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.
“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.
There were a number of presentations, mostly e-posters, at AIDS2020:Virtual that focused on HIV criminalisation. We have compiled them all below given that access was (and remains) limited.
The only oral presentations specifically covering HIV criminalisation were delivered by HIV Justice Network’s Executive Director, Edwin J Bernard, presenting in three pre-recorded video sessions.
Below you will find the presentation ‘Bringing Science to Justice’ for the IAPAC 90-90-90 Targets Update, produced for the session, ‘Creating Enabling Environments for Optimal HIV Responses’. This eleven minute presentation, that also includes a number of video clips, covers the following:
The detrimental implications of HIV criminalisation on human rights and public health
The impact of the ‘Expert consensus statement on the science of HIV in the context of criminal law’
Lessons learned from HIV criminalisation on punitive responses to COVID-19
Conclusion: It is more critical than ever to commit to, and respect, human rights principles; ground public health measures in scientific evidence; and establish partnerships, trust, and co-operation between scientists, law- and policymakers and the most impacted communities.
Update (29 July): During a California HIV/AIDS Policy Research Centers virtual satellite session, Dr. Ayako Miyashita Ochoa of UCLA Luskin School of Public Affairs, Department of Social Welfare, interviewed activist Marco Castro-Bojorquez about the modernisation of California’s HIV-specific criminal law as an example of of evidence-based policymaking.
There were a number of poster presentations that also focused on HIV criminalisation in the following countries/jurisdictions:
PEF 1737 United States
PEF 1738 England & Wales
PEF 1739 Australia
PEF 1740 Niger
PEF 1742 Malawi
PEF 1781 Florida, USA
PEF 1794 Uganda
PEF 1841 Taiwan
The abstracts are below. Click on the title to download the pdf of the poster.
BACKGROUND: In 2017, 36 states had laws penalizing persons with HIV (PWH) for sexual or no-risk behavior (e.g., spitting). Research shows these laws do not impact sexual risk behaviors or diagnosis rates. Citizens likely are unaware of these laws; we do not expect direct behavioral effects. However, laws reflect states’ values and may mirror community attitudes towards PWH. Understanding how structural factors relate to stigma is important for stopping HIV stigma. METHODS: National HIV Behavioral Surveillance used venue-based sampling methods to interview men who have sex with men (MSM) in 23 U.S. cities from June-December 2017. Using Center for HIV Law and Policy reports, we categorized states’ HIV-specific laws as of June 2017. We compared MSM”s perceptions of community attitudes towards PWH between MSM living in states with versus without HIV laws. We obtained adjusted prevalence ratios using log-linked Poisson models assessing the relationship between law and four community stigma attitudes (discrimination, rights, friendship, punishment), which we then compared between black MSM in states with versus without laws. RESULTS: Two-thirds of MSM lived in states with HIV-specific laws. MSM in states with laws were more likely to report black race (38% versus 15%), poverty (23% versus 12%), or incarceration (25% versus 19%). Multivariable models found laws were related to perceived community beliefs that PWH “got what they deserved” (aPR=1.13, 95% CI: 1.03-1.24), but not other attitudes. Compared to black MSM in states without laws, black MSM in states with laws were more likely to believe persons in their community would discriminate against PWH (64% versus 50%), not support PWH’s rights (25% versus 16%), not be friends with PWH (24% versus 13%), and believe HIV was deserved punishment (32% versus 22%). CONCLUSIONS: MSM in states with HIV laws were disproportionately from marginalized groups. Laws were related to perceived community attitudes that HIV was deserved punishment; understanding specific stigma attitudes can inform interventions. Although black MSM reported high community stigma overall, stigma was significantly higher for black MSM in states with HIV laws. States may consider repealing or reforming HIV laws and focusing on effective prevention efforts to End the HIV Epidemic.
BACKGROUND: In England and Wales it is possible to be prosecuted for the sexual transmission of infection under the Offences Against the Person Act 1861 or the Criminal Attempts Act 1981. After the first prosecutions in 2003, National AIDS Trust (NAT) successfully advocated for legal guidance for prosecutors and worked with the Crown Prosecution Guidance (CPS) to develop this. DESCRIPTION: In 2018 NAT requested that the guidance be updated. In January 2019 the CPS shared a draft of their revised guidance with NAT, who then coordinated a joint response from NAT and other key stakeholders. This successfully ensured that the new guidance reflects medical developments such as Undetectable=Untransmittable and clinical guidance. Developments in case law have led the CPS to take the view that HIV/STI status deception may be capable of vitiating consent to sex. NAT is concerned that this could result in people who lie about their HIV status being prosecuted for rape or sexual assault, even with safeguards used and no transmission occurring. NAT prepared a briefing articulating legal, policy and public health arguments against this position, and presented it at a meeting with the CPS. As a result the CPS have added several caveats, but we still believe their position to be unacceptable and discussions are ongoing. LESSONS LEARNED: The successes we have had in improving the guidance demonstrate the importance of long-standing proactive engagement, relationship-building and collaboration. Collaborating with a range of key stakeholders including clinicians and lawyers enabled NAT to leverage wider authority and expertise. However, the issue of HIV status deception has illustrated the implications for HIV of legal developments in related but not directly transferable areas. Confidence in our understanding of the law and persistence in making our arguments heard has been crucial in ensuring ongoing engagement on this issue. CONCLUSIONS: The updated guidance will help to ensure that prosecutions for reckless or intentional transmission are conducted in a way that minimises harm to both individuals and the wider community. Regarding the issue of HIV status deception, possible next steps include securing parliamentary engagement, pro bono legal opinions, and further representations from local government and public health bodies.
BACKGROUND: A significant portion of people convicted of HIV transmission in Australia are not Australian citizens. Due to not holding citizenship, those convicted of serious criminal offences (which includes facing a prison term of 12 months or more), are at risk of having their visas cancelled and being removed from Australia. The HIV/AIDS Legal Centre (HALC) has represented a number of these clients in both their criminal and subsequent immigration proceedings to assist these clients in preventing their removal from Australia. DESCRIPTION: Where a person is not an Australian citizen and commits a criminal offence they are at risk of detention and removal from Australia. In two recent case studies of people with HIV convicted of HIV transmission, following the completion of their custodial sentences steps were then taken to cancel their visas and place them into immigration detention. Both clients had their visas cancelled and had to take steps to appeal the decisions. Part of the reason for the cancellation was the perception of ongoing risk to the Australian community. Neither client had been convicted of intentionally transmitting HIV to their sexual partner. HALC continues to represent one of the clients mentioned and the other has now exhausted all appeal options. LESSONS LEARNED: There are often many and varied reasons for HIV non disclosure and, from HALC”s experiences, following criminal and public health interventions it is unlikely that a person with HIV would continue to place their sexual partners at risk of contracting HIV. Decision makers in migration proceedings appear to be unwilling to accept that a person with HIV would no longer place their sexual partner at risk of HIV transmission as the decision makers note in their decisions that they there remains a risk to the community. CONCLUSIONS: The outcomes of these cases demonstrates the need for ongoing advocacy and law reform in the removal of offences for HIV non-disclosure, exposure and transmission, except where actual intent can be established to a criminal law standard. The cases also demonstrate the ongoing need for continued robust representation of those, often vulnerable migrants, who are facing visa cancellation.
BACKGROUND: To effectively fight against HIV, Niger adopted Law No. 2007-08 of April 30, 2007 related on HIV prevention, care and control. This law included problematic provisions, including the criminalization of exposure, HIV transmission, and the non-disclosure of HIV to the sexual partner. Actually, PLWHIV continue to be victims of the application of the provisions criminalizing the transmission of HIV through several criminal prosecution cases in 2017. DESCRIPTION: In June 2018, 13 civil society organizations created the “National Coalition for the Decriminalization of HIV in Niger”. This one benefited from the technical and financial support of HIV JUSTICE WORLDWIDE. Its advocacy objectives, by 2021, are to : repeal of offenses criminalizing exposure and transmission of HIV ; research and disseminate reliable and convincing data on the impact of HIV criminalization on access to HIV-related services. Since its creation, the Coalition has carried out the following activities: National workshop for consulting civil society stakeholders on the exposure, transmission and non-disclosure of HIV in Niger; The development of the Memorandum of December 20, 2018 entitled ‘exploring ways and means to resolve the problems of legal proceedings against people living with HIV in order to reduce to zero the new infections, deaths and discrimination linked to AIDS; Organization of several advocacy meetings during the ‘zero discrimination’ day (March, 2019) for public decision-makers and partners. LESSONS LEARNED: Judicial police officers and magistrates have to exercise greater caution when considering a criminal prosecution, and in particular, carefully assess the latest scientific data on the risks of transmission and the consequences of the infection; National AIDS Control Program needs a comprehensive assessment of the application of criminal legislation on the transmission, exposure and non-disclosure of HIV status in order to measure its impact on the effectiveness of national response. CONCLUSIONS: The criminalization of HIV transmission undermines public health efforts and does not take into account the reality of PLWHIV and especially women who are not always able to disclose their HIV status without fear of reprisals or violence, or to impose the wearing a condom. The threat of possible criminal prosecution only increases their vulnerability.
BACKGROUND: Building on the work of the Global Commission on HIV and the Law, and in order to promote an enabling environment for achieving the 90-90-90 targets, UNDP has supported regional-and national-level work on removing legal barriers to accessing HIV services in sub-Saharan Africa. Covering over 20 countries, this work consists of regional-level capacity building for duty-bearers and rights-holders from the different countries and in-country activities tailored to local realities. DESCRIPTION: In 2019/20, we evaluated the impacts of this work through a review of project documents and key informant interviews with stakeholders including civil society representatives, government officials, and UNDP staff, and conducted an in-depth case study in Malawi. LESSONS LEARNED: Participation in regional spaces empowered national-level stakeholders in their country level work. A participatory legal environment assessment (LEA), jointly owned by government and civil society, served as the starting point and the resulting document, providing an overview of the strengths and weaknesses of HIV-related national laws and policies, has served as a cornerstone for subsequent activities. For example, national advocacy efforts informed by the LEA, and participation by the Chair of the Parliamentary Committee on HIV in regional activities, were key to shaping a revised HIV law to better align with international human rights law. The new law has led to the reform of the institutional framework for the national HIV response. Judges participated in regional judges’ fora where they could request information on HIV-related science, discuss lived experiences with key populations’ representatives and hear about how legal issues were being addressed across the region. Lawyers from across the region took part in joint training. After one such training, and with technical support from regional partners to create a strong case, a lawyer chose to appeal the conviction of a woman under Malawi’s law criminalizing HIV transmission. The presiding judge had attended regional judges’ fora and, drawing on a firm understanding of HIV transmission dynamics, overturned the original ruling. CONCLUSIONS: A mix of regional and national level activities allows for tailoring of activities to national contexts while also providing space for peer networking and support where ‘difficult’ issues might more easily be discussed.
BACKGROUND: According to the Centers for Disease Control and Prevention (CDC), as of 2016, 108,003 people live with HIV (PLHIV) in Florida, which also has the highest rates of new HIV diagnoses in the country. Numerous complexities worsen Florida’s HIV risk environment, including sex work, human trafficking, injection drug use, and sex tourism. These topics are often bases for HIV-related arrests that journalists cover. HIV criminalization describes statutes that criminalize otherwise legal conduct or that enhance penalties for illegal conduct based on a person’s positive HIV status. METHODS: This study employed a systematic review of Florida news articles on HIV-related arrests published between 2009-2019. Through qualitative content analysis, our study analyzed how race, gender, and journalistic tone coalesce in reports of HIV-related arrests. RESULTS: A 2018 report from the Williams Institute indicated that white Floridian women are primarily arrested for HIV-related crimes. The systematic review found zero news reports on HIV-related arrests of white Floridian women, and only one article identified a female perpetrator whose race was undisclosed. Sixty-four other articles reported solely on the HIV-related arrests of men, predominantly black men. We identified two categories of articles where HIV was either central to the arrest, or the person’s HIV-positive status was reported but exhibited little pertinence to the arrest. CONCLUSIONS: Journalistic and police reporting behaviors risk inadvertently stigmatizing PLHIV at a time when public awareness of HIV depends on perceptions of HIV. This information will be used to shape equitable local nonprofit campaigns for community prevention, and HIV decriminalization efforts, while also combating the perpetuation of HIV misinformation.
BACKGROUND: The purpose of the research: To assess the compliance of the Uganda HIV and AIDS Control and Prevention Act, 2014 (the Act) with international human rights law standards.
Problem: In 2014, the Government of Uganda enacted a law to control and prevent HIV and AIDS. However, human rights advocates contest that the law contains provisions that don”t comply with international human rights law standards. METHODS: Study period: August 2014 – August 2015 Study design: Qualitative design. Data collection: The study used a document analysis method. Method of analysis: The study identified international human rights law standards related to HIV and AIDS and used them as benchmarks for the review, analysis and synthesis of the literature. RESULTS: The study established that: The Act carries provisions that comply with international human rights law standards. These include HIV counselling, testing, and treatment; state responsibility in HIV and AIDS control; the establishment of the HIV and AIDS Trust Fund; HIV-related human biomedical research; and prohibition of discrimination in various settings on grounds of HIV status. The Act also contains provisions that are not compliant with international human rights law standards. These include mandatory HIV testing, disclosure without consent, criminalization of actual and attempted HIV transmission, and criminal penalties for vaguely defined conduct. The Act lacks provisions that would make it more effective in controlling and preventing HIV and AIDS. These include commitments by the state to be accountable for its obligations stated in the Act; definition of what constitutes discrimination in various settings; and addressing challenges such as the causes of discrimination, inadequate professional human resources at health facilities, lack of HIV-friendly services in health facilities, and unregulated informal sector in complying with the law. CONCLUSIONS: The study identified the compliance and non-compliance of the Act to international human rights law standards. It made recommendations to the Government of Uganda, organisations of people living with HIV and AIDS, organisations that advocate for human rights, and national human rights institutions, on the need to eliminate, revise and add some provisions in the Act to create an enabling legal environment that conforms with international human rights law.
BACKGROUND: Taiwan ranks top amongst the most progressive Asian countries, including being the first to pass marriage equality in Asia. Yet, stigma and discrimination of certain sub-populations, specifically people living with HIV (PLHIV) continue to prevail, as reflected in the Article 21 of HIV special law which overly criminalizes HIV non-disclosure, exposure and transmission. METHODS: Using qualitative and quantitative approaches, Persons with HIV/AIDS Rights Advocacy Association (PRAA) of Taiwan makes a case on how the current criminal justice system in Taiwan adapt the narrative of ‘HIV as a weapon’ to prevent PLHIV from asserting their rights. RESULTS:Article 21 states that individuals with knowledge of their HIV-positive status, by concealing the fact, engage in unsafe sex with others or share injection syringes, diluted fluids, and thus infect others, shall be sentenced for 5 to 12 years. Data showed over 30 cases were identified from 2012 to 2019, the majority of prosecutions were associated with sexual activities. However, unsafe sex was often defined exclusively with use of condom, and the court rarely recognized scientific advancements in antiretroviral therapy and suppressed viral load. Cases included: prosecution from ex-partner whom knew defendant’s HIV status before their relationship; state prosecution without plaintiff by turning 14 HIV-positive witnesses into defendants; 13-year incarceration despite medical expert’s testimony on the unlikelihood of HIV transmission. Those who haven’t been prosecuted continued to face both physical and emotional health threats, such as a woman threaten by her admirer to disclose her status if she turns him down. Bias and prejudice, worsen by difficulties in proving self-disclosure or condom use commonly resulted in convictions. CONCLUSIONS:Article 21 and out-of-date judicial interpretation of HIV transmission risks gravely deprive the rights of PLHIV and further perpetuates stigma against PLHIV and affected communities through special criminal law on HIV. There’s a strong case to be made for abolishing Article 21 under the Constitution of Taiwan and the International Bill of Human Rights. Training and support on HIV advancements shall be given to all members of judicial and criminal law system to further inform any application of criminal law in cases related to HIV.
Russia: Names of released prisoners suffering from certain diseases to be passed to authorities of regions where they live
FSIN ordered to report the release of dangerously ill prisoners
Source: Pravo – Translated automatically by Deepl.com. For original article in Russian, please scroll down.
The exact list of diseases to be reported will be determined by the government.
On 20 July, President Vladimir Putin signed a law obliging prison administration staff to inform about the diseases of released prisoners. The relevant information will have to be passed by the FSIN bodies to the authorities of the region where the prisoner lives.
The author of the initiative was the Cabinet of Ministers. The State Duma adopted the document in its final reading on 7 July, and the Council of Ministers approved it on 15 July. The law will come into force only in six months.
Control over the provision of medical care to prisoners who have served their sentence is necessary due to lack of understanding of the gravity of the disease, “low educational and cultural level, mental disorders and asocial behavior,” as follows from the explanatory note to the bill.
At the same time, the exact list of diseases to be informed about has yet to be determined by the government. According to the authors of the initiative, in the case of newly released prisoners, different types of hepatitis, tuberculosis and HIV pose the greatest danger. Tens of thousands of people are released each year with these diseases, the explanatory note says.
ФСИН обязали сообщать об освобождении опасно больных заключенных
Точный список заболеваний, о которых нужно будет информировать, определит правительство.
Президент Владимир Путин 20 июля подписал закон, обязывающий сотрудников администрации исправительных учреждений информировать о заболеваниях вышедших на свободу заключённых. Соответствующую информацию органы ФСИН должны будут передавать властям региона, в котором проживает отбывший наказание.
Автором инициативы выступил кабмин. Госдума приняла документ в окончательном чтении 7 июля, Совфед одобрил его 15 июля. В силу закон вступит только через полгода.
Контроль за оказанием медицинской помощи заключённым, отбывшим наказание, необходим из-за непонимания ими тяжести заболевания, «низкого образовательного и культурного уровня, психических расстройств и асоциального поведения», следует из пояснительной записки к законопроекту.
При этом точный список заболеваний, о которых нужно будет информировать, еще только предстоит определить правительству. По мнению авторов инициативы, в случае только что освободившихся заключённых наибольшую опасность представляют разные типы гепатита, туберкулёз и ВИЧ. С этими заболеваниями ежегодно выходят на свободу десятки тысяч человек, говорится в пояснительной записке.
Watch all the videos of Beyond Blame @HIV2020 – our “perfectly executed…deftly curated, deeply informative” webshow
Earlier this month, advocates from all over the world came together for two hours to discuss the successes and challenges of the global movement to end HIV criminalisation.
All of the recordings of Beyond Blame: Challenging HIV Criminalisation for HIV JUSTICE WORLDWIDE are now available on the HIV Justice Network’s YouTube Channel.
Kene Esom, Policy Specialist: Human Rights, Law and Gender, United Nations Development Programme (UNDP)
The full-length director’s cut version – with enhanced audio and video – is now available in English as well as with the audio track of the recorded simultaneous translation in French, Spanish, Russian, and Portuguese.
“We have been being battling this fight for many years. Since the start of the HIV epidemic we as gay men, as gay women, as queers, as transgender people, as sex workers, as people using drugs, have been persecuted by the criminal law. And I’m here to say, “Enough! Enough!
We have achieved a great deal with our movement, with the HIV Justice Network. We have achieved a great deal in conscientizing law makers, law givers and the public. It is now time for us to join in unison to demand the end of these stigmatising, retrograde, unproductive, hurtful, harmful laws.
It is a long struggle we’ve engaged in. And it’s one that has hurt many of us. Some of us here today, some of us listening in, some of us who have spoken, have felt the most brutal brush of the law. They have been imprisoned, unjustly prosecuted, unjustly convicted, and unjustly sent away.
HIV is not a crime. But there is more to it. Criminalising HIV, criminalising the transmission or exposure of HIV, as many countries on my own beautiful continent Africa do, is not just stupid and retrograde. It impedes the most important message of the HIV epidemic now, which is that this epidemic is manageable. I’ve been on antiretroviral treatment now for very nearly 23 years. My viral load has been undetectable for more than 20.
We can beat this, but we have to approach this issue as public health issue. We have to approach it rationally and sensibly, and without stigma, and without targeting people, and without seeking to hurt and marginalise people.We’ve made calamitous mistakes with the misapplication of the criminal law over the last hundred years, in the so-called ‘war on drugs’. We continue to make a calamitous mistake in Africa and elsewhere by misusing the criminal law against queer people like myself. We make a huge mistake by misusing the criminal law against people with HIV.
Let us rise today and say, “Enough!”
Criminalization laws impact public health and perpetuate discrimination
HIV and LGBTQ Criminalization Laws are Both Human Rights and Public Health Issues, Experts Say
A panel at the 23rd International AIDS Conference (AIDS 2020, gone virtual this year due to COVID-19) discussed the growing right-wing populist movements around the world that threaten advances made by activists toward ending criminalization of people living with HIV and LGBTQ people.
Poland just re-elected President Andrzej Duda, whose party, PiS, declared “The LGBT and gender movement threatens our Polish identity, the nation, and the state.” PiS wants to “protect children from the LGBT ideology,” defines marriage in strictly heterosexual terms, and aims to outlaw adoptions by LGBTQ people. Around 100 localities in the country have declared themselves to be “LGBT-free zones.”
Botswana goes even further, reported Tebogo Gareitsanye of BONELA, a legal and advocacy organization in that country. Consensual sex between same-sex partners is illegal and prosecuted as “unnatural offenses” and “indecent practices.” That statute originally applied only to men who have sex with men. Sex between women was not outlawed until 1998.
Botswana law distinguishes between sexual orientation per se—which is, in fact, a protected category under employment discrimination law—and acting on one’s orientation, which is illegal. After a campaign by BONELA and others, the country’s High Court recently decriminalized private, consensual sex acts. However, Botswana’s government has appealed that decision, and a final ruling is still pending.
Beyond human rights implications, such laws also impact public health, since LGBTQ people will not seek health services for fear of being prosecuted, Gareitsanye noted. Similarly, laws that criminalize certain acts if someone is living with HIV impede public health, said Edwin J. Bernard of the HIV Justice Network. “Communicable diseases are public health issues, not criminal issues.”
HIV criminalization laws generally require the person in question to know their status. They therefore discourage people from being tested. Sean Strub of the Sero Project summed this up in a video shared by Bernard at the conference: “Take the test and risk arrest.” Another interviewee in that video, Patrick O’Byrne, Ph.D., RN-EC, of the University of Ottawa, reported that participants in their study were unable to distinguish between the public health department and the police. “That’s problematic,” O’Byrne commented.
In California, for example, people living with HIV (PLWH) can be prosecuted for four HIV-specific “offenses,” explained Ayako Miyashita Ochoa, J.D., of the University of California Los Angeles: solicitation while seropositive, exposure with intent to transmit HIV, exposure to a communicable disease, and an enhanced sentence for forced sex, if the rapist lives with HIV. Sex workers account for 95% of HIV-related prosecutions in the state, Ochoa reported.
Exposure to a communicable disease could, of course, be applied to many different viruses—including SARS-CoV-2, the virus that causes COVID-19. So far, there are no reports of people refusing to wear masks being prosecuted under that law. Nonetheless, in many countries, human rights have taken a backseat to the pandemic response, noted Thokozile Phiri Nkhoma of Facilitators of Community Transformation in Malawi. Civil society must address criminalization as well as rights and resource issues in the wake of the pandemic, Nkhoma demanded.
Beyond their effect on individual persons prosecuted under them, criminal laws perpetuate structural inequalities, discrimination, and xenophobia, argued Susana T. Fried of CREA, an international feminist organization based in India. To counter such effects, we need to strengthen solidarity between and with affected people. We also must be aware of the unintended effects some laws meant to protect vulnerable communities might have. For example, raising the age of marriage can protect young girls. However, it can also be used to outlaw consensual sex between young people, if it ties age of consent to age of marriage.
The consequences of these and other laws regulating sex and sexuality are quite intentional, concluded Marco Castro-Bojorquez of HIV Racial Justice Now: “The systems of oppression that we have created specifically to oppress certain communities were working very well in the criminalization of PLWH.”
How is the Expert Consensus Statement bringing science to justice?
Authored by 20 of the world’s leading HIV scientists, and endorsed by more than 70 additional expert scientists, as well as IAPAC, IAS and UNAIDS, the Expert Consensus Statement described current evidence on HIV transmission, treatment effectiveness and forensics so that HIV-related science may be better understood in criminal law contexts.
The Expert Consensus Statement was the end result of a multi-year process developed by a partnership comprising the International AIDS Society (IAS), the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the HIV JUSTICE WORLDWIDE Steering Committee.
The HIV Justice Network has now published an interim scoping report, written by HJN’s Senior Policy Analyst Sally Cameron, that explores the impact of the Expert Consensus Statement in the two years since its publication. It is now available in English and French (see bottom of page for download links).
The report concludes that the Expert Consensus Statement is meeting both its primary aim (to support defence arguments in HIV criminalisation cases) and its secondary aim (supporting lobbying for law and policy reform) in many jurisdictions. But it also found that the process of developing and promoting the content of the Expert Consensus Statement has delivered additional benefits that further support advocacy efforts to end HIV criminalisation.
In summary, the Expert Consensus Statement is being used to:
Assist HIV criminalisation defence arguments and strategic litigation, changing courts’ understanding of transmission risks associated with HIV and the effectiveness of modern treatments.
Shape advocacy for law and policy reform, including mobilising stakeholders to lobby for reform, delivering law and policy reform, improving legal and judicial practice, facilitating community advocates’ access to government and judicial bodies, and gaining support from public health bodies and customary and religious leaders.
Inform scientific and medical thinking, including being cited in many peer reviewed articles and in scientific and medical press, being hosted on the sites of scientific/medical/academic organisations, and being ranked the #1 JIAS article to date.
Develop stronger relationships that cross silos and advance capacity, enabling efficient and informal communications between partners to rapidly move projects forward, with Expert Consensus Statement authors supporting community organisations by assisting in defence cases, answering ad hoc questions and co-authoring abstracts, presentations and articles.
Disseminate accurate, positive messages about people living HIV and the issue of HIV criminalisation, including facilitating keynote addresses and presentations at notable conferences and meetings, and generating global mainstream, community and social media. Ultimately, interest in the Expert Consensus Statement has elevated the global conversation about HIV criminalisation, with co-ordinated messaging translating into a powerful positive narrative in many sites.
The criminalisation of the virus would create greater barriers to accessing healthcare systems already preventing many people from getting treatment.
After it was announced that no further action would be taken by police regarding the death of Belly Mujinga, a railway worker who contracted coronavirus after reportedly being spat on, there was national outcry. Her name has been plastered on placards at Black Lives Matter protests, while the public has pointed out that a man in Scotland who spat on a police officer while “joking” about coronavirus in April has been jailed for a year. But while this outrage is valid in the face of a government who continues to show their blatant disregard for black lives, criminalisation of diseases has been proven to be an ineffective tool for justice.
Over the past few months, parallels have been drawn between the Covid-19 pandemic and the HIV epidemic. Both viruses are communicable (they can be passed between people); both have been racialised, leading to racist and xenophobic attacks and stereotyping; community mobilisation has demanded adequate government public health responses for both health emergencies; and the impact of both viruses has highlighted the need for a global health approach which transcends borders.
When the World Health Organisation (WHO) declared Covid-19 a pandemic, many HIV organisations and activists advocated that the transmission of the novel coronavirusshould not be criminalised. As public fear of Covid-19 grew, HIV advocates predicted the negative impact on public health and possibility of human rights violations, similar to those seen for people living with HIV.
“Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself”
This strain of coronavirus is new and scientists are developing their understanding of it. In the past few weeks, there has been confusion about the probability of asymptomatic transmission (transmitting the virus when a person does not have Covid-19-like symptoms), as the WHO had previously commented that it was “very rare” and later stated that this wording had misled people. Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself. Globally, countries have implemented or have proposed laws against Covid-19 transmission and even exposure, without transmission, including Canada, France, India, and South Africa.
Often, the aim of criminalisation is to facilitate a tool for prevention and deterrence (to discourage people from passing on a virus) or as punishment for those who have or may have passed on a virus. HIV advocacy has illustrated over the years that the criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health.
In their Statement on Covid-19 Criminalisation, published in March, the HIV Justice Worldwide Steering Committee wrote that hastily drafted laws, as well as law enforcement, driven by fear and panic, are unlikely to be guided by the best available scientific and medical evidence – especially where such science is unclear, complex and evolving. “Given the context of a virus that can easily be transmitted by casual contact and where proof of actual exposure or transmission is not possible, we believe that the criminal justice system is unlikely to uphold principles of legal and judicial fairness, including the key criminal law principles of legality, foreseeability, intent, causality, proportionality and proof.”
The director of legal services at the Crown Prosecution Service (CPS), the public agency that conducts criminal prosecutions in England and Wales, found that 24% of cases reviewed had been charged incorrectly. In May a CPS press statement cited the speed and pressure to implement the laws as the cause of the wrongful charges. Across the Global North, it has been well documented that racialised communities are disproportionately impacted by Covid-19 and the Human Rights Campaign Foundation anticipates that LGBTQI communities will be disproportionately impacted by the virus. This is due to a myriad of reasons underpinned by systemic discrimination.
“Criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health”
HIV research has shown little evidence that criminalisation laws prevent transmission, in fact, it’s evidenced that such laws are bad for public health and fuel reluctance to get tested and treated. In the UK, testing and treatment of Covid-19 is free, as is the case with many other communicable diseases to remove the barrier to testing and treatment. Free testing and treatment access, irrespective of immigration status, is important, however, a briefing paper from Medact, Migrants Organise and New Economics Foundation (NEF), has shown that migrant communities blocked from healthcare because of the hostile environment, that “the coronavirus ‘exemption’ from charging and immigration checks is not working” and people have been asked to show their passports, and that people face additional obstacles such as language barrier and digital exclusion from emergency services.
Criminalisation exacerbates public health issues: in a Channel 4 report, Migrants Organise spoke of a man who died at home for fear of being reported to immigration authorities if he accessed healthcare. The threat of immigration enforcement disproportionately impacts those in precarious work and those with precarious migration status, all of whom are more likely to come from racialised groups and in some cases groups which are hyper-surveilled and criminalised.
The role of healthcare and access to it needs to be reimagined, where people are viewed as patients not passports and healthcare professionals are not the extended arm of the Home Office. Governments must implement better employment rights, so that employers are held to account and do not put staff such as Belly Mujinga, in harmful positions. Governments must provide better statutory sick pay so those in precarious work do not have to choose between their health and putting food on the table. We need to overhaul systemically discriminatory processes that don’t look after the most vulnerable, rather than implementing laws – such as criminalisation – that will systematically punish them.
New Francophone Africa HIV criminalisation advocacy factsheet published today
Today, HIV JUSTICE WORLDWIDE releases a new advocacy factsheet developed by and for Francophone activists engaged in the fight against HIV criminalisation in Francophone Africa.
Co-authored by Cécile Kazatchkine of the Canadian HIV/AIDS Legal Network and Alain Kra, an expert in HIV and human rights Expert from Côte d’Ivoire, on behalf of HIV JUSTICE WORLDWIDE, the factsheet is the first of several that will be published throughout the year focusing on a particular language and region.
“We are delighted to share this new resource with you today,” Cécile Kazatchkine writes below. “In it, you will find everything you need to know about HIV criminalisation in francophone Africa, the issues it raises and the strategies adopted by activists to address it. Many thanks to Alain Kra, an expert in human rights and HIV from Côte d’Ivoire, who co-authored this factsheet, and to our colleagues from the Francophone HIV JUSTICE WORLDWIDE network for their contributions and for sharing their experiences.”
Nous sommes heureux de partager aujourd’hui cette nouvelle ressource développée par et pour les militants francophones engagés dans la lutte contre la pénalisation du VIH. Vous y trouverez tout ce que vous devez savoir sur la pénalisation en Afrique francophone, les enjeux qu’elle soulève et les stratégies adoptées par les militants pour y répondre. Un grand merci à Alain Kra, Expert en droits humains et VIH de Côte d’Ivoire et co-auteur de ce feuillet d’information ainsi qu’à nos collègues du réseau francophone HIV Justice Worldwide pour leurs contributions et le partage de leurs expériences.
Cécile Kazatchkine, le Réseau juridique canadien VIH/sida
To provide a taste of the content to English-speakers, here are some of the introductory paragraphs from the 16-page PDF.
“African HIV legislation was drafted on the basis of the N’Djamena model law developed during a three-day workshop in 2004 organised by Action for West Africa Region-HIV/ AIDS (AWARE-HIV/AIDS) and funded by the United States Agency for International Development (USAID). This model, presented as a tool for the rapid dissemination of “good practices”, has led to a veritable “legislative contagion” in terms of HIV criminalisation across the continent, particularly in francophone Africa.
“Nineteen countries in francophone Africa currently have HIV-specific laws. Sixteen of these laws, which are supposed to guarantee the rights of people living with HIV, also criminalise HIV transmission or exposure. Criticism of the model law and a better understanding of the risks associated with HIV criminalisation have led to the revision of some laws in Togo, Guinea and Niger to limit the scope of HIV criminalisation.
“Similarly, criminal provisions in HIV laws adopted in 2010 in Senegal, 2011 in the Congo and 2014 in Côte d’Ivoire are more protective of the rights of people living with HIV. Like the revised laws, they include provisions expressly excluding criminalisation in certain circumstances, such as where condoms have been used or in cases of mother-to-child transmission. Congolese law precludes criminal liability in the greatest number of circumstances. In Cameroon and Gabon, HIV bills with provisions criminalising HIV were eventually abandoned, while in Comoros and Mauritius, HIV laws have never included criminalising provisions. Finally, in the Democratic Republic of Congo (DRC), the section of the HIV law criminalising the ‘deliberate’ transmission of HIV was repealed in 2018.”
The information sheet goes on to cover the disproportionate impact of HIV criminalisation on women across Africa; shows the many reasons why HIV criminalisation does more harm than good to the HIV response; explores the impact of science on laws and prosecutions; and includes links to further resources including those contained in the French-language version of the HIV Justice Toolkit.
We are grateful to our Global Advisory Panel member, Elie Balan, head of the LGBT Health Department (M-Coalition) at the Arab Foundation for Freedoms and Equality, for undertaking the translation.
The statement was originally published on 25 March in English, French and Spanish, and on 26 March in Russian.
The HIV Justice Network (HJN) continues to monitor the many ways legal, policy and police responses to COVID-19 is negatively impacting the human rights of people living with HIV, as well as individuals and communities most impacted by HIV.
Each week, Sylvie Beaumont, HJN’s Research / Outreach Co-ordinator, curates our HIV Justice Weekly newsletter. She ensures that all of the previous week’s key articles and podcasts critiquing punitive responses to HIV and/or COVID-19, as well as HIV and COVID-19 criminalisation cases can be found in one place.
This week, echoing the concerns of the HIV JUSTICE WORLDWIDE Steering Committee, amongst others, UNAIDS issued a strongly worded press release condemning governments for abusing the current state of emergency over the COVID-19 pandemic for overreaching their powers and enacting laws that target people who are living with, or vulnerable, to HIV.
“In times of crisis, emergency powers and agility are crucial; however, they cannot come at the cost of the rights of the most vulnerable,” said Winnie Byanyima, Executive Director of UNAIDS. “Checks and balances that are the cornerstone of the rule of law must be exercised in order to prevent misuse of such powers. If not, we may see a reversal of much of the progress made in human rights, the right to health and the AIDS response.”
Notably, UNAIDS singles out EU member states, Hungary and Poland.
In Hungary, a new bill has been introduced to remove the right of people to change their gender and name on official documents in order to ensure conformity with their gender identity, in clear breach of international human rights to legal recognition of gender identity.
In Poland, a fast-tracked amendment to the criminal law that increases the penalties for HIV exposure, non-disclosure and transmission to at least six months in prison and up to eight years in prison has been passed—a clear contravention of international human rights obligations to remove HIV-specific criminal laws.
In addition, UNAIDS condemns overly zealous policing that is especially targeting key populations already stigmatised, marginalised, and criminalised.
UNAIDS is also concerned by reports from a number of countries of police brutality in enforcing measures, using physical violence and harassment and targeting marginalized groups, including sex workers, people who use drugs and people who are homeless. The use of criminal law and violence to enforce movement restrictions is disproportionate and not evidence-informed. Such tactics have been known to be implemented in a discriminatory manner and have a disproportionate effect on the most vulnerable: people who for whatever reason cannot stay at home, do not have a home or need to work for reasons of survival.
They also highlight Kenya as a model of cjvil society rapid response to human rights concerns following the release of an advisory note “calling for a focus on community engagement and what works for prevention and treatment rather than disproportionate and coercive approaches.”
The statement concludes:
While some rights may be limited during an emergency in order to protect public health and safety, such restrictions must be for a legitimate aim—in this case, to contain the COVID-19 pandemic. They must be proportionate to that aim, necessary, non-arbitrary, evidence-informed and lawful. Each order/law or action by law enforcement must also be reviewable by a court of law. Law enforcement powers must likewise be narrowly defined, proportionate and necessary.
UNAIDS urges all countries to ensure that any emergency laws and powers are limited to a reasonable period of time and renewable only through appropriate parliamentary and participatory processes. Strict limits on the use of police powers must be provided, along with independent oversight of police action and remedies through an accountability mechanism. Restrictions on rights relating to non-discrimination on the basis of HIV status, sexual and reproductive health, freedom of speech and gender identity detailed above do not assist with the COVID-19 response and are therefore not for a legitimate purpose. UNAIDS calls on countries to repeal any laws put in place that cannot be said to be for the legitimate aim of responding to or controlling the COVID-19 pandemic.
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