Stop the Prague Public Health Authority’s persecution and intimidation of people living with HIV [Press release]

Pan-European Networks of communities of people living with and affected by HIV, doctors and scientists call upon the Government of the Czech Republic to immediately stop the Prague Public Health Authority’s persecution and intimidation of people living with HIV, and to return to evidence-based and proven practices in HIV prevention, testing and care in the Czech Republic.

Brussels, 19 February 2016 – The signatories of this open letter, representing communities of people living with, and affected by HIV, doctors and scientists addressing HIV and co-infections in Europe, are extremely concerned that the Prague Public Health Authority has initiated a police investigation into the sex lives of 30 men living with HIV on the sole grounds that these men have been diagnosed with a sexually transmitted infection (STI).

We understand that the Czech police are currently conducting investigations and are considering pressing charges against these men claiming that they have violated the provisions of Sections 152 and 153 of the Czech Criminal Code.

There is no evidence that punitive approaches to regulating the consensual sexual behaviour of people with living HIV are an effective HIV prevention or public health tool, but there is evidence that such approaches can be counterproductive by further stigmatising people with HIV, sending those in need of testing and treatment underground, harming individual and public health.

In addition, the release of medical information to the police appears to be a grave violation of personal freedoms of individuals living in the Czech Republic. The initiation of criminal prosecution against people living with HIV for alleged intentional gross bodily harm – despite the lack of a single complainant – raises grave concerns regarding the inappropriate application of criminal law to people living with HIV.

We also understand that a number of non-governmental organizations have recently spoken out against the acts of the Prague Public Health Authority and subsequent police investigation and they will approach the Czech liaison at the UN High Commissioner for Human Rights. Please also note that the responsible UNAIDS representative has already been informed and will receive further briefing from us.

With this letter we express our outrage at these human rights violations, and support the groups within the Czech Republic who initially raised objections and are working to support both people with HIV and the public health of all those living in the country.

Our main objections to the recent development are based on several arguments:

It violates the fundamental human right to personal integrity and privacy (Art 7 Sec. 1 of the Charter of Fundamental Rights and Freedoms), and breaches the Czech Republic’s international obligations under the existing National HIV/AIDS Strategy;
It is counterproductive to public health, ignoring well established WHO and UNAIDS recommendations on appropriate use of public health and criminal law as it relates to HIV. Evidence shows that criminalisation of HIV non-disclosure, potential or perceived exposure or non-intentional transmission deter people from getting tested and force them to hide their HIV status and/or sexual orientation, thus reducing opportunities for treatment which greatly reduces infectiousness.
There is a substantial body of evidence to show that the overly broad HIV criminalisation, in any form, is harmful for both individuals and society as it leads to increased latency of the epidemic, deters people from getting tested and treated, and thus ultimately contributes to a growing epidemic. We recognize that there has been a constant and alarming increase in the rate of new HIV infections in Europe in the last ten years. However, the active discrimination and violation of the human rights of any group of society will not contribute to the curbing of the epidemic.
The proposed prosecution of people living with HIV for alleged intentional spread of infectious diseases, or in fact the transfer of any health-related data of individual from the health care system to law enforcement organisations is potentially a violation of the European Union’s Data Protection Directive.

We demand that the Government of the Czech Republic adheres to the international principles and treaties, and scientific evidence universally accepted in the practice of HIV prevention, and we also demand that the current level of HIV care in the country is maintained and improved to assure at-risk groups feel that getting tested for HIV is and should be a reasonable decision for them. Nothing is as effective in linking to and retention in care than disseminating the right information, and fighting stigma and discrimination against people living with HIV, or any other groups such as men having sex with men. The active discrimination and legal persecution of people with HIV is in diametrical opposition to this evidence.

The signatories will continue to support local non-governmental organisations and other actors in their efforts to prevent HIV criminalization becoming a public health policy. We call on the Government of Czech Republic to ensure that the Prague Public Health Authority reverses this policy and ends police investigations of people with HIV simply for being diagnosed with an STI and instead relies on good public health practice as the most effective strategy to deal with HIV/AIDS.

Speaking on behalf of millions of people living with and affected by HIV across Europe, as well as experts in HIV science, public health and human rights, the signatories are ready to provide advice, guidance and the collection of good practices relating to HIV prevention to the government.

Contact:

HIV Justice Network: Edwin J Bernard, edwin@hivjustice.net

European AIDS Treatment Group: Tamás Bereczky on tamas.bereczky@eatg.org

Download and share the letter (with references). Also available on the EATG website

Open Letter to Prague Public Health Authority

Footnote: At the request of Czech AIDS Society a number of organisations representing European networks of communities of people living with and affected by HIV, doctors and scientists wrote today to head of Prague’s Public Health Authority to raise our concern about the initiation of a police investigation into the sex lives of 30 men living with HIV on the sole grounds that these men have been diagnosed with a sexually transmitted infection (STI).

We hereby would like to stress that disseminating the right information, and fighting stigma and discrimination against people living with HIV, or any other groups such as men having sex with men has proved have proved to be effective in responding to the epidemic, to link to and retain persons in care. The active discrimination and legal persecution of people with HIV is in diametrical opposition to this evidence.

Letter to Dr. Zdeňka Jágrová, Hygienicka, Head of the Prague Public Health Authority

US: A panel of health experts blasts HIV criminalisation laws as a failure that keep people from getting tested and ignore the current state of science

A panel of health experts blasted HIV criminalization laws in nearly three-dozen states as a failure, criticizing the statues for adding stigma to HIV, keeping people from getting tested, and oppressing already marginalized populations such as LGBT people.

And the laws – in place in Georgia and states across the South – or prosecuting people for HIV exposure using other criminal statues – which happens in Texas and four other states – also ignore that partners in consensual sex acts share responsibility for their sexual health, according to Scott Schoettes, a senior attorney and HIV Project Director at Lambda Legal.

“The story is about the AIDS monster out there trying to infect everyone and that is not the case,” Schoettes said (top photo). “Sexual health is a shared responsibility. It creates a sense of false security for the person who is negative – ‘There is this law in place and I can sit back and wait for someone to tell me.'”

He said the laws keep people with HIV from getting tested and few, if any, of the laws require prosecutors to show that an HIV-positive person had any intent to infect a sex partner. Nevermind, he adds, that it’s difficult to prove that someone did disclose their HIV status before sex and once convicted, some state laws call for them to be labeled as sex offenders.

“It becomes a he said, he said and the person with HIV, when you get into that courtroom, is naturally at a disadvantage. A lot of people think that when you have HIV, you have done something wrong. We are still fighting that misperception,” Schoettes said. “When you have a jury that is deciding the fate of someone, they are disconnected from the culture of the folks that they may be actually adjudicating.”

And that can mean steep sentences for people convicted under HIV criminalization laws. In July, Michael Johnson – a black, gay, HIV-positive college wrestler in Missouri – was sentenced to 30 years in prison for infecting a sex partner and putting four others at risk, though prosecutors didn’t show in court that Johnson was the man who infected him. In South Carolina, former gay Atlanta man Tyler Orr faces two counts of exposing another person to HIV and up to 20 years in prison – though he says he did disclose his HIV status to his sex partner.

Schoettes’ comments came during a panel discussion during the 2015 National HIV Prevention Conference in downtown Atlanta earlier this month. He was joined by Randy Mayer, chief of the HIV, STD and Hepatitis Bureau of the Iowa Department of Public Health; Tami Haught, an activist who led efforts in Iowa to reform its HIV criminalization law; David Knight, a trial attorney with the Civil Rights Division of the U.S. Department of Justice; and Terrance Moore, deputy executive director with the National Alliance of State & Territorial AIDS Directors.

‘It’s not a slam dunk’

Knight said the HIV criminalization laws don’t reflect the current state of science and risk surrounding HIV and pointed to a document released earlier this year by the Justice Department calling on states to reform their HIV criminalization laws.

“Two things that we really want to think about is that intentional transmission is atypical and uncommon, and HIV stigma hampers prevention,” Knight said.

The Justice Department document calls on states to tighten their HIV criminalization laws to scrap HIV-specific criminal penalties with two exceptions – when an HIV-positive person commits a sex crime where there is risk of transmission and when there is clear evidence that an HIV-positive person intended to infect another person and engaged in risky behaviors to do so.

But changing HIV criminalization laws in the three-dozen states that have them is a tough haul, Mayer (second photo) and Haught said. They built coalitions across groups and enlisted public health experts to help revise the law in Iowa, a measure passed in 1998 that carried harsh penalties and 25-year prison terms that were often doled out to those convicted.

“In my experience, almost everyone got the 25 years even though that was the maximum,” Mayer said. “It’s not a slam dunk. It’s not an easy sell. Many people, even people living with HIV find themselves on both sides of this issue.”

Iowa lawmakers revised the state’s HIV criminalization law in 2014 to treat HIV like other communicable diseases such as hepatitis and tuberculosis. The law also requires that prosecutors prove intent to transmit, Mayer said.

“We had to bring in the different coalitions and bring in partners. Lawmakers don’t care what is fair and what is right. But they will listen to the public health side of the law,” Haught said. “Iowa’s law was significantly modernized and everyone is better for it.”

The panelists argued that rather than criminalizing HIV-positive people, and adding to the stigma they face, they should be pushed to treatment options. The Centers for Disease Control & Prevention has said getting HIV-positive people tested and connected to care and treatment is key to controlling the disease. Undiagnosed HIV infections fuel the HIV epidemic, Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention, said during the Atlanta conference.

“Getting people into care is a better way to reduce transmission than these laws,” Mayer said.

Originally published in Project Q

New IAPAC guidelines to achieving 90-90-90 targets recommend ending HIV criminalisation

New guidelines from the International Association of Providers of AIDS Care (IAPAC ) are the first to highlight that HIV criminalisation is a critical barrier to optimising the HIV care continuum.

Currently only half of people living with HIV globally are aware of their status. Of the remaining 50% many are not yet engaged in care, receiving antiretroviral therapy (ART) in a timely manner or – the ultimate goal of HIV treatment and prevention – achieving sustained viral suppression.

These new guidelines are the first to include HIV criminalisation as one of eight key critical barriers that prevent people living with HIV from enjoying both the therapeutic and preventive effects of ART.

In many settings, optimizing the HIV care environment may be the most important action to ensure that there are meaningful increases in the number of people who are tested for HIV, linked to care, started on ART if diagnosed to be HIV positive, and assisted to achieve and maintain long-term viral suppression. Overcoming the legal, social, environmental, and structural barriers that limit access to the full range of services across the HIV care continuum requires multistakeholder engagement, diversified and inclusive strategies, and innovative approaches. Addressing laws that criminalize the conduct of key populations and supporting interventions that reduce HIV-related stigma and discrimination are also critically important. People living with HIV also require support through peer counseling, education, and navigation mechanisms, and their self-management skills reinforced by strengthening HIV literacy across the continuum of care.

The full HIV criminalisation recommendation (Recommendation 2) is below.

Recommendation 2: Laws that criminalize the conduct of PLHIV based on perceived exposure to HIV, and without any evidence of intent to do harm, are not recommended and should be repealed where they have been enacted. (A IV)

Numerous countries have enacted laws that criminalize behaviors associated with HIV exposure, many of which pose a low or negligible HIV transmission risk. No differences in behavior have been noted between settings that enact such laws and those that do not. Many of these laws do not take into account measures that reduce HIV transmissibility, including condom use, and were enacted before the preventive benefit of ART or antiretroviral (ARV)-based preexposure prophylaxis (PrEP) was fully characterized. Most PLHIV who know their status take steps to prevent transmitting HIV to others.HIV-specific laws thus primarily exacerbate HIV-related stigma and decrease HIV service uptake.

IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents

Sweden: HIV activists call for the abolition of the duty to disclose in line with scientific progress

The new knowledge we have today about the transfer risks, should contribute to a change in infectious disease control law design.

The duty to disclose for people living with HIV should be abolished as soon as possible, writes representatives from RFSL, RFSU and HIV Sweden.

HIV was included in the Swedish Communicable Diseases legislation in 1985. The purpose was to provide support for the measures it considered necessary to slow down the transmissions of HIV, an infection, they were convinced, that could become an epidemic out of control.

Despite the limited knowledge then available on HIV the Government noted in its preparatory work to the Act that: “If a cure is discovered meaning that infected people can become free of infection, the perception of infectiousness willl obviously change. It would also be the same if one could find that the infection, whether a cure is available or not, is not contagious in some periods “(Prop. 1985/86: 13).

In October 2013 the Public Health Agency launched its knowledge base “Infectiousness in treated HIV infection.” The Authority concluded that the risk of transmitting HIV through sexual contact when a condom is used, is almost non-existent.

The risk is also considered as very small if a condom is not used.

In Sweden, over 90 percent of those who received a hiv diagnosis are on effective treatment today. In accordance with the intentions that were in the preparatory work to the country legislation in 1985, the knowledge we now have about transmission risks, should contribute to a change in infectious disease control law design.

One of the positions that RFSL, RFSU and HIV Sweden usually get to explain is precisely why we believe that the so-called disclosure duties should be removed for people living with HIV.

The duty to disclose is one of several precautions that people living with HIV must follow under the current disease control legislation. The duty to disclose requires that people living with HIV must inform their sex partners of their HIV.

he duty to disclose takes the focus away from what is hiv prevention most central message: that all people in sexual encounters should take responsibility to protect themselves and their partners.

So under the legislation this responsibility rests with the party who knows about his/her HIV as the duty to disclose. This despite the fact that over 90 percent of those currently living with HIV are taking effective treatment and are exposing a sexual partner to an almost non-existent risk of HIV transmission.

It stands in stark contrast to the fact that in most cases, it is those who do not know they have HIV who transmit the virus to others. The highest risk of transmission comes from this undiagnosed population.

This group is of course under no obligation to disclose information about which they know nothing, and therefore does not have anything to tell. The duty to disclose is therefore counterproductive and contributes to the stigmatization of people living with HIV who know about their status.

RFSL, RFSU and HIV Sweden are calling for a revision of regulations of the 2004 Infectious Diseases Act and the abolition of the duty to disclose.

We have met with opposition within the authorities, medical officers, their lawyers and policymakers. Often we are subjected to the view that we do not fully understand how the law works and a belief that we want to bring HIV out of the Communicable Diseases Act. That is not the case.

We believe that HIV must be included in the Communicable Diseases Act from a prevention and treatment perspective. But we believe that the law can easily be designed in such a way that HIV, and any other relevant diseases, are excluded from a conduct that is counter-productive, which departs from Prevention key messages, which stigmatizes people living with HIV, and is not in line with the knowledge we have today about transmission risks.

To make it easier for policy makers and officials, we have in collaboration with lawyers developed an example of how Diseases Act may be formulated to overcome the misconceptions there may seem to be about our position. The example can be downloaded here.

It is now our hope that the government ensures that the revision of the Infectious Diseases Act be implemented promptly and that the duty to disclose for people living with HIV can thus be abolished in the near future.

Christian Antoni Möllerop

Vice ‘Union

RFSL

Kristina Ljungros

Chairman of the Federation

RFSU

Christina Franzen

President

HIV Sweden

—————————————–

Den nya kunskap vi i dag har om överföringsrisker, bör bidra till en förändring av smittskyddslagstiftningens utformning.

Informationsplikten för personer som lever med hiv bör avskaffas snarast, skriver representanter från RFSL, RFSU och Hiv-Sverige.

1985 inkluderades hiv i den svenska smittskyddslagstiftningen. Syftet var att ge stöd till de åtgärder man ansåg nödvändiga för att bromsa överföringarna av hiv, en infektion man då var övertygad om att kunde bli en epidemi utom all kontroll.

Trots den begränsade kunskap som då fanns om hiv konstaterade regeringen i förarbetena till lagen att: ”Om något botemedel upptäcks som innebär att den smittade kan bli smittfri, kommer detta självklart att ändra synen på när smittsamhet föreligger. Detsamma blir förhållandet om man skulle finna att infektionen, oavsett om något botemedel finns att tillgå eller ej, inte är smittsam i vissa perioder” (Prop. 1985/86:13).

I oktober 2013 lanserade Folkhälsomyndigheten kunskapsunderlaget “Smittsamhet vid behandlad hivinfektion”. Där slår myndigheten fast att risken för att överföra hiv genom sexuell kontakt vid välfungerande behandling, när kondom används, är närmast obefintlig.

Risken bedöms även som mycket liten om kondom inte används.

I Sverige har över 90 procent av de som fått en hivdiagnos en välfungerande behandling i dag. I enlighet med de intentioner som fanns i förarbetena till smittskyddslagstiftningen från 1985, måste därför den kunskap vi nu har om överföringsrisker, bidra till en förändring av smittskyddslagstiftningens utformning.

Ett av de ställningstaganden som RFSL, RFSU och Hiv-Sverige oftast får förklara är just varför vi anser att den så kallade informationsplikten borde tas bort för personer som lever med hiv.

Informationsplikten är en av flera förhållningsregler som personer som lever med hiv måste följa enligt den gällande smittskyddslagstiftningen. Informationsplikten kräver att den som lever med hiv ska informera sina sexpartners om sin hiv.

Informationsplikten tar bort fokus från det som är hivpreventionens mest centrala budskap: att samtliga personer i det sexuella mötet bär ansvaret för att skydda sig själv och sin partner.

Så som lagstiftningen är utformad vilar ansvaret på den av parterna som vet om sin hiv att informera. Detta trots att över 90 procent av dem som i dag lever med hiv har en välfungerande behandling och därmed utsätter sexpartners för en närmast obefintlig risk för hivöverföring.

Det står i stark kontrast till det faktum att det är de som inte vet om att de bär på hiv som överför viruset i de flesta fall till andra. Det är alltså dessa odiagnostiserade det finns en stor risk att få viruset överfört från.

För denna grupp gäller förstås ingen informationsplikt då de inget vet och därför heller inte har något att berätta. Informationsplikten är därför kontraproduktiv och den bidrar till att stigmatisera personer som lever med hiv och vet om sin status.

RFSL, RFSU och Hiv-Sverige har sedan informationsplikten lagreglerades 2004 jobbat för en översyn av smittskyddslagen och ett avskaffande av informationsplikten.

Vi har stött på patrull inom myndigheter, smittskyddsläkare, deras jurister och bland beslutsfattare. Ofta bemöts vi av en uppfattning om att vi inte helt har förstått hur lagen fungerar eller en övertygelse om att vi vill ta hiv ut ur smittskyddslagen. Så är inte fallet.

Vi anser att hiv måste ingå i smittskyddslagen ur ett preventions- och behandlingsperspektiv. Men vi anser att lagen enkelt kan utformas på så sätt att hiv, och eventuellt andra relevanta sjukdomar, undantas från de förhållningsregler som är kontraproduktiva, som frångår det som är preventionens centrala budskap, som stigmatiserar personer som lever med hiv, och som inte ligger i linje med den kunskap vi numera har om överföringsrisker.

För att underlätta för beslutsfattare och tjänstemän har vi i samarbete med jurister tagit fram ett exempel på hur smittskyddslagen kan formuleras för att råda bot på de missuppfattningar om vårt ställningstagande som kan synas finnas. Exemplet kan laddas ner här.

Det är nu vår förhoppning att regeringen ser till att en översyn av smittskyddslagen sker skyndsamt och att informationsplikten för personer som lever med hiv därmed kan avskaffas inom en nära framtid.

Christian Antoni Möllerop

Vice förbundsordförande

RFSL

Kristina Ljungros

Förbundsordförande

RFSU

Christina Franzén

Ordförande

Hiv-Sverige

Nigeria: The Ondo State government has announced the commencement of the implementation of its HIV Anti-stigma law which prescribed a 10 year jail term, fine of N500,000 or both for any person who by whatever means transmits HIV to another person

Akure – The Ondo State government has announced the commencement of the implementation of its HIV Anti-stigma law which prescribed a 10 year jail term, fine of N500,000 or both for any person who by whatever means transmits HIV to another person.

Giving details of the law, which was signed last year, the Secretary to the State Government and Chairman, Ondo State Agency for the Control of AIDS, Dr. Aderotimi Adelola, said stigmatization and discrimination discourages people infected with and affected by HIV from accessing health and social services.

The law stipulates further that anybody who discriminates against people living with HIV commits an offence and is liable to fine of N100,000.00 or imprisonment of six months or both.

He spoke in Akure while delivering a keynote address at a sensitization programme to facilitate and ensure the enforcement of a law for the prevention of the spread of HIV and AIDS, elimination of discrimination and stigmatization of people living with HIV and “other matters incidental thereto or connected therewith.”

Adelola said most times the rights of people living with HIV are violated, causing them to suffer both the burden of the disease and the consequential loss of other rights.

World Health Organization publishes analysis of impact of overly broad HIV criminalisation on public health

A new report from the World Health Organization, Sexual Health, Human Rights and the Law, adds futher weight to the body of evidence supporting arguments that overly broad HIV criminalisation does more harm than good to the HIV response.

Drawing from a review of public health evidence and extensive research into human rights law at international, regional and national levels, the report shows how each country’s laws and policies can either support or deter good sexual health, and that those that support the best public health outcomes “are [also] consistent with human rights standards and their own human rights obligations.”

The report covers eight broad areas relating to sexual health, human rights and the law, including: non-discrimination; criminalisation; state regulation of marriage and family; gender identity/expression; sexual and intimate partner violence; quality of sexual health services; sexuality and sexual health information; and sex work.

The authors of the report note that it provides “a unique and innovative piece of research and analysis. Other UN organizations are examining the links between health, human rights and the law: the United Nations Development Programme’s (UNDP’s) Global Commission on HIV and the Law published its report in 2012, and the Office of the High Commissioner for Human Rights (OHCHR) and United Nations Special Rapporteurs regularly report to the Human Rights Council on the impact of laws and policies on various aspects of sexual health. Nevertheless, this is the first report that combines these aspects, specifically with a public health emphasis.”

The points and recommendations made relating to overly broad HIV criminalisation (italicised for ease of reference) are included in full below.

Executive Summary: The use of criminal law (page 3)

All legal systems use criminal law to deter, prosecute and punish harmful behaviour, and to protect individuals from harm. However, criminal law is also applied in many countries to prohibit access to and provision of certain sexual and reproductive health information and services, to punish HIV transmission and a wide range of consensual sexual conduct occurring between competent persons, including sexual relations outside marriage, same-sex sexual behaviour and consensual sex work. The criminalization of these behaviours and actions has many negative consequences for health, including sexual health. Persons whose consensual sexual behaviour is deemed a criminal offence may try to hide it from health workers and others, for fear of being stigmatized, arrested and prosecuted. This may deter people from using health services, resulting in serious health problems such as untreated STIs and unsafe abortions, for fear of negative reactions to their behaviour or health status. In many circumstances, those who do access health services report discrimination and ill treatment by health-care providers.

International human rights bodies have increasingly called for decriminalization of access to and provision of certain sexual and reproductive health information and services, and for removal of punishments for HIV transmission and a wide range of consensual sexual conduct occurring between competent persons. National courts in different parts of the world have played an important role in striking down discriminatory criminal laws, including recognizing the potentially negative health effects.

3.4.5 HIV status (pages 22-23)

Although being HIV-positive is not itself indicative of sexual transmission of the infection, individuals are often discriminated against for their HIV-positive status based on a presumption of sexual activity that is often considered socially unacceptable.

In addition, in response to the fact that most HIV infections are due to sexual transmission, a number of countries criminalized transmission of, or exposure to, HIV, fuelling stigma, discrimination and fear, and discouraging people from getting tested for HIV, thus undermining public health interventions to address the epidemic.

Even where persons living with HIV/AIDS may be able, in principle, to access health services and information in the same way as others, fear of discrimination, stigma and violence may prevent them from doing so. Discrimination against people living with HIV is widespread, and is associated with higher levels of stress, depression, suicidal ideation, low self-esteem and poorer quality of life, as well as a lower likelihood of seeking HIV services and a higher likelihood of reporting poor access to care.

HIV transmission has been criminalized in various ways. In some countries criminal laws have been applied through a specific provision in the criminal code and/or a provision that allows for a charge of rape to be escalated to “aggravated rape” if the victim is thought to have been infected with HIV as a result. In some cases, HIV transmission is included under generic crimes related to public health, which punish the propagation of disease or epidemics, and/or the infliction of “personal injury” or “grievous bodily harm”.

Contrary to the HIV-prevention rationale that such laws will act as a deterrent and provide retribution, there is no evidence to show that broad application of the criminal law to HIV transmission achieves either criminal justice or public health goals. On the contrary, such laws fuel stigma, discrimination and fear, discouraging people from being tested to find out their HIV status, and undermining public health interventions to address the epidemic. Thus, such laws may actually increase rather decrease HIV transmission.

Women are particularly affected by these laws since they often learn that they are HIV-positive before their male partners do, since they are more likely to access health services. Furthermore, for many women it is either difficult or impossible to negotiate safer sex or to disclose their status to a partner for fear of violence, abandonment or other negative consequences, and they may therefore face prosecution as a result of their failure to disclose their status. Criminal laws have also been used against women who transmit HIV to their infants if they have not taken the necessary steps to prevent transmission. Such use of criminal law has been strongly condemned by human rights bodies.

Various human rights and political bodies have expressed concern about the harmful effects of broadly criminalizing the transmission of HIV. International policy guidance recommends against specific criminalization of HIV transmission. Human rights bodies as well as United Nations’ specialized agencies, such as UNAIDS, have stated that the criminalization of HIV transmission in the instance of intentional, malicious transmission is the only circumstance in which the use of criminal law may be appropriate in relation to HIV. States are urged to limit criminalization to those rare cases of intentional transmission, where a person knows his or her HIV-positive status, acts with the intent to transmit HIV, and does in fact transmit it.

Human rights bodies have called on states to ensure that a person’s actual or perceived health status, including HIV status, is not a barrier to realizing human rights. When HIV status is used as the basis for differential treatment with regard to access to health care, education, employment, travel, social security, housing and asylum, this amounts to restricting human rights and it constitutes discrimination. International human rights standards affirm that the right to non-discrimination includes protection of children living with HIV and people with presumed same-sex conduct. Human rights standards also disallow the restriction of movement or incarceration of people with transmissible diseases (e.g. HIV/AIDS) on grounds of national security or the preservation of public order, unless such serious measures can be justified.

To protect the human rights of people living with HIV, states have been called on to implement laws that help to ensure that persons living with HIV/AIDS can access health services, including antiretroviral therapy. This might mean, as in the case of the Philippines, for example, explicitly prohibiting hospitals and health institutions from denying a person with HIV/AIDS access to health services or charging them more for those services than a person without HIV/AIDS (167).

International guidance also suggests that such laws should be consistent with states’ international human rights obligations and that instead of applying criminal law to HIV transmission, governments should expand programmes that have been proven to reduce HIV transmission while protecting the human rights both of people living with HIV and those who are HIV-negative.

3.6 Legal and policy implications (pages 29-30)

5. Does the state consider that establishing and applying specific criminal provisions on HIV transmission can be counter-productive for health and the respect, protection and fulfilment of human rights, and that general criminal law should be used strictly for intentional transmission of HIV?

The full report can be downloaded from the WHO’s Sexual and Reproductive Health website.

Sudan: Draft law providing rights and protections for people living with HIV also comes with responsibilities, including criminalising 'intentional' transmission and non-disclosue to 'prospective spouses'

April 2, 2015 (KHARTOUM) – Sudan is in the process of drafting a law to protect the rights of those living with HIV/AIDS and ensure that they receive medical and psychological care. The bill, which is being drafted by legal experts, people living with HIV/AIDS, physicians and officials, will also criminalise the intentional transmission of the disease.

Sudan’s ministry of health revealed last December that there are 79,000 cases of AIDS in the country.

The draft law would state that people living with HIV/AIDS enjoy all the rights guaranteed by the constitution and international conventions ratified by Sudan.

It prohibits any form of discrimination based on HIV status that would lead to the degradation of their dignity or erosion of their rights or exploitation.

Furthermore, the draft bill gives the patients the right to housing, access to goods and services and prohibits subjecting any citizen to HIV check as a condition for employment or dismissing employees who contract the virus unless it is proven through a medical report that they are incapable of performing their job functions.

Even then, they will have the right to request being transferred to another job.

The law granted HIV/AIDS patients the right to request open-ended sick leave with full pay in case of health-related complications and to receive social security.

For children living with the virus, they would have the right of access to health care and medical counseling and cannot be dismissed or transferred from their schools.

The law also guarantees confidentiality of their information and ensures that it cannot be published in the media without the patient’s consent.

Court trials can be held in a closed setting if one of the parties involved has HIV/AIDS, the law says. It also dictates that HIV screening would be voluntary and confidential. It would also allow infected moms to retain custody of their children.

But the law also obliges patients to take the necessary steps including seeking medical help to prevent transmission of the virus to others. Failing to do so would be punishable by law.

Should an infected individual decide to marry they should notify their prospective spouse and comply with instructions that prevent transmitting the virus.

Honduras reforms 20 year-old omnibus HIV law eliminating mandatory testing and providing free healthcare

Finally, after months of hard work and activism, Honduras managed to approve the reform of 47 articles of the HIV Law, which helps people with HIV in the country. This reform seeks to guarantee the rights of people with HIV and/or AIDS and, thus, ensure a comprehensive response to the epidemic.

One of the most significant achievements of this reform is the 47^th article, which establishes that “all people with HIV are exempted from payment of the recovery fee or any other fee for the provision of services”; an amount charged in different health centers to patients with HIV, which was causing people to abandon their treatment.

One of the most significant achievements was the modification of the article which established that people with HIV were not allowed to adopt any children or even worst were not allowed to get married. Massive HIV testing in detention centers and mandatory HIV testing for vulnerable groups were also eliminated.

This achievement marks a milestone in the respect for the rights of people with HIV, since it is the first time to reform this law, after 20 years of having been created. “It has been a struggle for many years to get the process started, and now it was approved in a short period of time, which is a great achievement. The project was introduced in May, 2014”, explained Sandra Zambrano, Executive Director of Asociación para una vida mejor para personas con y afectadas por el vih (APUVIMEH).

“The excitement is great, I’m really happy, we have won and it seems incredible that it has happened (…) This is only the beginning of many changes, and it motivates me to keep fighting. It has been difficult, we are a minority, but together we have succeeded and that means a lot”, said Luis Javier Tejada.

The reform will take effect once it is published in the official newspaper of Honduras named “Gazette”.

Undoubtedly, this success is the product of arduous teamwork that has been carried out thanks to organizations such as UNAIDS and the Pan American Health Organization, in conjunction with the Honduran civil society and other international organizations.

Gambia's National Assembly passes new HIV omnibus law that appears to be protective and supportive, but anti-gay law with life sentence for 'aggravated homosexuality' if living with HIV remains on the books

The Minister for Health and Social Welfare, Omar Sey, on Wednesday, 19th March, presented a bill entitled HIV AND AIDS PREVENTION AND CONTROL BILL, 2015 to the National Assembly during a session held in Banjul.In reading it for the second and third times, the health minister said the new Bill states that the ministers responsible for basic and secondary education, higher education and health shall ensure that students are educated on HIV and AIDS in public and private schools at basic, secondary and higher levels, including formal, non-formal and indigenous learning systems.

Mr. Sey said it shall be ensured that education and training courses cover mode of transmission, prevention and other sexually transmitted infections as well as human rights of the people living with HIV and vulnerable groups.

Further dwelling on the Bill, he said health care personnel shall ensure that education and information on HIV and AIDS form part of the health services that they render to their patients and that the ministry of health shall ensure that health care personnel are appropriately trained on information and education on HIV and AIDS.

On sensitization of HIV and AIDS in the work place, he said all employees and members of the armed forces and security services shall receive standard HIV and AIDS education which shall include themes on the causes, modes of transmission and prevention of HIV and on confidentiality at the work place and the acceptance of workers living with HIV and AIDS.

The health minister said community education on HIV and AIDS shall be launched, including the education of nationals abroad.

He said part of the Bill also requires the provision of information for tourists and passengers on transit.

In his intervention, Hon. Ousman Bah of Sabach Sanjal, who seconded the motion, commended the health ministry and said the bill is timely and relevant in the fight against HIV and AIDS. He urged his colleagues to pass the bill without hesitation.

Following some amendments, the Bill was eventually passed by the whole committee of the house.

But: http://www.theguardian.com/world/2014/nov/21/gambian-leader-approves-anti-gay-law

Infectious Disease Society of America (IDSA) and HIV Medicine Association (HIVMA) Position on the Criminalization of HIV, Sexually Transmitted Infections and Other Communicable Diseases (2015)

This statement was issued by the Infectious Diseases Society of America (IDSA) and the HIV Medicine Association (HIVMA) on the urgent need to repeal or modernize HIV-specific criminalization statutes and laws criminalizing transmission or exposure to sexually transmitted infections and other communicable diseases.