Colombia: Constitutional court to examine whether the law criminalising HIV transmission is discriminatory

Source: El Tiempo, April 27, 2019 – Google translation, for article in Spanish, please scroll down.

Is Penalising HIV infection discriminating?

Should a person who transmit HIV or hepatitis B go to jail for 6 years? That is the debate that the Constitutional Court will have to settle in the coming days, by resolving a lawsuit against the law that criminalizes the transmission of these diseases.

The plaintiff considers that Article 370 of the Criminal Code violates the rights to equality and restricts the free development of personality, in particular, sexual freedom. This law establishes that there will be imprisonment of 6 to 12 years for those who, knowing that they have HIV or hepatitis B, “perform practices through which they may contaminate another person, or donate blood, semen, organs or, in general, anatomical components”

According to the lawsuit, this penalizes the fact that a person living with these diseases has sex, and makes it a crime regardless of whether preventive measures, such as antiretroviral treatments and others, are taken that make the transmission of diseases unlikely.

Thus, the plaintiff says that although the purpose of this mechanism is to protect public health, this does not justify prohibiting a population group from freely expressing their sexuality, and adds that there would be no harm when there are consensual relationships in which measures are taken to prevent infections.

On the violation of equality, the plaintiff says that the article only refers and penalizes people with HIV or hepatitis B, and not others with potentially contagious and sensitive diseases.

The debate is broad, in total the Court received 15 statements of opinion from different organizations, ministries, universities, and even the Constitutional Court of South Africa, to feed its considerations. And there are almost as many arguments in favour as there are against.

For example, the Colombian Anti-AIDS League supported the demand because it considered that rights were violated, adding that laws that criminalize exposure to HIV leave the burden of prevention to the people who live with it and said that the real challenges are more education and better access to medical testing services and counselling

The statement sent by Edwin Cameron, magistrate of the Constitutional Court of South Africa and who lives with HIV since 1985, points out the harm of criminalizing people living with HIV, as it increases the stigma and makes it harder for them to dare to seek medical help and prevention information

He also said that to resort to norms that criminalize HIV, the UN recommends to governments that they address only those who intentionally spread the virus and concluded that if the goal is to safeguard public health, it is more effective to have better prevention and care programmes.

The statement sent by the Ministry of Justice gives the plaintiff reason that the rule is discriminatory because it is directed only to people with HIV – who have also been recognized as subjects of special constitutional protection – or hepatitis B and adds that there is no justification for the rule to be for people with these two diseases and not for others who are aware of having different infectious-contagious diseases

However, with regard to the restriction on sexual freedom, the Justice Department considered that the rule “does not violate the right to the free development of personality, but is limited to establishing the criminal consequences resulting from its abusive and harmful exercise against the rights of other people and the community “ For all this, it asks the Court to study the lawsuit and decide.

The Ministry of Health indicated, on the contrary, that the rule does not violate either the right to equality or the free development of the personality, but rather that the demand is based on an inference from the plaintiff that this restricts sexual freedom, and therefore asks to leave the rule as it is.

The Attorney General agrees that the plaintiff interpretation is that the law punishes the fact of having sex even when there is no transmission of the disease, which, says the Public Ministry, is not true. For the Attorney General’s Office, the rule is clear that in order for the offense to be established there must be an intention to cause harm by carrying out practices that could end in transmission. Because of this, the reasons for the claim are not valid and the Court is being asked not to study it and declare itself inhibited

In any case, the decision will be made by the Court, the lawsuit was handed over to Judge Cristina Pardo, who has already made a presentation that will be debated in the next few days by the Court’s full chamber.


¿Penalizar el contagio de VIH es discriminar?

Demanda dice que tipificar la propagación del virus discrimina a personas con VIH o hepatitis B.

Por: María Isabel Ortiz Fonnegra

27 de abril 2019 , 08:00 p.m.

¿Debe ir a la cárcel por 6 años una persona que contagie a otra de VIH o hepatitis B? Ese es el debate que deberá zanjar la Corte Constitucional en los próximos días, al resolver una demanda contra la ley que penaliza la propagación de estas enfermedades.

El demandante considera que el artículo 370 del Código Penal vulnera los derechos a la igualdad y restringe el libre desarrollo de la personalidad, en particular, la libertad sexual. Esta ley establece que habrá prisión de 6 a 12 años para quien, sabiendo que tiene VIH o hepatitis B, “realice prácticas mediante las cuales pueda contaminar a otra persona, o done sangre, semen, órganos o en general componentes anatómicos”.

De acuerdo con la demanda, esto penaliza el hecho de que una persona que viva con estas enfermedades tenga sexo, y lo convierte en delito sin importar si se toman las medidas preventivas que hacen improbable la transmisión de enfermedades, como tratamientos antirretrovirales y otros.

Así, el demandante dice que aunque el fin de esta media es proteger la salud pública, esto no justifica prohibirle a un grupo poblacional expresar libremente su sexualidad, y agrega que no habría afectación cuando se tienen relaciones consensuadas en las que se toman medidas para prevenir contagios.

Sobre la vulneración a la igualdad, dice que el artículo solo se refiere y penaliza a personas con VIH o hepatitis B, y no a otras con enfermedades también potencialmente contagiosas y delicadas.

El debate es amplio, en total la Corte recibió 15 conceptos de diferentes organizaciones, ministerios, universidades, e incluso de la Corte Constitucional de Sudáfrica, para alimentar sus consideraciones. Y hay casi tantos argumentos a favor como los hay en contra. 

Por ejemplo, la Liga Colombiana de Lucha contra el Sida apoyó la demanda pues consideró que sí se vulneran los derechos, agregó que leyes que penalizan la exposición al VIH dejan toda la carga de la prevención a las personas que viven con él y dijo que los verdaderos desafíos son más educación y mejor acceso a servicios de pruebas médicas y consejería.

El concepto enviado por Edwin Cameron, magistrado de la Corte Constitucional de Sudáfrica y quien vive con VIH desde 1985, señala los perjuicios de criminalizar a las personas que viven con esa enfermedad, pues incrementa el estigma y hace más difícil que se atrevan a buscar ayuda médica e información sobre prevención. 

También dijo que de recurrir a normas que criminalicen el VIH, la ONU recomienda a los gobiernos que estas se dirijan solo a quienes intencionalmente propagan el virus y concluyó que si el objetivo es salvaguardar la salud pública, es más efectivo tener mejores programas de prevención y atención.

El concepto enviado por el Ministerio de Justicia le da la razón al demandante en que la norma es discriminatoria pues está dirigida únicamente a personas con VIH –que además han sido reconocidas como sujetos de especial protección constitucional– o hepatitis B y agrega que no se advierte justificación para que la norma sea para personas con esas dos enfermedades y no para otras que son conscientes de tener enfermedades infectocontagiosas riesgosas distintas. 

Sin embargo, frente a la restricción a la libertad sexual, la cartera de Justicia consideró que la norma “no vulnera el derecho al libre desarrollo de la personalidad, sino que se limita a establecer las consecuencias penales que acarrea su ejercicio abusivo y lesivo frente a los derechos de las demás personas y la comunidad”. Por todo esto, le pide a la Corte que estudie la demanda y decida.

El Ministerio de Salud indicó, al contrario, que la norma demandada no vulnera ni el derecho a la igualdad ni el libre desarrollo de la personalidad, sino que la demanda se basa en una inferencia del accionante de que esto restringe la libertad sexual, por lo que pidió dejar la norma tal y como está.

La Procuraduría coincide en que el demandante interpreta que la norma castiga el hecho de tener sexo aun cuando no exista transmisión de la enfermedad, lo cual, dice el Ministerio Público, no es cierto. Para la Procuraduría, la norma es clara en que para que se configure el delito debe existir una intención de causar daño realizando prácticas que podrían terminar en contagio. Por esto, las razones para la demanda se caen y le pidió a la Corte no estudiarla y declararse inhibida.

En todo caso, la decisión será de la Corte, la demanda le correspondió por reparto a la magistrada Cristina Pardo, quien ya hizo una ponencia que será debatida en los próximos días por la sala plena de la Corte.

Kazakhstan: Women living with HIV submit report to CEDAW, recommending repeal of HIV criminalisation provision in Kazakhstan penal code

Source: EWNA, published on March 11, 2019

For the first time, HIV+ women in Kazakhstan submitted a shadow report to CEDAW 

Today in Geneva, at the pre-sessional working group of the 74th meeting of the UN Committee on the Elimination of All Forms of Discrimination against Women (CEDAW) , representatives of the community of women living with HIV, women who use drugs and sex workers from Kazakhstan presented for the first time a shadow report from civil society on rights situations for women from key groups.

In July 2018, civil society organizations submitted the Shadow Civil Society Report on Discrimination and Violence against Women Living with HIV, Women Using Drugs, Sex Workers and Women from Prisons, to the UN Committee on the Elimination of All Forms of Discrimination against women. The report is based on studies of cases of violation of rights registered by non-governmental organizations in 2015-2017. The full report is available on the EZSS website, in Russian and English .

Here is the text of the oral statement presented by Lyubov Vorontsova, Kazakhstan Union of People Living with HIV (english text below):

“Thank you, Madam Chair.

I am a woman living with HIV from Kazakhstan and I represent the voices of women from my community.

We consider it extremely important to solve the problems of institutionalized discrimination that violates the rights of women and impedes access to health and social services, as well as contribute to social and economic vulnerability.

Women living with HIV have limited access to residential services in existing crisis centers designed to help women affected by violence. In the capital of Kazakhstan, a young girl with a child who was abused by her husband in winter is refused to be placed in an orphanage, since there is such a law and she has HIV. Article 118 of the Criminal Code of Kazakhstan provides for criminal penalties for putting people at risk of HIV infection, which has the opposite effect – this contributes to a higher risk of HIV infection, violence and gender inequality in the family, in the health care system, in society.

According to a study of the Stigma Index, 24.2% of women living with HIV, medical workers forced to terminate a pregnancy (abortion), 34% of women living with HIV never received advice on reproductive opportunities.

We recommend:

  • Revise Article 118. “Infection with Human Immunodeficiency Virus (HIV / AIDS)” of the Criminal Code of the Republic of Kazakhstan dated July 3, 2014 No. 226-V SA-RC to abolish the provision criminalizing the risk of acquiring HIV
  • To set up offices in crisis centers to work with drug addicts and HIV-positive women. Mobilize state efforts to expand the network of crisis centers and other emergency services for women who have experienced domestic violence, and to ensure adequate public funding for these institutions.
  • Introduce changes to the Order of the Minister of Health and Social Development of the Republic of Kazakhstan dated December 21, 2016 No. 1079 “On approval of the standard for providing special social services to victims of domestic violence”, limiting the possibility of women living with HIV in crisis centers.

Women who use drugs report the extreme prevalence of police brutality. Due to stigmatization, pregnant drug-addicted women cannot take advantage of necessary medical services, including drug treatment, antenatal care and post-natal care. Opioid substitution therapy is not available for women when they are hospitalized in any medical institution (including maternity hospitals, tuberculosis dispensaries, etc.).Immediately after childbirth, women are forced to travel independently to the substitution therapy program in order to receive drug support with methadone.

The rights of sex workers by medical personnel are violated, in particular, the humiliation of dignity, the infliction of physical and psychological violence, and the disclosure of HIV-positive status to third parties. For this reason, sex workers refuse timely diagnosis in medical institutions.

We recommend:

  • Develop and adopt a humanization policy for women who use drugs, laws and practices based on respect for human rights, which will protect and eliminate any discrimination and violence against women.
  • Include in the complex of preventive programs to combat HIV and AIDS at the local and national levels, training for police officers to reduce stigma and discrimination against women from vulnerable groups.
  • Actively investigate incidents of violence and any unlawful acts committed by law enforcement officers against sex workers, women who use drugs, and reported by public organizations.
  • Develop mechanisms for ensuring personal security and confidentiality that will allow women to report incidents of violence without fear for their safety.
  • Provide government funding for the provision of free family planning services, in particular contraception for marginalized and vulnerable women.
  • Provide training for medical personnel in providing quality sexual and reproductive health services for women living with HIV, sex workers and women who use drugs.
  • Include a substitution therapy program in the national health care system and drug practice, with further expansion and scaling in Kazakhstan, as well as develop mechanisms for access to treatment of opioid substitution therapy in hospitals (tub dispensary, maternity hospitals and others)

In Kazakhstan, there are no studies and disaggregated data in open sources regarding women prisoners. In the fifth periodic report, the state provides data on legislation that provides access to medical services for female prisoners. But this does not answer the question of whether it meets the needs of female prisoners.

We recommend:

  • Conduct research on the degree of satisfaction with women’s sexual and reproductive health services in places of detention, including data on women living with HIV and drug addicts, characterizing their access to antiretroviral treatment and drug treatment, including opioid substitution therapy. ”

ВПЕРВЫЕ ВИЧ+ ЖЕНЩИНЫ КАЗАХСТАНА ПРЕДСТАВИЛИ ТЕНЕВОЙ ОТЧЕТ В КЛДЖ

Сегодня в Женеве, на предсессионной рабочей группе 74 заседания Комитета ООН по ликвидации всех форм дискриминации в отношении женщин (CEDAW), представительницы сообщества женщин, живущих с ВИЧ, женщин употребляющих наркотики и секс-работниц из Казахстана, впервые представили теневой отчёт от гражданского общества о ситуации с нарушением прав в отношении женщин из ключевых групп.

В июле 2018 г. организациями гражданского общества был подан «Теневой отчет гражданского сообщества о дискриминации и насилии в отношении женщин, живущих с ВИЧ, женщин, употребляющих наркотики, секс — работниц и женщин из мест лишения свободы» в Комитет ООН по ликвидации всех форм дискриминации в отношении женщин. Отчет основан на исследованиях, случаях нарушения прав, зарегистрированных неправительственными организациями в 2015-2017 гг. С полным отчетом можно ознакомиться на сайте ЕЖСС, на русскоми английском языках.

Приводим текст устного заявления, которое представила Любовь Воронцова, Казахстанский Союз Людей, Живущих с ВИЧ (english text below):

«Спасибо, госпожа Председатель.

Я женщина, живущая с ВИЧ из Казахстана, и представляю голоса женщин из своего сообщества.

Мы считаем крайне важным решить проблемы институционализированной дискриминации, которая нарушает права женщин и препятствует доступу к медицинским и социальным услугам, а также способствуют социальной и экономической уязвимости.

Женщины, живущие с ВИЧ, имеют ограниченный доступ к услугам проживания в существующих кризисных центрах, предназначенных для помощи женщинам, пострадавшим от насилия. В столице Казахстана молодая девушка с ребенком, которая зимой подверглась насилию со стороны мужа, получает отказ быть помещенным в приют, поскольку существует такой закон и у нее ВИЧ. Cтатья 118 Уголовного Кодекса Казахстана предусматривает уголовное наказание за постановку в риск заражения ВИЧ, что имеет обратный эффект — это способствует более высокому риску заражения ВИЧ, насилия и гендерного неравенства в семье, в системе здравоохранения, в обществе.

По результатам исследования Индекс Стигмы 24,2% женщин, живущих с ВИЧ, медицинские работники принуждали к прерыванию беременности (аборту), 34% женщин, живущих с ВИЧ, никогда не получали консультацию по репродуктивным возможностям.

Мы рекомендуем:

  • Пересмотреть Статью 118. «Заражение вирусом иммунодефицита человека (ВИЧ/СПИД)» Уголовного кодекса РК от 3 июля 2014 года № 226-V ЗРК, чтобы отменить норму, устанавливающую уголовную ответственность за риск заражения ВИЧ.
  • Создать отделения в кризисных центрах для работы с наркозависимыми и ВИЧ-положительными женщинами. Мобилизовать усилия государства по расширению сети кризисных центров и других служб экстренной помощи женщинам, пережившим домашнее насилие, гарантировать адекватное государственное финансирование для этих учреждений.
  • Внести изменения в Приказ Министра здравоохранения и социального развития Республики Казахстан от 21 декабря 2016 года № 1079 «Об утверждении стандарта оказания специальных социальных услуг жертвам бытового насилия», ограничивающий возможность пребывания в кризисных центрах женщин, живущих с ВИЧ.

Женщины, употребляющие наркотики, сообщают о крайней распространенности жестокости полиции. Из-за стигматизации беременные наркозависимые женщины не могут воспользоваться необходимыми медицинскими услугами, в том числе наркологической, дородовой и послеродовой помощью. Опиоидная заместительная терапия не доступна для женщин при госпитализации в любые медицинские учреждения (включая родильные дома, противотуберкулезные диспансеры и т.д.). Сразу после родов женщины вынуждены самостоятельно добираться до программы заместительной терапии, чтобы получить лекарственную поддержку метадоном.

Нарушаются права секс-работниц со стороны медицинского персонала, в частности, унижение достоинства, причинение физического и психологического насилия, раскрытие ВИЧ-положительного статуса третьим лицам. По этой причине секс-работницы отказываются от своевременной диагностики в медицинских учреждениях

Мы рекомендуем:

  • Разработать и принять политику гуманизации в отношении женщин, употребляющих наркотики, законов и практик, основанных на уважении прав человека, которые обеспечат защиту и исключают любую дискриминацию и насилие в отношении женщин.
  • Включить в комплекс профилактических программ по противодействию ВИЧ и СПИД на местном и национальном уровнях обучающие мероприятия для полицейских о снижении стигмы и дискриминации по отношению к женщинам из уязвимых групп.
  • Активно расследовать случаи насилия и любых незаконных действий, совершенных сотрудниками правоохранительных органов против секс-работниц, женщин, употребляющих наркотики, зарегистрированных и сообщенных общественными организациями.
  • Разработать механизмы обеспечения личной безопасности и конфиденциальности, которые позволят женщинам сообщать о случаях насилия без страха за свою безопасность.
  • Обеспечить государственное финансирование на предоставление бесплатных услуг по планированию семьи, в частности контрацепции для маргинализированных и уязвимых женщин.
  • Обеспечить подготовку медицинского персонала по предоставлению качественных услуг по сексуальному и репродуктивному здоровью для женщин, живущих с ВИЧ, секс-работниц и женщин, употребляющих наркотики.
  • Включить программу заместительной терапии в национальную систему здравоохранения и наркологическую практику, с дальнейшим расширением и масштабированием в Казахстане, а так же разработать механизмы для доступа к лечению опиоидной заместительной терапии в условиях стационаров (тубдиспансер, родильные дома и другие)

В Казахстане отсутствуют исследования и дезагрегированные данные в открытых источниках в отношении женщин-заключенных. В пятом периодическом докладе государство приводит данные о законодательных актах, которые обеспечивают доступ к медицинским услугам для женщин-заключенных. Но, это не отвечает на вопрос о том, удовлетворяет ли это потребности женщин-заключенных.

Мы рекомендуем:

  • Провести исследования о степени удовлетворения услугами по сохранению сексуального и репродуктивного здоровья женщин в местах лишения свободы, включая данные о женщинах, живущих с ВИЧ и наркозависимых, характеризирующие их доступ к антиретровирусному лечению и наркологической помощи, включая опиоидную заместительную терапию.»

US: Five laws categorised as “bad” laws by the Human Rights Campaign in Missouri , including HIV/AIDS criminalisation laws

Missouri ranked in lowest category for LGBTQ protections, nondiscrimination

The Human Rights Campaign recently released their fifth annual State Equality Index — a state-by-state report detailing statewide laws and policies that affect LGBTQ people, assessing how well states are doing to protect LGBTQ individuals from discrimination.

This year, Missouri received the lowest rating, “High Priority to Achieve Basic Equality.” This rating is given to states that focus on raising suport for basic LGBTQ equality laws, such as non-discrimination laws, and for states focusing on municipal protections for LGBTQ people including opposing negative legislation.

Twenty-eight states earned this rating. Seventeen states earned the highest rating, “Working Toward Innovative Equality,” while the remaining five earned “Solidifying Equality” or “Building Equality.”

Karis Agnew, field director for PROMO, Missouri’s statewide LGBTQ advocacy organization, explained that they expected this rating for Missouri.

“It does not surprise me because there are basic protections that LGBTQ people lack in Missouri and those include protection of employment, housing and public accommodations,” Agnew said.

Missouri has a total of six laws that benefit LGBTQ people — hate crime laws, a college and universities non-discrimination law, a sexual orientation non-discrimination policy for state employees, an anti-bullying law specifically for cyberbullying, transgender inclusion in sports, and name and gender updates on identification documents for drivers licenses.

Missouri has five laws that the HRC categorizes as “bad” laws including HIV/AIDS criminalization laws, a state Religious Freedom Restoration Act, and transgender exclusions in state Medicaid coverage.

Missouri lacks all parenting laws such as parental presumption for same-sex couples, second parent adoption, and foster care non-discrimination. Missouri also lacks basic non-discrimination laws for employment, housing, public accommodation, education, adoption, foster care, insurance, credit, and jury selection.

The absence of youth laws in Missouri include anti-bullying laws, protection from conversion therapy, and laws to address LGBTQ youth homelessness. In the health and safety category, Missouri lacks laws including LGBTQ nondiscrimantion protections in Affordable Care Act exchanges, transgender healthcare coverage, and name and gender updates on identification documents for birth certificates.

Alex Padilla, co-president of Spectrum, an LGBTQ group at Missouri State Univerity, explained his fear regarding how few laws Missouri has protecting LGBTQ individuals like himself.

“Whenever I first came out, I was working at a fast food job and I was worried that I could be fired for who I was,” Padilla said.

He explained that he did a quick search online and found that there were no laws protecting him from being harassed or fired because of who he was.

Agnew, who prefers using gender-neutral pronouns, explained that although this rating is low, organizations like PROMO are working hard behind the scenes to make sure Missouri’s laws are progressing.

“When it comes to passing laws that are pro-equality, the thing that we really need the most to be able to do that is make sure that we don’t have bills that are anti-LGBTQ,” Agnew said.

Agnew explained that in 2018 five anti-LGBTQ laws were filed but PROMO worked to ensure zero made it to the governor’s desk to be signed.

“When those are filed, that is our priority, so it is really hard for us to file proactive legislation and pass proactive legislation when we have legislation that is harmful to LGBTQ people that we work so hard to prevent from passing,” Agnew said.

Agnew said a big reason why Missouri is far behind other states in passing pro-LGBTQ legislation is that Missouri legislators are not aware of what it is like to live as an LGBTQ individual.

“I think a lot of our legislators in Missouri honestly don’t know what it’s like to be LGBTQ — the majority of our legislators are not LGBTQ themselves,” Agnew said. “And because of that, I think a lot of them have a lot to learn from their constituents that are.”

Agnew said this year is the 21st year that PROMO has worked to file the Missouri Nondiscrimination Act, which would add protections for sexual orientation and gender identity in places of employment, housing and public accommodations.

“When their constituents aren’t bringing it up they assume it’s not important and not needed,” Agnew said. “The number one thing people can do is engage their elected officials and talk to them about why something like the Missouri Nondiscrimination Act is so important to them.”

Padilla explained how important it is for students to get involved.

“Help us lobby for equality, Padilla said. “Advocating for these things and showing that you are an ally is really helpful to all of Missouri and all of Missouri’s LGBTQ people.”

PROMO is hosting an “Equality Day,” a day of lobbying where people in the community come up to Jefferson City and talk to legislators about the Missouri Nondiscrimination Act on April 10.

Uganda: Mapping of the legal environment shows how the current criminal justice system discriminates against people living with HIV

Published in the Daily Monitor on Febraury 22, 2019

Report shows how laws discriminate against HIV positive people

KAMPALA- Various existing laws criminalise people living with HIV/ Aids, according to a new report released in Kampala on Thursday.

The report is titled: “Draft report on the assessment and mapping of the legal environment on provisions of HIV and TB services to let populations, persons living with HIV and tuberculosis”

“The existing legal framework is not favourable for some categories of the key, vulnerable and priority populations to freely access health services in Uganda. Specifically, the lifestyles sex workers, men who have sex with men, transgender persons and makes them most affected by the existing legal framework in Uganda,” read part of the report

It adds: “The laws criminalise sex work, same sex relationships and drug use. This results into violence, harassment, disappointment of sex workers and their legal recourse to address injustice against them.” “The other law, the HIV and Aids prevention and Control Act although not specifically targeting key vulnerable and priority populations, has implications for both the general affected by HIV in Uganda.”

The report indicates that the HIV and Aids Prevention and Control Act 2014 provides for voluntary HIV testing in Sub Section 9. However, the voluntarism is not considered if a person commits a sexual offense as part of the criminal proceedings and yet Section 8 provides for identity of a person tested with HIV not to be disclosed or released to any person except in accordance with the law and medical standards.

The report was carried out by civil society organisation Center for Health, Human Rights and Development (CEHURD) in conjunction with Aids and Rights Alliance for South Africa (ARASA).

The current criminal justice system is also discriminative as it hands down more deterrent jail terms to those suspects found to be living with HIV than their counterparts that are not.

Reacting to the aforementioned finding, a law professor at Makerere University, Prof. Ben Twinomugisha, explained that sometimes it’s prudent for the prosecution to take an HIV test of a suspect accused of committing a sexual offense for purposes of securing a conviction.

However, he was also quick to say that this compulsory HIV testing will lead to violation of their human rights and that this will drive those infected away instead of going to hospital to get medication.

“But a civil society organisation and I, have since petitioned court challenging Section 43 of the HIV Prevention and Control Act about criminalization of HIV,”  Prof. Twinomugisha said

“Why is it that a person suffering from Hepatitis B, which is more deadly than HIV are not subjected to a test when they commit a crime,” he wondered.

The study was carried out in three districts of Gulu, Mbarara and Tororo.

The study was mainly about the extent to which laws and policies protect and promote the rights of persons living with HIV/ Aids, let populations like sex workers, truck drivers and fishermen can access health care and services.

The HIV prevalence in Uganda stands at 6.2%. In 2016, approximately 1.4 million people were living with HIV and 28,000 Ugandans were estimated to have died of Aids-related illness.

Travel and long-stay restrictions for foreign nationals with HIV have no logical basis and have been deemed a human rights violation by the United Nations

Published in South China Morning Post on February 5, 2019

Visa restrictions for HIV-positive immigrants still in place in dozens of countries

  • Recent leak in Singapore of data of HIV-positive people renewed attention on its curbs on long-term stays by those who have the virus
  • Countries with restrictions include Russia and the United Arab Emirates; there’s no logical basis for them any more, UNAids says

A data leak of Singaporean medical records exposing the HIV-positive status of 14,200 people last month triggered concerns about a backlash for those whose health status was made public in a country that continues to stigmatise the disease.

But the case, involving the records of 8,800 foreign nationals who tested positive for HIV in Singapore, also shines a spotlight on the city state’s restrictive policies towards foreigners with HIV, who face barriers to staying in the country for more than 90 days unless married to a Singaporean national.

The records were leaked by a foreigner in just such a situation, American Mikhy Farrera Brochez, who was deported after serving jail time for drug-related crimes and fraud, including hiding his HIV status. He was able to access the records with help from his boyfriend, a Singaporean doctor.

Singapore is one of only a handful of developed nations that still have laws restricting the long-term stay of foreign nationals with HIV – laws that have been deemed a human rights violation by the United Nations.

“When this [1998] law was brought in there was a lot more fear of unknown issues around disease … but [today] the logic is just not borne out by any scientific or medical basis,” says Eamonn Murphy, UNAids regional director for Asia and the Pacific.

Instead, countries that still have such restrictions in place often do so because of “historical convention, ideology, or even passivity”, Murphy says. He notes that UNAids is renewing its focus on the issue this year, compiling a new report on national restrictions.

UNAids most recent comprehensive report on HIV-related travel and immigration laws in 2015 listed 35 countries with such restrictions.

However, incomplete data published in 2018 by UNAids named at least 18 countries that have policies restricting entry, stay or residence for people living with HIV. Information from many countries were left off the list, and will be updated this year to reflect the true extent. The same report found that 60 countries require testing for residence or other permits, including marriage, not limited to foreigners.

The exact numbers, however, are difficult to pin down, experts say. An independently researched global database counts 49 countries with HIV-related restrictions on long-term stay in 2018, based on information sourced from local embassies and reports from travellers and immigrants. Countries with restrictions include Russia, Singapore, and the United Arab Emirates.

“The data the countries present about themselves in diplomatic settings can be different from the policies that are actually executed,” says American epidemiologist Jessica Keralis, who has researched the public health impacts of such HIV-related restrictions.

For example, countries may not have regulations “on the books”, but employers can revoke visas for HIV-positive employees, or state insurance policy can make it difficult for immigrants to afford treatment, she says.

In other cases, official policy may not be known by regional or local officials and institutions.

These distinctions matter for HIV-positive immigrants, whether white-collar workers, migrant labourers or students, according to David Haerry, who publishes the Global Database on HIV-Specific Travel and Residence Restrictions, which names the 49 countries.

“Oftentimes people [sent abroad for work] don’t know and they fall in the trap: if you don’t know and you have to be tested on the ground, and then you are sent back on health grounds, your company knows,” he says. “It’s a big issue.”

Haerry receives daily emails through the database from people around the world wondering how to travel or relocate safely while living with HIV. In recent years, he’s seen restrictive policies become more of an issue for students looking to study abroad, but who fear the consequences of mandatory HIV testing even in countries where there is no explicit restriction on those who are HIV-positive.

For such situations, “we have no solution”, Haerry says.

Many national restrictions are holdovers from the 1980s, before the disease’s transmission was understood and the antiretroviral therapies and daily medications that can prevent its spread became widely available, according to UNAids’ Murphy. But he has seen progress globally.

A number of countries changed their policies after UNAids launched a 2008 campaign against the 59 governments that had bans at that time. The United States, South Korea and China were among the nations to remove restrictions in 2010, although South Korea retained some related to immigration, while China reportedly has mandatory HIV testing for some visas.

Singapore revised its own regulations in 2015 to allow people living with HIV to enter the country for short-term stays of less than three months, while South Korea in 2017 removed its final restriction, which mandated the testing of foreign teachers.

But conservative cultures, social stigma and inertia have kept some restrictions in play in other nations, experts say. The majority of such restrictions are found in conservative countries; more countries in the Middle East than anywhere else have them.

“The basis of discrimination is misconception and fear, and with HIV these boil down to drug use, men who have sex with men, and all these realities that countries don’t want to face,” says Peter Wiessner, who co-authors the global database. “There’s also xenophobia mixed in.”

That element can have a negative public health impact, according to Keralis.

“It communicates that HIV is a foreign contagion and a foreigners’ problem, and if [citizens] don’t mix with foreigners then they are not at risk,” she says. She notes that, paired with a lack of proper sex education, this can create a dangerous situation.

“There’s no incentive for people to seek more information or modify their behaviours,” she says.

 

 
 

Canada: Workshops find that HIV non-disclosure laws are little known amongst women living with HIV and contribute to social injustices

Published in aidsmap on February 4th, 2019

HIV non-disclosure laws perpetuate social injustices against women in Canada

Krishen Samuel
Published: 05 February 2019

People living with HIV in Canada can be charged with aggravated sexual assault and be registered as sexual offenders if they do not disclose their HIV status, but many HIV-positive women have little knowledge of this law, according to a recent qualitative study. The law contributes to increased HIV-related stigma, social injustices and vulnerability to violence for women living with HIV, argue Dr Saara Greene and colleagues.

Forty eight women took part in seven arts-based workshops which each took place over a four-day period. Each workshop included an education session regarding the legal implications of non-disclosure, followed by a focus group discussion that allowed women to share thoughts, feelings and concerns regarding the law.

Canada is one of many countries that continues to criminalise non-disclosure of HIV positive status in sexual acts between consenting individuals. Transmission of the virus does not need to occur: a person can be prosecuted for exposure to the virus in the absence of transmission.

In 2012, the Supreme Court of Canada clarified its position on HIV transmission, ruling that people living with HIV are legally required to disclose their status to sexual partners before engaging in sexual activities that pose a ‘realistic possibility of transmission’. According to the Court, two combined factors could be used as a defense against this realistic possibility of transmission: a low plasma viral load (under 1500 copies/ml) and the use of a condom.

Thus, the law does not acknowledge biomedical advances that conclusively show transmission is impossible if the infected individual is virally suppressed (see our factsheet on undetectable viral load and transmission). The ruling leaves room for those engaging in condomless sex with an undetectable viral load to be prosecuted. In Canada, a charge of aggravated sexual assault could carry a maximum sentence of life imprisonment and registration on the sex offender registry.

A more recent 2018 federal directive issued by the attorney general states that a person living with HIV who has maintained a suppressed viral load (under 200 copies/ml of blood) should not be prosecuted, because there is no realistic possibility of transmission. However, this directive only applies in Canada’s three territories and not in the provinces where the vast majority of the population live. Advocates are calling on the provinces to issue similar directives.

The workshops were carried out in 2016 and 2017, in three Canadaian provinces (Ontario, Saskatchewan and British Columbia). The median age of participants was 47 (range: 30-59); the majority of women were Indigenous (60%), with only a small percentage of white women (8%). It was important for minority women to be oversampled as HIV prevalence is nearly three times higher in Indigenous peoples across Canada, with high rates of HIV diagnoses occurring in young Indigenous women. Additionally, 42% of women charged with HIV non-disclosure are Indigenous.

Most women were heterosexual (73%), cisgender (94%) and born in Canada (79%). One-third of women were single, with 29% reporting a common-law relationship.

Analysis of the focus group discussions revealed the following themes:

Confusion and concerns regarding the law

Overall, the education sessions revealed that women were largely unfamiliar with and poorly-informed about laws pertaining to non-disclosure. Questions and concerns were related to legal implications (such as a whether charges could be brought against them for exposure in the absence of transmission or for sexual interactions several years ago). Several women asked what it meant to have a low viral load.

Social and legal injustice

Women felt that the law perpetuates existing injustices in the lives of diagnosed HIV positive women. Thus, factors such as stigma, sexism, racism, colonialism and a lack of education might put those already disadvantaged at a higher risk of being criminalised.

“Like even this isn’t accessible or something understandable for some of my people because we have literacy issues. Some of our people, they left residential school at grade 6 and grade 8…” (Jaqueline, Saskatchewan, speaking about a legal factsheet given to participants)

A contradiction inherent in HIV non-disclosure criminalisation law is that while individuals who are unaware of their HIV status and have a high viral load are more likely to unknowingly infect others, these individuals cannot be prosecuted under Canadian law as intent cannot be proven. The women expressed that the law unjustly targets those who are diagnosed:

“…When I was first diagnosed, I had a higher viral load because I wasn’t being treated. And so actually the silent people who don’t know are more at risk of passing it on. So, who is this [law] even protecting? We are the least likely to pass it on.” (Lori, British Columbia)

As a result of assault laws being used in non-disclosure cases, a common sentiment expressed by women living with HIV was that they were carrying a biological weapon. Thus, HIV stigma was internalised, as a result of the legal system depicting women as capable of inflicting serious harm on their partners:

“…If I was going to go over there and stab [participant] with a knife, that’s aggravated assault. So, they’re taking that knife away and using HIV. I may not have given it to her. So, it’s like the knife never even touched her or the knife wasn’t used. I’m still charged.” (Rachelle, British Columbia)

Sexual surveillance

Participants expressed a sense that they were under surveillance by the criminal justice system when it came to their sex lives. In order to prove innocence, women would need to provide evidence of both a low viral load and condom use, or of disclosure.

The researchers labelled this an ‘intimate injustice’, with HIV-positive women needing to prove their innocence within an inherently unjust and oppressive system. The lengths that women would have to go through to prove this innocence is reflected here:

“So how many people do you have in that room? You have the lawyer that’s witnessing the paper that you’re signing that you’ve disclosed. You have the doctor to say, ‘Yeah, you’re under a viral load’. You’ve got the forensic scientist there getting any evidence. You know, everybody is watching.” (Lilian, British Columbia)

A common question related to undetectability was:

‘So when I look at it, I’m undetectable. So, I cannot transmit HIV to who I’m going to have sex with. So why is it any of their business that I have it when I’m undetectable?’

Another common question was how to prove that a condom was used or that disclosure had occurred after a sexual encounter had taken place. It could come down to a ‘he said, she said’ situation, with the HIV-positive woman needing some form of conclusive proof that she had used a condom or disclosed her status prior to engaging in sexual contact.

“Okay, so say I had a sexual partner. I just met this guy. And my CD4 count is 880. I’m undetectable. But I’ve got to tell him before we get into bed. Do I need to make him sign a document and lock it up and have it witnessed by the neighbor?” (Zainab, Ontario)

Vulnerability to violence

Non-disclosure laws may place women at greater risk for violence. As many as 80% of Canadian women living with HIV have experienced violence in adulthood and the requirement to disclose HIV status to sexual partners could increase the likelihood of intimate partner violence by placing women in a vulnerable position.

Women expressed that they do not always have control over when or how sex occurs with their partners; this negates their agency when it comes to negotiating condom use or disclosing their HIV status.

There was also the question of how disclosure applied in cases of domestic abuse and rape. The law would require women to disclose to abusive partners, placing them at risk of even more violence. The troubling nature of this was expressed in this quote:

“I was raped by three [people] in [Canadian city]. They broke into my home and they held me prisoner for 24 hours and beat me and raped me. And if I had told him I was HIV positive, I would have been dead. I know it. So where does that fit in the picture?” (Julie, British Columbia)

Additionally, the law could be used against HIV-positive women by vindictive partners wishing to ‘punish’ them. Many women had been threatened with charges for non-disclosure by disgruntled partners:

“Could they turn around and even if you’re honest and told them, then … they lied and said, ‘Well, I caught it from her’, or him. And they go to the police and get them charged, just out to be spiteful and mean.” (Catherine, Saskatchewan)

Concerns over violence were particularly salient for Indigenous women:

“When you include the Indigenous community and the numbers and statistics there, like we’re already like 10 times the rate of being gone missing, murdered and, you know, facing violence every day. So, when you throw in … you know, HIV, you know, like it just becomes sometimes not even safe. A lot of people stay in very vulnerable situations because of this law…” (Jaqueline, Saskatchewan)

Conclusion

The researchers conclude that for women living with HIV in Canada, non-disclosure laws can lead to unjust victimisation, perpetuating legal and social injustices. Many of the women did not have the necessary legal knowledge to fully understand the implications of their sexual behaviour to begin with. HIV-related stigma has become legally entrenched and results in women who are anxious about sexual encounters and fearful that they will need to find ways of proving their innocence. Non-disclosure laws may also lead to increased violence against women.

When combined with factors such as sexism, racism, colonialism and violence against women, HIV criminalisation results in continued oppression and thus, advocacy for legal reform is necessary and urgent. The recent federal directive is a step in the right direction but it will still take some time for this to filter down to provincial police and prosecutors.

Reference

Greene S et al. How women living with HIV react and respond to learning about Canadian law that criminalises HIV non-disclosure: ‘how do you prove that you told?’ Culture, Health & Sexuality online ahead of print, 2019. (Abstract).

Livestream: Beyond Blame – Challenging HIV Criminalisation: Building Bridges Across Movements: Linking HIV Criminalisation With the Criminalisation of Abortion, Drug Use, Gender Expression, Sexuality and Sex Work (HJN, 2018)

Welcome by Luisa Cabal (UNAIDS) Moderator: Susana Fried (CREA and Global Health Justice Partnership) With: Ricki Kgositau (AIDS Accountability International), Oriana López Uribe (BALANCE / RESURJ), Nthabiseng Mokoena (ARASA), Niluka Perera (Youth Voices Count), Jaime Todd-Gher (Amnesty International), Kay Thi Win (Asia Pacific Network of Sex Workers)

Livestream: Beyond Blame – Challenging HIV Criminalisation: Plenary 2 (HJN, 2018)

Welcome to BEYOND BLAME – Challenging HIV Criminalisation, live from De Balie in Amsterdam, 23 July 2018.

11:2012:10 What About Human Rights? The Benefits and Pitfalls of Using Science in Our Advocacy to End HIV Criminalisation Facilitator: Laurel Sprague (UNAIDS) With: Chris Beyrer (John Hopkins Bloomberg School of Public Health), Edwin Cameron (Constitutional Court of South Africa), Richard Elliott (Canadian HIV/AIDS Legal Network), Lynette Mabote (ARASA), Paula Munderi (IAPAC)

12:1013:00 Women and HIV Criminalisation: Feminist Perspectives Facilitator: Naina Khanna (Positive Women’s Network – USA) With: Sarai Chisala-Tempelhoff (Women’s Lawyers Association, Malawi), Michaela Clayton (ARASA), Kristin Dunn (AIDS Saskatoon), Deon Haywood (Women With A Vision)

New report from the Global Commission on HIV and the Law states that discrimination and punitive laws hamper the global HIV response

Bad laws and discrimination undermining AIDS response

AMSTERDAM, July 22 – Discrimination against vulnerable and marginalized communities is seriously hampering the global effort to tackle the HIV epidemic according to a groundbreaking new report by the Global Commission on HIV and the Law. Despite more people than ever before having access to antiretroviral treatment, the new report emphasizes that governments must take urgent action to ensure rights-based responses to HIV and its co-infections (tuberculosis and viral hepatitis). The new report comes on the eve of the biannual global AIDS conference, which is taking place in Amsterdam.

The Global Commission on HIV and the Law – an independent commission convened by UNDP on behalf of UNAIDS – operates with the goal of catalyzing progress around laws and policies that impact people affected by HIV. In 2012, the Commission highlighted how laws stand in the way of progress on AIDS while citing how to institutionalize laws and policies that promote human rights and health. The 2018 supplement to the Commission’s original report assesses new challenges and opportunities for driving progress on HIV, tuberculosis and viral hepatitis through evidence and rights-based laws and policies.

“Progress on tackling the AIDS epidemic shows that when we work together we can save lives and empower those at risk,” said Mandeep Dhaliwal, the Director of Health and HIV at UNDP. “However, the new report is also a warning that unless governments get serious about tackling bad laws, the overall AIDS response will continue to be undermined and we will fail those who are left behind.”

For the past six years, the Global Commission has made clear how marginalized groups are continually left behind in the global HIV response. Men who have sex with men, people who use drugs, transgender people and sex workers face stigma, discrimination and violence that prevents their ability to receive care, and LGBT populations are still under attack in many countries around the world.

Young women and adolescent girls are also uniquely affected by HIV and are not receiving adequate care. In 2015, adolescent girls and young women comprised 60 percent of those aged 15 to 24 years living with HIV and almost the same percentage of new HIV infections were among this cohort. Sexual and reproductive health care, including HIV testing and treatment, have consistently been kept out of the hands of the women and girls who need them.

“Global politics are changing, and repressive laws and policies are on the rise,” said Michael Kirby, former Justice of the High Court of Australia. “In recent years, political trends have negatively impacted the global HIV response: civic space has shrunk, migrants don’t have access to health care, and funding has dropped.”

The report warns that shrinking civil society space due to government crackdowns is hampering the HIV response as marginalized groups are seeing key health services cut off. The fight against HIV, tuberculosis and viral hepatitis will only be won if civil society is empowered and able to provide services, mobilize for justice and hold governments accountable.

“In the wake of the ongoing global refugee crisis, borders have tightened and access to health services has been restricted for millions of migrants – exactly the opposite of what is needed,” said Dr. Shereen El Feki, Vice-Chair of the Commission. “Condemning people who have left their homes to seek safety strips them of their human rights and in the process increases their vulnerability to HIV and its co-infections.”

Refugees and asylum seekers are often at high risk of HIV and overlapping infections like tuberculosis, but harsh laws restrict health care access. Laws must change to ensure that everyone, no matter where they are from, can receive quality health services. The world is also still off track in funding responses to HIV, tuberculosis and viral hepatitis: in 2015 – the same year that countries adopted the 2030 Agenda for Sustainable Development and its pledge to leave no one behind – donor funding for AIDS fell by 13 percent. Sadly the small uptick in donor funding for HIV in 2017 is at best an anomaly.

Despite these challenges, UNDP together with its UN and civil society partners have helped 89 countries revise their laws to protect people’s health and rights since 2012. Successes include:

·         HIV criminalization laws have been repealed in Ghana, Greece, Honduras, Kenya, Malawi, Mongolia, Switzerland, Tajikistan, Venezuela, Zimbabwe and at least two US states.

·         Leaders are taking steps to address gender inequities to bolster the rights of women and girls who are disproportionately affected by HIV: Tunisia recently passed a law to end violence against women in public and private life, and Jordan and Lebanon have strengthened legislation on marital rape.

·         Access to health care is being prioritized with emphasis on emerging illnesses that target people vulnerable to HIV, including Portugal instituting universal access to hepatitis C treatment in 2015, and France following suit in 2016. A court ruling in India led the Government of India to change its policy on who is eligible for tuberculosis treatment.

·         Governments are taking steps to protect the rights of vulnerable groups: Canada, Colombia, Jamaica, Norway and Uruguay have decriminalized possession of small amounts of cannabis and Jamaica erased the criminal records of low-level drug offenders.

The success and sustainability of the global HIV response will be determined in large part by urgent action on laws and policies. The Commission calls on governments and leaders around the world to institute effective laws and policies that protect and promote the rights of people affected by HIV and its co-infections. Since 2012, there have been positive changes in transforming laws and policies, and advancements in science that make it possible to further accelerate progress. The future will be determined by legal environments that drive universal health and human dignity.

Media contact:

In Geneva: Sarah Bel, Communications Specialist, sarah.bel@undp.org, Tel: +41 79 934 1117

In New York: Sangita Khadka, Communications Specialist, UNDP Bureau for Policy and Programme Support, sangita.khadka@undp.org; +1 212 906 5043

The Global Commission on HIV and the Law is an independent body, convened by the United Nations Development Programme (UNDP) on behalf of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Additional information is available at www.hivlawcommission.org.

Published in UNDP website on July 22, 2018

Livestream: HIV IS NOT A CRIME III National Training Academy: Closing Plenary (HJN, 2018)

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 6 June 2018

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Pre-show with Mark S King and guests 00:08

2) Rapporteur session 03:48

3) Issues around the AIDS 2020 conference 13:30

4) State reports 16:17

5) Breaking news 40:14

6) Thank you’s 41:37

7) Chant 48:04

8) After show 49:59

Facilitated by Naina Khanna Positive Women’s Network – USA CALIFORNIA With Susan Mull Rapporteur PENNSYLVANIA and many, many others

Side show interviews with Sean Strub SERO Project PENNSYLVANIA and Edwin J Bernard HIV Justice Network UK