US: HIV criminalisation laws increase stigma and discrimination and impede effective treatment and prevention

These laws were meant to protect people from HIV. They’ve only increased stigma and abuse.

By 

Laws in many states make it a crime to have sex without disclosing your HIV status. Advocates say they may actually worsen the spread of the virus.

The policy: Criminal penalties for knowingly exposing someone to HIV

Where: Twenty-six states around the country

In place since: The 1980s

The problem:

In March 1981, an otherwise healthy Los Angeles man contracted a rare form of pneumonia usually seen only in people with severely compromised immune systems. Doctors treated him with antibiotics, but his condition worsened, and within two months, he was dead.

The Center for Disease Control, as it was then known, identified four similar cases — generally healthy young men who suddenly became very ill with the same rare lung disease — and in June 1981 published the first official report on the condition that would become known as AIDS. By the time the report was published, another of the men had died. By the end of the year, there were 337 reported cases of the condition, and 130 people had died.

Researchers discovered HIV, the virus that causes AIDS, in 1984. But the death toll kept rising, and the panic along with it. Fear and misunderstanding of the disease were such that when one student at a New York City school was thought to have the virus, 944 of the school’s 1,100 students stayed home, according to a Time magazine report. In one 1985 poll, 50 percent of people supported a quarantine of people with AIDS. Amid this panic, the idea emerged that “there were people who were intentionally spreading HIV,” Scott Schoettes, HIV project director at the LGBTQ civil rights group Lambda Legal, told Vox.

The idea may have been fueled by longstanding social prejudices, including homophobia. As journalist Steven Thrasher writes in a Guardian column on the now-debunked myth of a gay flight attendant as HIV’s “Patient Zero,” “we like to blame individuals (especially queer folks, women, immigrants and people of color) for diseases, particularly communicable ones that involve sex. Societally, it is far easier to blame them for disease rather than to deal with the complex medical, political and epidemiological causes.”

Nonetheless, states soon began instituting criminal penalties for knowingly exposing others to the virus — Florida, Washington, and Tennessee did so in 1986, Helen McDonald writes at Autostraddle. In 1990, the federal Ryan White Act, which provided funding for HIV treatment, required states to show they could prosecute people who exposed others to HIV. The laws began to proliferate, and by 2011, 33 states had one or more laws criminalizing HIV exposure. As of last year, such laws remained on the books in 26 states, according to the CDC.

How it worked:

The first problem with the laws was a simple one, according to Schoettes and others: The crime they were intended to combat didn’t actually exist. There is no evidence that a significant number of people were ever intentionally trying to infect other people with HIV.

But because many of the laws were broadly written, they were used to prosecute people who had never intended to harm anyone else — and, in some cases, who had done no harm.

Mark Hunter, for example, told Vox that he contracted HIV at the age of 7 through treatment for his hemophilia. Hunter led a healthy and active life — he had a six-figure job in Washington, DC, he said, when, in 2006, two ex-partners filed charges against him for failing to disclose his HIV status to them. Neither woman had contracted the virus, but nonetheless, he was sentenced to 12 years in prison in Arkansas, where the charges were filed.

Hunter ended up serving three years. Today, he is out on parole and living in Louisiana, but he still has to register as a sex offender. He is an outspoken advocate against laws of the kind that sent him to prison. “When we talk about criminalization, the base issue is stigma,” he told Vox. “That stigma comes from fear.”

Hunter’s is just one of many such stories. Perhaps the best-known case is that of Nick Rhoades, who had sex with another man in 2008 without disclosing his HIV status. The other man subsequently learned that Rhoades had HIV and went to a doctor for antiretroviral medication. The law in Iowa, where the men lived, required the doctor to notify police that a sex crime had occurred, according to the National Registry of Exonerations. The men had used a condom, and Rhoades’s partner had not contracted the virus. Nonetheless, Rhoades was arrested and sentenced to 25 years in prison.

Stories like these have also made people around the country afraid to get tested because “you can’t be prosecuted under one of these laws unless you know your HIV status,” Schoettes said. Testing and treatment are key ways of reducing HIV transmission, and by making people afraid to get tested, HIV criminalization laws may actually increase the spread of the virus.

study conducted in Toronto between 2010 and 2012 (laws criminalizing HIV exposure also exist in Canada) found that 7 percent of men who had sex with men were less likely to get an HIV test for fear of future prosecution — the study authors estimated that this fear could lead to an 18.5 percent increase in HIV transmission. And in general, HIV criminalization laws likely contribute to stigma and discrimination around HIV, which world health groups like UNAIDS have identified as some of the biggest barriers to effective treatment and prevention.

Meanwhile, “these laws were used to manipulate and coerce people to stay in abusive relationships,” Tami Haught, organizing and training coordinator for the SERO Project, a group that works to end HIV criminalization, told Vox. In Iowa, where Haught lives, it was difficult for people with HIV to definitively prove they had disclosed their status to their partners as the law required. Haught recalls a woman living with HIV whose abusive boyfriend told her, “if you call the cops or leave me I will tell them you didn’t disclose your status.” If that happened, the woman, not her abuser, could go to prison.

People with HIV were even afraid to report being raped, Haught said, for fear that they could be prosecuted for failing to disclose their status during the rape.

Those sentenced under the law, meanwhile, could face decades in prison even if they had used condoms. Once released, they were often forced to register as sex offenders. In Iowa, that meant having their HIV status disclosed publicly, sometimes with a mug shot in the newspaper, Haught said. They were subject to curfews and computer searches, had to submit to twice-yearly lie detector tests, and needed permission from authorities to leave the county, she added: “They were treated as if they were these dangerous predators rather than having a consensual sexual experience with another adult.”

In recent years, though, states have begun changing their laws. Iowa was the most high-profile example. Rhoades challenged his conviction in court in 2010, and around the same time, activists began lobbying state legislators to reform the law.

Rhoades and many others fought for years to get the Iowa law changed. Finally, in 2014, then-Gov. Terry Branstad signed a new law significantly reducing the penalties for exposing others to HIV. Under the new law, if someone intentionally infects someone else with HIV, the person can still face up to 25 years in prison. But if a person with HIV only acts with “reckless disregard” in exposing someone else to the virus — for example, by not using protection — that person can face one to five years in prison, depending on whether the other party actually contracts the virus. Meanwhile, taking “practical measures to prevent transmission” of the virus makes someone exempt from prosecution, according to the Center for HIV Law and Policy.

The law also removed the requirement that people convicted of exposing others to HIV register as sex offenders, and allowed previously convicted people to be removed from the sex offender registry. After the law was signed, two Iowans who had been forced to register as sex offenders under the old law had their ankle monitors publicly removed in celebration, Haught said. That year, Rhoades won his court case, and his conviction was set aside.

Many critics have argued the changes to Iowa’s law don’t go far enough. “HIV transmission should not be criminalized—ever,” wrote Mark Joseph Stern at Slate. “HIV criminalization laws do absolutely nothing to prevent the spread of the virus.”

But in general, Schoettes said, it’s been very difficult to convince state legislators to remove penalties completely. Also, “our concern is if you get rid of the law, prosecutors may just proceed under general criminal laws without parameters or guidance” — in some states, for example, people with HIV have been prosecuted for reckless endangerment or even assault with a deadly weapon. For that reason, Lambda Legal has backed reforming rather than removing these laws.

These efforts have had success in California, where in 2017 then-Gov. Jerry Brown signed a law ensuring that people cannot be prosecuted based on HIV status unless they actually intend to transmit the virus and do so. Colorado, Michigan, and North Carolina have also reformed their laws or regulations around HIV, Haught said. And according to Schoettes, advocates are also working to repeal or reform HIV criminalization laws in Florida, Illinois, Ohio, Indiana, and elsewhere.

Today, Mark Hunter is “in a good place,” he said. He is married, and has adopted his wife’s son from a previous relationship. He has a job with the state of Louisiana, he’s a deacon in his church, and he has started an HIV/AIDS foundation named after his brother. He will be off parole in April 2020.

But his driver’s license still has the words “sex offender” printed on it. And around the country, he still sees a lot of stigma around HIV.

“Change is coming,” he said, “but it’s coming slow.”


Anna North covers gender issues, reproductive rights, workplace discrimination, LGBTQ rights, and more for Vox. Previously, she worked for The New York Times.

US: American Medical Association adopts policy to advocate for repeal of legislation that criminalises nondisclosure of HIV status

Catch up with the news and other key moments from the AMA House of Delegates’ meeting in Chicago. The 2019 AMA Annual Meeting wrapped up on June 12.

Thursday, June 13

Prison inmates and staff should get more health education, training. Poor health outcomes are rampant in U.S. jails and prisons, thanks to subpar hand hygiene, oral health and other factors. The AMA, in a vote yesterday, also backed giving incarcerated women access to contraception. Read more.

Doctors back funding plans to end HIV epidemic. In a strong show of support for major action to “end the epidemic of HIV nationally,” delegates yesterday voted to advocate funding plans that focus on:

  • Diagnosing individuals with HIV infection as early as possible.
  • Treating HIV infection to achieve sustained viral suppression.
  • Preventing at-risk individuals from acquiring HIV infection, including through the use of pre-exposure prophylaxis (PrEP).
  • Rapidly detecting and responding to emerging clusters of HIV infection to prevent transmission.

In a separate action, AMA delegates took action to address the 32 states and two U.S. territories that have punitive laws criminalizing individuals who fail to disclose HIV status to sexual partners.

“Current criminalization laws are outdated and do not reflect the current science of HIV transmission or the fact that HIV is a chronic, but manageable medical condition—particularly since nondisclosure of other infectious diseases is not criminalized,” said AMA Board Member E. Scott Ferguson, MD.

People with HIV who take antiretroviral therapy medication as prescribed and are able to get and keep an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative sexual partners.

In light of that, delegates adopted new policy to:

  • Advocate for repeal of legislation that criminalizes nondisclosure of HIV status for people living with HIV.
  • Work with other stakeholders to develop a program whose primary goal is to destigmatize HIV infection through educating the public, physicians and other health care professionals on current medical advances in HIV treatment that minimize the risk of transmission due to viral load suppression and the availability of PrEP.

Webinar: Molecular HIV Surveillance (PWN-USA, 2019)

PWN’s Barb Cardell’s webinar on Molecular HIV Surveillance and its implications for marginalized communities living with HIV, including intersections with HIV criminalization.

Samoa: HIV criminalisation is a threat to public health indicates the Ministry of Health in its 2017 National HIV Policy report

M.O.H. against criminalization of HIV

The criminalization of the transmission of HIV in Samoa is a threat to public health. This is one of the highlights by the Ministry of Health indicated in their 98 page National HIV, AIDS, and STI Policy 2017-2022 report that was obtained by the Samoa Observer.

According to the prevention segment of the report, it points to some countries where criminal law is being applied to those who transmit or expose others to HIV infection.

“The Ministry of Health does not recommend nor endorse legislative measures to criminalize the transmission of HIV that is unintentional and views such measures as threats to public health.

“There is no data indicating that the broad application of criminal law to HIV transmission will achieve either criminal justice or prevent HIV transmission.

“Rather, such application risks undermine public health and human rights.

“Because of these concerns, UNAIDS urges governments to limit criminalization to cases of intentional transmission i.e. where a person knows his or her HIV positive status, acts with the intention to transmit HIV, and does in fact transmit it.

“Willful spread of HIV has been so rarely documented worldwide that it is largely hypothetical,” the report says.

According to the MOH Policy, since there are no cases have been processed in Samoa or Australia and New Zealand Commonwealth case law, legally it is urban myth and no legislation exists regarding the legal handling of such a case.

“Presently Samoan legal priorities regarding HIV, AIDS, and STI’s are primarily concerned with protecting the individual rights and confidentiality of people as well as safeguarding public health.

“Prosecuting a case of willful spread of HIV would necessarily involve addressing legal criteria in Sections 120-121 of the Crimes Act 2013.

“Supplying evidentiary support for a claim would entail 1) proving a person knew their HIV status prior to exposing other individual(s), 2) the individual did not disclose their HIV status to exposed person(s), 3) and the exposure resulted in HIV infection.

“Any action taken against to quarantine and accuse a case of a wilful spread of HIV would fall under the authoritative powers of MoH within Part 4 Section 36 of the Health Ordinance 1959 “Isolation of persons likely to spread infectious diseases” as well as Section 37 , Offenses in regards to infectious diseases,” according to the report.

The M.O.H. Policy also emphasized that all rights of people living with AIDS, national and international, must not be violated in the investigation, prosecution and sentencing of individuals involved in such a potential case.

The report can be downloaded here

US: Bill introduced in California to modernise outdated laws criminalising HIV

Sen. Scott Wiener and Assembly member Todd Gloria Announce Bill to Modernize Discriminatory HIV Criminalization Laws

APLA Health and other organizations join in support of bill to reform outdated laws that have not been updated since the 1980s and ‘90s

Today, California Sen. Scott Wiener (D-San Francisco) and Assembly member Todd Gloria (D-San Diego) introduced a bill to modernize laws that criminalize and stigmatize people living with HIV. Assembly member David Chiu is also a co-author of the bill, SB 239. SB 239 would amend California’s HIV criminalization laws, enacted in the 1980s and ’90s at a time of fear and ignorance about HIV and its transmission, to make them consistent with laws involving other serious communicable diseases.

The bill is co-sponsored by: APLA Health, the ACLU of California, Black AIDS Institute, Equality California, Lambda Legal, and Positive Women’s Network – USA. The organizations are part of Californians for HIV Criminalization Reform (CHCR), a coalition of people living with HIV, HIV and health service providers, civil rights organizations, and public health professionals dedicated to ending the criminalization of HIV in California. San Francisco Supervisor Jeff Sheehy also attended the announcement.

“These laws are discriminatory, not based in science, and detrimental to our HIV prevention goals,” Sen. Wiener says. “They need to be repealed. During the 1980s—the same period when some proposed quarantining people with HIV—California passed these discriminatory criminal laws and singled out people with HIV for harsher punishment than people with other communicable diseases. It’s time to move beyond stigmatizing, shaming, and fearing people who are living with HIV. It’s time to repeal these laws, use science-based approaches to reduce HIV transmission (instead of fear-based approaches), and stop discriminating against our HIV-positive neighbors.”

SB 239 updates California law to approach transmission of HIV in the same way as transmission of other serious communicable diseases. It also brings California statutes up to date with the current understanding of HIV prevention, treatment, and transmission. Specifically, it eliminates several HIV-specific criminal laws that impose harsh and draconian penalties, including for activities that do not risk exposure or transmission of HIV. It would make HIV subject to the laws that apply to other serious communicable diseases, thereby removing discrimination and stigma for people living with HIV, and maintaining public health.

“It’s time for California to reevaluate the way it thinks about HIV and to reduce the stigma associated with the disease,” Assemblymember Gloria says. “Current state law related to those living with HIV is unfair because it is based on the fear and ignorance of a bygone era. With this legislation, California takes an important step to update our laws to reflect the medical advances which no longer make a positive diagnosis equal to a death sentence.”

“These laws are outdated and only serve to fuel the spread of HIV in our communities. They also disproportionately impact people of color and women,” APLA Health CEO Craig E. Thompson says. “Our understanding of HIV has changed significantly since the 1980s and our laws need to change to reflect that. Updating these laws will reduce stigma and prevent people from going to prison simply because they are living with a chronic disease. We appreciate the leadership of Senator Wiener and Assemblymember Gloria on this critical social justice issue.”

In addition to the organizations co-sponsoring the bill, other CHCR members supporting the legislation include the Los Angeles LGBT Center, the Los Angeles HIV Law and Policy Project, the Transgender Law Center, Mexican American Legal Defense and Education Fund, the Free Speech Coalition, Sex Workers Outreach Project, and Erotic Service Providers Legal, Education, and Research Project.

Published on February 7, 2017 in AplaHealth

Czech Republic: Police drop charges against all 30 gay men living with HIV following Prague Public Health Authority ‘witch hunt’

All criminal charges have been dropped against the 30 gay men living with HIV who were reported to the police by the Prague Public Health Authority earlier this year after they were diagnosed with an STI, Czech media report today.

The draconian behaviour of Prague Public Health led to widespread condemnation by human rights defenders.

A change.org petition initated by the European AIDS Treament Group (EATG) was signed by more than 1000 supporters, including the HIV Justice Network.

Today’s media report in Aktuálně.cz notes that three of the 30 men had been indicted for potential HIV transmission (under a law criminalising ‘the spread of infectious human diseases‘) but prosecutorial authorities withdrew the charges due to lack of evidence.

Police spokesman, Jan Danek, told the paper that following an investigation there was no case to prove against any of the 30 men and all charges had been dropped.

Australia: Australian experts publish statement urging courts to consider current scientific evidence in criminal cases involving alleged HIV transmission or exposure

A group of leading HIV experts are calling for “caution to be exercised” when considering criminal charges against people who recklessly spread the disease.

In a consensus statement published in the Medical Journal of Australia, Australian researchers and scientists — including Professor Sharon Lewin and Professor Andrew Grulich — argue that “criminal cases involving HIV transmission or exposure require that courts correctly comprehend the rapidly evolving science of HIV transmission and the impact of an HIV diagnosis”.

The statement cites scientific evidence that shows the risk of HIV transmission to be negligible if a person is on treatment and has an undetectable viral load. It also claims that HIV isn’t as serious a condition as it used to be: “Most people with HIV are able to commence simple treatment providing them a normal and healthy life expectancy, largely comparable with their HIV-negative peers.”

“Given the limited risk of HIV transmission per sexual act and the limited long-term harms experienced by most people recently diagnosed with HIV, appropriate care should be taken before prosecutions are pursued,” says the statement.

While acknowledging that cases of deliberate transmission of HIV are “extremely unusual”, the group urge authorities to change behaviours through counselling rather than the courts.

“Careful attention should be paid to the best scientific evidence on HIV risk and harms, with consideration given to alternatives to prosecution, including public health management.”

The statement has been welcome by HIV advocacy groups.

“It’s incredible to see these experts come together and make a bold statement regarding HIV and the law,” said Richard Keane, President of Living Positive Victoria.

“The impact of HIV criminalisation or even the threat of it is a dangerous form of stigma and we’re still feeling the ripple effect more than two decades later.”

There have been at least 38 Australian criminal prosecutions for HIV sexual transmission or exposure since 1991.

“You don’t have to be convicted or even prosecuted for HIV criminalisation to affect you,” said Keane.

“The HIV community lives with the threat that a complaint can be made against us and the stigma that criminal prosecutions amplify and perpetuate.”

Keane hoped the statement’s focus on utilising the public health system rather the criminal courts in dealing with behaviour change would lead to better outcomes on policy.

“Most people on treatment are able to achieve an ‘undetectable’ viral load which makes it highly likely that the person will remain healthy and pose a negligible risk of transmitting HIV,” Keane said.

“The evidence outlined in this statement shows that the per-act risk of HIV transmission from even the most risky sex is still low. The message should be to encourage individuals to take care of their health and eliminate barriers to accessing treatment rather than intimidation through the justice system.

“By focusing on what the studies and science is telling us about treatments, relative risk and harm, that’s how we reduce HIV transmission whilst protecting the rights and dignity of people living with HIV. HIV is a health issue, not a criminal justice issue.”

Additional reporting Positive Living.

Published in Gay News Network on Nov 6, 2016

Mexico: Quintana Roo activists submit proposal for a change in the State HIV criminalisation law

Submission to eliminate the criminalisation of people with HIV (Desplácese hacia abajo para el artículo original)

This initiative has been proposed by the organisation ‘Vida Positiva’.

PLAYA DEL CARMEN, Q. Roo

A proposition to eliminate the criminalization and general criminalization of people with HIV having sex, focussing on cases of willful intent by amending Article 113 of the Criminal Code of Quintana Roo, is being put forward.

This initiative has been proposed by the civil association ‘Vida Positiva’ and delivered to deputy Laura Beristain Navarrete, president of the Commission for Health and Social Welfare of the XV Legislature to be adapted and submitted to the State Congress at the beginning of October.

Rudolf Geers, president of the activist group said that its aims are for the legislation mentioned to be replaced by a new article which sanction the transmission of a chronic or fatal disease deceitfully and when protection methods have not been used.

“What we propose is that the law be changed to only prosecute cases of actual transmission, removing talks of risks, and cases where there was actual deception and where people did not use protection, in order to qualify the intent of the situation. In the case of pregnant women, to only prosecute cases where the mother had the express intention of infecting the baby. There was one prosecution in January this year, “said the leader of Vida Positiva.

On this matter, Deputy Beristain Navarrete said it was an issue that will be analyzed in a responsible manner, which will be reviewed properly to be subsequently pass on to the committee because every project must be adapted for proper submission, especially when concerning such a sensitive issue as health risks.

Background information

Meanwhile, Geers highlighted that looking at the history of the law, this Article has only served to motivate cases of blackmail and extortion, which have threatened to expose people because of their HIV status, even without evidence, and even when cases did not proceed, the name of the person with the condition had been made public.

“This year, we have had  reports of four cases and the advice was to ignore them and just 3 years ago, a lawsuit under this law was recorded. Furthermore this legislation is based on a federal law adopted in 1991; a time when it was a deadly disease with no treatment; It also violates several national and international standards and is counterproductive to an effective response to HIV.

According to CENSIDA, this measure was taken internationally, including in Mexico since the last decade of the last century as a preventive measure against transmission or as a punishment of behaviours that are perceived as ‘willful’, however, we can state that this has not worked with punitive measures, and without public health policies.

“We need to increase resources and efforts with recommended HIV prevention strategies, improve the quality and comprehensiveness of care and reduce stigma and discrimination towards key populations and people living with HIV and other STIs, considering them as part of the solution and contributiors to a fair, inclusive and democratic Mexico”, stated the  National Center for the Prevention and Control of HIV and AIDS on the criminalisation of HIV and other STIs transmission.

Rudolf Geers, president of the civil association Vida Positiva stressed that in these cases the responsibility to prevent further transmission is shared; anyone who has casual sex should use a condom.

—————————————————————————

Proponen eliminar la criminalización de las personas con VIH

Esta iniciativa ha sido propuesta por la asociación civil ‘Vida Positiva’.

PLAYA DEL CARMEN, Q. Roo.- Proponen eliminar la criminalización y la penalización general de las personas con VIH por tener relaciones sexuales, especificando casos de intencionalidad consumada, mediante la modificación del artículo 113 del Código Penal de Quintana Roo.

Esta iniciativa ha sido propuesta por la asociación civil ‘Vida Positiva’ y entregada a la diputada Laura Beristaín Navarrete, presidenta de la Comisión de Salud y Asistencia Social de la XV Legislatura para su adecuación y presentación ante el Congreso del Estado a inicios del mes de octubre.

Rudolf Geers, presidente de dicha agrupación activista explicó que se tiene como objetivo que dicha legislación se sustituya por un nuevo artículo el cual sancione una transmisión de una condición de salud crónica o mortal con engaño y sin usar métodos de protección.

“Lo que nosotros proponemos que se cambie esta ley para que solo se castigue en caso de existir una transmisión, quitar la palabra peligro,  castigando los casos en que hubo engaño y que no usaron protección, para poder calificar la intencionalidad de la situación. En el caso de la mujer embarazada, solo cuando la madre tiene la intención expresa de infectar al bebé sea castigado. De estos tuvimos un caso en enero de este año”, dijo el dirigente de Vida Positiva A.C.

Antecedentes registrados

Al respecto la diputada Beristain Navarrete señaló que es un tema que se estará analizando de manera responsable, que se revisará de manera adecuada para posteriormente pasarla a comisión, ya que todo proyecto hay que adecuarlo para su correcta presentación, en especial un tema delicado en referencia a riesgos sanitarios.

Por su parte, Geers aseguro que de acuerdo a los antecedentes registrados, este artículo solo ha servido para motivar casos de chantajes y extorsiones, que han amenazado con exponer a personas por su condición de VIH, incluso sin pruebas y aunque posteriormente no proceda la demanda, pero si haciendo público el nombre de la persona con este padecimiento.

“De estos hemos tenido este año reportes de cuatro casos y el consejo simplemente fue ignorarlos y hace 3 años se registró un caso de una demanda por esta ley. Además esta legislación, está basada en una federal de 1991; época en que era un padecimiento mortal al no haber tratamiento; además viola varias normas nacionales e internacionales y es contraproducente para una respuesta eficiente ante el VIH.

De acuerdo a CENSIDA, esta medida había sido tomada a nivel internacional, incluyendo a México desde la última década del siglo pasado como una medida de prevención de transmisión o castigo de conductas que se perciben como ’dolosas’, sin embargo, aseguran que esto no tendrpa éxito con medidas punitivas si no políticas de salud públicas.

Prevención y control

“Es necesario incrementar recursos y esfuerzos en las estrategias recomendadas para prevenir la transmisión del VIH, mejorar la calidad y la integralidad de la atención y disminuir el estigma y la discriminación hacia las poblaciones clave y las personas afectadas por el VIH y otras ITS, considerándolas como parte de la solución y contribuyendo a un México justo, incluyente y democrático”, señala sobre la penalización por transmisión del VIH y otras ITS en Centro Nacional para la Prevención y Control del VIH y el Sida.

Rudolf Geers, presidente de la asociación civil Vida Positiva enfatizó que en estos casos la responsabilidad para evitar nuevas transmisiones es compartida; cualquier persona que tenga relaciones sexuales casuales sebe de usar condón.

US: American Association of Nurses in AIDS Care publishes new Clinician Guidelines to HIV Criminalization

ANAC believes HIV criminalization laws and policies promote discrimination and must be reformed. The American Nurses Association (ANA) has co-endorsed ANAC’s position statement opposing HIV criminalization and joined ANAC in calling for the end to unjust laws that criminalize HIV.  Thirty three states still have laws criminalizing HIV exposure.  These laws fuel stigma by institutionalizing discrimination and are based on outdated beliefs.  People living with HIV are still being arrested for HIV exposure.  ANAC is a member of the Positive Justice Project, a national coalition to end HIV criminalization in the U.S.  Read ANAC’s policy statement calling for the modernization of HIV Criminalization laws.

ANAC, with support from the Elton John AIDS Foundation has developed a downloadable tool: Clinician Guidelines to HIV Criminalization.

Download the clinician guidelines here. 

Australia: Queensland people living with HIV organisation, QPP, issues position statement on HIV criminalisation (press release)

Queensland Positive People (QPP) is a peer-based advocacy organisation which is committed to actively promoting self-determination and empowerment for all people living with HIV (PLHIV) throughout Queensland.

Below is their press release issued on 6 April 2016 in the light of the recent High Court ruling related to intent in HIV transmission cases.

Position Statement

The criminal law is an ineffective and inappropriate tool to address HIV non-disclosure, exposure or transmission. International best practice acknowledges that public health frameworks are best placed to encourage a shared responsibility for HIV transmission, and public health interventions seek to effect change in risk-taking behaviour among those who have difficulty taking appropriate precautions to prevent the transmission of HIV.

Urgent legal review of State and National guidelines for determining if an individual poses a reckless risk of HIV transmission is required following the scientific acceptance that PLHIV on treatment with an undetectable viral load pose a negligible risk of transmitting HIV via sexual intercourse. Despite scientific consensus on this issue, Australian criminal law has failed to acknowledge the contemporary science of HIV transmission and instead relies on incorrect, out of date and stigmatising perspectives of HIV that do not acknowledge that with proper adherence to HIV medication, it is a manageable chronic illness with a full life expectancy.

To explain why Australian criminal law lags behind United Nation recommendations and criminalises HIV transmission, Cipri Martinez, President of the National Association of People with HIV Australia (NAPWHA) states “stigma, fear and discriminatory perceptions of HIV influence the decision to proceed with criminal charges– a statement clearly evidenced by a lack of criminal prosecution or media attention regarding the transmission of other notifiable conditions such as syphilis or hepatitis.” HIV is treatable, but criminal charges perpetuate the inaccurate position that HIV is still a death sentence and therefore deserving of a severe punishment.

Current Status

A decision has been handed down in the High Court regarding a Queensland criminal HIV transmission case.

Whilst inappropriate to comment on the specifics of the case, the NAPWHA and Queensland Positive People (QPP) highlight that the trying of HIV transmission through the courts is a complex and fraught issue.

The overly broad use of the criminal law has far reaching negative impacts upon the HIV response. In line with UNAIDS guidance, NAPWHA and QPP urge that any application of the criminal law in the context of HIV must not undermine public health objectives.

Cipri Martinez states that “The use of the criminal law in responding to HIV transmission has been widely regarded as a blunt and ineffective tool with adverse implications for public health. In line with the recommendations of the UN Global Commission on HIV and the Law, the criminal law should only be reserved for cases where an individual exhibits clear malicious intent to transmit HIV with the purpose of causing harm.”

“There are alternatives to the criminal justice system to address HIV transmission or allegations that a person living with HIV is placing other people at risk of HIV, such as public health legislation” Martinez said.

Public health interventions are intended to prioritise education; support behaviour change; provide management as required; and actively utilise affected communities as a far more effective alternative to punitive and stigmatising legal sanctions.

NAPWHA and QPP support HIV prevention strategies being driven by an evidence-based, best practice model of public health interventions.

Criminalising HIV transmission sends unbalanced messages about the shared responsibility for prevention, creates disincentives for people to get tested and does, in fact, discourage disclosure of HIV status. These outcomes undermine prevention efforts and actually increase the risk of further HIV transmission.

Criminalising transmission does not acknowledge the complex factors that may impact an individual’s ability to disclose status or take the necessary precautions to prevent HIV transmission.

QPP President, Mark Counter agrees with NAPWHA’s position, saying “Public health interventions acknowledge the complex factors unique to each case, such as power imbalances, impairment, discrimination or other social determinants of health that may confuse or limit an individual’s ability to prevent transmission.”

National and State HIV strategies have identified the shared goals of achieving virtual elimination of HIV transmission in Australia by 2020.

“We are all working towards the shared goal of reducing HIV transmissions. The only way we are going to achieve this goal is by continuing to implement evidence-based human rights responses to HIV. These responses include educating the public about HIV and empowering people to avoid transmission or live successfully with HIV. The broad use of the criminal law does not help us achieve these goals” Counter says.

We need to be expanding programs which have been proven to reduce HIV transmission whilst protecting the human rights of people living with HIV and those who are HIV negative. Further, we need to encourage and empower people living with an unknown status to get tested and to ensure HIV prevention services are available to all that need them.

One of the unfortunate side effects of criminal prosecutions is the misinformed and stigmatising media that can accompany the reporting of these cases.

“We call on media outlets to appropriately report on HIV transmission cases with facts and not fear. Inaccurate statements not only undermine our efforts to educate the public about HIV, but also create an environment of fear for people living with HIV or people thinking about testing. It is vital that we encourage people to test – not discourage or frighten them from testing” Counter said.

For assistance in reporting appropriately on HIV, journalists should refer to the Australian Federation of AIDS Organisations HIV Media Guide.