CDC joins consensus on HIV that ‘Undetectable = Untransmittable’
The historic announcement has significant implications for HIV advocacy efforts.
In a statement acknowledging National Gay Men’s HIV/AIDS Awareness Day Wednesday, the Centers for Disease Control and Prevention (CDC) embraced a scientific consensus with profound impacts. “When [antiretroviral therapy] results in viral suppression, defined as less than 200 copies/ml or undetectable levels, it prevents sexual HIV transmission,” the statement said.
It was the first time the agency acknowledged what several massivestudies have consistently found: when an individual’s HIV viral count is undetectable, it is virtually impossible for them to transmit HIV to a sexual partner. “Across three different studies, including thousands of couples and many thousand acts of sex without a condom or pre-exposure prophylaxis (PrEP), no HIV transmissions to an HIV-negative partner were observed when the HIV-positive person was virally suppressed,” the statement continued. “This means that people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”
Hundreds of experts and organizations had already signed onto a massive “Undetectable = Untransmittable” (U=U) consensus statement organized by the Prevention Access Campaign. Bruce Richman, executive director of the campaign, responded to the news by telling HIV Plus Magazine, “This is the moment we have been waiting for!”
The implications of the CDC acknowledging that there is “effectively no risk” are massive in terms of both politics and policy. As HIV Plus Magazine notes, nearly half of all HIV-positive people in the U.S. have brought their viral load to an undetectable level through treatment, so it’s significant to recognize that they are not contributing to the epidemic.
As the CDC continues to roll out messaging and information, it will likely not only impact prevention campaigns, but also legal fights over HIV disclosure laws. There are 38 states that have some version of a law that criminalizes perceived or potential exposure or transmission of HIV, and another six where individuals with HIV have been prosecuted under broader statutes. These laws — some even three decades old — rely on antiquated science and punish people with HIV for not disclosing their status to sexual partners even when they pose no risk of transmission.
Though passed with the intention of trying to protect people from HIV, their enforcement actually makes it more difficult to fight the epidemic. Studies have shown that the laws discourage people from getting tested (so as to avoid culpability), which means it’s more likely that people don’t know they’re positive and aren’t in treatment. The laws simultaneously create a false sense of security, such that men who believe their state has such a law are actually slightly more likely to engage in riskier sexual behaviors like condomless sex. Instead of protecting people from HIV, these laws are actually making it far easier for HIV to spread while simultaneously reinforcing stigma against people who are HIV-positive.
The CDC’s embrace of the consensus that “undetectable equals untransmittable” could be an effective buffer for the enforcement of these laws, if not the basis for challenging them directly. In 2014, the Iowa Supreme Court issued a landmark ruling overturning a conviction under that state’s HIV criminalization law specifically because of the science showing that the individual could not have transmitted the virus because of his undetectable viral load. That same year, Iowa also became one of the first states to start to dismantle its HIV criminalization laws, which had previously been some of the harshest in the country.
Overcoming these stigmatizing laws and spreading knowledge about the research on undetectable viral loads is essential to the ongoing fight against HIV. As the CDC statement notes, men who have sex with men are still “severely affected by HIV,” representing two-thirds of all new diagnoses in the United States. Some studies have indicated that more transmissions are happening from people who have been diagnosed but who have not entered treatment. The case could not be stronger that getting them into treatment will, in most cases, halt their transmission of the virus.
Ideally, the CDC will build off this endorsement of the science and do more to advocate for that treatment. Unfortunately, President Trump has proposed massive cuts to the funding that helps supply 11.5 million people worldwide with antiretroviral drugs, and the health care policies he supports also make it harder for people with HIV to afford the care they need. It’s a good sign that the government has caught up with the science, but now it will be essential for officials to fund the policies that science supports.
California Law Modernizing HIV Criminalization Awaits Governor’s Signature
On Sept. 11, 2017, California lawmakers passed SB 239. As reported previously, the bill reduces HIV transmission from a felony to a misdemeanor. This means that people who are convicted will face no more than six months in jail rather than years in prison. The bill also eliminates several HIV-specific criminal laws that carry severe penalties, even for activities that do not risk exposure to HIV. SB 239 now awaits Governor Brown’s signature, the final step before becoming law.
For Nestor Rogel, a California activist living with HIV, the bill’s passage brings a sense of freedom. Rogel, who was born HIV positive, has always had to take numerous precautions to document his disclosure in order to avoid potential prosecution. Not only does the bill bring a sense of personal relief, but he’s hoping for broader changes in societal attitudes. “Decriminalization is a good step to destigmatization,” he told TheBody.com. “California is used as a model for so many things. I’m hoping that other states will take California as a model in this, as well.”
Idaho Statewide Coalition Created to Modernize HIV Criminalization Laws
Kerry Thomas was the first person ever prosecuted under these laws; in 1999, Thomas was convicted and sentenced to 15 years in prison for nondisclosure. In 2009, Thomas was prosecuted and again pled guilty to nondisclosure. This time, the judge sentenced him to 30 years. Thomas is not eligible for parole until at least March 2029.
In 2016, after attending the HIV Is Not a Crime conference, Kevin Lish of All Under One Roof LGBT Advocates of Southern Idaho began pulling together a statewide coalition to modernize laws and address the harsh penalties in the state’s HIV-specific codes. “We need laws that encourage people to be tested, know their status and have honest conversations with potential partners so that we can start curbing the number of new cases in Idaho,” he told A&U Magazine.
Now, the bad: Massachusetts Bill Would Criminalize Nondisclosure
Massachusetts Bill Would Criminalize Nondisclosure
Ten Massachusetts lawmakers are sponsoring H2295, which criminalizes HIV nondisclosure before sex or sharing needles. It also further criminalizes engaging in sex work (which is already a crime punishable by prison sentence) if the person is HIV positive, as well as donating or selling blood, organs, tissue and other bodily fluids or body parts. The proposed penalty would be a minimum of five years in prison (and a maximum of 15 years).
The bill has remained in the Joint Committee on the Judiciary since its introduction in January.
Maryland Adopts Law Authorizing Court-Ordered HIV and HCV Testing
In May, Governor Larry Hogan signed HB 1375 into law. The law authorizes judges to issue “emergency orders” for HIV and hepatitis C testing if the person is believed to have “caused exposure to a victim.” Victims include law enforcement officers, firefighters, emergency medical technicians (EMT), forensic scientists and health care workers collecting medical evidence of sexual assault. The law authorizes the test to be conducted via oral swab.
Tennessee Adopts Law Authorizing HIV, Hepatitis Testing of Arrested Individuals
May seems to have been a bad month for HIV criminalization. Tennessee also enacted a law requiring HIV and hepatitis testing. HB 1283 requires HIV and hepatitis testing for any arrested person if requested by a law enforcement officer, firefighter or EMT exposed to blood or bodily fluids “in any manner that presents a significant risk of transmission.” It also allows any employee of the state’s bureau of investigation’s crime laboratories who might have been exposed to bodily fluids to request such a test. Unlike the Maryland law, HB 1283 requires a blood test rather than an oral swab.
Maggi Duncan, executive director of the Tennessee Association of Police Chiefs helped draft the legislation. “We’re talking about a criminal,” she reportedly said, ignoring the fact that arrests do not automatically mean convictions or guilt. “In the course of being arrested, they could have possibly exposed a first responder.”
A new coalition in Texas aims to reform HIV criminalization & find a united voice for people living with HIV
by Chip Alfred
It’s called the Lone Star State to commemorate a single white star that signifies Texas’ battle for independence from Mexico. Now Texans living with HIV are waging another war—fighting a legal system that locks people up for decades for behavior that poses no risk of HIV transmission.
“We need to stop criminalizing people living with HIV,” says Venita Ray, public policy manager at Houston’s Legacy Community Health. Ray, fifty-eight, an African-American attorney, was diagnosed with HIV in 2013. “There’s no evidence to show that criminalization deters behavior, or that it stops transmission. It’s just to punish us for being HIV-positive,” she adds. “If we really want to end the epidemic, we can’t prosecute our way to zero.”
Texas ranks number two in the nation in number of AIDS diagnoses. It’s also the second largest state in the country in both area and population. Unlike most states, however, Texas has no HIV-specific criminal laws. Therefore, the data on the number of HIV criminalization cases and convictions is hard to gather. It also has effectively given prosecutors wide latitude in using general criminal laws to charge HIV-positive defendants with attempted murder and aggravated assault. Texas’ aggravated assault statute makes it a second-degree felony (two to twenty years in jail and a possible fine of $10,000) “to cause serious bodily injury to another or to use or exhibit a deadly weapon in the commission of an assault.” If an aggravated assault is committed against someone the perpetrator knows is a security officer, it’s a first-degree felony (punishable by five to ninety-nine years in prison and a possible fine of $10,000).
What I found most disturbing in researching this article is that the Court of Appeals and the Supreme Court of Texas have consistently upheld aggravated assault convictions in which HIV was considered “a deadly weapon”—even in cases where the only body fluid exchanged was saliva, which has never been documented to transmit HIV.
An HIV-positive man from Texas who spat at a police officer during his 2006 arrest for being drunk and disorderly was sentenced to thirty-five years behind bars by a Dallas court. The Court of Appeals affirmed the verdict, which mandates that the defendant serve at least half of his sentence before being eligible for parole. This was because the jury found that his saliva was a deadly weapon.
In the Texas legislature, there have been recent efforts to enact laws that would make it easier for prosecutors to invade the privacy of HIV-positive defendants and build criminal cases against them for no-risk behavior like spitting. Thanks to advocates like Venita Ray, none of this legislation has passed. “When I’m standing up in front of the legislature, I’m not speaking of a hypothetical person. I’m saying, ‘What you just did impacts me.’ That has power.” Ray, with the support of The Sero Project’s Assistant Director Robert Suttle and Organizing and Training Coordinator Tami Haught under the umbrella of Sero’s Network Empowerment Project, created Texans Living with HIV (TLHIV), the first statewide network of its kind in the U.S. “This network enables Texans with HIV to determine their own priorities, select and hold accountable leadership of their own choosing and to speak with a collective voice,” says Sean Strub, executive director of Sero. “Texas now has the organizational infrastructure to be better prepared to mobilize and advocate on a whole range of issues that affect people living with HIV.”
Venita Ray tells A&U the new coalition of about twenty advocates will focus on ending isolation for PLHIV and eliminating stigma. “The same communities that are already disproportionately impacted by the criminal justice system are the same people impacted most by HIV criminalization—black people, brown people, people living in poverty.”
TLHIV will take on issues that impact the quality of life for people with HIV and criminalization will be one of those. “We want to be that collective voice for people living with HIV in the state of Texas,” Ray explains. “We’re building power amongst ourselves.” The key, she says, is creating an environment where individuals feel safe to stand up, show up and speak up. “We’re building an army and we need them all. I’m a grandmother; I’m an auntie; I’m a yoga teacher. The more people see people like me or your Bible school teacher, the more we humanize this disease. The best thing I ever did was deciding not to be invisible and not be silent anymore.”
Gael Adrien Mbama: HIV laws must be modernized to prevent further stigmatization
More than 119,589 people diagnosed with thehuman immunodeficiency virus live in California. That diagnosis alone has allowed these people to be stigmatized and receive unfair treatment under the law.
Under the California Code, Health and Safety section 120291, HIV-positive individuals who knowingly expose their partners to thediseaserisk up to eight years in prison. Because of this law, HIV patients have been singled out and treated as felons, instead of as individuals dealing with a serious disease.
Some lawmakers seem to understand this. California State Senator Scott Wiener introduced Senate Bill 239, which lowers the offense of intentionally exposing others to HIV from a felony to a misdemeanor. While numerous lawmakers have supported the implementation of the bill, others have voiced strong disagreement.
For instance, Republican State SenatorJoel Anderson is on record stating that intentionally transmitting any life-altering diseases should require jail time. This stance is shared by other Republican state senators, such asJeff Stone, who insisted that transmitting HIV should remain a significant crime, as reclassifying this offense to a misdemeanor would be a “miscarriage of justice.”
Despite this harsh opposition, Californians must support SB 239. Passing this billwill help decrease HIV’s prevalence byencouraging people to get tested for the disease, instead of remaining clueless about their health condition, as only those aware of their HIV status can be charged. The bill would ensure thatthose who are HIV-positive arenot grossly persecuted with felony charges, and would place HIV on the same standardas other communicable diseases.
California’s HIV transmission lawswere written in the 1980s, when HIV’s hysteria was at its pinnacle and medication for the diseasewas nonexistent. These laws allowed law enforcement to prosecute HIV-positive people who exposed the virus to others, even if those exposed ended up not being HIV positive.Ayako Miyashita, director of the Los Angeles HIV Law and Policy Project at UCLA School of Law, saidthatwhilescientific advancementsover the past three decadeshave made the eradication of the HIV epidemic possible, the law has not caught up and continues to perceive HIV as an instant, life-ending disease.
Consequently, HIV is treated in California as a criminal issue, rather than a public health problem. And the results are devastating.
Like in too many criminal justice systems throughout the nation, minorities are unfairly targeted by California’s HIV laws. Black and Latino people make up an overwhelming 67 percent of individuals prosecuted for exposing others to HIV despite only representing 51 percent of HIV/AIDS cases in California.
Hussain Turk, a UCLA law alumnus who is HIV-positive, said he thinks California’s current laws promote violence and domestic abuse. Turk said people have used HIV transmission laws as a way to seek revenge against their HIV-positive partners.
This sentiment is echoed by Dr.Edward Machtinger, a UC San Francisco professor of medicine and director of the Women’s HIV Program at UCSF. Machtinger said people can be held hostage in abusive relationships because of their fear of prosecution for being HIV positive.
Machtinger said current criminalization laws written before the existence of effective HIV medications scare people away from being tested and beginning treatment. These laws alsoincrease the risk of more infections by shaming individuals who are HIV positive.
Indeed, because of these laws and the stigmatization that they create, HIV remains a tough disease to disclose.
Today’s HIV medications, if taken regularly, allow people to have undetectable HIV viral loads in their bloodstream and thus, lead lives without the risk of transmitting the virus to their partners.
It is clear SB 239, which is awaiting Gov. Jerry Brown’s approval, must be signed into law given the egregious problems resulting from California’s antiquated legislation.Threatening HIV patients with felonies has never been the appropriate means to tackle the HIV epidemic. HIV-positive individualswill continue to live with the fear that a felony is running through their veins, so long as the archaic laws from the 1980s continue to be enforced.
Of course, many SB 239 opposers believe that decreasing the offense of exposing partners to HIV from a felony to a misdemeanor will lead to a resurgence of new HIV infections. But, as Weiner points out, HIV is the only communicable disease being treated as a felony. Other life-altering diseases, like syphilis for instance, only lead to misdemeanor charges. As such,thosewho purposely infect their partners will still be prosecuted but on the chargeof a misdemeanor, which is the standard for all other serious communicable diseases.
California ranks among the highest number of HIV cases in the nation, so it is crucial to acknowledge the indisputable failures of the current law and support SB 239. This bill can put an end to the discrimination experienced by those who are HIV positive and encourage people to get tested, therefore decreasing infections.
It is time to modernize these laws that promote racial injustice and stigmatization. And ultimately,people who are HIV positive are not felons; they just have an illness.
Australia: Proposed sexual health law in New South Wales is a step backwards & runs counter to good public health
PROPOSED SEXUAL HEALTH LAW REFORMS IN NSW SLAMMED BY EXPERTS
The reforms would see people with HIV or an STI who fail to take “reasonable precautions” face a fine or up to six months in prison.
The New South Wales government has introduced a bill that would see people with HIV or an STI who fail to take “reasonable precautions” face a fine or up to six months in prison.
The Public Health Amendment (Review) Bill 2017seeks to make changes to Section 79 of the Public Health Act 2010, removing the existing law around disclosure of HIV, but replacing it with a new offence meaning anyone who knows they have an STI could be charged for not taking undefined “reasonable precautions”.
Sexual health organisation ACON has criticised the bill, saying it is at odds with good public health practice.
“Given that most of the STIs that would be covered by this proposal are treatable, it is our position that the new offence created in s79 introduces unprecedented, unjustified, and disproportionate penalties and runs counter to good public health processes,” ACON said in a statement on its website.
“This new offence could deter people from sexual health testing and contact tracing. The evidence indicates that HIV and other STIs are more likely to be transmitted via someone who has undiagnosed infection.”
ACON said that STIs are a health issue, not a criminal issue, and called on concerned members of the public to contact NSW Minister for Health Brad Hazzard.
Nic Holas of HIV organisation The Institute of Many agreed that the proposed new law is worrying.
“Those of us in the HIV-positive community are very concerned about the proposed changes to the Public Health Act,” he said.
“It used to be that you had to disclose your HIV status or face some kind of penalty, potentially. Last year the New South Wales government recognised that that kind of forced disclosure put all the responsibility on HIV-positive people, which was unfair and ultimately unhelpful in ending HIV.
“But now it seems what they’re trying to do is remove that—which is really great—and introduce punitive charges on anyone who’s HIV-positive or anyone with an STI if they don’t take reasonable precautions.”
Holas called the proposed law “really extreme” and said it could deter testing and result in worse public health outcomes.
“That’s extremely concerning for us, because the World Health Organisation says that those sorts of extreme punitive measures do the opposite of driving down rates of HIV and STIs, and send them upwards,” he said.
Holas said there is already provision under the law for a person intentionally spreading an STI to be charged with grievous bodily harm. He called for the proposed new offence to be scrapped.
“What’s far more important to ending HIV and the current high rates of STIs is to encourage testing and treatment, not heavy prison sentences,” he said.
Canada: Ontario leads the world in the over-criminalisation of HIV non-disclosure
Ontario a ‘world leader’ in unjustly prosecuting people living with HIV, advocates say
HIV-positive individuals being ‘criminalized’ when it comes to disclosing their status to sexual partners, by a criminal justice system that has failed to catch up to the science around HIV and the risks of transmission, critics argue.
It was around Christmas in 2008 when Chad Clarke said he got a phone call from a former partner screaming at him that he had given her HIV.
The next three years would see Clarke arrested for aggravated sexual assault, denied bail twice, pleading guilty to avoid a longer sentence, sent to prison where he was placed in protective custody, and put on the national sex offender registry for life.
The charge related to a failure to disclose his HIV status, although Clarke said that at the time he did not believe he was HIV-positive. Although he had tested positive in 2004, he said he had believed a second test showed he was negative. He said he’s been on medication, with an undetectable viral load, since 2008.
“HIV is not a crime,” Clarke, 45, told the Star in a recent interview. “It’s a public health issue. Isn’t health supposed to be key?”
People living with HIV in Canada risk an aggravated sexual assault charge and prison time if they don’t disclose their status to their sexual partner, unless a condom is used and the individual has a low viral load, which refers to the amount of the HIV virus in their blood.
Advocates have long complained of HIV-positive individuals being unjustly prosecuted by a criminal justice system that has failed to catch up to the science around HIV and the risks of transmission.
It’s an issue that is now on the agenda of federal Justice Minister Jody Wilson-Raybould, who has referred to an “over-criminalization of HIV non-disclosure” and is looking at introducing changes this year. But critics say the Ontario government has so far failed to match the federal government’s efforts in what remains a complex and sensitive area of the law.
“There are some serious injustices taking place right now,” said Ryan Peck, executive director of the HIV & AIDS Legal Clinic Ontario. “People living with HIV are being criminalized for engaging in behaviours that should not be criminal, and to make it worse, people living with HIV are being charged, prosecuted and convicted of aggravated sexual assault.”
It wasn’t long ago when the media proclaimed AIDS as the “gay plague” that carried a death sentence, but the stigma around HIV/AIDS has hardly disappeared, as advocates point to the continued criminal prosecution of those who don’t disclose their status to their sexual partners as one example.
At least 184 people in 200 cases have been charged in relation to HIV non-disclosure since 1989, according to a report published this year by the Canadian HIV/AIDS Legal Network. In Ontario, at least nine cases have been taken to court since 2012.
“When used correctly and no breakage occurs, condoms are 100 per cent effective at stopping the transmission of HIV,” according to a 2014 consensus statement published by a number of leading Canadian HIV/AIDS medical experts. As well, because of advances in medication that can keep a person’s viral load low or undetectable, advocates say that the risks of transmission are far lower than they once were, regardless of condom use.
Therefore, they say, HIV-positive people should not be required to be placed in the delicate position of disclosing their status, unless there is intention to transmit HIV as well as actual transmission of HIV.
“In the best of all worlds, that would be the right thing do,” Toronto criminal defence lawyer Cynthia Fromstein, who has represented many HIV-positive individuals, said of a person disclosing one’s status.
“However, people have faced bad reactions, people have faced violent reactions, to disclosing their HIV status. People are also just people, they face rejection, which is hard, and particularly if you know that you in fact don’t pose a risk to someone, then I think people don’t want to put themselves in that position.”
Matters are further complicated by the fact that Ontario has no official prosecutorial guidelines to help guide Crown attorneys in their approach to these cases, and to decide whether to even bring one to court.
It gets even more complicated when you consider the Supreme Court’s last pronouncement on the topic in 2012, where it was found that a person must disclose if there is a “realistic possibility of transmission,” a phrase that has left Crown attorneys and judges differing on just what that means.
The federal government has been studying the issue since last year, and it’s expected to be discussed at the upcoming federal, provincial and territorial justice ministers’ meeting in Vancouver this week.
The gathering comes almost a year after Wilson-Raybould announced last Dec. 1, World AIDS Day, that she intended to look into the criminal justice system’s handling of HIV non-disclosure cases and work on the issue with her provincial and territorial counterparts.
“HIV treatment has slowed disease progression to the point that, for many, HIV infection can now be regarded as a chronic, manageable condition,” she said in a statement at the time.
“Still, the over-criminalization of HIV non-disclosure discourages many individuals from being tested and seeking treatment, and further stigmatizes those living with HIV or AIDS. Just as treatment has progressed, the criminal justice system must adapt to better reflect the current scientific evidence on the realities of this disease.”
The Criminal Code contains no laws specifically related to HIV non-disclosure, but the offence of aggravated sexual assault — reserved for the most egregious sexual assaults — is typically laid in such cases, and almost always carries prison time following conviction.
HIV/AIDS organizations do not oppose prosecutions in the rare cases where an individual had the intent to transmit the HIV virus, although whether the charge should still be aggravated sexual assault remains a matter of discussion.
While the federal government is responsible for amending the Criminal Code, it is the responsibility of provincial Crown attorneys to apply the law, and use their discretion when deciding whether to prosecute a particular offence.
In a statement sent to the Star last week, the federal department of justice said the government hopes to provide an update on its work on the issue by the end of the year. But it also reiterated that enforcement of the laws is very much a provincial matter.
“The work currently being undertaken with provincial partners will allow each jurisdiction to make informed decisions about how to address prosecutorial and charging practices within their area of responsibility,” the statement said.
Advocates have demanded that Ontario Attorney General Yasir Naqvi order a moratorium on the prosecution of non-disclosure cases — except in cases where intentional transmission of the virus is alleged — until the federal government implements its plan, which may include prosecutorial guidelines that the provinces could choose to adopt.
Their pleas have so far proven to be unsuccessful, as Crown attorneys in Ontario continue to bring non-disclosure cases — even where the virus was not transmitted — to court.
“The intolerable fact remains that Ontario continues to be a world leader in unjustly prosecuting people with HIV,” the Ontario Working Group on Criminal Law and HIV Exposure wrote in an April letter to Naqvi.
“The pattern of zealous, overly broad prosecution of people living with HIV in Ontario is the result of deliberate choices, both by individual prosecutors and (the Ministry of the Attorney General).”
Naqvi’s office said last week that he did meet with the working group last year, and that during the meeting, “the attorney general reiterated his commitment to work with the federal government as they review the way our justice system handles HIV-related cases.”
The discussion between advocacy groups and successive attorneys general in Ontario on non-disclosure prosecutions have been described as more or less one-sided, with very little progress being made on the government’s side.
Several years ago, the government did propose prosecutorial guidelines for non-disclosure cases, but the three outside experts allowed to read them — and who are also barred from discussing their contents — said they were so bad they told the ministry that no guidelines would be a better option.
“I don’t think it would be fair to say that we were consulted in the drafting of anything,” said Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, who was one of the three experts, along with Peck and criminal defence lawyer Jonathan Shime, to see the draft.
“We had repeatedly put forward our ideas about what we thought they should be about.”
Among those suggestions: an acknowledgement that an undetectable viral load alone means there is no realistic possibility of transmission, regardless of condom use.
What prosecutors do have access to is a so-called “practical guide” prepared in 2010 by Hamilton Crown attorney Karen Shea, who successfully prosecuted Johnson Aziga for first-degree murder, an infamous 2009 case in which two of the women infected with HIV by Aziga later died from AIDS. Aziga’s trial heard that he had known since 1996 that he was HIV-positive, but did not start taking medication until 2005, two years after his arrest.
Shea’s 72-page document, which the Ministry of the Attorney General fought for years to keep secret after receiving a freedom of information request from Toronto lawyer Marcus McCann, covers everything from the elements the Crown must prove to secure a conviction, to the kind of information that should be sought on an HIV-positive individual from public health officials.
McCann expressed concern that the guide could have a chilling effect on individuals seeking help from public health authorities, as the guide encourages Crowns to seek information on accused persons from public health to use in court.
Indeed, HIV test results and other information gleaned from public health have been put on the record in court by the Crown at bail hearings and trials in non-disclosure cases.
The provincial government has previously acknowledged that while it’s not an official policy or guideline, Shea’s guide has been used to assist other Crown attorneys, although it’s unclear which parts are still consulted given that the science and case law have evolved since 2010.
“Many roads lead to Karen Shea. I don’t think she’s the only destination, but she is clearly on the turnpike as one of those stops,” said Elliott at the Canadian HIV/AIDS Legal Network.
Shea declined to comment to the Star.
Crown attorneys take into account scientific developments and new case law when considering to prosecute a case, said a spokesperson for the Ministry of the Attorney General, who confirmed that the ministry’s criminal law division has a “group of experienced prosecutors who are available to provide advice on HIV exposure cases,” but didn’t say who is part of that group.
The last time the Supreme Court ruled on HIV non-disclosure, in a 2012 case known as R v. Mabior, it found that disclosure was not necessary if the individual had a low viral load and a condom was used.
But Chief Justice Beverley McLachlin, writing for a unanimous court, also said that the double requirement “does not preclude the common law from adapting to future advances in treatment and to circumstances where risk factors other than those considered in this case are at play.”
The meaning of that statement has played out in Canadian courtrooms since 2012, including in a recent Brantford non-disclosure case, where the Crown argued that Mabior requires low viral load andcondom use to avoid disclosure obligations, but the judge found otherwise.
The case involved a man, C.B., who has a low viral load but did not disclose to two women before having condomless sex. He was subsequently charged with two counts of aggravated sexual assault. Neither complainant was infected with HIV.
The trial took place in April, four months after Wilson-Raybould announced the federal government would target the over-criminalization of HIV non-disclosure.
Testifying for the defence, Dr. Philippe El-Helou, director of the HIV Clinic at McMaster University, said that in all of his years treating HIV patients, “he has not seen a transmission occur from a carrier who has an undetectable viral load,” Ontario Court Justice Robert Gee wrote in his decision.
The judge acquitted C.B. of all charges.
“The question becomes: Is condom use the only way to raise a reasonable doubt about the risk of transmission in a person with a low viral load or, if at the time Mabior was decided in 2012 it was the only way, has the science advanced to the point where it no longer is?” Gee wrote in a ruling released last month.
“The defence takes the position that the Supreme Court’s decision was not intended to establish an absolute and fixed rule that a low viral load and condom use was the only way to raise a reasonable doubt about the possibility of transmission.”
Gee sided with the defence, accepting El-Helou’s evidence that given C.B.’s undetectable viral load, “the risk of transmission in this case was as close to zero as can be measured.”
It is exactly the kind of case that advocates have long demanded be kept out of courtrooms in the first place, and why they hope sound prosecutorial guidelines would be of great help to Crown attorneys.
Chad Clarke has become an outspoken advocate since leaving prison in 2011, marching in the streets and speaking at numerous HIV/AIDS conferences. What he would most like to see is his name taken off the sex offenders’ registry.
He said he has post-traumatic stress disorder that goes “through the roof” every year when he has to sign in with police, one of the conditions of being on the registry. He lives on a fixed income, applying for jobs is difficult, and family relationships are strained.
“If you want to keep the charges against me, I’ll live with that, but take me off that damn sex offenders’ registry, because every day that I look at myself in the mirror, I see myself as a sex offender, and that’s not cool,” he said.
“I would like to personally see that instead of sticking this person in jail, you get them a point of care, you get them on medication right away, you get them mental health care, because trust me, mental health (issues) will go with you the rest of your life if you have HIV.”
How a group of dedicated advocates in Colorado ‘modernised’ their HIV-related laws to improve the legal environment for people living with HIV. Featuring Barb Cardell and Kari Hartel of the Colorado Mod Squad and Colorado State Senator, Pat Steadman.
Interviews by Mark S King
Written and introduced by Edwin J Bernard • Directed and produced by Nicholas Feustel for the HIV Justice Network
US: A review of HIV criminalisation laws in the US
HIV Crime Laws: Historical Relics Or Public Safety Measures?
Thirty-three states have laws that can be used to prosecute people living with HIV. Some states are looking to either repeal those laws or reduce their severity.
Robert Suttle clearly remembers telling his boyfriend that he was HIV positive the night they met. But after they split, three quarrel-filled months later, that became a point of contention: His “ex” pressed charges against him.
Suttle’s home state, Louisiana, is one of 33 states with laws that can be used to prosecute people living with HIV. And in Louisiana, intentionally exposing someone to HIV/AIDS is a felony punishable by up to 11 years in prison.
Because he wanted to put the whole ordeal behind him, Suttle accepted a plea bargain in 2009 and ended up doing 6 months in prison. He said he found out too late that pleading guilty meant registering as a sex offender wherever he goes.
Now some states are looking to either repeal such laws or reduce their severity. At issue is the balance between protecting public health and protecting the civil rights of individuals living with HIV.
The laws, which date to the 1980s and ’90s, vary greatly from state to state. Most impose criminal penalties on people who know their HIV status and potentially expose others to the virus. In some states, a conviction can mean up to 35 years in prison.
Twenty-four states require HIV-positive people to disclose their status to sexual partners, while six states require people to register as sex offenders as part of their punishment if they are convicted of an HIV-specific crime. In 22 states, felony laws, which cover assault and attempted murder for example, are used to prosecute people living with HIV who knowingly expose someone to the virus. And 25 states criminalize activities such as spitting, even though they are unlikely to transmit the virus.
Other states have statutes that tack on extra punishment based on the defendant’s HIV status. In Utah, for example, HIV-positive people convicted of prostitution, patronizing a prostitute, or solicitation are guilty of a felony, punishable by up to five years in prison, if they knew their status at the time of the crime. For an HIV-negative person, those same crimes would be a misdemeanor punishable by no more than six months in prison for a first-time offense.
Critics say the laws are relics of the past and demonize people infected with the virus. Some studies have shown that the laws don’t reduce HIV transmission and may actually drive up HIV rates, because people who feel stigmatized are less likely to get tested. A study published in June by researchers with the U.S. Centers for Disease Control and Prevention found no evidence that the laws reduce transmission of the virus.
“It’s very embarrassing and dehumanizing,” said Suttle, 38, who now lives in Harlem, New York, and works as an assistant director for the Sero Project, which advocates to end laws that criminalize people living with the virus.
In 1994, Texas became the first state to repeal its HIV criminal laws, according to the Center for HIV Law and Policy. But since then, people have been prosecuted for HIV exposure under general criminal laws such as attempted murder, which Catherine Hanssens, the center’s executive director, said illustrates why straight repeal of the laws is not enough. Texas courts have upheld that seminal fluid of a man living with HIV may constitute a deadly weapon.
In 2012, Illinois became the second state to revise its HIV crime laws, by requiring prosecutors to prove a defendant intended to transmit HIV and limiting prosecution to a more narrow definition of sexual activity. Iowa followed suit in 2014. Last year, Colorado enacted a law that repealed two HIV criminalization statutes and revised another by requiring that all sexually transmitted infections be treated equally under the law, rather than singling out HIV for prosecution.
California lawmakers are also considering a bill that would make it a misdemeanor to transmit HIV, rather than a felony. A similar HIV bill failed in Florida in May, but is expected to be re-introduced in the next session.
Also in May, the Ohio Supreme Court heard arguments in a case challenging the state’s criminal HIV law. The crux of the case: whether or not the law discriminates against people living with HIV, as well as whether requiring disclosure of one’s HIV status violates the First Amendment.
The push to reform HIV crime statutes “has become a national movement, and it’s part of the larger conversation about overcriminalizing people,” said Allison Nichol, law and policy counsel for the Sero Project.
“We need to take this out of the realm of someone committing a sex crime,” said Nichol, who used to prosecute sex crimes in Indianapolis. “These laws continue to feed a false narrative that people with HIV present a danger to public health, when in fact that is no longer true.”
But supporters of the laws argue they protect public health, and some states have moved in the opposite direction.
In May, Maryland Gov. Larry Hogan, a Republican, signed a law that, among other things, authorizes a judge to issue an emergency order to get someone tested for HIV if it’s believed that person has “caused exposure to a victim.” The law updates a previous one and is intended to treat rape victims who may have contracted HIV or hepatitis C. The same month, Tennessee enacted a law strengthening a statute requiring anyone who’s been arrested to be tested for HIV/AIDS if a law enforcement officer requests it.
“We’re talking about a criminal,” said Maggi Duncan, executive director of the Tennessee Association of Police Chiefs, who helped draft the legislation. “In the course of being arrested, they could have possibly exposed a first responder.”
The law was expanded to include all forms of hepatitis, which is on the rise in the state, Duncan said, “but HIV could easily become on the rise again with needle use, and that’s a real concern with heroin being on the upswing.”
Years of Activism
Activists have pushed for years to change the laws, with a focus on educating lawmakers and prosecutors about how HIV is transmitted. One key fact: An HIV-positive person whose viral load is undetectable has almost no chance of spreading the virus.
“More and more, there’s a realization that HIV criminalization laws have not kept up with science,” said Dan Kirk, a former prosecutor with the office of the Cook County State’s Attorney, which has jurisdiction over Chicago. Last year, then-Cook County State’s Attorney Anita Alvarez called for the law to be revised further.
Today, prosecutors in Illinois have to prove that an offender intended to transmit HIV. Defendants can assert a legal defense if a condom was used, but they cannot use being in treatment as a defense. This despite condoms being less effective — 80 percent — than anti-retroviral drug treatment — 95 percent — at reducing the risk of transmission, according to the CDC.
Under the measure pending in California, it would no longer be a felony to fail to disclose a positive HIV status. Instead it would be a misdemeanor on a par with failing to disclose any other transmitted disease. To be charged with a misdemeanor, the defendant must have known that he or she has a communicable disease and acted with the specific intent to infect another person, engaged in conduct that poses a substantial risk for transmission, and actually transmitted the disease to another person.
“We want people to get tested. We want people to get on medication. We want people to be honest about their HIV status,” said California state Sen. Scott Wiener, a Democrat who sponsored the legislation. “But you don’t accomplish those things by sending people to prison.”
Gray Area
Scattershot state reporting makes it difficult to say how many cases are prosecuted under the HIV transmission laws, according to Hanssens.
But it isn’t difficult to find individual examples. In June, for example, an HIV-positive Georgia man with mental health problems was charged with reckless conduct for allegedly spitting in the eye of a police officer.
In July, a 58-year-old South Carolina man was sentenced to 35 years in prison after he was found guilty of sexually assaulting a 5-year-old girl and potentially exposing her to HIV. Medical tests showed the child did not contract the virus. He was sentenced to 25 years for the rape and 10 years for the potential exposure.
Prosecuting — or defending — these cases can be difficult: How do you prove that someone has disclosed their HIV status? Often, as in the case of Suttle, it becomes a case of “he said, he said.”
A 2015 report by the Williams Institute at the UCLA School of Law found the overwhelming majority of people — 95 percent — charged with HIV crimes in California were sex workers. The report also found that nearly every charge resulted in a conviction; the average prison sentence was longer than two years. Two-thirds of people charged were black or Latino. White men accused of an HIV-related crime were significantly more likely to be released and not charged, the report found.
“This is really a public health issue,” said Scott Schoettes, an HIV project director at Lambda Legal who has worked on HIV legal policy for years.
“It shouldn’t be addressed by criminal law unless there’s malicious intent.”
As a physician who has spent his career in correctional settings and providing health care to persons who are homeless, I have seen how racism, poverty and heterosexism form a Bermuda Triangle, creating a deadly trap for thousands of men and women. Sometimes the barriers are in our attitudes, but sometimes they are in our structures – especially public policy.
HIV criminalization laws in the United States were written at a time when we knew little of the virus, the epidemiology, or the disease. Missouri’s laws – and those in more than 30 other states – have not been updated with our much-improved knowledge of transmission and treatment.
HIV is not easily transmitted. With diagnosis and treatment, that risk is reduced to effectively zero. With diagnosis and treatment, HIV is a manageable disease, no longer a death sentence. The severe penalties of HIV-specific criminal codes spring from bias, misinformation and fear. They increase stigma, which drives testing and treatment underground and serves to spread HIV by discouraging people to know their status or to seek appropriate treatment if HIV-positive.
Michael Johnson is a man trapped in the Bermuda Triangle of our racism, sexism and heterosexism. An African-American gay man from Indianapolis who grew up in poverty, Johnson struggled against the barriers that our society erects. By perseverance and hard work, despite a learning disability, he managed to access an opportunity for college education through a wrestling scholarship.
Then Missouri’s outdated and flawed policies intervened in Johnson’s life. He was convicted and sentenced to more than 30 years in prison for “reckless exposure and transmission of HIV” in July 2016.
The conviction was overturned, however, on December 20, 2016, based on the state’s failure to comply with Johnson’s discovery request and his inability to prepare a meaningful defense. He has now been returned to St. Charles County and has pled not guilty as the process of a re-trial gets underway.
Michael Johnson has already spent over three years incarcerated for his alleged actions. I teach our medical students at Saint Louis University not only about HIV, but also about health equity, health literacy, the effect of repetitive and cumulative trauma, and other social determinants of health. These are the influences that shape, for good or ill, an individual’s ability to thrive and flourish. Continued incarceration is unlikely to create conditions for Johnson’s future success, nor does it improve society in any way.
Johnson’s incarceration is an indictment of our society for our failures, and we would do well to heed the lessons we can learn and change our direction. Race, class, and sexual orientation continue to divide our nation, and we see dramatic results of our responses to these topics in our physical and virtual communities with some frequency.
The massacre at Pulse, the night club in Orlando, is perhaps the most shocking recent example. Ignorance can breed fear, which, in turn, can breed hatred. But this process is not inevitable. We can slow down and alter this process through our words and our actions.
We all have the power to influence others. As Michael Johnson faces the next step of his legal journey, we have the power to frame public and private discussion around him and the issues surrounding his case. We should honor Michael Johnson, ourselves and our community by pursuing knowledge, reflecting on our biases, and carefully selecting our vocabulary. We can choose to always use language about Johnson that respects his full humanity.
We ought to do even more. We should seek medically accurate information about HIV and use our power as citizens to change public policy so that it is based on medical science. We should end the stigma of being HIV-positive and encourage Missourians to be tested and treated. The impact of that change would create a healthier and safer world for all of us.
Fred Rottnek, MD, MAHCM, is the director of Community Medicine and Professor in the Family and Community Medicine at Saint Louis University. As the previous medical director of Corrections Medicine for the Saint Louis County Department of Public Health, his clinical practice for the past 15 years was at the Buzz Westfall Justice Center and Family Courts.
Cases of non-disclosure of HIV rising in the courts
In the last two months alone, three new cases of non-disclosure of HIV-positive status have been prosecuted in Quebec. This increase contrasts with past practices and has alreted the advocacy groups of people living with HIV who fear a paradigm shift.
“Between 1998 and 2012, there were 21 cases, followed by 10 cases from 2012 to 2016, which was already a significant increase,” said Liz Lacharpagne, a lawyer with the Coalition of Quebec Community Organizations to Fight AIDS (COCQ-SIDA) . Three cases in two months are unheard of for the Canadian Coalition for HIV Criminalization Reform (CCRCV), of which Ms. Lacharpagne is a member, and that is why this coalition intends to urge the federal Department of Justice to act Before the trend worsens.
Individuals who do not disclose their HIV status when there is a possibility of transmitting HIV to their partner may be subject to criminal charges in Canada. The problem is that this judicial response is not limited to the transmission of HIV, according to the CCRCV, which therefore finds it inappropriate.
Canada is the only country in the world to treat non-disclosure of HIV status as a serious sexual assault. To date, there have been nearly 200 charges laid for non-disclosure in Canada. In the majority of cases where the complaint led to a conviction, HIV was not transmitted.
The fact itself of not informing one’s partner is considered as sexual assault. “The average prison sentence for a person convicted of offenses related to” The non-disclosure of HIV is 54 months – more than double the average sentence for sexual assault (24 months), ” notes the Canadian HIV / AIDS Legal Network. “A discriminatory situation that ignores scientific data on HIV and international recommendations such as those of UNAIDS,” says Liz Lacharpagne.
Chad Clarke felt the ground slipping under his feet when he learned that a warrant was being issued against him. He went to the authorities and then pleaded guilty. “To have a lesser sentence,” he says. Liable to 15 years in prison, he was sentenced to four years. “If I had understood that I would be a life-long sex offender, I would not have pleaded guilty,” he said six years after his release. Chad says he did not know he was HIV positive. In prison he had difficulty accessing appropriate medical care. No antiretroviral treatment for several weeks, no blood test for more than two years. Today, he is on the National Sex Offender Registry and cannot find a job.
Alexander McClelland, a PhD student in sociology at Concordia University, is conducting research on the impacts of a non-disclosure conviction. Of the 14 people he looked at, “none was aware of putting his/her partner in danger. Sometimes the doctor explained that because their viral load was undetectable, there was no risk of transmission. “Others were not always able to impose condom use on their partner. He reports in particular the case of a sex worker who is HIV-positive as a result of rape.
“She recounts that she insisted that her client wear a condom, he refused. She was intoxicated at the time of the act, which diminished her ability to impose it on him. In court, her words did not weigh much. Of all the consequences documented by the researcher, the trauma associated with being labelled a sex offender is the heaviest. Like Liz Lacharpagne, Alexander McClelland believes that criminalization could deter people from being screened, according to the logic that, if one is unaware of one’s HIV status, one can not be accused of non-disclosure.
Consultation in progress
These judicial subtleties were first echoed in Ottawa. In December 2016, Jody Wilson-Raybould, the Canadian Minister of Justice, stated that “… disproportionate criminalization of non-disclosure of HIV status discourages many people from testing and being treated […]. The criminal justice system in Canada must adapt to better reflect the available scientific evidence …. A working group of stakeholders is currently working on a reform. Nothing, however, has yet emerged from their work.
For its part, the CCRCV is conducting a pan-Canadian consultation with about 40 organizations to reach consensus on recommendations to the government. “We do not know, at this point, what the best way to reform is, but we know what needs to be done,” said Nicholas Caivano, a policy analyst with the Canadian HIV / AIDS Legal Network. Criminalization should be applied only in cases where there is a proven intention of transmission, never when precautions preventing transmission have been made, and the charge of sexual assault should never be used in a case of non-disclosure . ”
While awaiting the criminal justice reform (under the federal Department of Justice), the CCRCV does not rule out a moratorium on prosecutions (which falls to the provinces). “There is a lack of awareness of the problem among prosecutors,” says Liz Lacharpagne. Guidelines are needed to ensure that prosecutions are conducted in an informed manner, taking into account scientific advances. ”
In Quebec, at the office of the Minister of Justice, Stéphanie Vallée, they would not comment on the progress of the work, preferring to rely on the federal government. The federal Department of Justice declined our request for an interview, deeming any discussion premature in the circumstances. “This work, which includes an extensive review of the criminal law, the role of public health, applicable medical sciences, and current charges and prosecution practices, is underway.”
Behind the jurisprudence
The Supreme Court of Canada (SCC) established in 1998 that an HIV-positive person must disclose his or her status before having sex with a significant risk of transmission. Non-disclosure is considered as fraud in relation to the partner’s consent. Non-consensual sex is considered as a sexual assault. In 2012, Mabior established the concept of “realistic possibility” of transmission. The CSC considers that this possibility is not established if the viral load is low and if a condom is used. Implicitly, if only one of these two criteria is met, there is a “realistic possibility”. This is contradicted by science.
Behind Science
The Partner study was conducted between 2010 and 2013 among 767 serodiscordant couples. On average, at the beginning of the study, HIV-positive partners had been receiving antiretroviral therapy for five years. Couples had had sex without a condom for two years. With a total of 44,000 condomless relationships, no transmission occurred.
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La non-divulgation du VIH en hausse devant les tribunaux
Au cours des deux derniers mois seulement, trois nouveaux cas de non-divulgation de séropositivité ont fait l’objet de poursuites au Québec. Cette augmentation tranche avec les pratiques passées et alarme les groupes de défense des personnes vivant avec le VIH, qui redoutent un changement de paradigme.
« Entre 1998 et 2012, on a recensé 21 cas, puis 10 de 2012 à 2016, ce qui était déjà une augmentation significative », relève Liz Lacharpagne, avocate à la Coalition des organismes communautaires québécois de lutte contre le sida (COCQ-SIDA). Trois cas en deux mois, c’est du jamais vu pour la Coalition canadienne pour réformer la criminalisation du VIH (CCRCV), dont Mme Lacharpagne est membre, et c’est pourquoi cette coalition entend presser le ministère fédéral de la Justice d’agir avant que la tendance ne s’emporte.
Les personnes qui ne divulguent pas leur séropositivité alors qu’il y a possibilité qu’elles transmettent le VIH à leur partenaire peuvent faire l’objet d’accusations criminelles au Canada. Le problème, c’est que cette réponse judiciaire ne limite pas la transmission du VIH, selon la CCRCV, qui la juge donc inappropriée.
Discrimination
Le Canada est le seul pays au monde à considérer comme une agression sexuelle grave la non-divulgation de séropositivité. Jusqu’à présent, on a recensé au Canada près de 200 accusations portées pour non-divulgation. Dans une majorité de cas où la plainte a mené à une condamnation, le VIH n’a pas été transmis.
C’est le fait de ne pas informer son partenaire qui est reconnu comme une agression sexuelle. « La peine moyenne d’emprisonnement pour une personne declaree coupable d’infractions relatives à la non-divulgation du VIH est de 54 mois — plus du double de la peine moyenne pour agression sexuelle (24 mois) », relève le Réseau juridique canadien VIH/sida. « Une situation discriminatoire qui ignore les données scientifiques sur le VIHet les recommandations internationales telles que celle de l’ONUSIDA », estime Liz Lacharpagne.
Chad Clarke a senti le sol se dérober sous ses pieds quand il a appris qu’un mandat d’arrêt pesait contre lui. Il s’est présenté aux autorités, puis a plaidé coupable. « Pour avoir une peine moins lourde », raconte-t-il. Passible de 15 ans de prison, il écope de quatre ans. « Si j’avais compris que je serais fiché à vie comme délinquant sexuel, je n’aurais pas plaidé coupable », dit-il six ans après sa libération. Chad affirme qu’il ne se savait pas porteur du VIH. En prison, il a eu difficilement accès aux soins médicaux appropriés. Pas de traitement antirétroviral pendant plusieurs semaines, pas de test sanguin pendant plus de deux ans. Aujourd’hui, fiché au registre national des délinquants sexuels, il ne trouve pas d’emploi.
Doctorant en sociologie à l’Université Concordia, Alexander McClelland mène une recherche sur les impacts d’une condamnation pour non-divulgation. Des 14 personnes dont il a examiné la trajectoire, « aucune n’avait conscience de mettre son partenaire en danger. Parfois, le médecin leur avait expliqué que leur charge virale étant indétectable, il n’y avait pas de risque de transmission. » D’autres n’étaient pas toujours en mesure d’imposer le port du condom à leur partenaire. Il rapporte notamment le cas d’une travailleuse du sexe, séropositive à la suite d’un viol.
« Elle relate avoir insisté auprès de son client pour qu’il porte un condom, il a refusé. Elle était intoxiquée au moment de l’acte, ce qui diminuait ses capacités à le lui imposer. En cour, sa parole n’a pas pesé lourd. » De toutes les séquelles documentées par le chercheur, le traumatisme associé au fait de se voir étiqueter délinquant sexuel est la plus lourde. Tout comme Liz Lacharpagne, Alexander McClelland estime que la criminalisation pourrait dissuader des personnes de se faire dépister, suivant la logique que, si on ignore son statut sérologique, on ne peut être taxé de non-divulgation.
Consultation en cours
Ces délicatesses judiciaires ont trouvé un premier écho à Ottawa. En décembre 2016, la ministre de la Justice du Canada, Jody Wilson-Raybould, déclarait que « […] la criminalisation disproportionnée de la non-divulgation de la séropositivité décourage bon nombre de personnes de passer des tests de dépistage et de se faire traiter […]. Le système de justice pénale au Canada doit s’adapter pour mieux refléter les données scientifiques disponibles[…]. » Un groupe de travail réunissant les acteurs concernés travaille actuellement à une réforme. Rien toutefois de concret n’en est encore ressorti de leurs travaux.
De son côté, la CCRCV mène une consultation pancanadienne auprès d’une quarantaine d’organisations pour établir un consensus sur les recommandations à adresser au gouvernement. « Nous ne savons pas, à ce stade-ci, quelle serait la meilleure façon de réformer, mais nous savons ce qui doit l’être, commente Nicholas Caivano, analyste des politiques au Réseau juridique canadien VIH/sida. La criminalisation ne doit s’appliquer que dans des cas d’intention avérée de transmission, jamais lorsque des précautions empêchant la transmission ont été prises, et on ne doit jamais recourir à l’accusation d’agression sexuelle dans un cas de non-divulgation. »
En attendant une réforme du droit criminel (relevant du ministère de la Justice fédéral), la CCRCV n’exclut pas de demander un moratoire sur les poursuites (incombant aux provinces). « On observe une méconnaissance de la problématique chez les procureurs, dit Liz Lacharpagne. On souhaiterait des directives pour que les poursuites soient menées de manière éclairée, en tenant compte des avancées scientifiques. »
À Québec, au bureau de la ministre de la Justice, Stéphanie Vallée, on se garde de tout commentaire sur l’avancée des travaux, préférant s’en remettre au fédéral. Le ministère fédéral de la Justice a décliné notre demande d’entrevue, jugeant toute prise de parole prématurée dans les circonstances. « Ce travail, qui comporte un vaste examen du droit pénal, du rôle de la santé publique, des sciences médicales applicables et des pratiques d’inculpation et de poursuite actuelles, est en cours », ont-ils fait valoir par courriel.
Derrière la jurisprudence
La Cour suprême du Canada (CSC) a établi en 1998 qu’une personne séropositive doit divulguer son statut avant une relation sexuelle exposant à un risque important de transmission. La non-divulgation est considérée comme une fraude au consentement du partenaire. Une relation sexuelle non consentie est considérée comme une agression sexuelle. En 2012, l’arrêt Mabior instaure la notion de « possibilité réaliste » de transmission. La CSC considère que cette possibilité n’est pas établie si la charge virale est faible et si un condom est utilisé. Implicitement, si seul l’un de ces deux critères est rempli, il y a « possibilité réaliste ». Ce que la science contredit.
À la traîne de la science
L’étude Partner a été menée entre 2010 et 2013 auprès de 767 couples sérodiscordants. En moyenne, au début de l’étude, les partenaires séropositifs suivaient une thérapie antirétrovirale depuis cinq ans. Les couples avaient des relations sexuelles sans condom depuis deux ans. Avec un total de 44 000 relations sans condom, aucune transmission n’a eu lieu.
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