-positive women have little knowledge of this law, according to a recent qualitative study. The law contributes to increased HIV-related stigma, social injustices and vulnerability to violence for women living with HIV, argue Dr Saara Greene and colleagues.

Forty eight women took part in seven arts-based workshops which each took place over a four-day period. Each workshop included an education session regarding the legal implications of non-disclosure, followed by a focus group discussion that allowed women to share thoughts, feelings and concerns regarding the law.

Canada is one of many countries that continues to criminalise non-disclosure of HIV positive status in sexual acts between consenting individuals. Transmission of the virus does not need to occur: a person can be prosecuted for exposure to the virus in the absence of transmission.

In 2012, the Supreme Court of Canada clarified its position on HIV transmission, ruling that people living with HIV are legally required to disclose their status to sexual partners before engaging in sexual activities that pose a ‘realistic possibility of transmission’. According to the Court, two combined factors could be used as a defense against this realistic possibility of transmission: a low plasma viral load (under 1500 copies/ml) and the use of a condom.

Thus, the law does not acknowledge biomedical advances that conclusively show transmission is impossible if the infected individual is virally suppressed (see our factsheet on undetectable viral load and transmission). The ruling leaves room for those engaging in condomless sex with an undetectable viral load to be prosecuted. In Canada, a charge of aggravated sexual assault could carry a maximum sentence of life imprisonment and registration on the sex offender registry.

A more recent 2018 federal directive issued by the attorney general states that a person living with HIV who has maintained a suppressed viral load (under 200 copies/ml of blood) should not be prosecuted, because there is no realistic possibility of transmission. However, this directive only applies in Canada’s three territories and not in the provinces where the vast majority of the population live. Advocates are calling on the provinces to issue similar directives.

The workshops were carried out in 2016 and 2017, in three Canadaian provinces (Ontario, Saskatchewan and British Columbia). The median age of participants was 47 (range: 30-59); the majority of women were Indigenous (60%), with only a small percentage of white women (8%). It was important for minority women to be oversampled as HIV prevalence is nearly three times higher in Indigenous peoples across Canada, with high rates of HIV diagnoses occurring in young Indigenous women. Additionally, 42% of women charged with HIV non-disclosure are Indigenous.

Most women were heterosexual (73%), cisgender (94%) and born in Canada (79%). One-third of women were single, with 29% reporting a common-law relationship.

Analysis of the focus group discussions revealed the following themes:

Confusion and concerns regarding the law

Overall, the education sessions revealed that women were largely unfamiliar with and poorly-informed about laws pertaining to non-disclosure. Questions and concerns were related to legal implications (such as a whether charges could be brought against them for exposure in the absence of transmission or for sexual interactions several years ago). Several women asked what it meant to have a low viral load.

Social and legal injustice

Women felt that the law perpetuates existing injustices in the lives of diagnosed HIV positive women. Thus, factors such as stigma, sexism, racism, colonialism and a lack of education might put those already disadvantaged at a higher risk of being criminalised.

“Like even this isn’t accessible or something understandable for some of my people because we have literacy issues. Some of our people, they left residential school at grade 6 and grade 8…” (Jaqueline, Saskatchewan, speaking about a legal factsheet given to participants)

A contradiction inherent in HIV non-disclosure criminalisation law is that while individuals who are unaware of their HIV status and have a high viral load are more likely to unknowingly infect others, these individuals cannot be prosecuted under Canadian law as intent cannot be proven. The women expressed that the law unjustly targets those who are diagnosed:

“…When I was first diagnosed, I had a higher viral load because I wasn’t being treated. And so actually the silent people who don’t know are more at risk of passing it on. So, who is this [law] even protecting? We are the least likely to pass it on.” (Lori, British Columbia)

As a result of assault laws being used in non-disclosure cases, a common sentiment expressed by women living with HIV was that they were carrying a biological weapon. Thus, HIV stigma was internalised, as a result of the legal system depicting women as capable of inflicting serious harm on their partners:

“…If I was going to go over there and stab [participant] with a knife, that’s aggravated assault. So, they’re taking that knife away and using HIV. I may not have given it to her. So, it’s like the knife never even touched her or the knife wasn’t used. I’m still charged.” (Rachelle, British Columbia)

Sexual surveillance

Participants expressed a sense that they were under surveillance by the criminal justice system when it came to their sex lives. In order to prove innocence, women would need to provide evidence of both a low viral load and condom use, or of disclosure.

The researchers labelled this an ‘intimate injustice’, with HIV-positive women needing to prove their innocence within an inherently unjust and oppressive system. The lengths that women would have to go through to prove this innocence is reflected here:

“So how many people do you have in that room? You have the lawyer that’s witnessing the paper that you’re signing that you’ve disclosed. You have the doctor to say, ‘Yeah, you’re under a viral load’. You’ve got the forensic scientist there getting any evidence. You know, everybody is watching.” (Lilian, British Columbia)

A common question related to undetectability was:

‘So when I look at it, I’m undetectable. So, I cannot transmit HIV to who I’m going to have sex with. So why is it any of their business that I have it when I’m undetectable?’

Another common question was how to prove that a condom was used or that disclosure had occurred after a sexual encounter had taken place. It could come down to a ‘he said, she said’ situation, with the HIV-positive woman needing some form of conclusive proof that she had used a condom or disclosed her status prior to engaging in sexual contact.

“Okay, so say I had a sexual partner. I just met this guy. And my CD4 count is 880. I’m undetectable. But I’ve got to tell him before we get into bed. Do I need to make him sign a document and lock it up and have it witnessed by the neighbor?” (Zainab, Ontario)

Vulnerability to violence

Non-disclosure laws may place women at greater risk for violence. As many as 80% of Canadian women living with HIV have experienced violence in adulthood and the requirement to disclose HIV status to sexual partners could increase the likelihood of intimate partner violence by placing women in a vulnerable position.

Women expressed that they do not always have control over when or how sex occurs with their partners; this negates their agency when it comes to negotiating condom use or disclosing their HIV status.

There was also the question of how disclosure applied in cases of domestic abuse and rape. The law would require women to disclose to abusive partners, placing them at risk of even more violence. The troubling nature of this was expressed in this quote:

“I was raped by three [people] in [Canadian city]. They broke into my home and they held me prisoner for 24 hours and beat me and raped me. And if I had told him I was HIV positive, I would have been dead. I know it. So where does that fit in the picture?” (Julie, British Columbia)

Additionally, the law could be used against HIV-positive women by vindictive partners wishing to ‘punish’ them. Many women had been threatened with charges for non-disclosure by disgruntled partners:

“Could they turn around and even if you’re honest and told them, then … they lied and said, ‘Well, I caught it from her’, or him. And they go to the police and get them charged, just out to be spiteful and mean.” (Catherine, Saskatchewan)

Concerns over violence were particularly salient for Indigenous women:

“When you include the Indigenous community and the numbers and statistics there, like we’re already like 10 times the rate of being gone missing, murdered and, you know, facing violence every day. So, when you throw in … you know, HIV, you know, like it just becomes sometimes not even safe. A lot of people stay in very vulnerable situations because of this law…” (Jaqueline, Saskatchewan)

Conclusion

The researchers conclude that for women living with HIV in Canada, non-disclosure laws can lead to unjust victimisation, perpetuating legal and social injustices. Many of the women did not have the necessary legal knowledge to fully understand the implications of their sexual behaviour to begin with. HIV-related stigma has become legally entrenched and results in women who are anxious about sexual encounters and fearful that they will need to find ways of proving their innocence. Non-disclosure laws may also lead to increased violence against women.

When combined with factors such as sexism, racism, colonialism and violence against women, HIV criminalisation results in continued oppression and thus, advocacy for legal reform is necessary and urgent. The recent federal directive is a step in the right direction but it will still take some time for this to filter down to provincial police and prosecutors.

Reference

Greene S et al. How women living with HIV react and respond to learning about Canadian law that criminalises HIV non-disclosure: ‘how do you prove that you told?’ Culture, Health & Sexuality online ahead of print, 2019. (Abstract).

[Update] US: Missourians living with HIV testify in House committee hearing in support of proposals to modernise HIV criminalisation laws

Published in Houston Herald on Feb. 4, 2019

By Alexis Allison

Proposals to reduce criminal HIV exposure penalties encourage prevention

JEFFERSON CITY — LaTrischa Miles doesn’t spit when she runs.

A mother of three, the treatment adherence supervisor at Kansas City Health Center was diagnosed with HIV in 1995. She remembers the day like her birthday, and she remembers it when she’s running.

“Running is not a pretty sport. You see a lot of things when you’re running. You smell a lot of things when you’re running,” Miles said. “A lot of runners get dry mouth, and they spit, a lot. But I dare not. Because if I spit … I may get arrested at the finish line.”

Current Missouri law makes it a felony for a person knowingly infected with the human immunodeficiency virus to “recklessly” expose someone else without their knowledge or consent — whether or not the person meant to do so, and whether or not the victim contracted HIV. The law lists sex, needle-sharing and biting as methods of transfer.

It’s not clear whether spitting during a half-marathon violates the law, but that uncertainty is part of the problem. “As a person living with HIV,” Miles said, “I’ve lived in the shadow of these criminal laws.”

But for the second year in a row, Reps. Tracy McCreery, D-St. Louis, and Holly Rehder, R-Sikeston, have filed separate but similar bills to modernize what some call the “criminal HIV exposure” law.

Each proposal would apply penalties currently reserved for exposing someone to HIV to other “communicable diseases,” such as hepatitis C or HPV, and minimize the punishment for those convicted. The proposals also update the law’s language to reflect current understanding about how HIV is transmitted.

Miles and a slew of public health advocates, students and Missourians living with HIV testified in a House committee hearing Monday in support of the proposals. The witnesses emphasized the need for a revised bill that would reduce stigma, encourage people to know their status and reflect modern science.

“So much has changed. HIV is no longer a death sentence. It’s a chronic disease. It’s a human disease,” Miles said. “Persons living with HIV that once took 16 pills a day … now have the option to take one pill a day.”

Lawmakers passed the original bill in the late ‘80s, an era when the rampant spread of AIDS through sex made lovers into killers, and the law ensured they would be punished accordingly. Mere exposure can lead to a class B felony conviction. If the victim contracts HIV, the charge bumps up to a class A felony, punishable by up to 30 years or life in prison. It’s the same consequence in Missouri for murder.

Both proposals would consider whether the person with a communicable disease intended to transmit it to someone else, and the consequences would be less severe. Rehder’s bill makes knowingly exposing another person to a communicable disease a class C felony; if transmission occurs, the charge becomes a class B felony.

“For comparison’s sake, if you’re driving while intoxicated and hurt someone but don’t kill them in Missouri, it’s a class C felony,” Rehder said. “If you’re driving while intoxicated and in an act of criminal negligence you cause the death of someone, then it’s a class B felony, so that makes it more consistent.”

McCreery’s bill offers a less severe punishment, diminishing the consequences for exposing another person to a communicable disease to a class B misdemeanor — or a class A misdemeanor if the victim contracts the disease.

The severity of the current law also serves as a disincentive for people to know their HIV status, Rehder said. If a person doesn’t know they have HIV, they can’t be convicted of exposing the virus to another person.

And, Rehder said, people who are unaware of their positive status are responsible for 90 percent of HIV transfer — and that ignorance is a public health issue.

“The bottom line is, we want people to get tested and know their status and get treatment,” she said.

Another strategy the proposals encourage is prevention. Under the current law, condom use — which the Centers for Disease Control and Prevention recommends as a preventative strategy — is not a defense. The new proposals note that using science-based, preventive measures (including condoms) could serve as evidence that the person with the disease did not intend to expose or transmit it.

The proposals offer a few more updates based on the scientific advancements that have happened in the last 30 years. For one, they’ve removed “biting” from the list as a way to transfer HIV. In fact, transmitting HIV via biting is extremely rare — so rare that the CDC notes it’s only happened when the bite led to “severe trauma with extensive tissue damage and the presence of blood.”

McCreery’s bill removes the current law’s enhanced punishments for HIV-positive sex workers; Rehder’s does not address it. McCreery’s bill also eliminates punishments for a person with HIV or hepatitis who endangers a correctional or mental health employee.

The current law lists exposure to feces, urine or saliva as a means for transmission. Rehder’s version no longer specifically penalizes HIV or hepatitis and applies only in the case of exposure to “bodily fluids … scientifically shown to be a known means of transmission of a serious infectious or communicable disease.”

Rehder acknowledged that neither proposal is perfect, and the final product may lie somewhere between the two.

“We’re working closely together to present Missouri-specific options to update Missouri’s antiquated HIV laws,” McCreery said in an interview after the hearing. “We wanted to send a strong message to Missourians that this is a nonpartisan issue.”

 

Published in Fox2Now on December 1, 2018

Lawmakers, health officials push Missouri HIV law rewrite

JEFFERSON CITY, Mo. – Some Missouri legislators and public health professionals are calling for a rewrite of the state’s HIV laws, which they say are outdated and medically inaccurate.

The St. Louis Post-Dispatch reports that Republican Rep. Holly Rehder and Democratic Rep. Tracy McCreery proposed bills in the last legislative session to reduce the state’s penalties for exposing someone to HIV. They plan to present the same bills in the 2019 session.

Missouri’s roughly 30-year-old law states that an HIV-positive individual could be convicted of a felony if he or she exposes a partner to the disease without the partner’s knowledge or consent. The law gives a minimum 10-year sentence for transmitting HIV and minimum five-year sentence for knowingly exposing someone to HIV.

Advocates say such laws result in questionable prosecutions and negative public health outcomes.

 

US: The SERO Project looks back at its achievements in 2018

January 2019 Newsletter

Table of Contents

HIV is Not a Crime III

HIV is Not a Crime III Training Academy (HINAC III), produced by Sero in partnership with the Positive Women’s Network-USA, educated and trained 245 advocates from 36 U.S. states and six countries (Canada, Mexico, Belize, Germany, UK, and Colombia).

 

The gathering was held June 3-6, 2018, at Indiana University-Purdue University Indianapolis (IUPUI) with in-state organization partners, the Indiana HIV Modernization Movement, and Brothers United. 

 

HINAC III included a two-day Black United Leadership Institute (BULI) pre-conference for 50 participants, to elevate leadership of Black people, especially PLHIV, in state-level efforts to address HIV criminalization. The full report from the 2018 HINAC Training Academy can be read here.

 

The inaugural HIV is Not a Crime (HINAC I) event was held at Grinnell College, in Grinnell, Iowa, in June 2014. HINAC II was held in May 2016 at the University of Alabama/Huntsville, with 297 participants from 34 U.S. states, Puerto Rico, and four countries (Mexico, Canada, England, and Germany). 

 

Planning is now underway for HINAC IV, date and location to be announced soon.

 

Sero video from HINAC III for Day With(out) Art 2018: Alternate Endings, Activist Risings

Sero supporter Mark S. King worked with Visual AIDS to create a video at HINAC III as part of Visual AIDS Day With(out) Art 2018: Alternate Endings, Activist Risings. Thank you to Mark and Visual AIDS, as well as Stacy Jennings, Billy Willis III, Susan Mull, Shyronn Jones, and Contonnia Turner, all featured in the video.

 

Network Empowerment Project: Tools to Strengthen a Movement

Sero’s Network Empowerment Project was inspired by the Denver Principles and other PLHIV self-empowerment initiatives and launched to facilitate the creation and strengthening of PLHIV networks, whether they are focused on advocacy, education, recreation, provision of services, or social support.

 

PLHIV networks improve health outcomes for people living with HIV as well as contribute to stigma reduction and improve advocacy outcomes. PLHIV Networks enable us to:

  • Determine our own agenda(s), rather than having them defined by others;
  • Choose our own priorities and strategies;
  • Select and hold accountable leadership of our own choosing;
  • Speak with a collective voice.

When we create community and work together, our voices are heard more clearly, and we have a greater influence on the policymaking that so profoundly affects our lives. PLHIV networks also have traditionally been the incubators from which emerges new PLHIV leadership.

 

NEP’s online tool kit provides resources, research, and contacts to help create and strengthen PLHIV networks.

Sing Your Song: PLHIV Networks Change Lives

On December 1, 2018, World AIDS Day, Sero released a new video about PLHIV networks, filmed at the Mississippi Positive Network‘s “We, the Positive” summit in Jackson, Mississippi in October 2018. It is a moving illustration of the power of networks to change lives and strengthen the voice of PLHIV.

 

State Updates

Texas: A Network is Born

In May 2017, history was made when Texans living with HIV, from Houston, Dallas, San Antonio, Beaumont, and elsewhere, created the Texans Living With HIV Network. Venita Ray, a woman living with HIV who helped organize the meeting, said, “TLHIV will be a collective voice for all Texans, ensuring that we are involved with all policies and decisions that impact our quality of life.”

“TLHIV will continue the legacy of involvement by people living with HIV embodied in the Denver Principles,” says Ray, who also serves as deputy director of Positive Women’s Network-USA. “Nothing about us without us!”

Sero staffers Tami Haught and Robert Suttle, along with facilitator Laura McTighe, were on hand at the gathering, which was supported by Sero and the Southern AIDS Coalition.

Michigan Passes HIV Criminalization Reform

Excerpt from Michigan Makes Strides in HIV Disclosure Law press release], published by Michigan Coalition for HIV Health and Safety:

January 8, 2019 – LANSING, MI. After five years of work by the Michigan Coalition for HIV Health and Safety with the Michigan Department of Health and Human Services (MDHHS), advocates living with HIV and other national and local partners, Michigan’s HIV disclosure law has been modernized.

The new legislation, HB 6020 and HB 6021, was introduced by State House Representative Jon Hoadley (D-Kalamazoo) and was supported by the Republican majorities in the House and Senate. After passing both chambers, the bill was presented to Governor Snyder who signed the bill December 27, 2018.

Previously, a person living with HIV (PLHIV) could face a felony up to 4 years in prison for not disclosing their HIV status prior to any type of sexual penetration. The degree of risk of HIV transmission was not a factor in the statute; including circumstances where there was no HIV transmission, nor even any risk of HIV transmission.

The amended law removes those living with HIV who are on treatment and virally suppressed—posing no risk of transmitting HIV—from being subject to prosecution. It also narrows the scope of sexual activities subject to prosecution, from “any type of sexual penetration to only “vaginal and anal sex.” Oral sex, which poses no or negligible risk of transmission regardless of whether the person with HIV is on treatment or virally suppressed, is no longer subject to prosecution.

View the full press release here.

Virginia is for (Justice) Lovers

In November, Ending HIV Criminalization and Over Incarceration in Virginia Coalition (ECHO VA) and Sero hosted a strategic planning meeting for service providers, grassroots activists, public health professionals, legal experts, and PLHIV to engage across differences; strengthen connections to broader struggles for racial, gender, economic, and health justice; and to develop shared values and priorities in the movement to end HIV criminalization in Virginia.

Georgia: HIV Rural Research and Training Conference

Sero hosted a workshop on HIV criminalization at the HIV Rural Research and Training Conference in Savannah, Georgia in September 2018. The workshop focused on strategies and tools to advance HIV criminalization reform efforts and, specifically, to update attendees on legislative reform efforts underway in Georgia and Florida.

Jack White III, co-director of THRIVE SS‘s Political and Social Action Network, presented current efforts of the Georgia HIV Justice Coalition. Sero’s Kamaria Laffrey discussed successes and challenges the Florida HIV Justice Coalition has experienced.

Sero’s Tami Haught and Cindy Stine led a discussion on building a diverse coalition of PLHIV; medical, public health, and legal professionals; and AIDS service, healthcare, and faith-based organizations to mobilize for change. 

To get involved with the Georgia HIV Justice Coalition, contact Johnnie Ray Kornegay III at johnnie.kornegay@counternarrative.org. For information about theFlorida HIV Justice Coalition, contact Kamaria Laffrey at kamaria.laffrey@seroproject.com.

Florida: Learning from the Legislative Process

Efforts in the Florida legislature to modernize HIV-related statutes made progress in 2017 and 2018. After a day-long stakeholders planning session in October, 2018, the Florida HIV Justice Coalition is now organizing for the 2019 legislative session.

Sero’s Kamaria Laffrey coordinates the Florida HIV Justice Coalition and works closely with its steering committee to expand their coalition of advocates and allies to share a clear, unified message with the community, media, and legislators on the detrimental effects of HIV criminalization.

 

The Steering Committee includes representatives from ACLU-FL, Lambda Legal, AHF, Sero Project, PWN, Southern Poverty Law Center, SAVE, Equality FL, The AIDS Institute, and Sex Workers Outreach Project. Kamaria also works on a regional training program to groom leaders, particularly women living with HIV, to educate and mobilize on HIV criminalization issues across Florida.

Pennsylvania: PLHIV Organizing in the Keystone State

Sero, Positive Women’s Network-Philadelphia, and the AIDS Law Project of Pennsylvania are working together to raise awareness of HIV-related stigma, discrimination, and criminalization in Pennsylvania.

 

Last May, Sero’s Sean Strub participated on a panel discussion at the LGBT Center of Central Pennsylvania with Julie Graham, a criminalization survivor, Alder Health Service’s Rosemary Brown, and Ronda Goldfein, Esq., executive director of the PA AIDS Law Project. Strub and Goldfein participated on a similar panel held in the Lehigh Valley at Northampton Community College.

 

In September, a delegation including Waheedah Shabazz-El (PWN-USA), Teresa Sullivan (PWN-Philadelphia), Andrea Johnson (PWN-Philadelphia), Adrian Shanker and Atticus Ranck (Bradbury-Sullivan LGBT Center in Allentown), Adrian Lowe (PA AIDS Law Project), as well as Strub and Goldfein, met with Pennsylvania Surgeon General Rachel Levine and her staff to review a range of HIV-related issues.

 

A statewide strategic planning session is scheduled for February 2019 to coordinate plans for launching a new Pennsylvania PLHIV HIV Justice Network.

 

If you are interested in joining the movement to create a statewide network in PA, contact: info@seroproject.com.

 

Idaho Moving Forward

The Idaho Coalition for HIV Health and Safety hosted a 2-day strategic planning meeting September 25-26, 2018. The meeting focused on drafting a modernization bill, messaging and advocacy organizing strategy.

North Carolina HIV Advocacy Conference

Sero’s Tami Haught joined Carolyn McAllaster (Duke HIV/AIDS Law Clinic), Jacquelyn Clymore (NC HIV/STD/Viral Hepatitis Director), Alicia Diggs (Positive Wellness Alliance), and Jeffery Edwards-Knight (Mecklenburg County Public Health) at the 2018 NC HIV Advocacy Conference: Building Power Across the Spectrum.

The opening plenary, “HIV Criminalization in North Carolina: Where We’ve Been and Where We’re Going,” presented changes in North Carolina’s HIV control measures, reviewed task force processes, and discussed the interaction between state and county health officials and where North Carolina fits within national efforts to end HIV criminalization.

North Carolina AIDS Action Network debuted this short video.

International AIDS Conference

At the 22nd International AIDS Conference, held in Amsterdam in July 2018, Sero helped make awareness of and action addressing HIV criminalization a priority:

Sero co-sponsored a pre-conference, Beyond Blame 2018: Challenging HIV Criminalization.

Sero’s Robert Suttle spoke on a panel at the conference’s opening plenary (Robert’s comments begin at 1:38:00). Right after Robert’s eloquent comments, Sir Elton John and Prince Harry came on stage for their presentation!

An Expert Consensus Statement on the Science of HIV in the Context of the Criminal Law was released at a press conference with representatives from the International AIDS Society, International Association of Providers of AIDS Care, UNAIDS, Sero, and HIV Justice Worldwide. The statement, now endorsed by more than 70 of the most respected HIV scientists, physicians, and researchers in the world, was also published in the Journal of the International AIDS Society.

Professor Linda-Gail Bekker, the President of the International AIDS Socity, listens intently as Kerry Thomas, a member of Sero’s board of directors, spoke at the press conference by telephone from the prison in Idaho where he is incarcerated and serving a 30-year sentence for HIV non-disclosure, despite using condoms and having had an undetectable viral load.

Sero’s Kamaria Laffrey (left) spoke at the march that opened the conference, joined by Laela Wilding and Quinn Tivey, icon AIDS activist Elizabeth Taylor’s granddaughter and great-grandson, who are continuing Dame Elizabeth’s legacy through their work with the Elizabeth Taylor AIDS Foundation.

S.O.S.

Dear Sero Project supporters and allies,

Working to end HIV-related stigma, discrimination, and criminalization can be frustrating or disheartening, especially for those who suffer the most extreme consequences of such injustice. That’s partly because HIV stigma bias is, unfortunately, rising rather than declining. Even as we make progress in our efforts to end HIV criminalization—and we have made progress this year—the road ahead stretches long into the future.

Decades ago, I first viewed my AIDS activism as a temporary priority, something that could be fixed and then I could move on with other endeavors and priorities in my life. My perspective changed over time, as it did for others, because we learned, or experienced, how inextricably HIV-related injustices are linked to other injustices. Even as effective therapy changed what it meant to live with HIV, it only brought those other injustices into starker relief.

Eventually, I stopped looking for where the road ended, for some mythical point in the future when all will be well, and came to understood that activism was a defining value in my life, fundamental to my purpose. A similar commitment is reflected in Sero’s staff—Robert Suttle, Tami Haught, Ken Pinkela, Kamaria Laffrey, Cindy Stine, and Gonzalo Aburto—and it is shared by so many partners, allies, and comrades in the broader community of those fighting to end HIV criminalization. I salute all of them and I salute you.

Let’s hope 2019 brings a renewed respect for people living with HIV and many more allies in our struggle for justice for all.

Regards,

Sean Strub

Executive Director

 

Sero at Harvard Law School

Last March, Sero’s Executive Director, Sean Strub, participated on a panel, Creating a Viral Underclass, at an event at Harvard Law School organized by Harvard Law School Lambda, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, and the Center for Health Law and Policy Innovation.

 

Sero Holiday Card Project

Every year, Sero’s Cindy Stine coordinates a Holiday Card project to send cards to incarcerated people, mostly people living with HIV or other chronic health conditions. Volunteers all over the U.S. prepare cards according to the restrictions imposed by prison officials (no glitter, colored paper, etc.) Cindy collects the cards and sends them to the recipients to let them know there is a community that cares about them and is thinking of them, especially over the holidays.

Media Watch: Sero in the News

 

Many thanks to Allison Nichol, Sero’s Senior Legal and Policy Advisor, for her dedication and commitment to the rights of people living with HIV. Allison has taken a new full-time position as Director of Legal Advocacy for the Epilepsy Foundation of America. We are grateful that she will continue to work with Sero on several projects in a pro bono capacity, and we wish her the best of luck in this new role.

 

Thank You

Sero’s work is made possible by contributions from many donors, including major support from the Elton John AIDS Foundation, H. van Ameringen Foundation, Broadway Cares/Equity Fights AIDS, Ittleson Foundation, ViiV, AIDS Healthcare Foundation, and the Levi Strauss Foundation. Please support Sero’s work by donating online.

 

US: Robert Suttle reflects on outdated HIV-specific criminalisation laws and the work of advocates to change them all over the US

by 
 
UNDER LOUISIANA LAW, YOU CAN WIND UP WITH A $5,000 FINE AND FIVE YEARS’ JAIL TIME IF SOMEONE COMES IN CONTACT WITH YOUR SPIT — IF YOU’RE HIV POSITIVE. THESE LAWS ARE BASED ON OUTDATED SCIENCE AND MULTIPLE ORGANIZATIONS ARE WORKING TO CHANGE THEM.

Whenever Robert Suttle thinks about his time in jail, his eyes go soft, he lets out a long breath and his lips purse a bit. It’s noticeable that he — after almost a decade — still gets emotional about what put him behind bars.

In 2008, while working as an assistant clerk for the Louisiana Court of Appeals, Suttle went through a bitter breakup that resulted in a tit-for-tat trial, ending in Suttle being sentenced to six months in jail and registering as a sex offender for intentionally exposing a sexual partner to HIV. But there was no transmission of the virus.

And even though Suttle says he disclosed his status to his partner and that the sex was consensual, it didn’t matter much under Louisiana’s HIV exposure law, which states that anyone with HIV or AIDS who has unprotected sex can be tried and charged with a nonviolent felony. Offenders can be sentenced to up to 10 years in prison and must register as a sex offender in some cases.

But Louisiana’s intentional HIV exposure statute, enacted in 1987, revised in 1993 and again in 2011, is out of date and not backed by science. For example, spitting and biting are considered grounds to be charged for criminal exposure to AIDS, even though it’s impossible to transfer the virus through spit and exceedingly rare for HIV to be passed on through biting (and the risk is nonexistent if the skin isn’t broken).  

What’s more, Suttle, who was diagnosed with HIV in 2002, couldn’t pass the virus on anyway. Antiretroviral treatment had made his viral load undetectable, which means the level of HIV in his blood was so low that it would’ve been impossible to transmit.

“I didn’t quite understand how it could come to this,” Suttle says. “It was being gay and HIV positive that led me to … being criminally liable.”

As more people become aware of possible criminal charges — thanks in part to local reporting on alleged offenders — some of those most at-risk are unwilling to get tested. Criminalizing one’s status has created a stigma, advocates say, which in turn can endanger whole communities.

“[People know] that if they test positive, they can get charged or arrested,” says Gina Brown, an HIV and AIDS activist in New Orleans who is HIV positive. “The laws need to change, and people in charge need to get educated.”

Across the nation, HIV transmissions have been steadily declining since the beginning of the decade. At the same time, the demographics of the disease have changed. No longer does HIV primarily affect gay men; today, those who are most at risk also include injection drug users and poor people of color, particularly in the South. Despite that shift, regulations and laws that criminalize one’s HIV status still abound, and they have roots in outdated science that has largely been debunked.

There are currently 26 states with HIV-specific criminalization laws, some of which penalize behavior regardless of whether the virus was actually transmitted. That number was higher in the 1980s and ’90s, when fear of HIV — and myths around how it spread — was rampant. Lawmakers claimed at the time that the statutes were meant to protect the general public. Instead, they have had the opposite effect: Since you can’t be prosecuted if you don’t know your status, there’s an incentive to not getting tested. Studies have also shown that HIV criminalization has little to no effect on deterring people from spreading the virus willingly, and in fact, such laws have only worsened its spread.

Nearly all of the states with the highest rates of new HIV diagnoses — in 2017, Louisiana ranked third — have HIV-specific exposure laws still on the books.

“People don’t know the collateral consequences,” says Suttle, who now works as an assistant director at Sero Project, a nonprofit that fights stigma and discrimination by focusing on HIV criminalization. “These laws hinder people from getting care.”

Suttle says the biggest obstacle is education, especially among people who still view HIV and AIDS as a death sentence.

“Education of the masses cannot be stressed enough. You can talk to anybody, and people honestly think that [people charged under HIV exposure laws] should be fully prosecuted and locked up,” Suttle says, adding that Sero Project has tried to humanize people living with HIV through anti-criminalization campaigns, lobbying and public outreach.

Sero Project is one of only a handful of national organizations — the Elizabeth Taylor AIDS Foundation and the Center for HIV Law and Policy are two others — that have been on the front lines of fighting against HIV criminalization.

This year, Sero Project, in partnership with the Positive Women’s Network, launched a training academy to teach advocates how to organize and repeal state HIV criminalization laws. In South Carolina, Sero Project’s training helped establish a coalition of 50 lawmakers, advocates and nonprofits to try and change the state’s HIV criminalization laws.

“They gave us the tools to do our own work here within our community, and educate people. Now we have more and more people who are interested, because every time we get out and share with the community, we’re getting more people asking about the laws,” says Stacy Jennings, chair of the Positive Women’s Network regional chapter in South Carolina. “It’s sad that [people living with HIV] don’t know [about the laws] because they should know. Every chance we get we’re teaching them.”

As a result of Sero Project’s efforts to get communities educated on local laws, Suttle has seen a sea change in the number of people coming forward to fight the stigma around being HIV positive.

And that’s been helpful in places like Louisiana, where advocates say the need for educating and empowering people to get tested and stay healthy is dire.

“We actually have been able to get into the offices of legislators and tell them why this law is outdated and plain wrong,” says Brown, the AIDS activist. “We have some of the highest rates of HIV transmission in the country, and that won’t get better so long as there are laws that actively make people fearful of getting tested.”

—

This is the third installment in NationSwell’s multimedia series “Positive in the South,” which explores the HIV crisis in the Southern U.S., and profiles the people and organizations working to alleviate it.

Published in NationSwell on December 22, 2018

Kenya: Five people living with HIV file petition at the High Court in Nairobi to declare HIV criminalisation law unconstitutional

Overturn law criminalising deliberate transmission of HIV, say petitioners

Five people living with HIV have petitioned the judiciary to declare unconstitutional a law that makes it illegal to transmit the virus and other sexually transmitted infections.

The petitioners said the law makes it almost criminal for HIV-positive people to marry and for women living with the virus to give birth and raise children.

The petition targets Section 26 of the Sexual Offences Act, which criminalises intentional transmission of HIV even among married couples.

Those found guilty can be jailed a minimum 15 years or for life.

“Thousands of discordant couples and breastfeeding mothers living all over Kenya run the risk of being arrested and charged under this provision if they come forward for HIV testing,” said M.A, the fourth petitioner representing discordant couples.

The petition was filed at the High Court in Nairobi on Monday with the help of the Kenya Legal and Ethical Issues Network on HIV and Aids.

“The key to a successful HIV response and ending Aids is making sure everyone with HIV knows their status and gets on treatment. These laws make that impossible,” the petitioner said.

A growing global consensus amongst experts and institutions such the World Health Organisation and Unaids show that laws criminalising HIV transmission weaken the ability of governments to end the Aids epidemic.

The sexual offences Act section 26 says: “any person who, having actual knowledge that he or she is infected with HIV or any other life threatening sexually transmitted disease intentionally, knowingly and willfully transmits it… is liable upon conviction to imprisonment for a term of not less 15 years but which may be for life.”

Kelin boss Alan Maleche said this is one of the worst HIV criminalization laws in the world.

“This petition will not only safeguard the rights of those living with and affected by HIV and other sexually transmitted infections but also help alleviate the discrimination and stigma they face and help Kenya remain on track in achieving the 2020 UNAIDS Fast Track targets in ending Aids,” he said yesterday.

In 2015, the High Court declared section 24 of the HIV and Aids Prevention and Control Act unconstitutional.

The section also criminalised intentional spread of HIV, instituting a maximum jail-term of seven years with the option of a fine.

Nelson Otwoma, the Director at the National Empowerment Network of People living with HIV/AIDS in Kenya, said HIV criminalization laws are also notorious for abuse and arbitrary enforcement.

“Such abuse will always be targeted at persons living with, vulnerable to or believed to be living with HIV whether or not their actions were culpable and whether or not their actions exposed another to the risk of contracting HIV,” he said.

Published on December 13, 2018 in the Star

US: Q & A with Sen. Scott Wiener, one of the authors of Senate Bill 239 that modernised HIV criminalisation law in California

Successful HIV Criminalization Reform in California: Q and A with Sen. Scott Wiener

The majority of states have laws that criminalize activities engaged in by HIV-positive people that are not criminalized when engaged in by the rest of the population.

Many of these laws improperly single out HIV over other infectious diseases and reflect a lack of understanding of both how HIV spreads and how it can be treated.

In 2017, California passed legislation which modernized and improved California’s HIV criminalization law. One of the authors of the law was State Senator Scott Wiener. I recently had a chance to ask Sen. Wiener some questions about that process.

His responses are given here in hopes of supplying useful information for legislators, lobbyists, and activists in other states who are interested in starting the reform process in their own states or other jurisdictions around the world. This interview has been edited for clarity.

Mark Satta: You sponsored and helped author California Senate Bill 239, which in 2017 was signed into law by Governor Jerry Brown. Senate Bill 239 modernized HIV criminalization in California. Can you give us a brief overview of what California HIV criminalization law looked like before the passage of this new law and what the major changes are that passage of the new law brought about?

Sen. Scott Wiener: In the late 1980s and early 1990s, California, like many states, adopted very harsh felonies to punish HIV-positive people who engaged in sexual activity with other people without disclosing their HIV status.

California has a catchall misdemeanor for willfully exposing someone to an infectious disease, which has been on the books for many years. But HIV, of all the many serious, deadly infectious diseases, was singled out for especially harsh felony treatment. The laws didn’t require you to transmit HIV, and in fact didn’t even require any meaningful risk of infection. So if you were virally suppressed, for example, or if the other person was on PrEP, or if you were engaging in sexual activity that really didn’t create much of a risk, under the old laws, it didn’t matter. They were very broad, draconian laws.

There was one law specific to sex workers where there didn’t even have to be physical contact. If [a sex worker] solicited someone without telling them they were HIV-positive, even if they never actually had sex, they were guilty of a felony. The new law converts sex worker felonies into misdemeanors.

It was really women, and in particular African American women and sex workers, who were targeted. And really, the laws did nothing to actually reduce HIV infections — all it did was stigmatize people with HIV and encourage people to hide their status.

So they’re just terrible, horrible laws and that’s why we tried to reform them.

Satta: In writing the bill, what were the major sources of information that you and Assembly member Gloria consulted to determine the ways in which California’s criminalization of HIV failed to accord with our scientific and medical understanding of HIV/AIDS?

Sen. Wiener: Part of [our information was] based on data on how you reduce and eliminate HIV infections, and the whole concept of getting to zero, which I’m very familiar with. You do it by encouraging people to get tested regularly so they know their status, and then if they do test positive, they quickly go on medication to become virally suppressed. And the people who are negative have access to all preventative tools, including PrEP.

So when you criminalize and single out people with HIV, it encourages people not to get tested. Because if you don’t know your status then you can’t be guilty of a crime. It encourages people to be very secretive about their status. And being secretive about your status undermines public health. That’s not how you get people tested or into treatment. You want people to feel comfortable being very open about their status. So that was the bedrock of the science we relied on.

If our goal is to prevent HIV infections, to keep people negative, and to keep positive people healthy, we must do that through a public health approach, not through a criminalization approach. Criminalization does not reduce HIV infections — in fact, it does the opposite.

We also had plenty of data on who was being targeted by these laws. It was targeting specific demographics. So even if one were to believe that criminalization somehow reduces infection—which it doesn’t— why would almost half of arrests and prosecutions be of women when they’re only 12 percent of the HIV-positive population? We also worked extensively with a broad coalition that included many public health organizations, physicians, and people who really understand the science.

Satta: In advocating for the bill in the California state senate, what messages and information resonated most strongly with your colleagues?

Sen Wiener: It depended. When you explained about how criminalization doesn’t reduce infections, for a certain segment of colleagues, that was enough. But what really resonated with others was that HIV was being treated differently than other infectious diseases, and more harshly. I had one colleague—a moderate Democrat from a pretty conservative district—and I was not sure if we would get her vote. When I talked to her about it and told her that HIV was being treated differently, as a felony, while other infectious diseases were a misdemeanor. She said to me, “Wait, you’re telling me that Ebola and TB are a misdemeanor, but HIV is a felony, and you want to move HIV into the same category as TB and Ebola?” And I said, “Yes.” And she said, “That’s all I need to know. Whenever I’m asked about it, that’s how I’ll answer.” And she voted for the bill.

 Satta: What advice would you give activists and legislators in other states or jurisdictions who are interested in advocating for legislative reform around HIV criminalization?

Sen. Wiener: First, build a very, very strong and broad coalition. The endorsement list for SB 239 was pages long. It included every reputable civil rights organization, public health organization, LGBT organization, immigrant organization — I mean, everything. You look at these incredibly well-respected organizations ranging from the ACLU, to Planned Parenthood, to respected healthcare advocacy organizations, and even before you delve into the facts, you say, “Look: if all these groups are supporting this, this is a bill I’m supporting.” This is especially true for Democrats.

Because of that broad coalition, lobbying for the bill was incredibly impactful. As an author, that made my life a lot easier. I talked to almost every member of the legislature about the bill one-on-one over the course of the year, but having the coalition aggressively lobbying made a big difference.

Then, really talk to legislators, colleague to colleague. Lots of people have this reaction where they think that if someone is trying to infect someone, they should be guilty of a felony. But you have to talk to them about the notion of the sociopath trying to infect people. Does that happen? Yes, but it’s extremely rare, and those are not the people being prosecuted under these laws.

You also have to indicate that this is a priority for LGBT civil rights organizations. That was very powerful, too. Equality California made the bill its number one priority of the year. For a number of Democrats, this is very compelling. Democrats, in California at least, want be on the right side of LGBT issues. And even though HIV goes beyond the LGBT community, obviously, there’s an enormous overlap.

Also, educate the reporters who are going to cover potential legislative reform. What we found was that there were a couple of publications in California—the San Francisco Chronicle and the Sacramento Bee in particular—that had reporters who really got it. For a number of other publications it was more hit and miss. And even when you had a good reporter, the editors would put clickbait headlines on. So other than some really good articles in the Bee and the Chronicle, we were never able to get accurate coverage. It would always be sensationalist. The headline would be something like, “Bill Proposes Making it Not a Felony to Intentionally Infect Someone with AIDS.” The Los Angeles Times was unfortunately notorious for clickbait headlines like that, which really flamed people up. We even got to the point where we did a call in and we invited the press just to talk about the basic facts of the bill and it didn’t work. So, before you even start you need to identify the reporters likely to report on this, sit down with them, and try to educate them about the facts.

Mark Satta is a 2018-2019 Petrie-Flom Center Student Fellow. 

Published on December 11, 2018 in Bill of Health

Zimbabwe: Calls to repeal law on HIV transmission and non-disclosure as it is not supported by scientific evidence

Repeal law on transmission of HIV

HARARE – There are calls to repeal a law that imposes criminal penalties on people who know they have HIV and engage in behaviours that might transmit the virus to others, without disclosing their status.

Deputy director HIV/Aids and STIs in the Health and Child Care ministry, Tsitsi Apollo, told delegates this week at a Symposium on HIV and Law organised by Zimbabwe Lawyers for Human Rights and National Aids Council that Section 79 (1) of the Criminal Codification and Reform Act on deliberate transmission of HIV presents a barrier towards the country’s goal of reaching the 1st 90 by end of 2020.

She was referring to an ambitious goal set by UNAiDS, the UN agency dealing with the disease, to tackle the epidemic by 2020 by having 90 percent of people with HIV to know their status, 90 percent of diagnosed people to be on treatment, and 90 percent of those on treatment to have suppressed levels of the virus in their bodies.

“The law should be repealed as it violates the rights of recipients of care. The law should be grounded with scientific evidence to facilitate justice delivery”  Apollo said.

She said the law draws conclusions on deliberate HIV transmission from the fact that one is on ARVs – a direct contradiction of science. “It is difficult to ascertain direction of HIV transmission. Phylogenic analysis of virus samples from defendant and complainant is pre-requisite. It is difficult to exclude other possible sources of infection, even with evidence of a negative status at start of relationship…”

Published in Daily News on December 1, 2018

 

Uganda: New efforts underway in Uganda to challenge HIV legislation, especially its provisions on the disclosure of HIV status

Kampala, Uganda | IAN KATUSIIME | Rosemary Namubiru, a nurse, was in 2014 sentenced to three years in jail for criminal negligence over what seemed a potential infection of a baby with HIV the virus that causes AIDS. Her crime was that as an HIV positive nurse, she placed the life of a baby in danger when she pricked herself with an injection she was administering.