US: CDC finally admits criminalisation is problematic

A campaign by the HIV Prevention Justice Alliance for the US Centres for Disease Control and Prevention (CDC) to confront criminalisation in the United States is finally bearing fruit.

The HIV Prevention Justice Alliance is network of organisations advocating for effective and just HIV prevention policies for the United States, coordinated by Community HIV/AIDS Mobilization Project (CHAMP) in collaboration with AIDS Foundation of Chicago, and SisterLove.

Their campaign began in 2008. The Alliance was extremely concerned that prosecutions for HIV-associated spitting and biting were doing a lot of harm.

CDC has long maintained that contact with saliva, tears, or sweat does not expose others to an appreciable risk of HIV transmission. The continued perpetuation of false information by the justice system and the media on how the virus is transmitted underscores the need for more effective HIV communication and education strategies at the highest levels that are accessible to the general public. In light of an unabated and growing HIV epidemic among certain segments of the U.S. population, we believe that it is incumbent upon the CDC to aggressively respond and provide the public with the most accurate information to reduce HIV vulnerability.

A December 2008 letter from the CDC had previously pledged to do all of what they now promise to do (see below), but when no action was taken, the Alliance sent another letter in January 2010 to the CDC’s Kevin Fenton – Director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention – “to urge CDC to take action on the steps it had identified to address the criminalization of HIV.”

In a letter signed by Fenton, the CDC has now agreed to:

Update and expand the “Rumors, Myths, and Hoaxes” section of the CDC website by April 30th 2010.
Update and expand CDC’s factsheet and question and answer sets (Q&As) regarding HIV transmission to better address myths and misconceptions about HIV transmission by April 30th 2010.
Develop internal talking points to ensure CDC staff is equipped to deliver consistent, scientifically accurate information when they receive inquiries around issues of criminalization and/or myths and misconceptions about HIV transmission by April 30th 2010.
Survey health departments, beginining May 2010 to determine whether they have collaborative relationships with criminal justice personnel and, if so, how these relationships affect HIV prevention efforts in communities.
Use information obtained from the surveys to develop a communications package to provide to state and local health departments with the tools and messages they need to facilitate interactions with their criminal justice counterparts by August 30, 2010.

The letter concludes: “While these activities represent a concrete beginning, we realize there is much to be done to address the need for a public health, rather than punitive perspective to drive how people living with HIV/AIDS are approached in the United States. We all must continue to be forward thinking in this endeavor, and collectively we will make a broader impact. We at CDC appreciate the work organizations such as yours do in the communities affected by this disease.”

I’d like to congratulate all those involved in persuading the CDC to take its first tiny steps towards making a stand against the draconian treatment of people living with HIV in the United States. Their response is focused on the most egregious criminal prosecutions, and there is, indeed, “much to be done to address the need for a public health, rather than punitive perspective to drive how people living with HIV/AIDS are approached in the United States.”

For example, the CDC could also publically state that non-disclosure laws do more harm than good for public health, and also support the idea (which they already are exploring on a population level) that on an individual level people on successful antiretroviral treatment are as as unlikely to expose their sexual partners to HIV as those who wear condoms.

Click on the image of Mr Fenton’s pledge to read the entire letter.

Uganda: ‘Human rights will suffer’ under new HIV/AIDS law (update)

Update: December 3rd

The United Nations Special Envoy on AIDS in Africa, Elizabeth Mataka – and NGOs that include the Uganda Network on Law, Ethics and HIV/Aids (Uganet) and ActionAID – have added to the many voices urging Uganda to reconsider its proposed HIV and AIDS Prevention and Control Bill.

The Daily Monitor reports that Ms Mataka told journalists in Kampala yesterday:

“I emphasise the importance of creating a bigger and social environment conducive for HIV prevention and to refrain from laws that criminalise the transmission of HIV and stigmatise certain groups in the population. These laws can only fuel the epidemic further and undermine an effective response to HIV.”

Dorah Musinguzi, acting Executive Director of Uganet stated:

“We are cognisant of the fact that the draft Bill contains provisions that seek to address the HIV/AIDS pandemic but we need a law on the basis of which rights can be claimed and duties articulated in the context of HIV/AIDS. AIDS is no longer just a disease but a human rights issue. The law should be carefully crafted to find the right balance between promoting the public health while safeguarding and promoting human rights.

Original post: November 6th

A group of more than 50 Ugandan and international organizations and individuals have released a report criticising many of the provisions in the HIV and AIDS Prevention and Control Bill which is on its way to becoming law in Uganda.

A press release from Human Rights Watch (HRW) begins

The report criticizes repressive provisions in the legislation as contrary to the goal of universal access to HIV prevention, care, and treatment. The proposed law includes mandatory testing for HIV and forced disclosure of HIV status. It also criminalizes the willful transmission of HIV, the failure to “observe instructions on prevention and treatment,” and misleading statements on preventing or controlling HIV.

Worryingly, the latest version of the bill, released a few days ago, has now a added provision criminalising attempted transmission, which “further opens the door for abusive prosecutions”, HRW notes.

However “failure to inform one’s sexual partners of HIV status is no longer criminalised” along with the rather interesting provision that would have criminalised “failure to take reasonable steps and precautions to protect oneself from HIV transmission.”

Some might argue if criminalisation of HIV exposure or transmission remains in the Bill, why not allow for the prosecution of someone who does not protect oneself from HIV? That way, the law focuses on equal responsibility for HIV transmission/acquisition.

However, in a high prevalence country like Uganda (where an estimated 5.4% of the adult population is living with HIV) this would be unworkable, and would criminalise pretty much everyone who has unprotected sex, or at least is diagnosed HIV-positive – obviously a major backwards move, as this would remove any incentive for testing.

The HRW press release also focuses on the potential for criminalisation of HIV exposure and transmssion to disproportionately affect women, even though many lawmakers believe these laws protect them.

The report also highlighted how laws that criminalize HIV transmission can result in disproportionate prosecution of women because more women are tested as part of pre- or ante-natal medical care and therefore know their HIV status. Women’s inability to safely negotiate condom use or disclosure to partners who might have been the source of their infection is not recognized in the bill as defenses against criminal penalties. Women who transmit HIV to their infants after birth via breast milk would also be subject to criminal prosecution, the report says.

“Women and girls have been disproportionately affected by HIV/AIDS,” said Joseph Amon, health and human rights director at Human Rights Watch. “My fear is that mandatory testing and disclosure will lead to prosecution and violence instead of treatment and care.”

Last month a Ugandan MP introduced a separate Anti-Homosexuality Bill that would impose the death penalty on HIV-positive gay men in Uganda if they have sex with another man.

The proposals have been roundly criticised by pretty much every human rights and HIV organisation in the world.

Canada: Video project highlights anger, frustration with criminalisation

A new video project by Canada-based filmmaker Orazio Caltagirone, AIDSphobia, is now available to watch on YouTube.

Mixing speeches by Edwin Cameron with TV footage and other existing media, the video explores various issues surrounding the criminalisation of people living with HIV. Although it can be confusing and difficult to watch at times, it is obvious that the filmmaker is passionate about the subject, and angry. “One of the main reasons why I decided to make this video is because this situation is getting out of control in my country,” Orazio tells me in an email.

The video totals 60 minutes, but is split into ten parts.

1 3:57 AIDSphobia INTRO

2 4:59 IN THE BEGINNING…

3 5:21 SPITTING

4 4:15 THE STIGMA

5 4:25 AIDS IS A MASS MURDERER

6 8:50 JOHNSON AZIGA

7 8:59 RELIGION

8 7:51 GTD: STATS

9 7:28 10 REASONS

10 4:41 CLOSING CREDITS

Canada: ‘Enough, this is it, no more’ says advocate

Today, Xtra.ca has an extraordinary interview with Bob Watkin, the outgoing Chair of the HIV and AIDS Legal Clinic of Ontario (HALCO), that illustrates just how oppressed and under seige some HIV-positive Canadians (particularly gay men knowledgable about the law) are feeling about the approach of the criminal justice system to HIV non-disclosure before sex.

He is angry. So angry that he makes some pretty radical statements, including attacking his own!

One of those things [I disagreed with] is the way HALCO’s Ontario Working Group on Criminal Law and HIV approached the issue of HIV criminalization. Its position that criminalization — criminal charges against HIV-positive people for failure to disclose their serostatus to sex partners — may be called for in some instances is anathema to me. I will not accept it or agree with it.

I’ve read the Working Group’s position statemen t several times (and know and respect many of the people involved in the Group), and I can’t see anything in it that supports criminal charges for non-disclosure. It’s main message is: “The criminal law is an ineffective and inappropriate tool with which to address HIV exposure.”

He also suggests that anyone accused of non-disclosure engage in a one-person act of civil disobedience.

I’m suggesting to HIV-positive people that, if they find themselves charged in connection with failure to disclose allegations, they exercise their legal right to refuse to give statements that could end up being used against them in criminal court, that they should no longer cooperate with anyone, anywhere, anytime, or answer any questions about their sexual conduct…I’m not suggesting that anyone act irresponsibly. What I’m saying is it doesn’t matter what your actions are.

That this interview appears in a national gay forum, rather than one solely aimed at HIV-positive individuals, is remarkable (and brave not just of Bob Watkin, but also Xtra‘s editorial director, Matt Mills), but also somewhat problematic. If the pattern follows that of the UK, the majority of HIV-negative gay men support prosecutions, and even amongst HIV-positive individuals the sides are not clear-cut. Hence the rather strong comments (two so far, but it’s only just been published) from readers.

There’s no doubt in my mind that Canada (and Ontario in particular, where non-disclosure is now being charged as attempted murder ) is the front line in the fight against the criminalisation of HIV non-disclosure, exposure and transmission. What happens there may well determine the future for many other wealthy, low-prevalence countries with similar legal systems. The lines in the sand have been drawn, and Bob Watkin (and Xtra – which covers this issue almost every week: see also ‘Finding a way out of the HIV criminalization loop’ from September 10) is issuing a call to arms.

Below are highlights of Bob Watkin’s interview with Matt Mills.

I cannot condone in any way the conduct of anyone that results in someone else being infected. But there is no justification at all — anyway, anywhere, anyhow — for the criminalization of HIV and AIDS.

[…]

What led us to this point is an abject failure of the public health system and its proven inability to deal with a chronic long-term disease, HIV…It may be very difficult for people to accept being locked up by public health but it’s much better to be locked away, treated and educated in a medical setting, than to be locked in a prison.

[…]

The charges boil down to allegations. There is no other evidence that is really relevant. In all of these situations, no one disputes that the sex occurred. Two people make an irresponsible decision, one of them happens to be HIV-positive. Only one of them is absolved and that just isn’t right.

All this has created an environment in which people are not getting tested. They are afraid to know. People who have means are leaving the country, getting tested elsewhere and in fact getting treatment elsewhere, so they don’t leave evidence of their HIV status.

We as HIV-positive people have to say, “Enough, this is it, no more.” Unless we start saying that as a group we’re just going to find our lives become more and more and more dreadful.

US: Iowa’s criminal HIV transmission law placed under the microscope

A series of articles published this week in the Iowa Independent, have scrutinised Iowa’s poorly-written, erroneously named ‘criminal transmission of the human immunodeficiency virus’ law (transmission is not required to be found guilty) following the May sentencing of 34 year-old Nick Rhoades to 25 years in prison after he pleaded guilty to a one-off act of non-disclosure with another man he met online. The articles suggest that there is a growing, grass-roots movement to reform the law, confirmed by a regular reader of my blog from Iowa, who tells me “some disparate elements are forming to get this law off of Iowa’s books. My state senator seems to be on board and hopefully we can all get ourselves together to form a lobby by this fall to ready ourselves for the legislative session in January.”

Journalist Lynda Waddington’s first article for the Iowa Independent, published last Monday, focuses on the Rhoades case and the history of Iowa’s HIV-specific law passed in 1998, the same year that Mr Rhoades was diagnosed HIV-positive. Since then, 36 people have been charged of whom 24 have been convicted. Ten men and two women are currently in an Iowa prison serving sentences up to 25 years for this ‘crime’.

She critiques the law for being poorly-written, allowing it encompass sexual acts with a “minuscule risk of transmission — such as kissing”. She then writes:

Further, Iowa law not only mandates informed consent of the specific act, but for the person consenting to have knowledge “that the action of exposure could result in transmission.” While this particular phrase could have been added as a protection for individuals with mental deficiencies, could it also be used to prosecute someone who engaged in a low-risk intimate activity without realizing that the activity could potentially result in transmission?

Indeed, sources close to the Rhoades case have informed me that oral sex was the only HIV transmission risk that occurred between the two men, although the Court is vague on this, and the police report too squeamish to mention anything other than “intimate contact”.

In her second article, published on Wednesday, Waddington examines further the impact of this law in Iowa, which she notes has been upheld by the Iowa Supreme Court three times.

She quotes Rhea Van Brocklin, community relations director for the AIDS Project of Central Iowa who states that the law does not appear to dissuade people at high-risk of HIV from testing:

“It could be hearsay within the community that people are afraid to get tested because of the law, but our agency specifically hasn’t seen that,” she said. “In fact, we doubled our testing numbers in 2008. We had a goal to test between 400 and 500 high-risk individuals and we tested about 800 last year. What we see is that people are taking HIV seriously and they want to know their status.”

[This is extremely interesting since I’m currently researching the claim made by many anti-criminalisation advocates that criminal HIV transmission laws deter people from testing, and, from what I am reading, there is no evidence to support these claims.]

The rest of the second article explores whether Iowa’s law should be revised or repealed. She interviews former Iowa representative, Ed Fallon, who voted for the law in 1998, but who now “believes that it might be time for the state to revisit criminal transmission laws.”

“It seems to me that since it is now 11, almost 12, years later, it wouldn’t be bad time to take a look at it again,” said Fallon, who admits he had some reservations before casting his affirmative vote for the bill. “I can think of so many bills we worked on that in the following year, or a few years later, we were rewriting or revisiting. … So, yes, surely the are some tweaks or changes that the legislature could consider relevant to this law, especially with all the new knowledge we have of the disease.”

He recalls that the impetus to pass the law was based on the State accessing Ryan White HIV funding from the Federal Government. However, the homophobia that informed the banning of gay marriage in the same legislative session may also have played a role.

“Certainly, in terms of that conversation, AIDS was a ‘gay disease,’ and we had to crack down on the lifestyle that helped spread the disease. So, there may have been a connection [between criminal transmission and same-sex marriage], but I honestly can’t recall if those types of sentiments continued into this debate.”

The discussion around reform or repeal is the subject of Waddington’s third article published on Friday. She interviews Bob Rigg, an experienced academic who is part of a committee examining the reorganising of Iowa’s criminal code, who warns advocates fighting for reform to be careful what they wish for.

“When people start playing around with the criminal code or they start saying that we should amend our Constitution, I’m like, ‘No, we shouldn’t.’ I err on the side of caution,” he said. “If you think what you’ve got is bad, be careful. You just might end up with something even worse.”

He suggests that a more pragmatic (if extremely conservertive), softly-softly approach might produce better outcomes for individuals convicted under Iowa’s ‘criminal transmission of HIV’: let the judges do what they do, but since the prison authorities have leeway to release individuals on parole, it is they who end up deciding how long a 25 year sentence really is.

“Just because a defendant is sentenced to 25 [years], doesn’t mean he or she is going to serve 25. Some of these individuals could be paroled in as little as two.”While state intervention to reduce prison sentences may not be an intended consequence of the initial legislation, Rigg argues that it can have “a moderating effect” on an otherwise extreme sentence.

“It is the judge’s job to sentence them. It is the DOC’s job to evaluate them for release,” he said.

Of course, this doesn’t the address the fact this is still a discriminatory, outdated law. The article ends somewhat downbeat, however, noting that law reform can be a long, long road.

A comment after the last article, from an HIV-positive Iowan, highlights that such long-term goals are absolutely necessary:

If it’s not possible to eliminate the HIV law in Iowa, amend it to add intent; probably most persons in Iowa that know their HIV status (and you have to know it to be prosecuted under the law) are under treatment and extremely low infection risk. When I was considered for prosecution under the law I was defending myself from an assault–I bit someone on the finger (he stuck his finger in my mouth, actually). Now, it’s not likely I could infect someone in the normal way, let alone a finger bite and yet THREE of Johnson County assistant DA’s recommended I be prosecuted under Iowa’s HIV law.

Canada: MPs, activists rally against criminalisation outside Parliament; Edwin Cameron gives lecture tonight

Canadian MPs Libby Davies, Bill Siksay and Hedy Fry joined with activists, people living with HIV, and supporters on Ottawa’s Parliament Hill on Wednesday, to protest Canada’s criminalisation of people with HIV due to its discriminatory HIV disclosure laws. The rally was organised by the group Legalize AIDS.

Libby Davies (NDP), MP for Vancouver East, told the rally: “We’re here today to take a very strong position that a criminalised approach to HIV/AIDS is not going to deal with the public health issues that we need to deal with. It’s not going to deal with the issues of complex human behaviour that we need to deal with. It’s not going to deal with issues of sexuality and how we approach our individual and collective and societal responsibilities.”

Watch a 3 minute 16 second video of the rally, produced for Xtra.ca.

Tonight, Justice Edwin Cameron of South Africa’s Constitutional Court, will speak in Toronto in a public lecture against the criminalisation of HIV exposure and transmission. For details, click here. He will also speak this weekend at The Canadian HIV/AIDS Legal Network’s 1st Annual Symposium on HIV, Law and Human Rights. For details, click here.

Justice Cameron recently addressed a criminalisation meeting in Stockholm, Sweden, which I attended. A report of the meeting will appear on my blog next week.

Norway: HIV advocates call for repeal of HIV criminalisation law

A group of Norweigian advocates known as HIV Manifesto are calling for the Norwegian government to repeal Section 155 of the Norwegian penal code, a 1902 infectious disease law that has only ever been used to criminalise HIV transmission.

The campaign has been picked up by Canada’s gay newspaper, Xtra – the report is below.

Full information about the HIV Manfesto campaign, which is supported by the IAS and IAPAC, amongst others, is available in English here and Norwegian here.

Norwegian activists call for repeal of HIV law

HIV CRIMINALIZATION / Century-old law works against prevention, they say

Krishna Rau / National / Thursday, January 22, 2009

Activists in Norway are calling for the repeal of a 1902 law on infectious diseases they say is being used to attack people with HIV.

Section 155 of the Norwegian penal code states that, “Any person who, having sufficient cause to believe that he is a bearer of a generally contagious disease, willfully or negligently infects or exposes another person to the risk of infection shall be liable to imprisonment for a term not exceeding six years if the offence is committed willfully and to imprisonment for a term not exceeding three years if the offence is committed negligently.”

The section goes on to state that, “Any person who aids and abets such an offence shall be liable to the same penalty. If the aggrieved person is one of the offender’s next-of-kin, a public prosecution shall be instituted only at the request of the aggrieved person unless it is required in the public interest.”

The group HIV Manifesto is calling for the Norwegian government to remove the section.

Its manifesto states, “This legal paragraph was introduced in 1902 in order to protect the society from the public threat of infectious diseases. However it has only been applied in cases involving HIV, and is often referred to as the
‘HIV paragraph.’

“It has never been documented that Section 155 prevents HIV transmission. On the contrary there are reasons to believe that it imposes several negative consequences for both individuals and society.”

HIV Manifesto claims the law actually works against HIV prevention.

“The paragraph produces a false safety for HIV-negatives, who assume that HIV-positives have and will show the full responsibility to avoid HIV transmission; hence it contributes to deteriorating use of safer sex,” states the group. “The law makes some people think it is better not to test for HIV, to avoid the risk of being punished by this law.”

“The law takes the attention away from the real challenges, in particularly the psychosocial ones. The risk of being punished also makes some people reluctant to inform about their sexual partners, and hence the paragraph can inhibit the determination of the transmission source. The paragraph undermines more efficient actions to prevent HIV transmission.”

UNAIDS: Edwin Cameron on criminal HIV transmission

UNDP and UNAIDS Secretariat Consultation on criminalization of HIV transmission, Geneva 31 October – 2 November 2007

Opening remarks on 2 November and recap of previous day (1 November 2007) by Edwin Cameron, Supreme Court of Appeal of South Africa

The debate over the last two days has revealed many differences between us – but also
substantial common ground. We have found broad agreement amongst ourselves that:

• the criminal law is in general an inappropriate tool for regulating HIV infection and transmission;
• there is no public health rationale for invoking criminal law sanctions against
those who transmit HIV or expose others to it;
• the sole rationale for so doing must be found in the criminal law aim of retribution;
• the retributive nature of the justification means that a high threshold is required
for its invocation to be warranted;
• the use of the criminal law in this context should therefore generally be confined
to cases of the intentional transmission of HIV; and
• use of the criminal law can never be justified where the person accused of HIV
transmission or exposure has no actual knowledge of his or her HIV infection.

More importantly even than these areas of consensus, and far more important than the
issues that continue to divide us is this: that we have, in this meeting, found our moral and intellectual centre, as well as a clear path to our forward impetus. This lies in what can appropriately be called a “crisis of criminalization”: laws are being enacted that appear to be so ill-judged, so poorly formulated and so over-broadly expressed that they unite us in alarm at their enactment and in concern that their adoption might be emulated elsewhere. (1) We have reached strong consensus on the need for a clearly and respectfully expressed, but emphatic and unequivocal response to these laws and to the threat of further such enactments.

In thinking about the terms of this response, there are, as Justice Michael Kirby has
observed, questions of both principle and strategy. These require us to be pragmatic in the terms and content of our response, and to bear in mind – as we have rightly been reminded by the legislators among us– that those enacting these laws hold positions of authority and come from communities that are feeling the real impact of HIV.

Yet strategy and pragmatism should not mute our commitment to a clearly principled
position. We tend to feel defensive in opposing criminal statutes which we know to be
detrimental to HIV prevention and to the lives and safety of those living with and at risk of HIV. Yet here we must draw strength by reminding ourselves of the history of other battles that were fought in this epidemic. Often these appeared to involve “unwinnably” quixotic struggles: yet in each case the viewpoint of justice and rationality ultimately prevailed.

Here we should remind ourselves of the struggle to make human rights count at all in
global and national responses to the epidemic – a struggle started by Jonathan Mann,
and most prominently and eloquently advanced by Michael Kirby over the last twenty
years; and the battle to formulate and adopt the International Guidelines on Human
Rights and HIV and AIDS – which initially seemed over-ambitious, but which were
vindicated when the entire international community stood behind human rights principles in the Declaration of Commitment adopted at the UN General Assembly Special Assembly on HIV and AIDS in 2001.

Most signally, the fight to introduce mass public provision of anti-retroviral treatment in resource-poor settings in Africa and elsewhere – until 2000, that seemed an impossible prospect; yet now it is a commonplace of national and international AIDS policy. For myself, this last issue has an especial resonance, since next week I will mark a significant anniversary. It will be ten years since I started on the ARV therapy that saved me from certain death from AIDS.

This for me is not merely a private celebration, but a constant reminder that far too few of those who right now need ARVs are receiving them – and that daily the toll of
unnecessary deaths from AIDS continues to climb. While 400 000 people are receiving
publicly-provided ARVs in South Africa, and 60 000 in Zimbabwe – figures whose growth
we should celebrate – many multiples more people need the life-saving medications but
are not receiving them, and are facing death from AIDS. And it bears most directly on
our deliberations, for the ill-judged laws that trouble us seem indubitably certain to make access to testing and thence to treatment more difficult in countries where they are adopted. And treatment access represents the most urgent issue in the response to the epidemic in Africa today.

Our response must therefore take into account both the increasing prosecutions of HIV
transmission and exposure in resource-rich countries, where HIV prevalence generally
remains low and the enactment of these laws in high-prevalence, low-resource
countries. Our response has an especial importance in these countries, for regrettably the capacity for strong, well-informed and assertive civil-society responses to these laws is often lacking there. And it is in these countries, as many in the meeting have insistently reminded us, that the burden of the HIV epidemic falls most harshly on women; and it is upon women that the severest impact of these laws will also fall, for most people in Africa who know their HIV status are women who discover it through their visits to ante-natal clinics.

In formulating the imperative arguments against criminal responses to HIV transmission and exposure we must again go back to the roots of this epidemic. HIV is treated exceptionally for one over-riding reason: the stigma associated with it as a sexually transmitted infection. No other infectious disease, not even any other sexually transmitted disease, is treated as HIV is treated. From May 1981, when the first case of AIDS was diagnosed within the gay community of San Francisco, HIV has been treated differentially, and more harshly.

It can truly be said that stigma lies at the heart of the experience of every person living with HIV – as is poignantly articulated by the witness of persons with HIV recorded at the meeting that the AIDS and Rights Alliance of Southern Africa held with the Open Society Institute in Johannesburg in July 2007. (2)

It is stigma that makes those at risk of HIV reluctant to be tested; it is stigma that makes it difficult – and often impossible – for them to speak about their infection; and it is stigma that continues to hinder access to the life-saving ARV therapies that are now increasingly available across Africa and elsewhere. Legislators – bewildered, or baffled, or at a loss as to how to respond effectively to the epidemic – may be seduced into erroneously taking recourse to criminalization, which may seem attractive, effective and media-friendly. Yet, tragically, it is primarily stigma that lies behind the drive towards criminal responses to the epidemic. It is stigma, rooted in the moralism connected with the sexual transmission of HIV that often provides the main impulse behind the enactment of these laws.

But the enactment of such laws in turn merely adds fuel to the fires of stigma. It is not only prosecutions for HIV transmission and exposure, but the chilling content of the enactment of the laws themselves, that reinforces the idea of HIV as a shameful,
disgraceful, unworthy condition. And so prosecutions and laws of this sort, by
reinforcing stigma, make it more difficult for those with or at risk of HIV to access testing, to talk about diagnosis with HIV, and to receive treatment and support.
We therefore have a drab but irrefutable calculus: these laws will lead to more deaths, more suffering and greater debilitation from AIDS. We ourselves and the UN system must speak skillfully and deftly and respectfully, but must not compromise principle in setting out the case against laws and prosecutions that detrimentally affect a just and rational response to AIDS.

Too many lives are at stake for that message to be blunted.

Notes
1 The meeting considered generally laws in Asia, Europe, Southern, Western and Central Africa.
2 See Meeting Report, ARASA/OSISA Meeting on the Criminalization of HIV Transmission, July, 2007

(Disclaimer: These remarks are those of the author and do not necessarily reflect the view of those attending the meeting or of the UNAIDS Secretariat, UNDP or other Cosponsors of UNAIDS.)

From http://www.unaids.org/en/MediaCentre/PressMaterials/FeatureStory/20071106_criminalization_HIV_transmission.asp