Kyrgyzstan: CEDAW recommends the decriminalisation of HIV transmission through consensual sex

Concluding observations from the Committee on the Elimination of Discrimination against Women on the fifth periodic report of Kyrgyzstan

43.       The Committee welcomes the decision of the Constitutional Chamber of the Supreme Court of 27 January 2021 to declare unconstitutional the provisions precluding persons living with HIV/AIDS from adoption, guardianship and foster parenting. However, the Committee is concerned about the criminalisation of HIV/AIDS transmission through consensual sexual relations between adults, impediments to access to healthcare, discriminatory terminology, reported isolation from children and barriers to access childcare facilities for women living with HIV/AIDS.

44.       The Committee recommends that the State party:

(a)        Decriminalise the transmission of HIV/AIDS (article 149 of the Criminal Code) through consensual sexual relations between adults;

(b)        Ensure access to healthcare, including confidential testing, antiretroviral treatment, psychological support and the confidentiality of information regarding women’s HIV status, and impose deterrent penalties for the disclosure of such status;

(c)        Eliminate repressive elements of epidemiological investigation and review the wording of HIV infection codes;

(d)        Ensure that women living with HIV/AIDS are not isolated from their children based on their HIV status and have adequate access to childcare facilities free from stigmatization; and

(e)    Prohibit the practice of employers requiring HIV certificates for accessing and keeping employment.


In September 2021 EWNA jointly with Women’s Network of Key Communities submitted the alternative report with particular focus on HIV criminalisation in Kyrgyzstan

Austria: Austria’s AIDS Support organisations call for the destigmatisation of HIV positive people in criminal law

HIV-positive people are discriminated against in court

Translated with (free version) – For original article in German, please scroll down

AIDShilfen: HIV-positive people are discriminated against in court
Criminal law should follow scientific findings. HIV infections should no longer be prosecuted.

Vienna – Austria’s AIDS support organisations are protesting against discrimination in court and demand “the destigmatisation of HIV-positive people in criminal law”. People with HIV who regularly take their therapy and whose viral load is below the detectability limit “do not pose a threat”, it was stressed. “It is high time that criminal law follows the scientific findings,” warned Andrea Brunner, Executive Director of Aidshilfe Wien.

In the past, HIV-positive people have been held criminally responsible despite effective therapy and even though no transmission had taken place. The potential risk of infection was assumed, according to the AIDS support organisations. In 2020, the Higher Regional Court (OLG) of Graz overturned such a first-instance decision on the grounds that successful HIV therapy precluded criminal liability.

Adequate therapy as prevention
Sections 178 and 179 of the Criminal Code (Strafgesetzbuch, StGB) “or the previous case law on the subject”, however, continue to expose people with HIV to discrimination and stigmatisation. Since it has been proven that regular and effective therapy prevents the HIV virus from being passed on, those affected would not be committing a “dangerous act” during sexual intercourse, argues Aidshilfe. Since there is no risk of transmission, the facts of section 178 (“risk of spreading”) are not fulfilled. However, the fear of criminal consequences could contribute to a decrease in the willingness to test among those affected.

The Austrian Aids Support Services demand that an HIV infection should no longer be covered by the punishability of section 178f. As long as this remains the case, “the current state of medical research must be taken into account in the decision by a court. This means that both safe sex and the consistent pursuit of drug therapy must be grounds for exclusion from a trial.”

Broad support from parties
The demands meet with broad support among the parties represented in the National Council. The health spokespersons of the SPÖ, FPÖ do so unreservedly. NEOS (Neues Österreich) health spokesperson Fiona Fiedler is “basically in favour of reducing discrimination and promoting education”, but courts already take the state of science into account – “this demand is therefore obsolete”.

The press office of the ÖVP parliamentary club refers to the Ministry of Justice. There, the demands of the Aids organisations are currently being examined, it says on request. According to the press office of his club, the Green health spokesman Ralph Schallmeiner has already made an appointment with Andrea Brunner, managing director of Aids Hilfe Wien, to discuss possible improvements. (APA, red, 25.10.2021)

HIV-Positive werden vor Gericht diskriminiert
Das Strafrecht solle wissenschaftlichen Erkenntnissen folgen. HIV-Infektionen sollen nicht mehr strafrechtlich verfolgt werden.

Wien – Die Aidshilfen Österreichs protestieren gegen Diskriminierung vor Gericht und fordern “die Entstigmatisierung von HIV-Positiven im Strafrecht”. Menschen mit HIV, die regelmäßig ihre Therapie einnehmen und deren Virenlast unter der Nachweisbarkeitsgrenze liegt, “stellen keine Gefährdung dar”, wurde betont. “Es ist höchst an der Zeit, dass das Strafrecht den wissenschaftlichen Erkenntnissen folgt”, mahnte Andrea Brunner, Geschäftsführerin der Aidshilfe Wien.

In der Vergangenheit seien HIV-positive Menschen trotz wirksamer Therapie und obwohl gar keine Übertragung stattgefunden habe, strafrechtlich zur Verantwortung gezogen worden. Es sei das Gefährdungspotenzial für eine Ansteckung unterstellt worden, so die Aidshilfen. 2020 hob das Oberlandesgericht (OLG) Graz eine solche erstinstanzliche Entscheidung mit der Begründung auf, dass eine erfolgreiche HIV-Therapie eine Strafbarkeit ausschließe.

Adäquate Therapie als Prävention
Die Paragrafen 178 und 179 im Strafgesetzbuch (StGB) “beziehungsweise die bisherige Rechtsprechung dazu” setze Menschen mit HIV aber weiterhin Diskriminierung und Stigmatisierung aus. Da erwiesen ist, dass eine regelmäßige und wirksame Therapie eine Weitergabe des HI-Virus unterbindet, würden Betroffene beim Geschlechtsverkehr jedoch keine “gefährdende Handlung” setzen, argumentiert die Aidshilfe. Da kein Risiko für eine Übertragung besteht, sei der Tatbestand des Paragrafen 178 (“Gefahr der Verbreitung”) nicht erfüllt. Die Angst vor strafrechtlichen Konsequenzen könne jedoch dazu beitragen, dass die Testbereitschaft bei Betroffenen sinkt.

Die Aidshilfen Österreichs fordern, dass eine HIV-Infektion nicht mehr von der Strafbarkeit von Paragraf 178f erfasst sein soll. Solange dies der Fall bleibt, “muss bei der Entscheidung durch ein Gericht der aktuelle Stand der medizinischen Forschung beachtet werden. Das bedeutet, dass sowohl Safer Sex als auch das konsequente Verfolgen einer medikamentösen Therapie als Ausschlussgrund für ein Verfahren gelten müssen.”

Breite Unterstützung von Parteien
Bei den im Nationalrat vertretenen Parteien stoßen die Forderungen großteils auf Unterstützung. Die Gesundheitssprecher von SPÖ, FPÖ tun dies vorbehaltlos. Neos-Gesundheitssprecherin Fiona Fiedler ist “grundsätzlich dafür, Diskriminierung abzubauen und Aufklärung voranzutreiben”, Gerichte würden den Stand der Wissenschaft aber schon jetzt berücksichtigen – “diese Forderung ist daher obsolet.”

Die Pressestelle des ÖVP-Parlamentsklubs verweist auf das Justizministerium. Dort werden die Forderungen der Aidshilfen aktuell geprüft, heißt es auf Nachfrage. Der grüne Gesundheitssprecher Ralph Schallmeiner hat, laut Pressestelle seines Klubs, bereits einen Termin mit Andrea Brunner, Geschäftsführerin der Aids Hilfe Wien, vereinbart, um etwaige Verbesserungen zu diskutieren. (APA, red, 25.10.2021)


[Feature] It Takes More Than A Village to End HIV Criminalisation

The proverb says, “It takes a village to raise a child”. But what if a mother in the village is living with HIV, and some of the villagers stigmatise her? What if that stigma creates a situation where the mother living with HIV is unjustly criminalised because of her HIV status? Then it takes more than a village to get justice for that woman. It takes a global movement to end HIV criminalisation to sensitise and train lawyers and expert witnesses.  It takes national communities of women living with HIV to support that woman following her release, and to educate the community in which she lives about HIV.


In 2016, a Malawi court convicted a woman living with HIV of “negligently and recklessly doing an act likely to spread the infection of any disease which is dangerous to life” under section 192 of the Malawi Penal Code. She had attended a village meeting with her baby which she breastfed as usual before passing the child to her grandmother. Another woman then asked her to hold her baby. It was alleged that this child began breastfeeding briefly before the woman realised what was happening. The child’s mother then reported the incident to the police. The woman was arrested and without legal advice or representation, pleaded guilty, was convicted, and sentenced to nine months’ imprisonment with hard labour.

The circumstances of the case are all the more shocking because women living with HIV are encouraged to breastfeed in Malawi (and in other countries with high HIV prevalence and settings in which diarrhoea, pneumonia and undernutrition are common causes of infant and child deaths) and because HIV-related prosecutions involving breastfeeding are exceedingly rare. Unfortunately, we have seen an increase in the number of such cases since 2016. HJN is working to address this in a number of ways because we believe there should never be prosecutions of women living with HIV for breastfeeding.

In addition, the accused woman was taking antiretroviral therapy. The chances of HIV transmission through even long-term breastfeeding are very low (which is why WHO guidelines recommend it when access to infant formula and clean water are limited) and the chances of transmission during the brief period the baby allegedly fed were infinitesimally small. In fact, the accused woman’s own child, who was routinely breastfed, has not acquired HIV, calling into question any suggestion that she intended to cause harm to the other woman’s child. Perversely, for a system that unjustly condemned her for risking harm to the other woman’s child, her own baby was imprisoned with her, without any arrangements for appropriate feeding and care, negating any notion that the legal system’s purpose was to protect children.

Following media reports of her initial conviction, numerous individuals and organisations – including HJN and our HIV JUSTICE WORLDWIDE partners, ARASA and SALC – became involved in the case, ultimately changing the outcome for the woman and her family, and laying the groundwork for further anti-HIV stigma advocacy and education in the region. Her story demonstrates the vital role that education, training, strong networks, and community play in the pursuit of HIV justice.

Living with HIV-related stigma

When interviewed at her home in 2019, the woman referred to as “EL” talked about her life:[1]

[1] The initials EL are used instead of her full name following a court order of anonymity to protect her privacy. The interview took place in 2019, during the village visit described later in this article.

“As kids, there were the two of us — me and my brother. My parents faced challenges raising us. Finding the basic necessities like soap and food was a tall order, let alone talking about going to school. It was difficult to get learning materials as well as proper clothes to wear at school. I worked hard in class but couldn’t get past Standard 5 at primary school. Eventually I dropped out, and my brother did the same, … My daily life was taken up doing house chores just like any other girl in the village, as well as helping my parents with farming. At 16, I got married.”

EL further described how she was diagnosed HIV-positive in 2015 after a de facto compulsory HIV test at an antenatal visit. She already had two children and was pregnant with her third. She had heard about HIV but did not know much about it. EL said that the healthcare workers provided a lot of assistance, giving her accurate information about HIV, including the importance of adhering to her antiretroviral treatment (ARVs).

EL and two of her children. Photo: Amos Gumulira/UNDP Malawi

EL said that she generally enjoyed life in her village, although at times she was subject to stigma and discrimination:

“When I went to fetch water at the community borehole, people would laugh at me, and whenever I wanted to participate in community work, you would find pockets of community members talking ill about me. Some people used to insult me, calling me names. But I persevered because my relatives, including the Village Headman himself, gave me support and always stood by my side.”

Members of EL’s family also faced discrimination. “Due to lack of information, a lot of people thought HIV was hereditary and because I was diagnosed HIV-positive, this meant that all my family members had HIV, and they were discriminated against,” EL said.

EL wonders if more could have been done to help her fight stigma. In particular, EL gained a lot of knowledge about HIV from the counselling she got when diagnosed, but perhaps she could have been better equipped with information to share with people in her community:

“A lot of people don’t know that if you adhere to ARVs, you reduce the risk of transmitting HIV to others. This information needs to be passed on to many people. There are also other issues to do with ARVs. A lot of people don’t have adequate information on the effects of ARVs and at the end of the day, they start pointing fingers at each other, giving people room to start speculating about issues to do with witchcraft.”

EL’s prosecution had repercussions for her whole village. One woman from the community explained:

“I was there and very close to where EL was sitting. Yes, she was carrying another woman’s child. This other woman had given the child to EL for safe keeping while she went to stand in a queue, but honestly speaking, I didn’t see EL breastfeed the child. I just heard some people who were sitting a distance from where we were sitting, as they started pointing accusing fingers at her.”

She said that things moved so fast that before they could think of anything to stop what she called “the rumour.” It had gotten out of hand and people started saying that EL had intentionally breastfed the child to transmit HIV.

After receiving a summons, EL voluntarily turned herself in at the police station. She was accompanied by the Village Headman (her grandfather) who wanted first-hand information about what crime she was alleged to have committed. That same day, police transferred EL to a larger town, where she was remanded for three days. At the age of 29, this was the first time that EL had ever left her village.

Days later, she appeared in court and the charge sheet was read out. EL recounted that she had not understood what was happening and could not make arguments because she had no legal representation. EL agreed with the summary of events as they were described, so she was found guilty and was imprisoned together with her youngest child.

She described life in prison as “hell”:

“After a week, my brother showed up to give me my ARVs. All this talk about a woman with HIV breastfeeding. I breastfed but I also found it tough to feed my baby while in prison because there was no provision of special food for babies. We were eating nandolo (pigeon peas) almost every day with Msima ya Mgaiwa (maize meal). And there was only one toilet for a cell of more than 50 people.”

After some time, relatives and other members of her community started visiting, giving her money she could use to buy soap and food for her baby. “When we heard from our Village Headman that she had been arrested, we were so devastated”, a woman from EL’s village explained. “We raised funds for some members to go and give her support only to learn that she had been transferred to one town, then another, but some of us did manage on several occasions to visit her and offer our support when she was in prison.”

Then, out of the blue, EL received a message that some people had come looking for her. She went to meet them: a lawyer, Wesley Mwafulirwa, and his paralegal. They explained why they were there and asked if she would like them to appeal on her behalf. She accepted enthusiastically. “I was excited but at the same time I was confused because I could not believe that I could be so lucky to have these people come to help me.”

Fighting the charges

Solicitor Wesley Mwafulirwa had volunteered to attend training to address legal barriers to prison health and human rights presented by the Southern African Litigation Centre (SALC). He travelled from Malawi to South Africa to attend the training which addressed useful regional and international mechanisms, and presented insights about legal practice and strategic litigation to support prison health and human rights, particularly for those facing heightened vulnerability to HIV and TB.

Wesley Mwafulirwa Photo: Amos Gumulira/UNDP Malawi

At the training, two lawyers spoke about their pro bono work. Wesley remembers one of them, Allan Maleche (Executive Director of KELIN), saying that each participant should take at least one case when they go back to their country. It was a turning point in Wesley’s career.

He had not been home long when he saw an article in the newspaper about an HIV-positive person convicted for trying to spread HIV. That person was EL.

Wesley, who lives in a small town in northern Malawi, drove for more than ten hours to get to the jail where EL was incarcerated. He explained his determination, saying “I was so fired up! I’d just come from SALC’s training … and I said, ‘I want to take up this case’.”

Wesley interviewed EL and offered to take her case pro bono. Wesley contacted SALC, who offered technical support. Their first step was to get an order for anonymity to protect EL’s identity and gain greater control over media reporting. Next, they faced an ethical question. They wanted to challenge the constitutionality of the law but that would take a long time. Because EL was in prison, they decided to undertake a criminal appeal instead. They applied for EL to be let out of custody on bail pending appeal. This is usually a difficult application to win, but they were successful and EL was released from prison.

In the appeal, the court was asked to consider whether the conviction could be justified, whether the penal provision was constitutional (arguing it was overly broad and vague), and whether the sentence was manifestly unjust. Wesley used his learnings from the SALC training to raise international principles and instruments relating to sentencing, which the court referenced and upheld. Michaela Clayton, then Executive Director of the AIDS and Rights Alliance for southern Africa (ARASA), and now a member of HJN’s Supervisory Board, provided expert testimony. Another expert witness, Dr Ruth Brand, identified through HJN’s global network, gave expert scientific evidence to show the risk of HIV transmission had been “infinitesimally small.”

The case was heard by Honourable Justice Zione Ntaba, who held that the proceedings in the trial court were irregular and “blatantly bias” against EL, compromising her right to a fair trial. Justice Ntaba found the charge sheet had been defective and therefore EL’s plea should not have been recorded as guilty. She noted the law must be sensitive to the accused’s knowledge or belief (or lack of) that HIV would be transmitted. Justice Ntaba decided the conviction could not be justified, acknowledging human rights principles against the overly broad criminalisation of HIV non-disclosure, exposure, or transmission. EL’s sentence was set aside. (The Constitutional challenge was referred to a full-member panel of the Constitutional Court although the case was not pursued.)

Notably, Justice Ntaba was a member of the African Regional Judges Forum to discuss HIV, TB and Human Rights (a process which is owned and planned by the judges and run with support from UNDP and funding from the Global Fund).

Fighting the stigma

Shortly after EL’s arrest, the Coalition of Women and Girls Living with HIV and AIDS in Malawi (COWLHA) and the Malawi branch of the International Community of Women Living with HIV/AIDS (ICW-Malawi) discussed the case at a roundtable meeting. At first, everyone was surprised and even laughed, questioning how she could have breastfed someone else’s child. They had never heard of a criminal case involving infant feeding and did not understand what they were dealing with.

During their discussions, COWLHA and ICW-Malawi agreed that the prosecution of EL was a manifestation of stigma and misinformation about HIV in the community. They learned more about the unjust measures that EL had experienced, like being imprisoned without being given a chance to be heard and not being given the chance to prepare and take her medication and things she needed to care for her child. COWLHA and ICW decided to get involved.

Representatives from COWLHA and ICW meet with members of EL’s village. Photo: COWLHA/ICW

Concerned that EL could face social and community hostility after her release, COWHLA and ICW planned a visit to the village to provide psychosocial support to EL and to work with traditional community leaders to provide community sensitisation on HIV, addressing issues of stigma and discrimination. Their efforts helped change some community members’ ideas about HIV.

The community formed two support groups— one for youth and another for adults (notably both were predominantly female groups). They have conducted numerous activities, including home visits, supporting children to go to school, helping the elderly with house chores, and they have a garden where they grow vegetables and rice. They hoped to access loans to become self-reliant. They also had a list of issues they wanted to learn more about, including preventing mother-to-child transmission, sexual and reproductive health, positive living, stigma and discrimination, and treatment literacy.

Visiting EL at home

In September 2019, a three-member team comprising Edna Tembo (Executive Director of COWLHA), Charity Mkona (ICW Board Chair), and Peter Gwazayani (media consultant), set out for EL’s village.

The team was welcomed by the Group Village Headman, who took them to EL’s house. EL recognised Edna from the work COWLHA and ICW-Malawi had done in the community previously. EL welcomed the team with a big smile.

EL and her husband looked cheerful as they laid a mat on the veranda of their house for the visitors. Her mother later joined the discussion.

EL was interested to learn that HJN wanted to write about her case and the type of interventions that had been helpful, to share the story with advocates for HIV justice around the world.

EL recounted that when she returned to the village, “most members of my community received me with happiness, particularly my relatives. The day I arrived, they were jubilant. They celebrated with songs that we normally sing during special occasions in the village.”

COWLHA ED Edna Tembo and Charity Mkona of ICW chat with EL, her husband and her mother (at far distance). Photo: COWLHA/ICW

EL lives with her husband, five children and her mother in a compound made up of three grass thatched houses. She introduced her children:

“The oldest is 13 and she goes to school, as do the second and third. The fourth, a little girl, is the child I was with in prison. She has not yet started school. And then there is this one, who I am breastfeeding. She is the fifth one. She has been tested for HIV on two occasions and will be going for the last test soon. The other two tests have come back HIV-negative.”

EL’s accuser and her family still lives in the same village which has presented some difficulties. EL said that on several occasions she had tried to greet them when they passed each other, but she had been ignored. “They don’t talk to me but from deep down in my heart, I have no grudges against them,” EL said.  “I am just living my normal life,” EL says, although now she says that she would never agree to carry anybody else’s child, for any reason.

Moving beyond criminalisation

With respect to the community-level interventions, lawyer Annabel Raw, who worked at SALC during the time they supported the EL case said:

“As lawyers, we would never have thought to consider such an intervention had ICW-Malawi and COWLHA not shared their insights and been willing to support the client and her community. Their work has been so important to ensuring that meaningful justice was done to combat the actual root cause of the prosecution — stigma and discrimination — and to reconcile EL with her community.”

Engaging with the community also influenced ICW-Malawi and COWLHA’s thinking about HIV criminalisation. COWLHA’s Edna Tembo noted that:

Supporting people who have been prosecuted, particularly women, gives them power, … However, it is very important to stress that psychological support is absolutely vital for those who have been prosecuted. That includes family support, and a supportive community environment enabling acceptance of an individual accused.”

Tembo was also quick to emphasise that there is more work to be done. That work includes awareness raising and ongoing support to the community, especially to identify and train volunteers, empowering them to provide services at community level and to link them to health facilities and district offices for continued support and mentorship.

EL carries her youngest child home. Photo: Amos Gumulira/UNDP Malawi

EL described her dreams for the future:

“My wish now is to see my children progress in school so that they become productive citizens in this community and help it grow. That’s my dream. If they get educated, they will be able to stand on their own and support others. My husband is not employed and it is a challenge to get money for school fees for our children. We would love to get a loan or training to have greater knowledge of economic empowerment because we want to be self-reliant. We would then love to lease some land to grow rice to sell to pay back the loan.

“It’s also my wish to see the lives of all people in the community uplifted. We farm but on a small-scale. If we were to be supported with funds, I’d love to see the community establish big rice farms, working in groups, harvesting for consumption and for sale. In so doing, we would be able to uplift our lives for the better.”

Further Information

Learn more about Wesley’s experiences in EL’s case here and here.

Learn more about the African Regional Judges Forum here.

The full High Court judgement is available here, with a summary included here.

Read more about the successful HIV and AIDS Management Act community advocacy here.

This article is based on information provided by ICW-Malawi and COWLHA following their visits to EL’s village, and an interview with Wesley Mwafulirwa published by UNDP. HJN provided financial and logistical support for the village visits thanks to a grant provided to the HIV Justice Global Consortium from the Robert Carr Fund for civil society networks.     

Colombia: Constitutional Court rules in favour of soldier living with HIV, reaffirming his constitutional rights

The battle an active soldier diagnosed with HIV won against the Army in Colombia

Translation via For original article in Spanish, please scroll down.

To protect his fundamental rights to social security, the Sixth Chamber of the Constitutional Court ruled in favor of an active soldier diagnosed with HIV.

In 2015, an active soldier was evaluated by the Military Health Directorate of the National Army through a Medical Labor Board, there, he was evaluated for “the possible decrease of psychophysical aptitudes” after an HIV diagnosis, but he was not guaranteed treatment or follow-up by the institution.

That is to say, the soldier has had to comply with his treatment and all that it entails, in a private manner.

The 2015 report “was incomplete”, since it did not assign a percentage of loss of working capacity.

Nor did it establish criteria to determine the progress of his infection or the subsequent deterioration of his clinical conditions, the Constitutional Court explained.

In the tutela filed by the uniformed officer, three years later the Directorate denied him the possibility of repeating that evaluation “to determine the levels of his work reduction due to suffering from other illnesses that were aggravated as a result of HIV.”

Decision of the Court

Following the decision, the Sixth Chamber of Review, with Judge Gloria Stella Ortiz Delgado presiding, reaffirmed that persons with HIV are entitled to special constitutional protection.

In the specific case, the Constitutional Court argued: “The assessment carried out by the DISAN EJC in 2015 was incomplete, lacked motivation and did not analyze the medical history of the plaintiff in a comprehensive manner”.

Therefore, the Constitutional Court ordered the formation of a new Labor Medical Board.
It also recalled the obligation to respond in a timely manner to the requests made in this type of proceedings, especially in the case of members of the Army. Finally, the DISAN EJC was warned about the duty to provide the medicines required for the treatment of HIV.

Thus, the Chamber protected the rights to social security and administrative due process of the professional soldier on active duty.

He had been denied the procedures to monitor his disease and provide him with the necessary treatment.

This decision of the Court sets a precedent for members not only of the Army, but of the public force in the country.

Para proteger sus derechos fundamentales a la seguridad social, la Sala Sexta de la Corte Constitucional falló a favor de un soldado activo, diagnosticado con VIH.

Noticias Colombia.

En el 2015 un soldado activo fue evaluado por la Dirección de Sanidad Militar del Ejército Nacional a través de una Junta Médico Laboral, allí, se le evaluó por “la posible disminución de las aptitudes psicofísicas” tras un diagnóstico de VIH, pero no se le garantizó tratamiento ni seguimiento en la institución.

Es decir, el militar ha tenido que cumplir su tratamiento y todo lo que conlleva, de manera particular.

El dictamen del 2015 “resultó incompleto”, ya que no asignó un porcentaje de pérdida de capacidad laboral.

Tampoco estableció criterios para determinar el progreso de su infección o el posterior deterioro de sus condiciones clínicas, explicó la Corte Constitucional.

En la tutela que interpuso el uniformado, tres años después la Dirección le negó la posibilidad de repetir esa evaluación “para determinar los niveles de su disminución laboral por padecer otras enfermedades que se agravaron por consecuencia del VIH”.

Decisión de la Corte

Tras la decisión, la Sala Sexta de Revisión, con ponencia de la magistrada Gloria Stella Ortiz Delgado, reafirmó que las personas con VIH son titulares de una especial protección constitucional.

En el caso concreto, la Corte Constitucional argumentó: “La valoración efectuada por la DISAN EJC en 2015 resultó incompleta, incurrió en falta de motivación y no analizó la historia clínica del accionante de forma integral”.

Por lo tanto, la Corte Constitucional ordenó conformar una nueva Junta Médico Laboral.
También, se recordó la obligación de responder oportunamente las solicitudes elevadas en este tipo de trámites, especialmente cuando se trate de miembros del Ejército.
Finalmente, se advirtió a la DISAN EJC sobre el deber de suministrar los medicamentos que se requieran para el tratamiento del VIH.

Así la Sala protegió los derechos a la seguridad social y al debido proceso administrativo del soldado profesional en servicio activo.

Se le habían negado los procedimientos para hacerle seguimiento a su enfermedad y brindarle el tratamiento necesario.

Esta decisión de la Corte sienta un precedente para miembros no solo del Ejército, sino de la fuerza pública en el país.

Russia: In 2021, people living with HIV are still facing criminalisation, stigma, healthcare denial, dismissal and deportation

Who protects people with HIV in St Petersburg and how?

Stigma, denial of health services, dismissal, deportation – these are just some of the problems HIV-positive people in Russia can face. For 25 years Positive Dialogue NGO helps people with these problems.

A quiet street in the centre of St. Petersburg, a yard with bright graffiti – a portrait of a girl with long hair and the text Lu Blue. No other graffiti so far.

Mikhail Stupishin, the head of Positive Dialogue, meets me at the door. A few steps down, and we are in a bright office. The Positive Dialogue only recently moved into the building, because for years before it was located on the grounds of Botkin Infectious Diseases Hospital.

– The first quarter of the 21st century is coming to an end and people still have HIV-phobic cockroaches in their heads,” laughs Mikhail, pouring coffee and talking about the move. – Four premises were refused to us due to the nature of our business. At the preview, we explained that we are now focused on individual counselling and not on mass events, we said that we have a flow of clients, but not as a mausoleum, that we work with a socially significant disease – HIV infection. We were told: “Yes, yes, yes, everything is great”. And when it came to concluding an agreement, they said: “We looked at the website what you do. This is too extreme for us”.

I am reminded of Anna, the heroine of my text ‘Anna and Her Victories’, a mentee of Positive Dialogue. What is extreme is the treatment she and many other people face time and again because of their HIV-positive status. For example, when her own mother, an experienced health worker, forces her daughter to eat from separate dishes even though there is no contact-domestic transmission of HIV. Or when a person is not wanted to work because of his/her HIV status, despite the fact that thanks to therapy (free and accessible) his/her viral load has been undetectable for a long time – this means that he/she cannot infect anybody in any way. Anna told us that in the most desperate situations she called Positive Dialogue and thanks to her conversation with lawyer Alexander Loza she solved problems with her job and then with her studies more than once.

Alexander joins Mikhail and me, we shake hands and begin a conversation that lasts more than two hours, but even that time seems short. The problems faced by people with HIV in Russia are too many.

“Positive Dialogue started as far back as 25 years ago. It was founded by Nikolai Panchenko, a lawyer and one of the first registered HIV-positive people in the USSR. He recently celebrated his 70th birthday and handed over the leadership of the organisation to Mikhail Stupishin a few years ago, but Panchenko’s name keeps coming up in conversation – it was he who started the education work, talking about HIV prevention and life with HIV. This is as necessary now as it was a quarter of a century ago.

– Sasha has been working here since 2004, and I joined in 2015,” says Mikhail. – At that time two big prevention projects were launched: HIV prevention among men who have sex with men and HIV prevention among female sex workers. I came upon the recommendation of an acquaintance. I have secondary medical education. I am not a doctor but a paramedic. I know anatomy well, I know pathophysiology well, or at least I knew it, I understand where the legs are growing from.

In addition to his medical education, Mikhail graduated from the University of Culture, and Alexander studied at St. Petersburg State University. A medical doctor and a lawyer, both have extensive experience of working with people in difficult life situations.

– Many people need legal advice,” says Alexander. – Not everyone has the money to pay for a consultation, not everyone wants to talk about their specific problems, and not all lawyers are practiced at it.

– Do they often come to you with work-related issues? – I ask. But it turns out to be not quite what I imagined.

According to Alexander, medical workers who have to undergo compulsory tests, including HIV tests, every year are most afraid of being fired. However, police officers and employees of the Ministry of Emergency Situations also seek advice: contrary to the federal legislation, these agencies impose a complete ban on work for HIV-positive people – they issue local acts on undergoing medical examinations and declare them unfit or limited fit for service.

– Is there anything you can do in such situations?

– Well, back in Soviet times, an act was passed that people with HIV infection could not be commanders of aircraft,” Alexander sighs. – Five or seven years ago, one captain was diagnosed with HIV. He went to the General Prosecutor’s Office, the General Prosecutor’s Office went to the Supreme Court, and the Supreme Court ruled the act illegal. But the man had to disclose his status to everyone. It is not about the court per se – a person’s name can be hidden in the documents. But the employer often puts pressure on the employee, may spread rumours about him.

Mikhail cites the story of his acquaintance, who was literally “eaten up” at work, in the most ordinary office, when he found out about his HIV status. Litigating in such situations can be futile: legally, the case is a win-win – the dismissal is illegal, but they will not give you life at work.

People rarely go to court against employers, and as a rule, it is high-profile cases that change the local normative acts of an organization.

– We have it written into the law that this is discrimination, that the employer will be fined, there is criminal liability,” Alexander says. – But everyone tries to do it quietly: you resign at your own request, you get some severance pay, and you leave quietly (what happens to you next is your problem), while we will be white and fluffy. I always say that fighting for one’s rights is fraught: they can create such conditions that a person will be forced to leave. Constant stress is also bad for the body.

Last year, according to Alexander, the Prosecutor General’s Office tried to issue a local act banning people with HIV from working, but there was an uproar and the agency had to abandon the idea. But the Ministry of Railways and Communication seems to have succeeded in introducing a local ban.

– In general, if you start having problems at work because of your HIV status, the only way out is to look for a normal employer?

– We don’t have a ‘normal employer’ as such,” Alexander shakes his head.

– It’s not so much about the employer,” adds Mikhail, “it’s more about your direct supervisor or upper management if you are in his position.

He recounts cases of people being tested for HIV without their knowledge when they are hired. This practice is, of course, illegal:

– The issue of informing about a person’s status is generally very strict: no disclosure, only at the official request of the court or the prosecutor’s office. Only then the AIDS Centre is obliged to provide information whether the person is registered or not. If a person realises that he or she has not told anyone about his or her status, but the employer has the information, it means that during the medical examination, blood was taken for HIV infection. But, in theory, the employer cannot make any further moves, because the whole story is illegal.

– And what other problems do people come up with?

– Access to medical services,” Alexander answers without thinking for a second. – It happens that a person has to undergo a planned surgery, he knows that he is HIV-positive, and in the medical institution they either try to talk him out of it or redirect him somewhere else, or just put him into a paid ward, even though everything should be free of charge under the MHI.

– They either try to charge him money or refuse to take him at all because of his HIV status,” Mihail says without euphemisms.

– No one says it directly, they start using various medical terminology or “your indications are not right, maybe in a year”. In medical institutions we always recommend to ask for a written refusal. What the doctor says in the corridor, you will not be able to prove anywhere else. The doctor realises that by writing such a refusal he or she will put himself or herself and his or her medical centre in danger. And then the doctors are more likely to put on double gloves and do everything, gritting their teeth, – Alexander is sure.

– And they will do it as well as possible, so I won’t have to come back again,” laughs Mikhail.

– At the same time, everyone treats hepatitis C, which is more dangerous, much more easily,” says Alexander, bewildered. – If you tell dentists that you have hepatitis C, the doctors will take it easier than if you tell them about HIV.


In medical institutions, Alexander and Michael explain, often if a person says they are HIV positive, they are sent to the back of the queue. This is such a small discrimination. They won’t refuse to help, but they will accept him last – to disinfect everything afterwards. This is despite the fact that disposable instruments are used or everything is disinfected after each patient.

– Generally, health workers have instructions to suspect every patient is HIV and hepatitis C positive, to wear gloves and masks in every situation. But when funding is a problem, gloves can be wiped down with alcohol or something else cannot be done.

– And sometimes there is just a flood of patients, and it’s just the human factor.

– But if there is a risk of disease, health workers are immediately put on PEP – free post-exposure prophylaxis. This equates to an occupational injury,” Mikhail sums it up.

But legal recourse is not limited to medical issues either. People who are HIV-positive are increasingly facing blackmail.

– Either a former cohabitant or a former spouse blackmails them,” explains Alexander. – They start threatening that, for example, they will disclose their status to their relatives.

– Can this be dealt with?

– If a person fears it, they can go and write a statement to the police, because it is an invasion of privacy. Such reports are obligatory because we have a Criminal Code. The report will first be investigated, one party will be called, and then the other party will be called. Maybe at this stage the blackmailer will realise that he is doing it for nothing. Sometimes blackmail is attempted by people who are already HIV-positive themselves.

– Maybe both of them were already infected when they met and were afraid to tell each other. We are all afraid,” says Mikhail. – This goes to the issue of self-stigma caused by stigmatization from society. The further into the woods it gets, the harder it becomes to tell your partner. I recently had a consultation: we talked on the phone for an hour and a half (we didn’t have an office at the time). A guy “plus” (tested positive), he has a regular partner who is HIV-negative. The client says: “I know everything, I understand everything, I understand that people live with it, and the story with the pills does not embarrass me.


This is the self-stigma that emerges thanks to our beloved public, which still believes that HIV infection is collapse and death.

The situation is even more difficult when an HIV-positive person is a citizen of another country. One can avoid deportation only if one has close relatives or a spouse with Russian citizenship. The amendments about relatives, which make life a little easier for foreigners, have only recently appeared and do not always help.

– In one case, I had to file a lawsuit in Moscow against Rospotrebnadzor,” says Alexander. – A Ukrainian citizen has entered Russia. His wife is Russian. The court overturned Rospotrebnadzor’s decision that his stay on Russian territory was undesirable. The man’s wife recently called and said that he had to renew or get a new residence permit, but the police were refusing him on the grounds of his HIV status. They demand a certificate from the AIDS Centre that he is registered there and the AIDS Centre says: “We won’t take him on the register because he is a foreign citizen. All the same, there are legal obstacles.

– And if there are no close relatives who are citizens of the Russian Federation?

– A foreigner is subject to deportation. In the CIS, only two states still deport citizens with HIV: Russia and Armenia. The others have acknowledged that it is not dangerous, and the foreigner himself, knowing that he has HIV, runs to the nearest AIDS centre and gets registered there to receive therapy for money, because he himself is interested in it, because then he will have a normal life, work and finances to support himself.

– It is scary to think about the level of stigma faced by migrants with HIV. Where does this rejection of HIV-positive people, migrants and Russians come from? From ignorance?

– Now there is a lot of information, organizations, websites, information space has expanded. People can find and read everything themselves. But who is interested in it? The target group, people who have already become HIV carriers,” says Alexander.

– Stigma is associated primarily with a complete lack of awareness about this or that disease,” says Mikhail. – I have a number of acquaintances who still think that HIV can be contracted by drinking from the same cup. Speedophobia, or HIV-phobia, comes primarily from ignorance. Sexual transmission of HIV is now the predominant mode of transmission. HIV has long gone beyond the so-called key populations: injecting drug users, MSM (men who have sex with men), sex workers and sex workers. It has long entered the heterosexual field, socially adapted, with wives, husbands, families. At some point, people get tested because they feel bad: “Oh, we have HIV. Unexpectedly. There was a case when a young man – married, two children – went to hospital. He was brought by ambulance but he could not walk: he had terminal AIDS. Thanks to our Botkin doctors, who sometimes help out patients even in a very serious condition.

– But that is if there are no concomitant diseases,” adds Alexander. – But if a person has tuberculosis … At first, tuberculosis should be staved off, but as long as tuberculosis is being treated, there is no one left to treat HIV.

– Are there still a lot of HIV-dissidents?

Both my interlocutors nod. They say that a year ago, Russia started shutting down AIDS dissident websites that were writing about HIV being allegedly a conspiracy of pharmaceutical companies, and a number of NGOs addressed the State Duma with a proposal to introduce criminal punishment for AIDS dissidence. But fake information about HIV is still plentiful and it still leads to tragedies.

– The last high-profile case was in Krasnoyarsk in early summer,” says Alexander. – A little girl died there. The child was taken away from her mother, who was HIV-positive, and given to her grandmother, who also turned out to be a dissident. HIV infection has existed for so many years, there are already medical achievements, therapy, people live with it. The government gives you pills for free! Your task is just to take them at a certain time. That’s all. And live your life as you live it. Okay, if you had money taken out of your pocket you could say that it’s a conspiracy of pharmaceutical companies, but here the state takes all of it. What kind of conspiracy is that?

Mikhail points out that in St. Petersburg, the percentage of people who are registered and take therapy, thank God, is growing. But there is data that the incidence of the disease is also increasing, including among teenagers.

– So what to do about it?

– If we want to stop the growth of the infection in the general population, we have to forget about what we are told every day – about ‘crosses’, that there is no sex before marriage,” says Alexander. – It’s better to remove VAT from condoms, put condom machines in student dormitories for free distribution, certify female condoms. Elementary! Then the incidence of disease will go down. Let us at least introduce sex education in high schools, when hormones are kicking in. But no, we’re sitting here discussing television: “I got pregnant at 15. Oh, how did that happen?” And, again, our legislation: the age of consent is 16 and you can only talk about sex from the age of 18.

– That doesn’t mean we want to show pornographic films in school. We should at least tell them that they need to use condoms, and it’s not even about pregnancy, it’s about protecting yourself and your partner,” says Mikhail. – Of course, you have to somehow control who and what you say to immature minds. But now everything is so framed, you have to go through so many certifications to get into the same university. We are already silent about the school. And the university also has to make an application, select a specialist, and the specialist has to confirm his or her qualifications. Previously, universities used to invite NPOs in the areas they were interested in, but now this is practically non-existent.

Before the legislative changes, the rectors of universities often approached Positive Dialogue with requests to give lectures, tell them what HIV is and how to protect themselves from infection, and let them distribute condoms to those who wished to do so. Now all this is a thing of the past.

Mikhail says higher education institutions and teenage and youth centres under district administrations still have a prevention plan. But due to the new laws, the topic of sex may have to be circumvented. It is difficult for specialists to imagine how, especially taking into account that now HIV is sexually transmitted in the overwhelming majority of cases.

– Concerning access to preventive measures of HIV infection: the cheapest condoms cost 50 rubles for three pieces, but their quality leaves much to be desired. The simplest classic condom, which will not fit everyone’s size, is already 150 rubles for three pieces,” says Mikhail. – So what’s a student to do? Fortunately, we are able to replenish our stock and periodically hand out condoms with lubricant for free. It’s important that people get used to not getting it all for free, but to using a condom as such. Yes, there is pre-exposure and post-exposure HIV prevention (special pills that can be taken before or after potentially dangerous sexual contact), but there is still nothing better than a condom at this stage against HIV infection. Pre-exposure prophylaxis is very good, very right, but it does not protect against hepatitis, syphilis and other sexually transmitted infections.

Alexander recalls how Positive Dialogue had a joint project with a Swedish aid organisation many years ago. Colleagues told us that when HIV infection first appeared and became widely discussed, the reaction to people who were positive in Sweden was also harsh. For example, a car owned by an HIV-positive person could be sent straight to a landfill. Now, however, the situations are dramatically different in our countries. In Sweden and other European countries, sex education and all types of prevention, condoms are available and their use is encouraged. In Russia, there is an HIV epidemic, but neither sex education nor prevention is available to the extent needed.

– Prevention programmes in our country are underfunded,” says Mikhail. – But the process is necessary and it has to go on. The official statistics of St. Petersburg Committee on health protection says that there are supposedly only 10 thousand MSM in our six million citizens city. The official statistics on the incidence of disease among MSM is also understated.

Although HIV infection has long ceased to be a disease of exclusively key groups, it is still necessary to work with them and they need a special approach. But underreporting complicates the task, admits Mikhail.

Despite the fact that there are quite a few places in St. Petersburg where you can get anonymous rapid HIV testing, and the new office of Positive Dialogue has only recently opened, people already come here every day. The most recent clients include a couple starting life together and a young man who had a “risky situation”. Fortunately, all the tests were negative. But people who have just found out they are HIV-positive often come too.

Mikhail regrets that Positive Dialogue does not currently have the resources to provide fully qualified psychological help. “Psychological enquiries are coming in sporadically, but so far we have to work in peer counselling mode or refer them to partner support organisations.

– Everything comes down to money,” Mikhail explains. – The help of a competent professional psychologist is not cheap. And you need a whole staff here: the topic is not simple, it involves a lot of experience and different life situations. The specialists themselves are susceptible to burnout, there should be interchangeability, so that a person could be told: “Go for a walk for two weeks, so that no one touches you. Take care of the house, the garden, the garden”. There are situations that are more affecting to whom: to the person who asked for help or to the person who helps. Sometimes the stories are very difficult, especially when it is a newly discovered case. There are so many problems, you understand that they can be solved, but it takes time, you have to go through the stages of acceptance, especially the first and second stages, shock, anger, denial…

Positive Dialogue has literally only a handful of private donations, although the button on the website has been running since 2018. Getting the message across to a wider audience about how important it is to help people with HIV, that anyone of us can become a person with HIV, is very difficult. Grants and fundraising for individual projects help keep the organization going. Now, thanks to the EECA Fund for Operational Assistance to Key Populations of the region, we have managed to find and pay for new premises. In addition to assistance, it is necessary to engage in prevention, purchase and distribute condoms, buy test kits, ideally conduct seminars on adherence to healthy lifestyle and support groups for people with HIV with participation of medical consultants. Positive Dialogue once held lectures on HIV and the law even for doctors at a military medical hospital. The need for dialogue with doctors has not disappeared, but it has become much more difficult to organise such communication.

– As long as HIV doesn’t affect you personally, you stay out of it,” says Mikhail. – But if it has already touched you, you come running with goggling eyes: “Dear God, how can you live further? And it’s even better if a person runs here and not to the river embankment.

Over the past six years alone, Positive Dialogue has reached more than 31,500 people with its HIV prevention programmes. How many people it has helped in difficult situations is incalculable.

Positive Dialogue needs support to be able to fully assist all those in need. Any donation you can make will bring closer the time when the organisation will again have a full-time psychologist and perhaps support someone close to you. The organisation needs money for legal advice to help people who have been harassed at work, blackmailed or tried to leave the country. To do prevention work. So that the words “HIV is not a sentence” are not just words. So that the dialogue between different people, with all their advantages and disadvantages, can remain positive. Please support this organization. We all need it.

Слишком экстремальная помощь. Кто и как защищает людей с ВИЧ в Санкт-Петербурге

Стигматизация, отказ в оказании медицинских услуг, увольнение, депортация — вот лишь некоторые проблемы, с которыми могут столкнуться ВИЧ-инфицированные люди в России. Решать эти проблемы уже 25 лет помогают сотрудники общественной организации «Позитивный диалог»

Тихая улочка в центре Петербурга, двор с ярким граффити — портретом девушки с длинными волосами и текстом Lu Blue. Больше пока никаких надписей.

Михаил Ступишин, руководитель «Позитивного диалога», встречает меня у двери. Несколько ступенек вниз, и мы в светлом кабинете. В это помещение «Позитивный диалог» въехал совсем недавно, до этого организация годами располагалась на территории инфекционной Боткинской больницы.

— Первая четверть XXI века заканчивается, а люди до сих пор с ВИЧ-фобными тараканами в голове, — смеется Михаил, наливая кофе и рассказывая о переезде. — В четырех помещениях нам отказали в связи с родом нашей деятельности. На предварительном просмотре мы объясняли, что нацелены сейчас на индивидуальное консультирование, а не на массовые мероприятия, говорили, что поток клиентов у нас есть, но не как в мавзолей, что мы работаем с социально значимым заболеванием — с ВИЧ-инфекцией. Нам отвечали: «Да-да-да, все замечательно». А когда дело дошло до заключения договора, сказали: «Мы посмотрели на сайте, чем вы занимаетесь. Для нас это слишком экстремально».

Я вспоминаю Анну, героиню моего текста «Анна и ее победы», подопечную «Позитивного диалога». Вот уж что экстремально, так это отношение, с которым она и многие другие люди то и дело сталкиваются из-за ВИЧ-положительного статуса. Например, когда собственная мать, опытный медработник, заставляет дочку есть из отдельной посуды, хотя контактно-бытового способа передачи ВИЧ не существует. Или когда человека не хотят брать на работу из-за ВИЧ-статуса, несмотря на то, что благодаря терапии (бесплатной и доступной) у него уже давно неопределяемая вирусная нагрузка — это значит, что он вообще никак не может никого заразить. Анна рассказывала, что в самых отчаянных жизненных ситуациях звонила в «Позитивный диалог» и благодаря разговору с юристом Александром Лозой не раз решала проблемы с работой, а потом и с учебой.

Александр присоединяется к нам с Михаилом, мы пожимаем друг другу руки и начинаем разговор, который длится больше двух часов, но даже этого времени кажется мало. Проблем, с которыми сталкиваются люди с ВИЧ в России, слишком много.

«Позитивный диалог» начался аж 25 лет назад. Основал его юрист, один из первых зарегистрированных ВИЧ-положительных людей в СССР Николай Панченко. Недавно он отметил 70-летний юбилей, а несколько лет назад передал руководство организации Михаилу Ступишину, но в разговоре имя Панченко то и дело звучит — именно он начал просветительскую работу, рассказывая о профилактике и жизни с ВИЧ. Сейчас делать это так же необходимо, как и четверть века тому назад.

— Саша здесь с 2004 года работает, а я в 2015 году пришел, — рассказывает Михаил. — Тогда начали реализовываться два больших профилактических проекта: профилактика ВИЧ среди мужчин, практикующих секс с мужчинами, и профилактика ВИЧ-инфекции среди секс-работниц. Я пришел по рекомендации знакомого. У меня среднее медобразование. Я не врач, а средний медработник. Анатомию хорошо знаю, патофизиологию хорошо знаю или, по крайней мере, знал, понимаю, откуда какие ноги растут.

Вдобавок к медицинскому образованию Михаил окончил университет культуры, а Александр учился в Санкт-Петербургском государственном университете. Медик и юрист, у обоих большой опыт работы с людьми в сложных жизненных ситуациях.

— Юридическая консультация многим нужна, — говорит Александр. — Не у всех есть деньги на платную консультацию, не все хотят рассказывать о своих специфических проблемах, и не все юристы в этом практикуются.

— Наверное, часто обращаются по вопросам, связанным с работой? — спрашиваю я. Но все оказывается не совсем так, как я себе представляла.

По словам Александра, чаще всего боятся быть уволенными медицинские работники, которые должны ежегодно сдавать обязательные анализы, в том числе на ВИЧ. Но за консультациями обращаются и сотрудники полиции, МЧС: вопреки федеральному законодательству, в этих ведомствах вводят полный запрет на работу для ВИЧ-положительных людей — выпускают локальные акты о прохождении медосмотра и признают негодными или ограниченно годными к службе.

— В таких ситуациях можно что-то сделать?

— Ну вот еще в советское время был принят акт о том, что люди с ВИЧ-инфекцией не могут быть командирами воздушных судов, — Александр вздыхает. — Лет пять или семь назад у одного капитана выявили ВИЧ. Он обратился в Генеральную прокуратуру, Генеральная прокуратура пошла в Верховный суд, и Верховный суд признал этот акт незаконным. Но человек должен был раскрыть перед всеми свой статус. Дело не в суде как таковом — в документах фамилия человека может быть скрыта. Но работодатель зачастую давит на сотрудника, может распространять о нем слухи.

Михаил приводит в пример историю своего знакомого, которого буквально «съели» на работе, в самом обычном офисе, узнав о его ВИЧ-статусе. Судиться в таких ситуациях может быть бесполезно: с юридической точки зрения дело беспроигрышное — увольнение незаконное, но жизни на работе не дадут.

В суд против работодателя люди идут редко, и, как правило, это резонансные дела, которые меняют локальные нормативные акты организации.

— У нас записано в законодательстве, что это дискриминация, что работодатель будет оштрафован, есть уголовная ответственность, — говорит Александр. — Но все это стараются сделать по-тихому: ты уволишься по собственному желанию, тебе выплатят какое-то выходное пособие, и ты уйдешь спокойно (что с тобой будет дальше — твои проблемы), а мы будем белые и пушистые. Я всегда говорю, что борьба за свои права чревата: могут создать такие условия, что человек будет просто вынужден уйти. Постоянный стресс ведь тоже плохо влияет на организм.

В прошлом году, по словам Александра, локальный акт о запрете работы людям с ВИЧ пыталась издать Генеральная прокуратура, но поднялся шум, и ведомству пришлось отказаться от этой идеи. А вот у Министерства путей и сообщения, похоже, ввести локальный запрет получилось.

— В общем, если начинаются проблемы на работе из-за ВИЧ-статуса, единственный выход — искать нормального работодателя?

— У нас «нормального работодателя» как такового нет, — качает головой Александр.

— Тут дело не столько в работодателе, — добавляет Михаил, — сколько в твоем непосредственном руководителе или в высшем руководстве, если речь о его позиции.

Он рассказывает о случаях, когда при приеме на работу у людей без их ведома брали тест на ВИЧ. Практика эта, конечно, незаконная:

— Вопрос с информированием о статусе человека вообще стоит очень жестко: никакого разглашения, только по официальному запросу суда или прокуратуры. Только тогда Центр СПИД обязан предоставить информацию, состоит этот человек на учете или не состоит. Если человек понимает, что никому о своем статусе не говорил, а информация у работодателя появилась, значит попутно, при прохождении медкомиссии, кровь взяли на ВИЧ-инфекцию. Но, по идее, дальнейших телодвижений работодатель делать не может, потому что вся эта история незаконна.

— А еще с какими проблемами обращаются?

— Доступ к медицинским услугам, — ни секунды не раздумывая, отвечает Александр. — Бывает, что человеку предстоит плановая операция, он знает, что он ВИЧ-инфицированный, а в медицинском учреждении его пытаются либо отговорить, либо перенаправить еще куда-нибудь, либо просто положить в платное отделение, хотя для него все должно быть бесплатно по ОМС.

— Пытаются либо деньги содрать, либо вообще отказаться от него, потому что ВИЧ-статус, — обходится без эвфемизмов Михаил.

— Напрямую этого никто не говорит, начинается различная медицинская терминология либо «показания у вас какие-то не те, давайте, может, через годик». В медицинских учреждениях мы всегда рекомендуем просить письменный отказ. То, что врач говорит в коридоре, вы потом нигде никому не сможете доказать. Врач понимает, что, написав такой отказ, подставит сам себя и свое медучреждение. И тогда врачи скорее наденут двойные перчатки и все сделают, скрипя зубами, — уверен Александр.

— И сделают по возможности качественно, чтобы больше не приходил, — смеется Михаил.

— При этом к гепатиту С, который опаснее, все гораздо проще относятся, — недоумевает Александр. — Если сказать дантистам, что у вас гепатит С, врачи отнесутся к этому легче, чем если сказать про ВИЧ.


В медицинских учреждениях, поясняют Александр с Михаилом, зачастую, если человек говорит о своем положительном ВИЧ-статусе, его отсылают в конец очереди. Такая маленькая дискриминация. В помощи не откажут, но примут последним — чтобы после все продезинфицировать. Это притом, что используются одноразовые инструменты или же после каждого пациента все дезинфицируется.

— Вообще у медработников есть инструкции, по которым они в каждом пациенте обязаны подозревать ВИЧ-инфицированного и больного гепатитом С, надевать перчатки и маски в любой ситуации. Но, когда с финансированием проблемы, и перчатки можно спиртом протереть, и еще что-то не сделать.

— А иногда просто идет поток пациентов, и срабатывает просто человеческий фактор.

— Но, если есть риски заболевания, медработников сразу сажают на ПКП — бесплатную постконтактную профилактику. Это приравнивается к производственной травме, — подводит итог Михаил.

Но и медицинскими вопросами юридические обращения не исчерпываются. Люди с положительным ВИЧ-статусом все чаще сталкиваются с шантажом.

— Шантажирует либо бывший сожитель/сожительница, либо бывший супруг/супруга, — поясняет Александр. — Начинают угрожать, что, например, раскроют статус родственникам.

— А с этим можно бороться?

— Если человек опасается этого, он может пойти и написать заявление в полицию, потому что это вмешательство в частную жизнь. Такие заявления обязаны принять, поскольку у нас есть Уголовный кодекс. По заявлению сначала будет проводиться проверка, вызовут одну сторону, потом — вторую. Может быть, на этой стадии шантажирующий человек уже поймет, что зря это делает. Иногда шантажировать пытаются люди, которые сами уже ВИЧ-инфицированы.

— Может быть, оба уже были инфицированы, когда встретились, и боялись друг другу сказать. Мы все боимся, — говорит Михаил. — Это уже к вопросу о самостигматизации, вызванной стигматизацией со стороны общества. Чем дальше в лес, тем сказать партнеру становится сложнее. Недавно у меня была консультация — мы полтора часа проговорили по телефону (у нас в тот момент не было офиса). Парень «плюсанул» (тест оказался положительным), у него есть постоянный партнер, ВИЧ-отрицательный. Клиент говорит: «Я все знаю, все понимаю, понимаю, что с этим живут, и история с таблетками меня не смущает».


Вот эта самостигма появляется благодаря нашей любимой общественности, которая до сих пор считает, что ВИЧ-инфекция — это крах и смерть.

Еще сложнее ситуация, когда ВИЧ-положительный человек — гражданин другого государства. Избежать депортации можно только при наличии близких родственников или супруга/супруги с российским гражданством. Да и поправки про родственников, несколько облегчающие иностранцам жизнь, появились лишь недавно и помогают не всегда.

— По одному случаю пришлось подавать в суд в Москве против Роспотребнадзора, — рассказывает Александр. — Гражданин Украины въехал в Россию. Жена у него россиянка. Суд отменил решение Роспотребнадзора о нежелательности пребывания на территории РФ. Недавно звонила супруга того человека, сказала, что ему нужно продлевать или получать новый вид на жительство, а полиция ему на основании ВИЧ-статуса отказывает. Требуют справку от Центра СПИД о том, что он состоит там на учете, а в Центре СПИД говорят: «Мы не возьмем его на учет, потому что он иностранный гражданин». Все равно возникают юридические препоны.

— А если нет близких родственников — граждан РФ?

— Иностранец подлежит депортации. На территории СНГ только два государства все еще депортируют граждан с ВИЧ: Россия и Армения. Остальные признали, что это неопасно, да и иностранец сам, зная о том, что у него ВИЧ, бежит в ближайший Центр СПИД и встает там на учет, чтобы получать терапию за деньги, потому что он сам в этом заинтересован, потому что тогда у него будет нормальная жизнь, работа и финансы, чтобы себя содержать.

— О том, с каким уровнем стигматизации могут сталкиваться мигранты с ВИЧ, даже думать страшно. Откуда вообще такое неприятие ВИЧ-положительных людей, мигрантов и россиян? От невежества?

— Сейчас очень много информации, организаций, сайтов, информационное пространство очень расширилось. Люди сами могут все найти и прочитать. Но кто этим интересуется? Целевая группа, люди, которые уже стали носителями ВИЧ, — рассуждает Александр.

— Стигматизация связана в первую очередь с кромешной неосведомленностью о том или ином заболевании, — уверен Михаил. — У меня есть ряд знакомых, которые до сих пор думают, что ВИЧ-инфекцией можно заразиться, испив из одной чашки. Спидофобия, или ВИЧ-фобия, идет в первую очередь от неосведомленности. Сейчас половой способ передачи ВИЧ преобладает. ВИЧ-инфекция уже давным-давно вышла за пределы так называемых ключевых групп: потребителей инъекционных наркотиков, МСМ (мужчин, практикующих секс с мужчинами. — Прим. ТД), секс-работников и секс-работниц. Она уже давно вышла в гетеросексуальное поле, социально адаптированное, с женами, мужьями, семьями. В какой-то момент люди сдают анализы, потому что им плохо: «Ой, у нас ВИЧ-инфекция». Неожиданно. Был случай, когда в больницу попал молодой мужчина — женат, двое детей. Его привезли на скорой, он не мог ходить — СПИД, терминальная стадия. Спасибо нашим боткинским врачам, которые иногда вытягивают пациентов даже в очень тяжелом состоянии.

— Но это если нет сопутствующих заболеваний, — дополняет Александр. — А если у человека туберкулез… Сначала надо «забить» туберкулез, но, пока лечат туберкулез, уже и лечить от ВИЧ становится некого.

— А ВИЧ-диссидентов по-прежнему много?

Оба моих собеседника кивают. Говорят, что год назад в России стали закрывать сайты СПИД-диссидентов, писавших о том, что ВИЧ — это якобы заговор фармкомпаний, а ряд общественных организаций обратились в Госдуму с предложением ввести уголовное наказание за СПИД-диссидентство. Но фейковой информации о ВИЧ по-прежнему много, и это по-прежнему приводит к трагедиям.

— Последний резонансный случай был в Красноярске в начале лета, — говорит Александр. — Там умерла маленькая девочка. У мамы, ВИЧ-диссидентки, отняли ребенка, передали бабушке, а та тоже оказалась диссиденткой. ВИЧ-инфекция существует уже столько лет, уже есть достижения медицинские, терапия, люди с ней живут. Вам государство бесплатно дает таблетки! Ваша задача — просто их принять в определенное время. Всё. И живите как живете. Ладно если бы у тебя из кармана вынимали деньги, ты мог бы сказать, что это заговор фармкомпаний, но здесь-то государство все берет на себя. Какой тут заговор?

Михаил отмечает, что в Петербурге процент людей, состоящих на учете и принимающих терапию, слава богу, растет. Но есть данные, что и заболеваемость тоже растет, в том числе в подростковой среде.

— И что с этим делать?

— Если мы хотим остановить рост инфекции в общей популяции, мы должны забыть о том, о чем нам каждый день говорят, — о «скрепах», о том, что нет никакого секса до брака, — говорит Александр. — Лучше уберите НДС с презервативов, поставьте в студенческих общежитиях кондоматы для бесплатной их раздачи, сертифицируйте женские презервативы. Элементарно! Тогда пойдет снижение заболеваемости. Давайте хотя бы в старших классах вводить сексуальное просвещение, когда гормоны вовсю идут. Но нет, сидим, обсуждаем телевизор: «Забеременела в 15 лет. Ах, как же это случилось?» И, опять-таки, наше законодательство: возраст согласия — с 16 лет, а разговаривать о сексе можно только с 18 лет.

— Это не значит, что мы хотим показывать в школе порнографические фильмы. Надо рассказывать хотя бы, что нужно использовать презервативы, и дело даже не в беременности, а в том, что нужно обезопасить себя и своего партнера, — говорит Михаил. — Конечно, каким-то образом нужно контролировать, кто и что будет глаголать неокрепшим умам. Но теперь все поставлено в такие рамки, нужно пройти столько сертификаций, чтобы прийти в тот же вуз. Про школу мы уже вообще молчим. И вуз тоже должен сделать заявку, подобрать специалиста, а специалист должен подтвердить свою квалификацию. Раньше вузы приглашали НКО по тем направлениям, которые их интересуют, теперь этого практически не происходит.

До законодательных новшеств в «Позитивный диалог» нередко обращались ректораты вузов: просили провести лекции, рассказать о том, что такое ВИЧ, как предохраняться от инфекции, позволяли раздавать презервативы желающим. Сейчас все это осталось в прошлом.

Михаил говорит, что у вузов и подростково-молодежных центров при районных администрациях по-прежнему есть план профилактических мероприятий. Но в связи с новыми законами тему секса, видимо, придется обходить. Как — представить специалистам сложно, особенно учитывая, что сейчас ВИЧ в подавляющем большинстве случаев передается именно половым путем.

— К вопросу о доступе к профилактическим мерам по ВИЧ-инфекции: у нас самые дешевые презервативы стоят 50 рублей за три штуки, но качество у них оставляет желать лучшего. Простейший классический презерватив, который не всем подойдет по размеру, — уже 150 рублей за три штуки, — говорит Михаил. — И что делать тому же самому студенту? У нас, к счастью, есть возможность пополнять запас и периодически раздавать презервативы с лубрикантами бесплатно. Важно, чтобы люди привыкли не к тому, чтобы получать это все бесплатно, а к использованию презерватива как такового. Да, есть доконтактная и постконтактная профилактика ВИЧ (специальные таблетки, которые можно принять до или после потенциально опасного сексуального контакта), но все равно лучше презерватива на данном этапе против ВИЧ-инфекции ничего не придумали. Доконтактная профилактика — это очень хорошо, очень правильно, но от гепатитов, сифилиса и других инфекций, передающихся половым путем, она не защищает.

Александр вспоминает, как много лет назад у «Позитивного диалога» был совместный проект со шведской помогающей организацией. Коллеги рассказывали, что, когда ВИЧ-инфекция только появилась и стала широко обсуждаться, реакция на людей с положительным статусом в Швеции тоже была жесткой. Например, автомобиль, который принадлежал ВИЧ-положительному человеку, могли отправить прямиком на свалку. Зато сейчас ситуации в наших странах различаются кардинально. В Швеции, да и в других европейских странах, доступны секс-просвещение и все виды профилактики, презервативы, их использование поощряется. В России эпидемия ВИЧ — при этом нет ни секс-просвещения, ни профилактики в нужном объеме.

— У нас программы профилактики мало финансируются, — говорит Михаил. — А процесс нужен, он должен идти. Вот официальная статистика нашего петербургского комитета по здравоохранению: на наш шестимиллионный город якобы всего 10 тысяч МСМ. Официальная статистика по заболеваемости среди МСМ тоже занижена.

Хотя ВИЧ-инфекция уже давно перестала быть болезнью исключительно ключевых групп, работать с ними по-прежнему нужно, им необходим особый подход. Но заниженная статистика серьезно усложняет задачу, признается Михаил.

Несмотря на то что в Петербурге немало мест, где можно анонимно пройти экспресс-тестирование на ВИЧ, и новый офис «Позитивного диалога» работает совсем недавно, сюда уже приходят каждый день. Из последних клиентов — пара, начинающая совместную жизнь, и молодой человек, у которого произошла «рискованная ситуация». К счастью, все тесты оказались отрицательными. Но часто обращаются и люди, только что узнавшие о положительном ВИЧ-статусе.

Михаил сожалеет, что сейчас у «Позитивного диалога» нет ресурсов для того, чтобы оказывать полноценную квалифицированную психологическую помощь. «Психологические» обращения идут через раз, но пока работать приходится в режиме равного консультирования или перенаправлять в партнерские помогающие организации.

— Все упирается в деньги, — поясняет Михаил. — Помощь грамотного профессионального психолога стоит недешево. Да и здесь нужен целый штат: тема непростая, связана с большими переживаниями, разными жизненными ситуациями. Сами специалисты подвержены выгоранию, здесь должна быть взаимозаменяемость, чтобы человеку можно было сказать: «Иди погуляй недели две, чтобы тебя никто не трогал. Занимайся домом, садом, огородом». Бывают ситуации, которые даже непонятно на кого сильнее действуют: на человека, который обратился за помощью, или на человека, который помогает. Иногда истории очень сложные, особенно когда это вновь выявленный случай. На тебя вываливается столько проблем, понимаешь, что их можно решить, но нужно время, нужно пройти стадии принятия, особенно первую и вторую, шок, гнев, отрицание…

Частных пожертвований у «Позитивного диалога» буквально единицы, хотя кнопка на сайте работает с 2018 года. Донести до широкой аудитории мысль о том, как важно помогать людям с ВИЧ, о том, что человеком с ВИЧ может стать любой из нас, очень сложно. Держаться организации помогают гранты, привлечение финансов на отдельные проекты. Вот сейчас найти и оплатить новое помещение получилось благодаря Фонду оперативной помощи ключевым группам населения региона ВЕЦА. А, помимо помощи, нужно заниматься и профилактикой, закупать и распространять презервативы, закупать тест-системы, в идеале еще проводить семинары по приверженности здоровому образу жизни, группы поддержки для людей с ВИЧ с участием медицинских консультантов. Когда-то «Позитивный диалог» проводил лекции по теме «ВИЧ и право» даже для врачей военно-медицинского госпиталя. Потребность в диалоге с врачами никуда не делась, только организовать такое общение стало гораздо сложнее.

— Пока ВИЧ не касается тебя лично, ты в это дело не лезешь, — говорит Михаил. — А если уже коснулось, то прибегаешь с выпученными глазами: «Боже-боже, как жить дальше?» И это еще хорошо, если человек сюда прибегает, а не на набережную реки.

Только за последние шесть лет работы «Позитивный диалог» охватил своими программами профилактики ВИЧ более 31,5 тысячи человек. Скольким людям он помог в трудной ситуации, подсчету не поддается.

Чтобы полноценно оказывать помощь всем, кто в ней нуждается, «Позитивному диалогу» нужна поддержка. Любое посильное пожертвование приблизит то время, когда в организации снова появится штатный психолог и, возможно, поддержит близкого вам человека. Организации нужны деньги на юридические консультации, чтобы помогать людям, которых притесняют на работе, шантажируют или пытаются выслать из страны. Чтобы вести профилактическую работу. Чтобы слова «ВИЧ — не приговор» были не просто словами. Чтобы диалог между самыми разными людьми со всеми их плюсами и минусами оставался все-таки позитивным. Пожалуйста, поддержите эту организацию. Она нужна нам всем.

US: Decriminalising HIV would protect disadvantaged communities from HIV infection and further marginalisation

HIV criminalization perpetuates intersecting forms of discrimination

Imagine you are a transgender Black woman in Florida. You are already facing housing and workplace discrimination, gender-based violence and social and institutional racism. One of your few options for financial support is sex work, but you do not plan to have intercourse with clients. Unfortunately, a sting operation leads you to be taken to the police station. You wonder why the cisgender white woman you work alongside was not caught. Upon arrival at the station, you are forced to get tested for HIV. You test positive. You are now a convicted felon and may have to register as a sex offender.

This fictional narrative illustrates the severity of the criminalization of HIV in the United States and is an accurate representation of the discrimination felt by LGBT, non-white individuals, sex workers and those who experience the intersectional disenfranchisement of multiple identities. According to Avert Global Information and Education on HIV and AIDS, transgender people are 49 times more likely to be affected by HIV than the general world population. Over half a million Americans have died since the beginning of the AIDS epidemic in the 1980s. A disproportionate number of these people were non-white, LGBT or both. By looking at the Movement Advancement Project’s maps of states with HIV laws, 34 states still discriminated against those with HIV in 2020, with transgender women being the most globally discriminated against. HIV should be nationally decriminalized since the penalties only further marginalize disadvantaged communities.

A 2017 article by the National LGBT Task Force and the Center for HIV Law & Policy states that transgender sex workers are “nearly six times as likely to be living with HIV than the general trans population, and 25 times as likely relative to the general population.” Transgender women, especially those who are non-white, are profiled significantly more for sex work.The data illustrates how transgender women are more at risk of being presumed HIV positive, which perpetuates transphobic, homophobic, sexist and racist discriminatory practices.

Some may argue that decriminalizing HIV will lead to an increase in cases. In fact, data has been shown that HIV criminalization laws disincentivize HIV testing. This is because in some states, it is mandatory that the arrestee be tested once entering the police station. A 2015 study by Yang, et al. found that the decriminalization of sex work could actually reduce 33-45% of new HIV infections, illustrating the counterproductive attributes of HIV criminalization. Data has also shown that HIV penalties are significantly based on one’s race and sex, which caused the state of California to change HIV charges of sex workers from felonies to misdemeanors. While this change in California is an improvement, officials can still discriminate based on race, sexual orientation and gender identity. Overall, this illustrates that the criminalization of HIV is maintained in order to keep a discriminatory social hierarchy that hurts transgender women’s social mobility, especially Black transgender women.

The differences of prosecution among states is important because data shows that transgender women can be prosecuted for even non-transmissible actions. Data by the Movement Advancement Project shows 17% of the American LGBT population lives in a state where there is an HIV criminalization law, HIV-specific sentencing and/or laws that may require individuals to register as sex offendes; 35% lives “in a state with a HIV criminalization law;” and 21% in a state without a HIV criminalization law but where a positive status does affect sentencing. Liberal states, such as Massachusetts, criminalize exposure to, as well as transmission of, HIV. Sex workers can be charged with a felony for spitting or biting — even though neither action spreads HIV. This further shows that states have multiple avenues to discriminate against marginalized groups through the criminalization of HIV. The evidence illustrates the need to decriminalize HIV on a national level to protect marginalized communities, especially  transgender women, transgender women of color and Black transgender women. By decriminalizing HIV, Americans are further protected from infection and forms of discrimination.

Year in review: Celebrating successes, highlighting the many challenges ahead

This past year has shown us what happens when one pandemic –  HIV – is overshadowed by another pandemic, COVID-19.  Despite the many lessons learned from our collective advocacy against HIV criminalisation that we and our HIV JUSTICE WORLDWIDE partners highlighted in March, these lessons were mostly ignored by policymakers around the world.

The result was a series of knee-jerk legal, policy and police responses leading to the overzealous policing of people living with HIV and other key and inadequately served populations already subject to existing inequalities in law and policy, which we have been highlighting in our HIV Justice Weekly newsletter since March.

This latest pandemic overshadowed, and in some cases undermined, the work we and others have been doing to ensure a fair, just, rational and evidence-based response towards people living with HIV by the criminal justice system.

This past year we documented at least 90 cases of unjust HIV criminalisation in 25 countries, with Russia and the United States being the worse offenders.  Women living with HIV were accused in 25% of those cases. Three of these cases were for breastfeeding.  In the United States, more than 50% of those accused in HIV criminalisation cases were people of colour.  

2020 also saw Poland passing a new law against COVID-19 that also increased the criminal penalty for HIV exposure, and number of disappointing HIV criminalisation higher court appeals in the US (Ohio), and Canada (Ontario and Alberta) that appeared to ignore science over stigma.

And yet, despite the many difficulties of 2020, the movement to end unjust HIV criminalisation has continued to gain momentum.

In the United States, Washington State modernised its HIV-specific criminal law in March, reducing the ‘crime’ from a felony to a misdemeanour, adding in a number of defences, and eliminating the sex offender registration requirement.  Earlier this month, legislators in Missouri published plans to modernise its HIV-specific criminal law next year.

In Europe, Sweden abolished the legal requirement to disclose HIV status in March, the Spanish Supreme Court set an important precedent for HIV criminalisation cases in May, and in June, Scottish police ended the stigmatising practice of marking people living with HIV as ‘contagious’ in their database.

In Francophone Africa, HIV-specific criminal law reform in Benin and across the region is looking likely thanks to a recognition that existing laws do not reflect up-to-date science.

And in Eastern Europe and Central Asia, a process to completely abolish the draconian HIV-specific criminal law in Belarus has begun.

There is still so much more to do, however.  Despite these successes, as well as the many milestones the HIV JUSTICE WORLDWIDE movement has achieved since its launch in 2016, we will not rest until everyone living with HIV in all their diversity is treated equally, fairly and justly by all actors of the criminal justice system.

Uganda: HIV activists ask government to review the HIV/AIDS law and remove clauses that criminalise HIV

Activists, chief justice call for review of HIV/AIDS law

By Betty Amamukirori, John Masaba

The majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status.

HIV/AIDS activists have asked the Government to review the HIV and AIDS Prevention and Control Act 2014, saying it is fuelling stigma and discrimination.

The activists, while speaking at the Philly Bongole Lutaaya memorial lecture, said the law has clauses in it that if left unchanged could undo the country’s gains in the fight against the disease.

Dora Musinguzi, the executive director of Uganda Network on Law and Ethics (UGANET), said clauses that criminalise HIV, especially intentional transmission are causing more harm because it’s scaring people away from testing, disclosing their status to the spouses or seeking treatment.

She pointed out clauses such as sections 41 and 43 which spell out punishments for attempted transmission of HIV and intentional transmission, respectively.

“We need to do everything it takes to repeal this law, especially the punishment for exposure to HIV/AIDS. We need to remove the criminalisation under the law because it is causing more harm,” Musinguzi said.

The activists said the majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status to their significant others for fear of prosecution. This, they said, has fuelled self-stigma.

Justice Alfonse Owiny-Dollo, in his keynote address as the guest speaker, agreed that the law needs to be amended if Uganda is to achieve its goal of ending the AIDS epidemic by 2030. His address was read by the Judiciary’s Chief Registrar, Sarah Langa.

Owiny-Dollo called on Parliament to enact and review laws that will improve the wellbeing of the society especially the people living with HIV.

“The HIV and AIDS Prevention and Control Act 2014 may need to be reviewed,” he said.

“Ending HIV requires enabling legal and social environments that guarantee the health, dignity and security of all people living with or at risk of HIV. This is the only way to ensure that all those in need of HIV prevention, treatment, care, and support have access to these services without fear of discrimination, exclusion or bias,” Owiny-Dollo said.

He said much as there are enabling laws on non-discrimination on the basis of one’s HIV status, the HIV-positive still face limitations when seeking justice. These include lengthy proceedings and an unfriendly court environment.

The lecture was held under the theme Access to HIV services during COVID-19 pandemic. It was held at the Office of the President auditorium and was notably attended by the late Lutaaya’s children, friends, activists, musicians living with HIV. The HIV prevalence is 6.2% amongst adults aged 15-64 years; 7.6% in women and 4.7% in men.

Tezra Lutaaya, a daughter of the deceased, said although her father championed the fight against the disease, stigma and discrimination against HIV-positive persons is still rife.

“I strongly believe that an end to HIV is in sight if we continue to fight stigma, make sure seamless information and access to all interventions are available and that we continue to have dialogue with the young people both infected and affected by HIV,” she said.

Esther Mbayo, the Minister for the Presidency, said if AIDS is to be ended by 2030, there is need to exhibit the spirit of Philly Lutaaya.

“We need to get out of our comfort zones, especially now that we are dealing with two pandemics — HIV and COVID-19. On an individual level, we need to test for HIV with our partners and together irrespective of the results, decide to prevent HIV,” she noted.

She called for deliberate efforts to reach those at most risk of getting infected with HIV in order to reduce the high HIV prevalence and towards ending stigma and discrimination.

Owiny-Dollo urged the Government to prioritise creating awareness, promoting advocacy that reaches the young people and all generations with messages on HIV and AIDS.

We Are People, Not Clusters! Why public health surveillance using blood taken for HIV resistance testing risks doing more harm than good

by Edwin J Bernard, HJN’s Executive Director

A series of articles and editorials in the October 2020 issue of the American Journal of Bioethics published last Friday examine a growing concern amongst community leaders of people living with HIV and our scholarly allies: the use of blood taken from people living with HIV during routine testing prior to starting or changing antiretroviral therapy in surveillance databases, without our permisssion, for public health purposes. 

This is already taking place across the United States and in some Canadian provinces, and is currently being considered elsewhere in the world.

The rollout of so-called ‘molecular HIV surveillance’ to identify ‘clusters’ of transmissions to attempt to further improve public health responses to HIV is a growing source of anxiety and concern for people living with HIV in the US and Canada, especially for people who are already marginalised and criminalised in other ways, because they can’t be certain that this data won’t be shared with law enforcement or immigration authorities, which can lead to prosecution and/or deportation.

Coming to Facebook Live on 30th September – HIV Justice Live! Whose Blood is it, Anyway?  Like or follow us on Facebook to watch and participate in the first of our new interactive webshows, which will focus on molecular HIV surveillance.


In our lead guest editorial, entitled ‘We Are People, Not Clusters!’ which I co-authored with Alexander McClelland, Barb Cardell, Cecilia Chung, Marco Castro-Bojorquez, Martin French, Devin Hursey, Naina Khanna, Brian Minalga, Andrew Spieldenner, and Sean Strub, we support the concept of “HIV data justice” put forth in the lead target article, by Stephen Molldrem and Anthony Smith, Reassessing the Ethics of Molecular HIV Surveillance in the Era of Cluster Detection and Response: Toward HIV Data Justice.

“HIV data justice draws on the collective resources of the HIV/AIDS movement to build new alliances aimed at providing affected individuals and communities with greater control over how their data are utilized in the healthcare system, with the paired aim of providing them with greater access to better services on terms of their own choosing.”
Molldrem and Smith


In the editorial, we welcome Molldrem and Smith’s critique of the controversial rollout of molecular HIV surveillance (MHS) in the United States, which explores three intersecting concerns:

(1) the non-consensual re-purposing of personal health information and biomaterial for public health surveillance;

(2) the use of molecular HIV surveillance data in larger databases to find ‘clusters’ of infections and to make determinations about transmission directionality, and the criminalising implications that follow such determinations; and

(3) the way MHS amplifies the targeting and stigmatisation of already oppressed and marginalized communities.

The editorial questions the rationale behind the use of MHS as one of four pillars of the US Centres for Disease Control (CDC) End The Epidemic (ETE) Plan and calls for the abolition of molecular HIV surveillance in the United States as it is currently being rolled out by the CDC because it blurs the boundaries between consent and criminalisation.

Instead, we envision a future of new participatory and intersectional racial and viral justice possibilities, one which ensures the lives, voices, self-determination, and autonomy of people living with HIV are central to HIV research and public health practice.

Further reading

Bryn Nelson. Questioning the Benefits of Molecular Surveillance. POZ Magazine, July-August 2020.

US: “Institutionalized discrimination gives people a reason to avoid getting tested or having open conversations around the disease”

The HIV Pandemic Is Still Raging—and Won’t Stop Until We End the Stigma

One of the hardest lines I’ve ever had to deliver was, “I’m going to die.” It was the initial response of my character Ricky after being diagnosed with HIV during the height of the epidemic in season two of the 1990s drama POSE.

Ricky, like me, is a young Black queer man. I, the actor, had to contend with how true this statement must have felt for him, because an HIV diagnosis was largely a death sentence in 1990. Today, despite all the advances in science and medicine, as a Southerner, I am more likely than the average American to contract HIV, less likely to receive treatment, and more likely to die from HIV.

Tens of thousands of people are diagnosed every year, and in some states, annual diagnoses are on the rise. This is particularly true in the South, which accounts for 51 percent of HIV diagnoses despite only making up 38 percent of the U.S. population. There is a level of complacency around HIV that troubles me. Most people don’t understand that we’re still in the midst of the HIV epidemic.

It is true that HIV is no longer a death sentence, but fear, misinformation, and shame surrounding the disease remain and make the epidemic harder to contain. Stigma makes it harder to educate people about the disease, and stops people from seeking crucial treatment that saves lives and prevents its spread.

Americans are still seriously misinformed about HIV. The GLAAD and Gilead Science’s ‘State of HIV Stigma’ Survey found that the public’s knowledge of HIV is dangerously inaccurate and that they hold significant feelings of stigma towards people living with the disease. According to their study, only 60 percent of Americans believe that “HIV is a medical condition that can be treated,” despite the fact that drugs treating HIV have been on the market for over a decade. Even more troubling, nearly 6 in 10 Americans wrongfully believe that “it is important to be careful around people living with HIV to avoid catching it.”

Scientists have proven that HIV cannot be passed through healthy, unbroken skin, and people with HIV who take HIV medicine as prescribed and keep an undetectable viral load have virtually no risk of sexually transmitting HIV to their HIV-negative partners. Yet, this is not widely understood by the public and contributes to more people unnecessarily contracting the disease. A study in Toronto, where HIV is criminalized, found that men who had sex with men were less likely to get tested because of the laws, creating an exponential 18.5 percent increase in HIV transmission.

Around the same time Ricky found out he had HIV, I was born in Florida, a state that still criminalizes HIV and uses the law to punish people and perpetuate stigma. Engaging in consensual sex or donating blood or organs without disclosing one’s HIV status is a third-degree felony in the Sunshine State. This could lead to five years in prison and a $5,000 fine. Florida isn’t alone; today 34 states have HIV-specific criminal laws or sentence enhancements that apply to people living with HIV. This kind of institutionalized discrimination gives people a reason to avoid getting tested or having open and honest conversations around the disease.