AIDS 2016: Justice Edwin Cameron addresses delegates at Durban AIDS conference

I owe my life to you, says judge

19 July 2016

“The fact that I am here today at all is a tribute to the activists, researchers, doctors and scientists in the audience,” Judge Edwin Cameron told delegates to the Durban Aids conference, delivering the Jonathan Mann memorial address. He asked sex workers and transgender people to join him on stage. His godson Andy Morobi also addressed the conference.

It is a great privilege and an honour to be here. At the start of a very busy conference, with many stresses and demands and anguishes, I want to start by asking us to pause quietly for just a few moments.

It has been 35 years since the Western world was alerted to Aids. The first cases of a baffling, new, terrifying, unknown syndrome were first reported in the northern summer of 1981. The reports were carried in the morbidity and mortality weekly reports of the CDC on 5 June 1981.¹

These last 35 years, since then, have been long. For many of us, it has been an arduous and often dismaying journey.

Since this first report, 35 million people have died of Aids illnesses² – in 2015 alone, 1.1 million people.^³

We have felt the burden of this terrible disease in our bodies, on our minds, on our friends and colleagues, on our loved ones and our communities.

Aids exposes us in all our terrible human vulnerability. It brings to the fore our fears and prejudices. It takes its toll on our bodily organs and our muscles and our flesh. It has exacted its terrible toll on our young people and parents and brothers and sisters and neighbours.

So let us pause, first, in remembrance of those who have died –

those for whom treatment didn’t come in time
those for whom treatment wasn’t available, or accessible
those denied treatment by our own failings as planners and thinkers and doers and leaders
those whom the internal nightmare of shame and stigma put beyond reach of intervention and help.
These years have demanded of us a long and anguished and grief-stricken journey.
But it has also been a journey of light – a journey of technological, scientific, organisational and activist triumph.

So we must pause, second, to celebrate the triumphs of medicine, science, activism, health care professional dedication and infrastructure that have brought ARVs to so many millions.

Indeed, the fact that I am here today at all is a tribute to the activists, researchers, doctors and scientists in the audience.

Many of you were responsible for the breakthroughs that led to the combination anti-retroviral treatment that I was privileged to start in 1997 – and which has kept me alive for the last 19 years.

I claim no credit and seek no praise for surviving. It felt like an unavoidable task.

All of us here today who are taking ARVs – let us raise our hearts and humble our heads in acknowledgement of our privilege – and often plain luck – in getting treatment on time. That treatment has given us life.

So let us pause, third, to honour the doctors – the scientists – the researchers – the wise physicians and strong counsellors who have saved lives and healed populations in this epidemic.

As important, fourth, let us pause to honour the activists, whose work made treatment available to those who would not otherwise have received it.

We pause to honour the part, in treatment availability and accessibility, of angry, principled and determined activists, in South Africa’s Treatment Action Campaign and elsewhere. For millions of poor people, their anger brought the gift of life.

Without their courage, strategic skill and passion, medication would have remained unimaginably expensive, out of reach to most people with HIV. They led a successful campaign that saved millions of lives.

The fact that many millions of people across the world are, like me, receiving ARV treatment, is a credit to their work.

They taught us an important lesson. Solidarity and support are not enough. Knowledge and insight are not enough. To save lives, we need more. We need action – enraged, committed, principled, strategically ingenious action.

They refused to acquiesce in a howling moral outrage. This was the notion that life-saving treatment – treatment that was available, and that could be cheaply manufactured – would not given to poor people, most of them black, because of laws protecting intellectual property and patent-holders’ profits.

The Treatment Action Campaign and their world-wide allies frontally tackled this. They changed the way we think about healthcare and essential medicines access.

What is more, without the Treatment Action Campaign, President Mbeki’s nightmare flirtation with Aids denialism between 1999 and 2004 would never have been defeated.

Instead, the TAC took to the streets in protest. They demanded treatment for all. And when President Mbeki proved obdurate, they took to the courts.

Because of my country’s beautiful Constitution, they won an important victory. Government was ordered to start making ARV treatment publicly available.

Today my country has the world’s largest publicly provided anti-retroviral treatment program.⁴ More than 3.1 million people, like me, are receiving ARVs from the public sector.⁵

I am particularly proud that when someone with HIV registers for treatment in South Africa, they should not be asked to show an identity document or a passport or citizenship papers. That is as it should be. The imperatives and ethics of public health know no artificial boundaries.

In the sad history of this epidemic, the triumphs of Aids activists, on five continents, are a light-point of joy.

So there is much to celebrate. I celebrate the joy of life every day with the medication – which keeps a deadly virus effectively suppressed in my arteries and veins, enabling me to live a life of vigour and action and joy.

But we must not forget that Aids continues to inflict a staggering cost on this continent and on our world.

What is more important than my survival, and that of many millions of people in Africa and elsewhere on successful ARV treatment, is those who are not yet receiving it.

There still remains so much that should be done. More importantly, there still remains so much that can be done.

Too many people are still denied access to ARVs. In South Africa, despite our many successes, well over six million people are living with HIV. And, though about half of South Africans with HIV are still not on ARVs,⁶ from September this year ARVs will be provided to all with HIV, regardless of CD4 count.

Globally, of the 36.7 million people living with HIV at the end of 2015, fewer than half had access to ARVs.⁷

Worse, the pattern of ARV availability is one that reflects our own weaknesses and vices as humans – our prejudices and hatreds and fears, our selfish claiming for ourselves what we do not grant to others.

Most of those still in need of ARVs are poor, marginalised and stigmatised – stigmatised by poverty, sexual orientation, gender identity, by the work they do, by their drug-taking and by being in prison.

Dr Jonathan Mann, to whom this lecture is dedicated, did pioneer work in recognising the links between health and human rights. He stressed that to address Aids, “we must confront those particular forms of inequity and injustice – unfairness, discrimination – not in the abstract, but in its specific and concrete manifestations which fuel the spread of Aids.”⁸

He recognised that the perils of HIV are enormously increased by laws that specifically criminalise transmission of HIV and exposure of another to it. This was also confirmed by the wonderful and authoritative work the Global Commission on HIV and the Law has recently done.

These laws are vicious, ill-considered, often over-broad and intolerably vague. By criminalising undefined “exposure”,⁹ they ignore the science of Aids, which shows how difficult HIV is to transmit.¹⁰ Apart from driving those at risk of HIV away from testing and treatment, they enormously increase the stigma that surrounds HIV and Aids.

Across this beautiful continent of Africa, men who have sex with men (MSMs) remain chronically under-served. They lack programs in awareness, education, outreach, condom provision and access to ARVs. As a recent study by Professor Chris Beyrer and others has shown, we have the means to end HIV infections and Aids deaths amongst men having sex with men. Yet “the world is still failing”.¹¹

For this, there is one reason only – ignorance, prejudice, hatred and fear. Theworld has not yet accepted diversity in gender identity and sexual orientation asa natural and joyful fact of being human.

Seventy eight countries in the world continue to criminalise same-sex sexual conduct. Thirty four of them are on this wide and wonderful continent of Africa.

It is a shameful state of affairs. As a proudly gay man I have experienced the sting of ostracism, of ignorance and hatred. But I have also experienced the power of redeeming love and acceptance and inclusiveness.

We do not ask for tolerance, or even acceptance. We claim what is rightfully ours. That is our right to be ourselves, in dignity and equality with other humans.

Discrimination on the ground of sexual orientation or gender identity is a colossal and grievous waste of time and social energy.

As our beautiful Archbishop Desmond Tutu has said, when we face so many devastating problems – poverty, drought, disease, corruption, malgovernance, war and conflict – it is absurd that we waste so much time and energy on sexual orientation (“what I do in bed with whom”.)¹²

The sooner we accept the natural fact that gender and orientation diversity exists naturally between us, the quicker we can join together our powers of humanity to create better societies together.

The same applies to sex workers. Sex workers are perhaps the most reviled group in human history – indispensable to a portion of mostly heterosexual males in any society, but despised, marginalised, persecuted, beaten up and imprisoned.

Sex workers work.¹³ Their work is work with dignity.

Why do people do sex work? Well, ask a sex worker –

To buy groceries, and pay their rent, to study, to send their children to school, and to send money to their parents and extended family.
It is hard work. Perilous work. Sex workers have a tough, dangerous job. They deserve our love and respect and support – not our contempt and condemnation.

They deserve police protection, not exploitation and assault and humiliation.

More importantly, they deserve access to every bit of HIV knowledge and power that can protect them from infection and can help them to protect others from infection.^¹⁴

Pre-exposure prophylaxis (PrEP) works for sex workers.¹⁵ It should be made available to them, as a matter of urgent priority, as part of all national Aids treatment programs.

In September 2015, the World Health Organization, recognizing PrEP’s efficacy, recommended that PreP be provided to all “people at a substantial risk of HIV,” including sex workers.^¹⁶

When we in South Africa launched our three-year National Sex Worker HIV Plan in March 2016, we proposed providing PrEP to sex workers. WHO recognized South Africa as the “first country in Africa to translate this recommendation into national policy.”¹⁷

Beginning last month (June 2016), the first programs began providing daily PrEP to sex workers in South Africa.¹⁸

Criminalising sex workers is a profound evil and a distraction from the important work of building a humane society.¹⁹

Especially vulnerable too are injecting drug users. Upon them are visited the vicious consequences of perhaps the most colossal public policy mistake of the last 80 years – the war on drugs.

The vulnerability of injecting drug users is evident in the high percentage of injecting drug users with HIV. Throughout the world, of about 13 million injecting drug users, 1.7 million (13%) are living with HIV.^²⁰

They are denied elementary life-saving services. This is not on the supposedly “dark” continent of Africa – but in the United States of America. If you want an example of evidence-ignoring public policy, that causes loss of life and injury, and spread of HIV, do not look complacently to President Mbeki’s South Africa twelve years ago – look to the United States of America, now, and the federal government’s refusal to make needle substitution available to IDUs . While the US government’s decision to partially lift this ban on federal funding for needle exchange programs earlier this year is a welcome development, this decision was only spurred by an outbreak of new HIV cases among drug users in the United States,^²¹ and the delay has undoubtedly resulted in preventable HIV infections.^²²

Injecting drug users living with HIV are further denied access to treatment. And the United States and Canada, healthcare providers are less likely to prescribe ARVs for injecting drug users, because they assume that IDUs are less likely to adhere to treatment and/or will not respond to it. This is in spite of research showing similar responses and survival rates for those who do have access to ARVs.^²³

We know exactly what we have to do to tame this epidemic.

We have to empower young people and especially young girls, to make health seeking choices when thinking about sex and when engaging in it.^²⁴

We have to redouble our prevention and education efforts.

Prevention remains a key necessity in all our strategies about Aids.

Second, we have to test, test, test, test, test, test and test. We cannot promote consensual testing enough. Testing is the gateway to knowledge, power, understanding and action.

Without testing there can be no access to treatment. The more we test, the more we know and the more we can do.

Testing must always be with the consent of the person tested. But we have to be careful that we do not impose unnecessarily burdensome requirements for HIV testing.

HIV is now a fully medically manageable disease. Consent to testing should be capable of being implied and inferred. We must remove barriers to self-testing.

I speak of this with passion – because, by making it more difficult for health care workers to test, we increase the stigma and the fear surrounding HIV.

We must make it easier to test, not harder. Gone are the terrible days when testing was a gateway only to discrimination, loss of benefits and ostracism.

In all this, we must be attentive to the big understated, underexplored, under-researched issue in the epidemic. That is the effect of the internalisation of stigma within the minds of those who have HIV and who are at risk of it.

Internalised stigma has its source in outside ignorance, hatred, prejudice and fear.

But these very qualities are imported into the mind of many of us with HIV and at risk of it.

Located deeply within the self, self-blame, self-stigma and self-paralysing fear are all too often deadly.^²⁵

We must recognise internalised stigma. I experienced its frightening, deadening effects in my own life. Millions still experience it. We must talk about it. And we must find practical ways to reduce its colossally harmful effects.

And, most of all, we must fix our societies. As my friend and comrade, Mark Heywood, has recently written, we have medically tamed Aids. But we have not tamed the social and political determinants of HIV, particularly the overlapping inequalities on which it thrives – gender, education, access to health care, access to justice. That is why prevention strategies are not succeeding.

A better response to HIV, Mark rightly says, needs a better world. Governments must deliver on their human rights obligations. Activists and scientists must join struggles for meaningful democracy, gender equality and social justice. Activists must insist on equal quality education, health and social services; investment in girls and plans backed by money to stem chronic hunger and malnutrition.²⁶

But, to end, I want to return to the light points in our struggle against the effects of this disease over the last 30 years.

I want to end with a thrilling fact – this is that, unexpectedly, joyously, beyond our wildest dreams, perinatal and paediatric ARVs have proved spectacularly and brilliantly successful.

First, let us rejoice that perinatal transmission of HIV can be completely eliminated. It was about this that the Treatment Action Campaign fought President Mbeki’s government all the way to the Constitutional Court, the Court in which I am now privileged to sit.

Now we know how effectively we can protect babies at birth and before birth from infection with HIV.

In South Africa, the rate of mother-to-child transmission of HIV is now reduced to 4%.²⁷ Worldwide, in 2015, 77% of all pregnant women received treatment to prevent perinatal transmission of HIV.²⁸

Last year, Cuba became the first country to eliminate mother to child transmission of HIV entirely.^²⁹ In 2016, Thailand, Belarus, and Armenia have also reached this milestone.^³⁰

More even, fifteen years ago we didn’t know how well babies and toddlers would tolerate ARVs.

We didn’t know just a decade ago how young children born with HIV would thrive on ARVs.

And would they take their ARVS? Would they grow to normalcy?

Instead of this uncertainty, we now know, triumphantly, that ARVs work wonderfully for children born with HIV.

I want to rejoice in the beauty and vigour of my godson Andy Morobi. Andy and I became family twelve years ago, at the end of 2004.

He is young, energetic, ambitious and enormously talented. He was born with HIV. He has been on ARVs for the last eight years. Like me, he owes his life to the medical and social miracle of anti-retroviral treatment.

I want to end on another light point. I want to honour the treatment activists from Africa, Europe, North America, South America, Australasia and Asia, who fought for justice in this epidemic.

I want to honour them, like Dr Jonathan Mann, to whom this lecture is dedicated. Like my mentor, Justice Michael Kirby of Australia, for their energy and courage and determination and sheer resourceful and resilience in fighting for justice in this epidemic.³¹

And I want to end by celebrating the fact that we have sex workers here this morning. They are wearing the T-shirts in the slide a few minutes ago. The T-shirts say: “THIS IS WHAT A SEX WORKER LOOKS LIKE”.

And, most of all, as a gay white man who has lived a life privileged by my race and my profession and my maleness, I ask that we celebrate the astonishing courage of transgender activists, of lesbians and gay men across the continent of Africa and in the Caribbean.

They are claiming their true selves. They do so often at the daily risk of violence, attack, arrest and imprisonment.

They have the right to be their beautiful selves. They are claiming a right to be full citizens of Africa, the Islands and the world. They have done so at extraordinary risk.

They know that they cannot live otherwise.

It is to these brave people that this conference should be dedicated: to the sex workers, injecting drug users, migrants, lesbian, gays and transgendered people, the children, the activists, those in prison, the poor and the vulnerable.

It lies within our means to do everything that will ensure whole lives and whole bodies for everyone with HIV and at risk of it.

All it requires is a passion and a commitment and a courage starting within ourselves. Starting within each of ourselves. Starting now.

Thank you very much.

For footnotes please see original articles in GroundUp

Beyond Blame @ AIDS 2016 Communique

DURBAN, SOUTH AFRICA, 17 JULY 2016

We cannot end the HIV pandemic without ending the epidemic of criminalisation of people living with HIV.

As activists, advocates, lawyers, and researchers engaged in the fight against HIV criminalisation, we are acutely aware of the harms it causes – to people who are criminalised, to those living with the threat of criminalisation, and to the HIV response in our countries. We stand in solidarity with survivors of unjust criminalisation, whose powerful stories we have heard and whose courage we honour.

The science of HIV is settled. HIV treatment works: it prevents disease, prevents death, and prevents transmission. Yet the scientific advances of recent years, which have saved countless lives, have all too often been misunderstood, misrepresented or ignored in the criminal justice system. The number of countries – 72 – with laws targeting people with HIV is increasing, not falling, and unjust prosecutions continue unabated. To protect both public health and human rights, these unjust laws must be repealed, police and prosecutorial policies must be reformed, and legal practitioners must be educated about the reality of HIV today.

There has been insufficient attention paid to the issue of HIV criminalisation within the scientific and medical community. While many researchers and clinicians are powerful and valued allies in our fight against unjust laws, we believe the medical and scientific communities can do more – indeed they must do more if the promise of ending HIV is to be achieved.

There has also been insufficient attention paid to these issues by the International AIDS Conference. As the leading global event in the HIV/AIDS arena, the IAC should provide greater prominence to the ways in which law and health intersect, especially in the area of HIV criminalisation. We call on the IAS to make a clear commitment to greater visibility of and access to HIV criminalisation-related research and policy.

We call on the scientific and medical community to join us as advocates in the fight to end HIV criminalisation. We are united by a common desire to see an end to new HIV infections, to AIDS deaths, to HIV-related discrimination, and to stigma against communities living with and affected by HIV. There can be no ‘end to AIDS’ while people with HIV face police action, prosecution, and imprisonment. We cannot reach the 90-90-90 target while criminal laws actively discourage testing, treatment, and prevention.

Public health policy, treatment, and support programmes are all impeded if they are not coupled with creating an enabling environment free of HIV criminalisation. The time is right for a new, holistic approach that incorporates all these issues under a single umbrella of action to end HIV.

ABOUT HIV JUSTICE WORLDWIDE

HIV JUSTICE WORLDWIDE is an initiative made up of global, regional, and national civil society organisations – most of them led by people living with HIV – who are working together to build a worldwide movement to end HIV criminalisation. All of the founding partners have worked individually and collectively on HIV criminalisation for a number of years.

The founding partners are: AIDS and Rights Alliance for Southern Africa (ARASA); Canadian HIV/AIDS Legal Network; Global Network of People Living with HIV (GNP+); HIV Justice Network; International Community of Women Living with HIV (ICW); Positive Women’s Network – USA (PWN-USA); and Sero Project (SERO).

ABOUT BEYOND BLAME @ AIDS 2016

On 17 July 2016, 150 advocates, activists, researchers, and community leaders met in Durban for a full-day pre-conference meeting for AIDS 2016, to discuss progress on the global effort to combat the unjust use of the criminal law against people with HIV. The Durban meeting followed similar successful meetings held at the International AIDS Conferences in Melbourne (2014) and Vienna (2010). The purpose of the meeting was to provide practical opportunities for advocates working in different jurisdictions to share knowledge, collaborate, and energise the fight against HIV criminalisation. Detailed summaries and outcomes of the meeting, including a video summary, will be available in due course from www.hivjusticeworldwide.org

BEYOND BLAME
Challenging HIV Criminalisation @ AIDS 2016, Durban

(29 min, HJN, South Africa, 2016)

On 17 July 2016, approximately 150 advocates, activists, researchers, and community leaders met in Durban, South Africa, for Beyond Blame: Challenging HIV Criminalisation – a full-day pre-conference meeting preceding the 21st International AIDS Conference (AIDS 2016) to discuss progress on the global effort to combat the unjust use of the criminal law against people living with HIV.

Attendees at the convening hailed from at least 36 countries on six continents (Africa, Asia, Europe, North America, Oceania, and South America).

Beyond Blame was convened by HIV Justice Worldwide, an initiative made up of global, regional, and national civil society organisations – most of them led by people living with HIV – who are working together to build a worldwide movement to end HIV criminalisation.

The meeting was opened by the Honourable Dr Patrick Herminie, Speaker of Parliament of the Seychelles, and closed by Justice Edwin Cameron, both of whom gave powerful, inspiring speeches. In between the two addresses, moderated panels and more intimate, focused breakout sessions catalysed passionate and illuminating conversations amongst dedicated, knowledgeable advocates

USA: People living with HIV shared their determination to lead the fight for HIV decriminalization at the second HIV is Not a Crime conference

“Thirty-three years ago, a group of activists, tired of how they were being treated, drafted the Denver Principles,” Barb Cardell said to the sleepy but energized audience at an early morning session of the second HIV is Not a Crime conference. Cardell, a long-time HIV activist, is co-chair of the Colorado chapter of Positive Women’s Network, an advocacy network of women living with HIV.

In essence, recalled Cardell, activists were declaring, “Nothing is determined about us without us. … In 1983, we refused to let other people set the agenda. These are the shoes we walk in today.”

The Denver Principles opened with these words: “We condemn attempts to label us as ‘victims,’ a term which implies defeat, and we are only occasionally ‘patients,’ a term which implies passivity, helplessness and dependence upon the care of others. We are ‘People with AIDS.'”

This spring, nearly 300 activists from 34 different states and four countries (Canada, Germany, Mexico and the United States) gathered on the campus of Huntsville, Alabama, to continue that work. Many have been involved in advocacy for years, if not decades, and are determined that the fight for HIV decriminalization be led by those who are living with HIV. They are committed to fostering the meaningful involvement of people living with HIV and AIDS (commonly known as MIPA) in the discussions about policies that affect them.

Khafre K. Abif was diagnosed with HIV 27 years ago. Now, Abif is a community organizer with the Southern AIDS Coalition. “This is my first time working — and by working, I mean getting a salary — in HIV,” he said. Though this is his first paid job in the field, Abif has been advocating around HIV for nearly three decades, always as a volunteer determined to make sure that the voices of those with HIV were not left out of the discussions. “I always brought my table to the table,” he said. “I wasn’t waiting to be invited to the table.”

He doesn’t feel that his outspokenness is exceptional. “There’s a willingness [for people to speak up],” he pointed out. “But people need the support to do it. Once they know that someone will be standing beside and behind them when they speak out, they’ll do it.”

Such support has even reached behind bars to empower those traditionally silenced by prison walls. Kerry Thomas is on the board of the Sero Project. When he speaks at conferences across the country about the effects of HIV criminalization, he does so from the Idaho State Correctional Center, where he is serving a 30-year sentence under a state law criminalizing non-disclosure. Inside prison, he’s been active in combatting fear and ignorance about HIV and has been working to develop a network of imprisoned people living with HIV and other illnesses. He also reaches outside to educate people about the very real effects of criminalization laws. At 7:15 on Tuesday night, he called into the opening plenary to share his thoughts and experiences.

“A few months ago, I was sent a photo of the first HIV is Not a Crime conference,” he told the audience, his voice crackling through the cell phone set beside a microphone. He carries that photo with him at all times to remind himself that he is part of a larger movement. It’s a reminder that gets him through some of the isolation of being in prison. “There are times I may feel lonely, and that’s when the support from you guys means a lot.” At the same time, he acknowledges that the support and opportunities he has are exceptional. “I’m one of the lucky ones that has this community and has the opportunity to speak at these conferences,” he said. “But across the country, there are people who don’t.”

Naina Khanna, the executive director of the Positive Women’s Network USA, points to Thomas as an example of meaningful involvement by those most impacted by criminalization. “If you can figure out a way to have an incarcerated person regularly participate in these board meetings, then we should be able to eliminate barriers to meaningful participation,” she stated. But, she said, doing so involves creating spaces that are trauma-informed and healing as well as understanding — and that address the multiple barriers to participation. For some, physically attending a conference presents numerous challenges, including paying for travel and being targeted at airports for invasive and demeaning search procedures.

For some, having HIV is one of many identities to navigate. Ashton P. Woods refuses to compartmentalize his multiple identities as a black person, a person living with HIV, a gay man and a formerly homeless youth. “To people who say, ‘Pick an issue,’ I say, ‘That’s bullshit,'” he declared. Standing at the podium during a morning plenary, he reminded the audience of the need for solidarity and support for those even more in the crosshairs of intersecting oppressions. “We have to step up as people living with HIV because our trans sisters are at risk.”

Tommy Luckett is a black trans woman. She is also living with HIV in Arkansas, where it is a felony for people who know that they have HIV to engage in any form of sexual intercourse without disclosing their status. Spitting, biting and receiving medical and dental care are also criminalized for people who do not disclose their status.

The fear of prosecution looms over Tommy’s daily life, compounded by the fact that she is both black and trans. “All of these [identities] paint me as a target in my own home state,” she told TheBody.com. The threat of violence is ever present whenever she leaves her house. Across the country, trans women aredisproportionately targeted in hate-motivated attacks and murders. In 2015, it was reported that at least22 trans and gender non-conforming people were murdered in the U.S. This number reflects only the murders that were reported and investigated and whose victims were recognized as trans or gender non-conforming.

But despite the constant risks, Luckett is also an outspoken advocate for HIV and trans issues. She knows the importance of bringing the experiences of trans women of color living with HIV to the table so that their issues are not left out of the conversation. She often finds herself to be the only trans person around, which means having to be both cautious about her behavior and wary of her surroundings. That vigilance can be exhausting and discouraging. (There were at least eight people who identified as trans among the 300 attendees at the HIV is Not a Crime conference.)

“You want to know how to help trans women? Put them in your organization.” Luckett points to Positive Women’s Network USA and the Well Project as models. “They brought me to the table and listen to what I have to say,” she said. She also noted that, as one person, she cannot be everywhere at once — nor should she be expected to be. “When I can’t get to places, that’s where I need my allies to be and to carry my message,” she said.

Andy Spieldenner is an assistant professor at Hofstra University (where he was recently awarded the 2016 Distinguished Teacher of the Year award) and an officer of the U.S. People Living With AIDS Caucus. “Part of MIPA is making sure you’re not the only person in the room,” he noted. To expand meaningful participation — and to avoid burnout — he encouraged attendees to bring their peers along and help develop their leadership. “Ask if you can bring someone. Or just bring someone,” he recommended. Tell that person about the history of the organization, what happened at the last meeting or gathering, and anything else you know.

People living with HIV, particularly those most marginalized, are not waiting to be invited to the table. Some, like Abif, are bringing their own table to the table. Others are creating their own table, conducting research on the issues that impact them most. In 2015, sex workers and trans people published Nothing About Us Without Us: Sex Work, HIV Policy Organizing, Transgender Empowerment. The report is the first of a series and explores the ways in which HIV policies impact trans people who are sex workers or are profiled as sex workers.

That same year, the Transgender Law Center launched Positively Trans, a project to develop self-empowerment and advocacy by and for trans people living with HIV. The project conducted its own research about the experiences and challenges facing trans women living with HIV. Researchers were the trans people directly impacted; they reached out to hundreds of people, gathering partial responses from more than 400 trans people and complete responses from 157. In March 2016, Positively Trans published its first report, finding economic and systemic disparities for trans people, including the fact that the majority of trans women who are U.S. citizens earned less than $23,000 a year, more than 40% had been incarcerated in their lives and 69% had experienced HIV-related discrimination. The Center is also offeringdigital storytelling sessions, allowing people with HIV to tell their own stories instead of having them mediated by a third party.

“We need to prioritize the most impacted people,” declared Maxx Boykin, an organizer at AIDS Chicago and an organizing co-chair of the Chicago chapter of Black Youth Project 100, a national organization of young black activists. “Don’t tell them what they need. Listen — so they can tell you.”

Victoria Law is a freelance writer and editor. Her work focuses on the intersections of incarceration, gender and resistance. She is the author of Resistance Behind Bars: The Struggles of Incarcerated Women.

USA: Criminalisation advocates explain why using the right language is key to success

Jennie Smith-Camejo, the communications director of Positive Women’s Network – USA, stood at the podium at the second HIV Is Not a Crime conference on HIV criminalization in May. Behind her was a PowerPoint presentation with several examples of recent egregious headlines about people living with HIV.

“Woman With HIV Convicted of Biting Sister During Fight,” screamed one. “Man With HIV Assaults Hospital Employee,” read another. “Suspect Threatens to Transmit HIV to Police Officer,” announced a third.

“You don’t really hear [much] about HIV in the news anymore,” Smith-Camejo noted as she flipped through these headlines. “So, if these are what you’re seeing and hearing, what would you think?”

That is the challenge for people fighting HIV criminalization laws. How do you push past the fear and panic around HIV transmission when click-bait headlines dominate media coverage?

There’s no one opinion about what kind of messaging is most effective. For some, using language that appeals to their audience’s core values has been effective. Others reject that strategy, instead demanding more inclusive, intersectional messages that do not leave out the most vulnerable, such as sex workers and trans people.

“When you’re talking to people outside the HIV community, you have to think about what they’re thinking and hearing,” stated Jennie Smith-Camejo, the communications director of Positive Women’s Network – USA, an advocacy network of women living with HIV. “People’s views on policies and issues are more shaped by emotion than reason,” Camejo-Smith noted. But advocates have the power to appeal to these emotions. Using stories can change hearts and minds in ways that cold hard facts often do not, she said.

Jennie Smith-Camejo gives one example of messaging that appeals to a more conservative audience. When talking to people who may not care about the injustices of police profiling of trans women or HIV criminalization, she points to the way in which Cyd Nova, the harm reduction coordinator at the Saint James Infirmary, a clinic for current and former sex workers, frames the issue of policing as one that interferes with personal responsibility and protecting public health:

Trans women are disproportionately profiled and targeted by law enforcement for harassment and arrest. And because of policies like [using] condoms as evidence, trans women often face a choice between protecting themselves and their partners from HIV and risking arrest.

Effective messaging can sometimes prevent a harmful legislative amendment from even reaching the floor.LaTrischa Miles is a board member of Positive Women’s Network – USA, as well as the founder and president of Grace, a faith-based support group in in Kansas City for women affected by and living with HIV. When she learned that Missouri legislators planned to introduce a bill that would make it a crime for a person with HIV to spit at someone, she and other activists sprang into action. They contacted legislators and debunked the myths about saliva and HIV transmission. “Because they heard from us in the community, they didn’t even bring it forward for the hearing,” Miles recalled.

In Colorado, members of the Mod Squad and Senator Pat Steadman utilized language that appealed to a broader political spectrum as they pushed SB 146, a bill that repealed two criminalization statutes and reformed another. Instead of talking about criminalization as an injustice that needed to be eliminated, Steadman appealed to conservative values, such as personal responsibility. “We talked about barriers that criminalization poses to testing, treatment and public health,” Steadman stated in a celebratory address. “The biggest thing to take on is people’s fear and ignorance.”

To combat stigma and hammer home the importance of changing the law, Steadman’s talking point became: “The criminal law is a clumsy and ineffective tool for protecting public health.”

Advocates also shifted their messaging. Barb Cardell, a long-time HIV activist and member of the Colorado Mod Squad (“Mod” is short for modernization), recalled that the group had initially called themselves the HIV Decriminalization Task Force, then the STI Grassroots Modernization Alliance.

“We didn’t change anything else we were doing,” recalled John Tenorio, a rural Mod Squad member. Simply changing their name brought them more respect and support.

In Colorado, it appears that the shift worked. Steadman and the Mod Squad faced little opposition to repealing and reforming the criminalization statutes. (Instead, Steadman noted, the sticking point was the provision allowing minors to be tested and treated for HIV without parental consent.) SB 146 passed in both houses of the legislature and is now awaiting the governor’s signature.

But not everyone agrees with shifting the message to appeal to more conservative audiences. “You have to think about decriminalization — true repeal of these outrageous laws. Don’t talk to me about modernizing things to make them sound better. I am not here to wait years and years and years for this to happen,” said Maxx Boykin, an organizing co-chair of the Chicago chapter of Black Youth Project 100 (BYP100), a national organization of 18- to 35-year-old black activists, and a community organizer at AIDS Chicago. He tied HIV criminalization to the pervasive state violence against black people, particularly black youth. “You have to stop criminalizing who I am, who my friends are.”

Appeals to modernize laws will not stop the collision of criminalization faced by those marginalized by race, gender identity and poverty, he explained. “I have to talk about how [criminalization] disproportionately affects black people,” Boykin told TheBody.com. He draws parallels between HIV criminalization laws and the disparities in crack-cocaine sentencing. It’s a parallel that those already organizing against police and state violence understand all too well.

He also challenges people to think about criminalization as a whole, tying HIV criminalization to issues of racism and mass incarceration as well as explaining how people living with HIV are treated in prison and what HIV criminalization actually looks like.

Marco Castro-Bojorquez, a documentary filmmaker, community organizer and member of the steering committee for the U.S. People Living With HIV Caucus, arrived in the United States from Mexico 20 years ago. For him, an intersectional analysis needs to be present in every discussion.

“It’s difficult to talk to people about race and class,” he told The Body.com. “But you need to do it when talking about any injustice.” These conversations can be difficult, he acknowledged. “White people get offended or angry or sad,” he said. For them, he said, “it’s important to check your privilege and make sure you are not making us [people of color] responsible for your feelings. People don’t understand the amount of energy it requires for us [to explain racism and other injustices we face].”

He concentrates his energies on working with people who feel the brunt of marginalization the most — people of color, immigrants and trans people. In 2015 he helped launch Venas Abiertas: Una Red de Inmigrantes Latinxs Viviendo con el VIH/Sida (Open Veins: A Network of Latinx Immigrants Living With HIV/AIDS) for HIV-positive Latino immigrants to advocate for their needs and work with allies.

When Castro-Bojorquez talks about HIV criminalization, he’s often met with shock that such laws even exist. He recalls repeated conversations with his best friend. “He could not believe you could have sex with someone, use a condom, not transmit anything and still be thrown in jail,” he recounted. The two continued to have conversations about criminalization — and Castro-Bojorquez’s work to end it. “Now he’s super-knowledgeable about it,” he said.

Castro-Bojorquez also cautions against the tendency to characterize certain statutes as “not so bad,” explaining that “any law that criminalizes HIV is bad.”

Regardless of the words they choose, advocates say the message needs to be clear and not veer into other topics. Mark King, the blogger behind My Fabulous Disease, learned this firsthand.

In 1992, when Magic Johnson first announced that he was living with HIV, King was the newly appointed communications person for the Los Angeles Shanti Foundation, which provided emotional support for people dying from AIDS-related complications. Johnson’s announcement inevitably sparked office gossip, including speculation about which AIDS organization Johnson might endorse as well as the fact that Elizabeth Taylor had sent Johnson flowers, King recalled. That gossip was still buzzing when the phone began ringing with press requests. “I was young and stupid,” King recounted and, when he spoke with a reporter from the Los Angeles Times, he began chattering away, repeating the office gossip.

The next day, the Los Angeles Times ran King’s statements about Elizabeth Taylor and the rivalry for Johnson’s support among AIDS organizations. “I gave the reporter the story he wanted to write — about the competition among agencies — rather than the message I was supposed to deliver,” King recalled 24 years later. The lesson? “Hold on tight to your message and repeat it over and over so they can’t put in some stupid quote about Elizabeth Taylor.”

Originally published in The Body

Canada: Activist Christian Hui on why HIV criminalisation harms us all

US: Democratic Party pledges to "address HIV criminalization laws" in its 2016 draft party platform

Democratic Party Comes Out Strong for LGBTQ Equality in 2016 Party Platform

HRC Blog by post by Stephen Peters

Today, the Democratic Party released its draft 2016 party platform, including key provisions that focus on improving the lives of LGBTQ people and advocating for full equality.

“This is the most LGBTQ-inclusive platform of any major U.S. party,” said JoDee Winterhof, HRC’s Senior Vice President for Policy and Political Affairs. “We will continue to work with the Democratic Party to ensure the most robust platform for LGBTQ Americans. From protecting LGBTQ young people to ending the epidemic of violence against transgender people to passing an explicit and comprehensive federal non-discrimination law to bringing about an AIDS-free generation, the platform addresses many of the major challenges facing our community today.”

Here are some of the highlights:

LGBT Rights

Democrats applaud last year’s decision by the Supreme Court that recognized LGBT people— like every other American—have the right to marry the person they love. But there is still much work to be done. LGBT kids continue to be bullied at school, a restaurant can refuse to serve a transgender person, and a same-sex couple is at risk of being evicted from their home. That is unacceptable and must change. Democrats will fight for comprehensive federal non- discrimination protections for all LGBT Americans and push back against state efforts to discriminate against LGBT individuals. We will combat LGBT youth homelessness and improve school climates, and we will protect transgender individuals from violence. We will promote LGBT human rights and ensure America’s foreign policy is inclusive of LGBT people around the world.

Civil Rights

Democrats will always fight to end discrimination on the basis of race, ethnicity, national origin, language, religion, gender, sexual orientation, gender identity, or disability. We need to promote civility and speak out against bigotry and other forms of intolerance that have entered our political discourse. It is unacceptable to target, defame, or exclude anyone because of their religion, race, ethnicity, national origin, or sexual orientation.

HIV and AIDS

Democrats believe an AIDS-free generation is within our grasp. But we know far too many Americans still suffer, which is why we will implement the National HIV and AIDS Strategy, increase research funding for the National Institutes of Health, cap pharmaceutical expenses for people living with HIV and AIDS, address HIV criminalization laws, and expand access for HIV prevention medications, particularly for the populations most at risk of infection. Abroad, we will make the President’s Emergency Plan for AIDS Relief more effective and increase global funding for HIV and AIDS prevention and treatment. Democrats will always protect those living with HIV and AIDS from stigma and discrimination.

Supporting our Troops

[…]Democrats welcome and honor all Americans who want to serve and will continue to fight for their equal rights and recognition. We are proud of the repeal of Don’t Ask, Don’t Tell and the opening of combat positions to women. Our military is strongest when people of all races, religions, sexual orientations, and gender identities are honored for their service to our country.

Racial Justice

Democrats will fight to end institutional and systemic racism in our society. We will challenge and dismantle the structures that define lasting racial, economic, political, and social inequity. Democrats will promote racial justice through fair, just, and equitable governing of all institutions serving the public and in the formation of public policy. We will push for a societal transformation to make it clear that black lives matter and there is no place for racism in our country.

Gun Violence Prevention

With 33,000 Americans dying every year, Democrats believe that we must finally take sensible action to address gun violence. While gun ownership is part of the fabric of many communities, too many families in America have suffered from gun violence. We can respect the rights of responsible gun owners while keeping our communities safe. We will expand background checks and close dangerous loopholes in our current laws, hold irresponsible dealers and manufacturers accountable, keep weapons of war—such as assault weapons—off our streets, and ensure guns do not fall into the hands of terrorists, domestic abusers, other violent criminals, and those with severe mental health issues.

Canada: In Nova Scotia, glimmers of hope for science in the prosecution of HIV non-disclosure

Analysis by our HIV JUSTICE WORLDWIDE partner, the Canadian HIV/AIDS Legal Network.

Despite very few prosecutions, Nova Scotia has become an interesting place in Canada with respect to the criminalisation of HIV non-disclosure.

In April 2016, a trial judge from Antigonish ruled that non-disclosure before vaginal sex with a condom or a low viral load (< 1,500 copies/ml) did not amount to aggravated sexual assault.

Back in November 2013, a trial judge from Halifax acquitted a young man with an undetectable viral load who had not disclosed his HIV-positive status before sex without a condom.

These decisions represent significant developments in Canada, where the Supreme Court’s 2012 decision in R. v. Mabior opened the door to prosecutions even if a condom was used or the HIV-positive partner had a low or undetectable viral load.

Thanks to Nova Scotia judges, science might finally prevail.

In the recent Antigonish case, three medical experts testified, all aligning themselves with the Canadian consensus statement on HIV and its transmission in the context of the criminal law that was developed by eminent HIV experts in response to the 2012 Supreme Court decision.

They clearly testified that condoms are highly effective to prevent transmission (“protection is almost 100% when a condom is used,” said the Crown medical expert) and that being on treatment and having a low viral load dramatically reduce the chance of transmitting the virus.

Remarkably, they were also testimonies that the risk of HIV transmission in the absence of ejaculation is at most “negligible” and that HIV transmission from pre-ejaculate, if even possible, is not proven (there was no ejaculation with the first complainant and a reasonable doubt about ejaculation with the second complainant).

Based on the medical evidence before the Court, the trial judge concluded that the legal test of a “realistic possibility of HIV transmission” established in Mabior, which triggers the legal duty to disclose, had not been met. The accused was found not guilty of aggravated sexual assault.

Disappointingly, despite the absence of a “realistic possibility of HIV transmission,” the accused was nevertheless convicted of sexual assault causing bodily harm due to the psychological harm allegedly suffered by the complainants while waiting for their test results (neither of the complainants has contracted HIV).

Despite the progress made in acknowledging scientific evidence, this ultimate decision is highly problematic and arguably legally unfounded. It remains to be seen if the decision will be appealed.

The full decision can be downloaded from the Supreme Court of Novia Scotia’s website

Advocates fighting to end HIV criminalisation reach a global TV/web audience on The Stream

Last night, HIV criminalisation advocacy reached a global audience on both TV and the internet with The Stream, on Al Jazeera English.

During the 30 minute programme, HIV criminalisation survivor, and Sero advisory board member, Ken Pinkela appeared with co-hosts Malika Bilal and Omar Baddar in the Washington DC studio to discuss his case and the role HIV stigma played in his unjust prosecution and wrongful conviction.

He was joined via Skype by ARASA’s Executive Director, Michaela Clayton, who discussed the impact of HIV criminalisation on women in southern and eastern Africa.

Anand Grover, Senior Advocate at Supreme Court of India, founder of India’s Lawyers Collective, and a former UN Special Rappporteur on the Right to Health highlighted the many human rights concerns with a punitive approach to HIV prevention.

I was also on programme, highlighting the work of the HIV Justice Network and citing data from our recent report, Advancing HIV Justice 2.

Contributions were also seen from US HIV advocates Shawn Decker and Nina Martinez, and Colorado Senator Pat Steadman who worked with the Colorado Mod Squad to recently completely overhaul HIV criminalisation in Colorado.

Watch the entire programme below or on the The Stream’s website.

Sweden: Civil societies organisations call for guidelines to prosecutors in cases of HIV-criminalisation

“Major Uncertainty about HIV in Courts – The Prosecutor must act”

Open letter to the Prosecutor General Anders Perklev:

The organizations Hiv-Sweden, RFSL and RFSU call for guidelines for prosecutors for prosecutions against people living with HIV who are at risk of transmitting the virus via sexual contacts.

Signatory organizations promote the development of HIV in Sweden, how people living with HIV perceive their situation, the way in which case law looks and the medical successes in the field. Since 2013, the knowledge base “Infectiousness in Treated HIV Infection” has been developed by the Public Health Authority and the Reference Group for AntiViral Therapy (RAV), which shows that there is a negligible risk of HIV transmission during well-treated treatment.

Since 2016, there is also a document written by medical experts in which the disability rate in HIV is reduced from 40-60% to 0-10%.

These documents should have a major impact on the prosecution of persons, for whom crimes are prosecuted, how damages for a possible transfer should be measured and how seriously the chronic disease HIV should be considered.

RFSU, RFSL and Hiv-Sweden can say that there is great uncertainty in courts and justice in general how to handle the progress made in the medical field regarding HIV. There is no precedent since the knowledge base came and, as the Prosecutor is aware, no trial was given in the Supreme Court for Case B 2152-13, the Court of Appeal over Skåne and Blekinge, in which a person living with HIV and had a so-called well-treated treatment was released from criminal liability.

Signatory organizations welcome the Court of Appeal’s judgment, which clearly takes into account medical success, contagiousness and other facts in the case. Unfortunately, the Supreme Court (in connection with the grant of a review) did not refer to the decision NJA 2004 p. 176, which means that the judgment of the Court of First Instance can not be regarded as prejudicial.

Signatory organizations find it deeply unfortunate that the Supreme Court did not test the case partly referring to precedents no longer based on current knowledge. This means that the legal situation is unchanged and unclear, which creates legal uncertainty for people living with HIV.

Regrettably, we can say that the courts have begun to take care of the medical successes that have been made since 2004, and in the days a new intelligence judgment in which a man living with HIV and standing on a well-treated treatment is released from criminal liability (see Day’s Juridics 2016- 05-31 ). We hope that Objective B 212-15 from Uppsala District Court will proceed in the judicial system and create a new practice in this area.

The judgment states that the risk of HIV transmission to unprotected intercourse is so small in case of well-being treatment that one can not reasonably expect the effect of transfer and thus does not fulfill the objective crimes for the development of danger to another.

Even though the profession assesses the risk of HIV transmission to be neglected in well-preserved HIV even in unprotected intercourse, prosecutors continue to famble as to which acts will lead to prosecutions and which crimes are prosecuted. For example, some prosecutors choose to prosecute people living with HIV, with well-treated treatment, without the intention of transmitting HIV and there was no transfer for attempted abuse, which is neither reasonable nor correct.

RFSU, RFSL and HIV-Sweden want guidelines from the RA to the prosecutor who takes into account the major medical achievements and the knowledge base available to create a fairness in how the judicial system manages this already vulnerable group of people living in our society HIV.

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“Stor osäkerhet om HIV hos domstolar och rättsväsende – riksåklagaren måste agera“

Öppet brev till riksåklagaren Anders Perklev:

Organisationerna Hiv-Sverige, RFSL och RFSU efterlyser riktlinjer för åklagare avseende åtal mot personer som lever med hiv och som riskerar att överföra viruset via sexuella kontakter.

Undertecknande organisationer följer utvecklingen noga avseende hiv i Sverige, hur personer som lever med hiv uppfattar sin situation, hur rättspraxis ser ut och de medicinska framgångar som görs på området. Sedan år 2013 finns kunskapsunderlaget “Smittsamhet vid behandlad hivinfektion” framtaget av Folkhälsomyndigheten och Referensgruppen för AntiViral terapi (RAV), i vilket det framgår att det föreligger försumbar risk för överföring av hiv vid välinställd behandling.

Sedan år 2016 finns det även ett dokument skrivet av medicinska experter i vilket invaliditetsgraden vid hiv sänks från tidigare 40-60 % ned till 0-10 %.

Dessa dokument borde få stor inverkan på när personer åtalas, för vilka brott personer åtalas, hur skadestånd vid en eventuell överföring bör mätas och hur allvarlig den kroniska sjukdomen hiv skall betraktas vara.

RFSU, RFSL och Hiv-Sverige kan konstatera att det råder stor osäkerhet i domstolar och rättsväsendet i övrigt hur de ska hantera de framsteg som görs på det medicinska området gällande hiv. Det saknas prejudikat sedan kunskapsunderlaget kom, och som riksåklagaren väl känner till gavs inte prövningstillstånd i högsta domstolen för mål B 2152-13, Hovrätten över Skåne och Blekinge, i vilket en person som lever med hiv och hade en så kallad välinställd behandling friades från straffansvar.

Undertecknande organisationer välkomnar hovrättens dom, som tydligt tar hänsyn till medicinska framgångar, smittsamhetsdokumentet och fakta i övrigt i målet. Dessvärre hänvisade Högsta domstolen (i samband med att prövningstillstånd inte gavs) till avgörandet NJA 2004 s. 176 vilket innebär att hovrättens dom inte kan anses vara prejudicerande.

Undertecknande organisationer finner det djupt olyckligt att Högsta domstolen dels inte prövade målet dels hänvisade till prejudikat som inte längre baserar sig på aktuell kunskap. Detta innebär att rättsläget är oförändrat och otydligt, vilket skapar en rättsosäkerhet för personer som lever med hiv.

Glädjande nog kan vi konstatera att domstolarna ändock har börjat ta till sig av de medicinska framgångar som gjorts sedan 2004 och i dagarna kom en ny underrättsdom i vilken en man som lever med hiv och står på välinställd behandling frias från straffansvar (se Dagens Juridik 2016-05-31) . Vi hoppas att mål B 212-15 från Uppsala tingsrätt skall gå vidare inom rättsväsendet och skapa en ny praxis på området.

I domen konstateras att risken för överföring av hiv vid oskyddade samlag är så pass liten vid välinställd behandling att man inte rimligen kan förvänta sig effekten att överföring sker, och att det därmed inte uppfyller de objektiva brottsförutsättningarna för framkallande av fara för annan.

Trots att professionen bedömer risken för överföring av hiv vara försumbar vid välinställd hiv även vid oskyddade samlag fortsätter åklagare att famla när det gäller vilka gärningar som skall leda till åtal och vilka brott som åtalas för. Vissa åklagare väljer till exempel att åtala personer som lever med hiv, med välinställd behandling, utan uppsåt att överföra hiv och där ingen överföring skett för försök till misshandel vilket varken är rimligt eller korrekt.

RFSU, RFSL och Hiv-Sverige önskar riktlinjer från RÅ till landets åklagare som tar hänsyn till de stora medicinska framgångar som gjorts och det kunskapsunderlag som finns, för att skapa en rimlighet i hur rättsväsendet hanterar denna redan utsatta grupp personer i vårt samhälle som lever med hiv.