Canada: Ontario Court of Appeal rules that HIV disclosure by police in news releases does not violate a person's constitutional rights

Court ruling sets ‘low bar’ for police to disclose HIV status

Ontario Court of Appeal finds police didn’t violate suspect’s Charter rights by disclosing health status in news release

If a person charged with a crime is found to be HIV-positive, that could be enough for police to disclose that very personal and sensitive information to the public.

That’s one takeaway from an Ontario Court of Appeal decision that advocates say is cause for concern for those living with HIV or AIDS, which continue to attract stigma and misunderstanding despite evolving science.

The province’s top court overturned a lower court decision last week, ruling that that Durham Regional Police did not breach former youth pastor Kris Gowdy’s constitutional rights following his 2012 arrest for Internet child luring when they disclosed in a news release that he was HIV-positive.

Gowdy was arrested after arriving at the home of someone who had been posing as a 15-year-old boy online, to perform oral sex, only to discover the individual was a police officer. Police searched his car and discovered documentation and medication proving he was HIV-positive. The arrest and Gowdy’s HIV status were widely reported on at the time, making international headlines.

Writing for a unanimous three-judge panel, Justice David Watt said the police force’s actions in disclosing Gowdy’s HIV status were “clearly in retrospect not advisable.”

But the judges held that the release of that information did not violate Gowdy’s right to security of the person because there had been no finding at trial that the disclosure had a psychological effect on Gowdy beyond the impact already caused by the charge he was facing.

They also concluded that provincial privacy legislation contains an exemption for municipal institutions to release personal information that they have lawfully gathered if it is for a “consistent purpose.”

In this case, Watt said that the “consistent purpose” was to further the investigation “by inviting responses from other sexual partners of Gowdy” who may be at risk of transmission.

“The police had reasonable suspicion; reasonable grounds to believe further offences had been committed was not required for the purpose of the media release,” Watt said.

The court dismissed Gowdy’s appeal of the conviction, but allowed the Crown’s appeal. The court substituted Gowdy’s two-year conditional sentence, which he served at home, with a one-year jail term, although it said he should not be re-arrested because he had already served his sentence.

As noted by the Court of Appeal, the lead investigator in the case did not seek legal advice or the permission of the police chief or his designate before issuing the news release, did not seek medical advice to find out the likelihood of transmission of the virus through a sexual activity such as fellatio, and did not seek to confirm Gowdy’s assertion that his medication had rendered his viral load so low that it made transmission unlikely.

Gowdy also never admitted in his interview with police that he had had sexual contact with individuals who were unaware of his HIV status, the court said.

“The lead investigator testified that, to his knowledge, he had never before investigated someone with HIV in his 23 years of policing,” Watt wrote. “The investigating officer acknowledged he did not consider the Charter rights of Kris Gowdy before requesting the media release.”

Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, one of the interveners in the appeal, said in an interview with the Star that police should have turned their minds to what the actual risks of transmission may have been in this case.

“I can’t think what that ‘reasonable suspicion’ is actually founded on. I don’t think the suspicion is a reasonable one, all the information the officer had was that this accused was HIV-positive,” Elliott said.

“This is a case in which merely finding out someone has HIV was seen by police as sufficient for putting out a press release, basically engaging in a fishing expedition.”

He also described the court’s interpretation of the “consistent purpose” exemption as “very, very liberal,” saying it sets an “extraordinarily low bar” that police have to clear before releasing a person’s HIV status.

The case highlights what advocates say is a lack of proper training for officers in dealing with HIV-positive individuals and the absence of clear statutes governing the disclosure of such information by police.

Durham police spokesman Dave Selby declined to comment on the court’s decision.

“In general, I can say that we regularly review our policies to ensure they are consistent with all applicable laws and judicial decisions. We will review this decision carefully, as well,” he said in an email. “We will continue to respect the fundamental privacy rights of all citizens while balancing our community safety responsibilities.”

Gowdy’s appeal lawyer, Russell Silverstein, said his client is considering whether to seek leave to appeal to the Supreme Court of Canada.

“When it comes to one’s HIV status, different considerations apply, it’s not the same as telling the world that the accused is suffering from cancer or some other disease,” he told the Star.

“You can’t say that the release of such information is per se a Charter breach, it’s going to depend on the circumstances, and the question is: what should the appropriate test be for the disclosure of that particular information?”

A former pastor with the Free Methodist Church of Canada, Gowdy posted an ad on Craigslist in 2012 looking for men interested in receiving oral sex, specifying he was looking for “under 35, jocks, college guys, skaters, young married guy.”

A detective with the OPP’s Child Sexual Exploitation Section homed in on the use of the words “young,” “skater,” and “under 35” in Gowdy’s ad, and began an online conversation with him, posing as a 15-year-old boy.

Shortly after agreeing to meet the “boy” for oral sex, Gowdy was arrested. He maintained in court that he never actually believed the person he was conversing with was 15 years old.

Gowdy, a former pastor with the Free Methodist Church of Canada, had kept his sexual orientation secret from his family and church, his 2014 trial heard. He had no prior criminal record and there were no complaints about inappropriate behaviour from the ministries where he had worked as a pastor.

“I regret incredibly my actions, they were foolish and inappropriate,” Gowdy told the Star in an interview in 2014. “It feels to me like there should be some kind of reprimand to these officers at the minimum.”

At trial, Justice Michael Block found that the release of Gowdy’s HIV status violated his constitutional rights. He circumvented the mandatory minimum sentence of one year in jail for the luring offence, and instead imposed a two-year conditional sentence, which Gowdy served at home. Gowdy’s name was to remain on the sexual offender registry for 20 years.

“Mr. Gowdy had a right to make his own choices concerning the disclosure of his HIV status,” Block said. “No doubt he would have chosen his own method and different timing if he ever determined to inform those near to him. Absent evidence of serious risk of transmission and rigorous compliance with statute, no one had the authority to make that decision for him.”

Russia: Lawmakers in the Altai Krai region unanimously agree to support a law to allow for mandatory HIV testing AND treatment

English version – Translation (For Russian version, please scroll down)

The Provincial Parliament’s legislative initiative will be sent to the State Duma as a draft federal law

BARNAUL, December 15. Deputies of the Legislative Assembly of the Altai Krai took the initiative to take on the federal law on compulsory treatment of people diagnosed with HIV. They decided to send a proposal to the State Duma as a session of the regional parliament adopted it, reports the press service of the Legislative Assembly.

“The Provincial Parliament will send to the State Duma a legislative initiative of the draft federal law” On Amendments to the Federal Law “On Prevention of Spread of the disease caused by HIV.” For example, citizens suffering from social diseases, which constitute a danger to others (tuberculosis), are subject to mandatory laboratory examination and medical observation or treatment and compulsory hospitalization or isolation in the manner prescribed by the law. The initiative involves the Altai Deputies to extend these norms to HIV-infected patients”, – said the press service.

They added that all 66 deputies unanimously supported the initiative to amend the Law. “The adjustment of the law is to allow professionals, as appropriate, provide forced treatment and monitoring of HIV-infected people to avoid the spread of the virus,” – explained the Legislative Assembly.

According to the press service, the medical check-up and treatment of HIV-infected people in Russia is fulfilled at the expense of the federal subsidies and intergovernmental transfers of the RF federal budget entities to ensure the procurement of antiviral drugs. “Thus, additional funding for coverage of medical observation and treatment of patients with HIV infection is not needed” – added the Legislative Assembly of the Altai Territory.

For most of the Altai Territory, the issue of HIV is relevant: according to the Regional AIDS Centre, for the past 10 years in the region, the number of people diagnosed with HIV has doubled to more over 24 thousand people. Now in the region 217 children and more than 3 thousand adults get treatment. According to official data of Ministry of Health of the Russian Federation, totally 824 thousand HIV cases are registered in Russia. The average therapy coverage nationally is about 40%.

Краевой парламент в порядке законодательной инициативы направит в Госдуму проект соответствующего федерального закона

БАРНАУЛ, 15 декабря. /Корр. ТАСС Ксения Шубина/. Депутаты Алтайского краевого Законодательного собрания выступили с инициативой принять на федеральном уровне закон о принудительном лечении людей с диагнозом ВИЧ. Решение направить такое предложение в Госдуму было принято на сессии регионального парламента, сообщили в пресс-службе Заксобрания.

“Краевой парламент направит в Госдуму в порядке законодательной инициативы проект федерального закона “О внесении изменений в Федеральный закон “О предупреждении распространения в Российской Федерации заболевания, вызываемого ВИЧ”. К примеру, граждане, страдающие социально значимыми заболеваниями, представляющими опасность для окружающих (туберкулез), в обязательном порядке подлежат лабораторному обследованию и медицинскому наблюдению или лечению и обязательной госпитализации или изоляции в порядке, установленном законодательством РФ. Инициатива алтайских депутатов предполагает распространить эти нормы и на ВИЧ-инфицированных больных”, – сказали в пресс-службе.

Там добавили, что все 66 депутатов единогласно поддержали инициативу о внесении изменений в ФЗ. “Корректировка закона должна позволить специалистам, в случае необходимости, проводить лечение и наблюдение за ВИЧ-инфицированными в принудительном порядке, чтобы избежать распространения вируса”, – пояснили в Заксобрании.

По данным пресс-службы, диспансерное наблюдение и лечение ВИЧ-инфицированных в России осуществляется за счет федеральных субсидий и межбюджетных трансфертов федерального бюджета субъектам РФ на обеспечение закупок антивирусных препаратов. “Таким образом, дополнительного финансирования на охват диспансерным наблюдением и лечением больных ВИЧ-инфекцией не потребуется”, – добавили в Заксобрании Алтайского края.

Для самого Алтайского края тема борьбы с ВИЧ актуальна: по данным регионального Центра СПИД, за последние 10 лет в регионе количество людей с выявленным диагнозом ВИЧ увеличилось в два раза – до более чем 24 тыс. человек. Сейчас в регионе получают лечение 217 детей и более 3 тыс. взрослых. По официальным данным Минздрава РФ, всего в России зарегистрировано 824 тыс. случаев ВИЧ-инфекции. Охват терапией в среднем по стране – около 40%.

Originally published in TASS

[Press release] Activists call on leaders to protect human rights and stop imposing criminal sanctions against people living with HIV and TB

INTERNATIONAL HUMAN RIGHTS DAY 2016, 10 DECEMBER 2016:

Windhoek, Namibia, 09 December 2016: On the eve of International Human Rights Day 2016, the AIDS and Rights Alliance for Southern Africa (ARASA), a partnership of 106 organisations working in 18 countries in southern and east Africa, calls on governments to curb the increasing trend of enacting and enforcing incoherent, ineffective laws that undermine human rights, including the right to health, and threaten to derail the progress made to end the twin epidemics of HIV and TB.

ARASA warns that the commitments made towards eliminating HIV and TB – including the 2016 Political Declaration on HIV and AIDS, the Sustainable Development Goals and the End TB strategy – stand on shaky foundations, unless they are supported by a human rights-based approach, including strong political will and coherence between law and science.

Although there has been some improvement in ensuring access to treatment and care for people living with HIV and TB, there is a still a long way to go in terms of aligning HIV, TB and human rights.

“We cannot talk about the 90-90-90 targets without addressing the endemic human rights barriers, underpinned by the criminalisation of key population groups, including sex workers, people who use drugs, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, people living with disabilities, and women. In addition, the current proliferation of HIV-specific criminal laws, which unjustly target people living with a treatable disease, are eroding the gains made in the HIV and TB responses,” said Michaela Clayton, Director of the ARASA.

The Advancing HIV Justice 2 report, published in June 2016 by the HIV Justice Worldwide partnership, of which ARASA is a member, highlights that, since 2000, 30 sub-Saharan African countries have now enacted overly broad laws related to the criminalisation of HIV transmission, exposure and non-disclosure.The Report also notes that the rise of reported prosecutions in Africa (in Botswana, South Africa, Uganda, and especially Zimbabwe), along with the continuing, growing number of HIV criminalisation laws on this continent, is especially alarming.

“It’s ironic that HIV criminalisation began in sub-Saharan Africa just as the commitment to HIV treatment scale-up was envisioned at the Durban 2000 AIDS Conference,” says the report’s author, Edwin J Bernard, Global Co-ordinator of the HIV Justice Network. “These laws were not based on evidence but political expediency – the vision of ‘ending AIDS’ is totally incompatible with criminalising people living with HIV.”

 

“In the course of the Southern Africal Litigation Centre’s work, we continue to observe significant stigma and discrimination against people living with HIV and key populations, including through inappropriate applications of criminal laws, and unhealthy, inhumane conditions of detention in southern Africa. An effective HIV and TB-response demands that governments urgently reform legal environments that enable these abuses, and advance meaningful access to justice and accountability for victims of rights violations,” said Kaajal Ramjathan-Keogh, Executive Director of the Southern Africa Litigation Centre (SALC).

 

Advocates around the world are working tirelessly to ensure that the criminal law’s approach to people living with HIV is consistent with up-to-date science, as well as key legal and human rights principles. But, unless investments are matched with clear programmatic articulation of human rights based approaches – essential for people living with HIV and TB and members of key and other vulnerable populations groups who currently have little or no access HIV and TB prevention, treatment, care, and support services – then the current rhetoric about the end of HIV and reduction of TB prevalence rates, will remain purely academic.

“Disclosure of HIV happens with support, with counselling and with an enablement. This is not the reality in the places where an average person seeks health services. HIV criminalisation goes against HIV prevention”, said Dora Kiconco Musinguzi, The Executive Director of the Uganda Network on Law, Ethics and HIV/AIDS (UGANET),

who have been petitioning against the Ugandan government for the amendment of the potentially harmful provisions of the HIV/AIDS control and Prevention Act 2015 which includes allowing for the disclosure of a person’s HIV-positive status, either forcefully, at the discretion of a health worker or at a’ concerned person’s’ request.

The evidence is in and the future is looking bleak: ARASA’s 2016 HIV, TB and Human Rights in Southern and East Africa (SEA) Report, which conducts scans of the legal and regulatory framework for responding to HIV, TB and sexual reproductive health (SRH) in SEA to determine whether laws, regulations and policies protect and promote the rights of all people, including key populations, continues to show that while these laws are meant to protect and promote the rights of all people, they are instead used against the most vulnerable people in our societies, not only moving them away from essential health services, but criminalising their rights to health and life.

This, while shocking figures released by the World Health Organisation in October 2016, show an estimated 10.4 million new TB cases and 1.8 million TB deaths in 2015, are a case in point. This is a 20% revision upwards from last year’s figures, showing that the TB epidemic is a bigger problem than we thought. There is no TB elimination scenario that is realistic without improved prevention.

Our conventional approaches to dealing with TB need to be revisited. As eloquently stated by Honourable Michael Kirby, a Member of the United Nations Secretary-General’s High–Level Panel on Access to Essential Medicines, in his Ten commandments for TB, TB requires rights-based approaches, and a revisiting of the ineffective hostile, punitive approaches, involuntary treatment and incarceration that have been levelled against people living with TB.

ARASA recommends that civil society and governments should work together to:

1.     Advocate to expand access to legal services for people with HIV and key populations and provide information about available legal services.

2.     Remove all overly broad and HIV-specific laws that criminalise HIV transmission, exposure and non-disclosure and criminalisation laws related to sex work, people who use drugs and gender identity for LGBTI.

3.     Expand HIV programming that is acceptable and accessible for LGBTI people, through LGBTI-friendly services.

4.     Advocate for legislation that explicitly criminalises marital rape and set a minimum age for marriage and access to Post Exposure Prophylaxis for Gender-Based Violence (GBV) survivors.

5.     Repeal laws that undermine or prohibit distribution of condoms and lubricants in prisons, including laws that criminalise sex between men in prisons

Matthew Weait, from the University of Portsmouth, writes on how stigma and the law affect the lives of people with HIV

HIV Stigma and the Criminal Law

December 1st marks World AIDS Day, an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. Matthew Weait, from the University of Portsmouth, writes here on how stigma and the law affect the lives of people with HIV.

Today, December 1st, is World AIDS Day.  According to the latest available data from UNAIDS, 1.1 million people died from AIDS-related causes in 2015, there are just over 2 million new HIV infections globally every year, and just under 40 million people are living with the virus.  These are depressing figures, particularly in light of the advances in our understanding of HIV, its prevention and treatment, the laudable rise in the number of people accessing antiretroviral therapy (ART) (up from 7.5 million to 18 million in the past five years), and the massive impact of ART on reducing the likelihood of onward transmission.

Despite the fact that the life expectancy of people on ART has improved significantly, especially for those who receive a timely diagnosis, and that there exist effective ways of avoiding infection, the stigma associated with HIV remains.  The impact of this stigma, and the associated discrimination which people living with HIV (PLHIV) and those in key populations are subjected to, is substantial and undermines the work being done to promote access to health and other services critical to curtailing the epidemic.

Stigma is not only correlated with adverse health outcomes for PLHIV (including depression and lower adherence to medication), but also with non-disclosure of status and with less safe sexual practices.  It is for these reasons that combating stigma, and the factors which contribute to it, has long been identified as a public health priority.

Among the most pernicious contributors to HIV stigma is the widespread and inappropriate use of criminal laws against PLHIV and those at heightened risk of infection.  For example, PLHIV or those suspected of being HIV-positive have been and are at risk of being investigated, prosecuted and imprisoned for exposure offences – where no transmission takes place – even where there is negligible risk (as when a PLHIV is on effective treatment and has an undetectable viral load), where there is no risk (e.g. through biting or spitting), and even where a partner has consented to the risk involved.

In some countries, such as Canada, the very fact of non-disclosure of status can, irrespective of risk, turn otherwise consensual sex into sexual assault.  And where transmission does in fact occur (which is more likely when someone does not know their status and is not on treatment than when they do know and are), PLHIV are at risk of extended custodial punishment, even if it is not their intention to cause harm.

These laws serve no public health purpose and, because it is typically only those that have a positive diagnosis who may be found criminally liable, do nothing to incentivise the testing which is a pre-requisite of treatment and care.

It is not only those already living with HIV who suffer from the enforcement of punitive laws.  The social opprobrium associated with and / or criminalization of transgender people, homosexuality, sex work, and injecting drug use in many countries of the world (including nations with high HIV prevalence) reinforces stigma, makes it harder to support those at heightened risk of acquiring the virus, and in fact makes infection more likely.

If the possession of condoms is treated as evidence of sex work, sex workers may not carry them; and if the possession of syringes is treated as evidence of drug use, the chance that these will be shared increases, as does the risk of transmitting blood-borne viruses (including HIV and hepatitis C).  Put simply, the policing of these communities, and the absence of harm reduction opportunities in the carceral settings they may find themselves in as a result of that policing, exacerbate risks which are already greater than for the general population.

The adverse impact of using criminal law in the fight against HIV, and on those directly and indirectly affected by it, has been extensively researched and documented.  The consensus among expert bodies such as UNAIDS and the Global Commission on HIV and the Law is that countries should review their punitive laws and significantly restrict their use, and there have been a number of progressive and welcome developments both in law reform and in policing, many of these led by coalitions of activists and clinicians.  At the same time, and despite the evidence of the harm that they cause, and the stigma which it feeds and sustains, countries continue to pass and enforce these laws.

Irrespective of any moral or ethical questions there may be about HIV transmission, exposure, or non-disclosure, it is incontrovertible that the criminal law makes the elimination of HIV harder.  If we are going to end the epidemic, this needs to be recognised and acted on as a priority. If not, more people will become infected, more people will get sick, more people will have a lower quality of life – even when virally suppressed – and more people will die.

Published in BioMed Central on Dec 1, 2016

Uganda: 5 months after filing their initial petition, activists renew their call to amend HIV law

Activists renew call for HIV law amendment

By Noah Jagwe

They argue that the law contains clauses that could deter all the benefits in the fight against the scourge.

According to this group, the law instead instills fear in communities about HIV disclosure and also fuels stigmatization.

Earlier this year, some 60 civil society organizations across the country challenged the criminalization of HIVin Uganda as well as other ‘harmful’ provisions in the Act.

Dora Kichoncho Musinguzi, the executive director Uganda Network on Law and Ethics, said the salient features that are scanned out in the law which they consider discriminatory are: Clauses 21, 41 and 43 of the Act that seek to criminalize HIV, particularly intentional transmission.

The Act would require mandatory disclosure of one’s HIV status, failure of which would be regarded as “criminal”, and attempting to or, intentionally transmitting the virus.

Failure to use a condom where one knows their HIV status would constitute a criminal offence, making them liable for prosecution.

The provisions in the HIV Act, according to Kichonco, do not only stigmatize and discriminate against people living with HIV, but also deter communities from seeking HIV services such as HIV testing and subsequently HIV treatment.

“It is five months since we filed the petition. The government has not responded to our case. This is procedurally wrong and negates justice,” she said.

Kichoncho said if the law continues “as we could see”, it would heighten stigmatization of people living with HIV and that many of the targets such as 90% of people knowing their status, 90% of those who with HIV are on treatment and 90% with suppressed  viral load set by the country might not be achieved.

“The law has been counterproductive to all the achievements Uganda has made.”

She said the legal environment in Uganda is not conducive and human rights have not been respected. “Laws that criminalize and stigmatize people with HIV must be repealed.”

Meanwhile, Dorothy Nassolo, communications officer of Forum of People Living with HIV/Aids Networks in Uganda said there is a crisis the country might not stand.

She said a number of patients have been hacked to death because they have been discovered by their spouses for taking ARVs covertly.

National Forum of People Living with HIV/AIDS officer Milly Katana said the most affected group by the law are women through gender-based violence at home.

Katana said it’s better for Uganda to look at other alternatives for instance biomedical tools, medical male circumcision and condoms. –

Published in New Vision on Dec 1, 2016

India: Sex workers organisations oppose Human Trafficking Bill which would make rehabilitation mandatory and HIV transmission a criminal offence

The most pressing concern is that the bill seems to be making rehabilitation mandatory

A consortium of rights bodies, especially of those working for sex workers, have come forward to speak out against the Human Trafficking Bill, which was sent to the Cabinet last month for approval. Associations of sex workers said that they fear that the bill will make it difficult for them to function. The most pressing concern, said Kusum, President of the All India Network of Sex Workers, is that the bill seems to be making rehabilitation mandatory. “Rehabilitation is needed for thousands of women who face trafficking around the country. But scores of practicing sex workers might not want it. Why not make it voluntary,” she says.

Dr Smarajit Jana, a health practitioner and the founder of Durbar Mahila Samanwaya Samiti, the first sex workers collective, agrees. Dr Jana was on a Supreme Court panel on the rights of sex workers, which submitted a report last month. He says that not a single state has statistics on rehabilitation. “Among the secretaries of the women and child development department of over 20 states we interacted with, 15 did not have any number for their own states,” says Dr Jana.

 The definition of a trafficking victim, both Dr Jana and Kusum said, was vague enough to include practicing sex workers. As per the Bill, a sex worker who gets married and has settled down will also come under the ambit of the definition. “There is also a clause that states that if a sex worker is found drinking and smoking with her friends, they can be booked for plying substances to her and punishable for over 10 years,” says Kusum.

Tripti Tandon of the Lawyer’s Collective says that the biggest lacunae in the bill is its failure to distinguish those in need of rescue from those who do not. “Since The Immoral Traffic (Prevention) Act will continue to function, the government is simply creating layer after layer of law, without really taking into account the problems of livelihood, sanitation, health which sex workers face routinely, like every working-class women,” says Tandon.

Another crucial loophole is that the bill states that if a person transmits HIV to another, then they will be punishable for a period of 10 years. “The problem is that many victims do not know if they are HIV positive. Globally, the debate is on decriminalising HIV patients,” says Dr Jana.

Published in DNA India on Nov 5, 2016

Mexico: Civil association in San Luis Potosi State urges parliament to rethink proposition to criminalise HIV transmission

English translation (Para artículo en español, desplácese hacia abajo)

Civil association urges a rethink of the criminalisation of HIV transmission as such an amendment to the penal code would promote higher levels of stigma and discrimination.

San Luis Potosi, SLP.- With regard to the initiative presented during the Ordinary Session No. 44, on October 27, 2016 in the State Congress by the State Governor Juan Manuel Carreras Lopez and Erika Velasquez Gutiérrez, the president of the Women Institute in San Luis Potosi, the civil association Amigos Potosinosen Lucha Contra el Sida condemned the initiative which they say, stigmatize people living with the Human Immunodeficiency Virus (HIV), and have therefore called for reconsideration of the initiative put forward, conveying the following position:

1. It is important to promote actions that recognise the human rights of women through the varied international tools signed and ratified in this matter by the Mexican State,  and which have been become mandatories following the constitutional reform of 2011 in the field of Human Rights.

2. It is not advisable to seek to punish conducts that are perceived to be fraudulent with regard to HIV and other sexually transmitted infections, as the evidence tell us that HIV prevention is not achieved through punitive measures, but by public health policies which promote changes at the structural level, to facilitate equal access to services that guarantee the sexual and reproductive health of women, and also strengthen programmes and activities that promote equality between women and men.

3. Criminalisation promotes stigma and discrimination against people with HIV, including girls, children, adolescents and women, contradictorily promoting actions that violate the dignity of these vulnerable groups.

4. It is very difficult to determine causality, fraud and intention and other varied factors involved in HIV transmission such as: the possibility of transmission, the type of exposure, the use of condoms or not, at what stage of infection the person is, whether the person is on antiretroviral treatment, if their viral load is undetectable, if there is any concomitant infection, the health status of the receiving partner and the agreements between spouses or casual partners, among others.

5. It is important to emphasize that punitive measures such as those intended to legislate through this initiative, could hinder and affect various multisectoral actions in prevention, detection and HIV care in our state.

6. It might influence people who perceive themselves as having  risk factors for HIV, to not undergo testing in order not to know their status and avoid any potential criminal proceedings made possible by testing. Such legislation may affect the continuous detection, prevention and care of HIV in Mexico [1], which seeks to facilitate the early diagnosis of people who perceived themselves to at risk so they can receive timely treatment to improve their quality of life and also help to curb the transmission chain.

7. Scientific evidence indicates that to stop the chain of transmission of HIV from one person to another, it is essential to combine prevention strategies, which include biomedical, behavioural and structural change, the latter emphasizing the need for actions that contribute to the eradication of stigma and discrimination associated with HIV-AIDS, and a punitive law does not contribute to these strategies.

8. The specific content of this initiative “Risk of contagion” could result in the legal responsibility for HIV prevention to fall only on those living with HIV, and could conceal the public health message that sexual partners have shared responsibility for their sexual health. People may mistakenly assume that their partners are HIV-negative because they are unaware of their status or do not disclose it, and they would therefore stop taking preventive measures.

9. Such amendments to the penal code will promote higher levels of stigma and discrimination against diverse HIV populations and their families.

Amigos Potosinos en lucha contra el Sida urges the State governor Juan Manuel Carreras Lopez and Erika Velázquez Gutiérrez president of the Women Institute in San Luis Potosi (sic), to reconsider the criminalization of HIV, as to do so would place people with HIV under a status of being possible criminals, which is contrary to their dignity as persons, violating their human rights and stigmatising them for their health condition.

Better yet, we encourage you to promote the creation of the State Council for the control of HIV, AIDS and STIs in San Luis Potosi, and to increase resources to prevent, detect and address HIV in a timely manner; to improve the quality and comprehensiveness of care services in the State that are provided by CAPASITS and by hospitals in the health system; to generate and strengthen empowerment programs for women and actions that seek to promote equal opportunities between women and men; finally to reduce stigma and discrimination against key populations affected by HIV and other STIs incorporating the MIPA principle [3] which speaks of greater involvement of people living with HIV as part of the solution and response, thereby contributing to a democratic, inclusive and non-discriminatory Mexico.

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Asociación Civil pide reconsiderar tipificar como delito trasmisión del VIH. Este tipo de adecuaciones al código penal promoverán mayores niveles de estigma y discriminación.

San Luis Potosí, SLP.- En relación a la iniciativa presentada, en la Sesión Ordinaria No. 44, día 27 de octubre del 2016 al Congreso del Estado, por el gobernador del Estado Juan Manuel Carreras López y Erika Velázquez Gutiérrez presidenta del Instituto de las Mujeres en San Luis Potosí la asociación civil Amigos Potosinos en Lucha Contra el Sida condenaron la iniciativa que a decir de ellos, estigmatiza a las personas con contagiadas con el Virus de Inmunodeficiencia Humana (VIH), por lo que llaman a reconsiderar la iniciativa formulada, difundiendo el siguiente posicionamiento:

1.- Es importante impulsar acciones a favor del reconocimiento de los derechos humanos de las mujeres en el orden internacional de los diversos instrumentos que en esta materia ha suscrito y ratificado Estado Mexicano, lo cual se convierte en obligatorio a partir de la reforma Constitucional del año 2011 en materia de Derechos Humanos.

2.-No es recomendable buscar castigar las conductas que se perciben como dolosas en relación al VIH y otras infecciones sexuales, ya que la evidencia científica nos señala que la prevención del VIH no se logra con medidas punitivas, sino con políticas en salud pública que faciliten acciones que promuevan cambios a nivel estructural que faciliten la igualdad en el acceso a servicios que garanticen la salud sexual y reproductiva de las mujeres, así también fortalecer los programas y acciones que promuevan la igualdad entre mujeres y hombres

3.- La penalización favorece el estigma y la discriminación hacia personas con VIH, incluyendo a las niñas, niños, adolescentes y mujeres, por lo que resulta contradictorio impulsar acciones que contravienen a la dignidad de estos grupos vulnerables.

4.- Es muy difícil determinar la causalidad, el dolo, la intencionalidad ya que intervienen diversos factores en la trasmisión del VIH, como son: la posibilidad de la trasmisión, el tipo de exposición, el uso o no de condón, la etapa de la infección en la que se encuentra la persona, si lleva tratamiento antirretroviral, si tiene carga viral detectable o indetectable, si existen enfermedades concomitantes, el estado de salud de la pareja receptora y los acuerdos establecidos entre cónyuges o parejas ocasionales, entre otros.

5.- Es importante enfatizar que medidas punitivas como las que se pretende legislar a través de esta iniciativa, podrían obstaculizar y afectar las diversas acciones multisectoriales en materia de prevención, detección y atención del VIH en nuestro Estado.

6.- Podría influir a que las personas que se perciban con factores de riesgo ante el VIH, omitan realizarse una detección temprana a fin de no conocer su estado serológico en virtud de prevenir un posible proceso penal. Este tipo de legislaciones pueden afectar al Continuo de la detección, prevención y atención en VIH en México[1], el cual busca que las personas que se perciban en riesgo se realicen un diagnóstico temprano, puedan recibir un tratamiento oportuno que mejore su calidad de vida y además contribuya a frenar la cadena de transmisión.

7. La evidencia científica señala que para detener la cadena de trasmisión del VIH de una persona a otra es indispensable realizar estrategias de prevención combinada, entre las cuales, destacan las biomédicas, las comportamentales y las de cambio estructural, estas últimas enfatizan las acciones que contribuyen a erradicar el estigma y la discriminación asociado al VIH-sida, y una ley con acciones punitivas no contribuye con estas estrategias.

8.- El contenido en específico de esta iniciativa de “Peligro de contagio” podría provocar que la responsabilidad jurídica de la prevención del VIH recaiga solamente en quienes viven con VIH, y podría invisibilizar el mensaje de salud pública de que las parejas sexuales tienen responsabilidad compartida sobre su salud sexual. Las personas podrían suponer erróneamente que sus parejas son VIH-negativas porque desconocen o no revelan su estado serológico, por tal dejarían de incorporar medidas de prevención.

9.-Este tipo de adecuaciones al código penal promoverán mayores niveles de estigma y discriminación hacia las diversas poblaciones con VIH y sus familias.

Amigos Potosinos en lucha contra el Sida exhorta al gobernador del estado Juan Manuel Carreras López y a Erika Velázquez Gutiérrez presidenta del Instituto de las Mujeres en San Luis Potosí (sic), a reconsiderar la penalización del VIH, de hacerlo colocarían a las personas con VIH bajo un estatus de posibles criminales, contraviniendo a su dignidad como personas, atentando a sus derechos humanos y estigmatizándoles por su condición de salud.

Mejor aún, le exhortamos a impulsar la creación del Consejo Estatal Para el control del VIH, Sida e ITS en San Luis Potosí, además incrementar los recursos  para prevenir, detectar y atender oportunamente el VIH; mejorar la calidad e integralidad de los servicios de atención en el Estado que son otorgados desde los CAPASITS y hospitales del sector salud; generar y fortalecer programas de empoderamiento para las mujeres y acciones que busquen promover la igual de oportunidades entre mujeres y hombres; por último a disminuir el estigma y la discriminación hacia las poblaciones clave y personas afectadas por el VIH y otras ITS incorporando el principio MIPA[3] que habla del mayor involucramiento de las personas con VIH como parte de la solución y respuesta, con ello contribuir a un México democrático, incluyente y sin discriminación.

US: New report explores how HIV criminal laws in California are enforced against foreign born populations

FOR IMMIGRANTS, HIV CRIMINALIZATION CAN MEAN INCARCERATION AND DEPORTATION 

New Study Shows 15 Percent of People who had Contact with Californa Criminal System because of HIV Criminalization Laws were Foreign Born

LOS ANGELES – A new study suggests that for some immigrants, an HIV-specific criminal offense may have been the triggering event for their deportation proceedings.  In HIV Criminalization Against Immigrants in California, Williams Institute Scholars Amira Hasenbush and Bianca D.M. Wilson, explore how HIV criminal laws are enforced in California, particularly against foreign born populations.

HIV criminalization is a term used to describe statutes that either criminalize otherwise legal conduct or that increase the penalties for illegal conduct based upon a person’s HIV-positive status.  California has four HIV-specific criminal laws, and one non-HIV-specific criminal law that criminalizes exposure to any communicable disease.  All HIV-specific offenses in California have the potential to lead to deportation proceedings.

“People living with HIV still face stigma and discrimination,” said Amira Hasenbush.  “If one is HIV-positive and enters the criminal system, one may be more severely impacted than those who are HIV-negative.  A major impact for HIV positive immigrants is possible deportation, possibly a far worse outcome than the original sentence.  Living with HIV is a public health matter, not a criminal one.”

Key Findings:

-Overall, 800 people have come into contact with the California criminal system from 1988 to June 2014 related to that person’s HIV-positive status.  Among those individuals, 121 (15 percent) were foreign born.

-Thirty-six people, or 30 percent, of these foreign born individuals, had some form of a criminal immigration proceeding in their histories. Among those who had immigration proceedings in their records, nine people (25 percent) had those proceedings initiated immediately after an HIV-specific incident.

-Like their U.S. born counterparts, 94 percent of all HIV-specific incidents in which immigrants had contact with the criminal system were under California’s felony offense against solicitation while HIV-positive.

-Eighty-three percent of the immigrants who had contact with the system based on their HIV-positive status were born in Mexico, Central or South America, or the Caribbean.

-While U.S. born people were divided fairly evenly between men and women, immigrants were overwhelmingly men: 88 percent of foreign born individuals in the group were men. (It should be noted that “men” may include transgender male-to-female individuals.  Problems created by a lack of data on transgender people within criminal justice databases are highlighted in the report.)

HIV Criminalization Against Immigrants in California was developed by analyzing the California Criminal Offender Record Information (CORI) data on HIV offenses in California, exploring the demographics and experiences of foreign born individuals as compared to their U.S. born counterparts. Future research beyond the enforcement data may explore whether initial patterns seen by sex and place of birth are perpetuated in other criminal systems or under other offenses. Future research can also explore the influence of sexual orientation and gender identity as a potential driver to the criminal system and as a potential mediating factor in experiences once in the system. This will help provide a more nuanced and complete picture of the experiences of people who are criminalized based on their HIV-positive status.

Read the report.

The Williams Institute, a think tank on sexual orientation and gender identity law and public policy, is dedicated to conducting rigorous, independent research with real-world relevance.

Canada: ‘HIV is not a crime’ documentary premieres in Montreal at Concordia University’s ‘The Movement to End HIV Criminalization’ event

Last week, Concordia Unversity in Montreal, Canada, held the world premiere public screening of HJN’s ‘HIV is not a crime training academy’ documentary, followed by three powerful and richly evocative presentations by activist and PhD candidate, Alex McClelland; HJN’s Research Fellow in HIV, Gender, and Justice, Laurel Sprague; and activist and Hofstra University Professor, Andrew Spieldenner.

The meeting, introduced by Liz Lacharpagne of COCQ-SIDA and by Martin French of Concordia University – who put the lecture series together – was extremely well-attended, and resulted in a well-written and researched article by student jounrnalist, Ocean DeRouchie, alongside a strong editorial from Concordia’s newspaper, The Link.

(The full text of both article and editorial are below.)

Presentations included:

  • Edwin Bernard, Global Co-ordinator, HIV Justice Network: ‘The Global Picture: Surveying the State of HIV Criminalisation’
  • Alex McClelland, Concordia University: ‘Criminal Charges for HIV Non-disclosure, Transmission and/or Exposure: Impacts on the Lives of People Living with HIV’
  • Laurel Sprague, Research Fellow in HIV, Gender, and Justice, HIV Justice Network: ‘Your Sentence is Not My Freedom: Feminism, HIV Criminalization and Systems of Stigma’
  • Andrew Spieldenner, Hofstra University: ‘The Cost of Acceptable Losses: Exploring Intersectionality, Meaningful Involvement of People with HIV, and HIV Criminalization’

Articles based on a number of these important presentations will be published on the HJN website in coming

weeks.

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The Movement to End HIV Criminalization

Decrying Criminalization

Concordia Lecture Series Prompts Discussion on HIV Non-disclosure

by Ocean DeRouchie — Published September 19, 2016 in The Link

The sentiment surrounding HIV/AIDS is often one of discomfort. But the reluctance to speak openly about such a significant and impactful disease is hurting the people closest to it.

Under current Canadian legislation, HIV non-disclosure is criminalized. It exercises some of the most punitive aspects of our criminal justice system, explained Alexander McClelland, a writer and researcher currently working on a PhD at Concordia.

McClelland was one of four panelists speaking under Concordia’s Community Lecture Series on HIV/AIDS on Thursday, Sept. 15 in the Hall building. The collective puts on multiple panel-based events in order to address the attitudes, laws, and intersections of political and socioeconomic stigma surrounding HIV/AIDS.

Talking About HIV, Legally

There are three distinct charges that guide prosecutors in HIV cases—transmission (giving the disease to someone without having disclosed your status), exposure (e.g. spitting or biting) and non-disclosure (not informing a sexual partner about your HIV/AIDS status).

Aggravated sexual assault and attempted murder are some of the charges that defendants often face, explained Edwin Bernard, Global Coordinator for the HIV Justice Network, during the discussion.

While there are clearly defined situations in which you are legally obligated to tell a sex partner about your HIV status, there are no HIV-specific laws. This results in the application of general law in cases that are anything but general.

In 2012, the Supreme Court of Canada established that “people living with HIV must disclose their status before having sex that poses a ‘realistic possibility of HIV transmission.’”

Aidslaw.ca presents a clear map of situations in which you’d have to tell a sex partner about your status because, in fact, it is not in all scenarios that you’d be legally required to have the discussion.

A lot of it depends on your viral load—the amount of measurable virus in your bloodstream, usually taken in milliliters. A “low” to undetectable viral load is the goal, and is achieved with anti-viral medication.

Treatment serves to render HIV-positive individuals non-infectious, and therefore lowering the risk of transmission. A “high” viral load indicates increased amounts of HIV in the blood.

If protection is used and with a low viral load, one might not have to disclose their status at all.

That said, there is a legal obligation to disclose one’s HIV-positive status before any penetrative sex sans-condom, regardless of viral load. You’d also have to bring it up before having any sex with protection if you have a viral load higher than “low.”

But not all sex is spelled out so clearly.

Oral sex, for instance, is a grey area. Aidslaw.ca says, “oral sex is usually considered very low risk for HIV transmission.” They write that “despite some developments at lower level courts,” they cannot say for sure what does not require disclosure.

There are “no risk” activities. Smooching and touching one another are intimate activities that, as health professionals say, pose such a small risk of transmission that there “should be no legal duty to disclose an HIV-positive status.”

Moving Up, and Out of Hand

Court proceedings are based on how the jury and judge want to apply general laws to specific instances. There are a lot of factors that can influence the outcome.

The case-to-case outlook leads to the criminal justice system dealing with non-disclosure in such a disproportionate way, said McClelland.

The situation begs the question: “Why is society responding in such a punitive way?” asked McClelland.

This isn’t to say that not disclosing one’s HIV status “doesn’t require some potential form of intervention,” he explained, adding that intervention could incorporate counseling, mental-health support, encouragement around building self-esteem and learning how to deal and live with the virus in the world. “But in engaging with the very blunt instrument that is the criminal law is the wrong approach.”

He continued to explain that the reality of the criminalization of HIV ultimately doesn’t do anything to prevent HIV transmission.

“It’s just ruining people’s lives,” said McClelland, who has been interviewing Canadians who have been affected by criminal charges due to HIV-related situations. “It’s a very complex social situation that requires a nuanced approach to support people.”

“It’s just ruining people’s lives. It’s a very complex social situation that requires a nuanced approach to support people.” – Alexander McClelland, Concordia PhD student

Counting the Cases

The Community AIDS Treatment Information Exchange, a Canadian resource for information on HIV/AIDS, states that about 75,500 Canadians were living with the virus by the end of the 2014, according to the yearly national HIV estimates.

That number has gone up since. On Monday, Sept. 19, Saskatoon doctors called for a public health state of emergency due to overwhelmingly increasing cases of new infections and transmission, according to CBC.

In Quebec, there have been cases surrounding transmission and exposure. In 2013, Jacqueline Jacko, an HIV-positive woman, was sentenced to ten months in prison for spitting on a police officer—despite findings that confirm that the disease cannot be transmitted through saliva.

In this situation, Jacko had called for police assistance in removing an unwelcome person from her home. Aggression transpired between her and the officers, resulting in her arrest and eventually her spitting on them, according to Le Devoir.

“[This case] is so clearly based on AIDS-phobia, AIDS stigma and fear,” added McClelland, “and an example of how the police treat these situations and use HIV as a way to criminalize people.”

Police intervention is crucial in the fight against HIV criminalization. McClelland urged people to consider the consequences of involving the justice system in these kinds of situations.

“It’s important to understand that the current scientific reality for HIV is that it’s a chronic, manageable condition. When people take [antivirals] they are rendered non-infectious,” he said. “They should then understand that the fear is grounded in a kind of stigma and historical understanding of HIV that is no longer correct today.”

The first instinct, or notion of calling the police in an instance where one feels they may have been exposed to the virus in some way is “mostly grounded in fear and panic,” he said.

“[Police] respond in a really disproportionate, violent way towards people—so I would consider questioning, or at least thinking twice before calling the police,” McClelland explained.

On the other hand, he suggested approaching the situation in more conventional, educational and progressive methods.

“I think it could be talked through in different ways—by going to a counselor, talking to a close friend, engaging with a community organization, learning about HIV and what it means to have HIV, and understanding that the risk of HIV transmission are very low because of people being on [antivirals].”

As for the current state of Canadian legislation, there are a lot of complexities that hinder heavy-hitting changes to the laws.

Due to the Supreme Court’s rulings in 2012, they are unlikely to review the decision for another decade. For now, the main course of action is “on the ground,” said McClelland. From mitigating people from requesting police involvement in order to “slow down the cases,” to raising awareness through events such as Concordia’s Community Lecture Series, and engaging with the people to resolve issues in community-based ways and collective of care.

Then, McClelland said, “trying to do high-level political advocacy to get leaders to think about how they can change the current situation” would be the next step.

Editorial: Community-Based Research is the Key to HIV Destigmatization and Decriminalization

Opinions by The Link — Published September 19, 2016

Receiving an HIV-positive diagnosis is already a life sentence. The state of Canada’s legal system threatens to give those living with the virus another one.

An HIV diagnosis is accompanied by its own set of complexities that are not encompassed in Canada’s criminal law. By pushing HIV non-disclosure cases into the same box as more easily defined assault cases, we are generalizing an issue that frankly cannot be simplified.

This does not reflect the reality that one faces when living with HIV. Criminalizing the virus further stigmatizes what should and could be everyday activities.

This puts the estimated 75,000 Canadians living with HIV at risk of being further isolated. This takes us backwards, considering the scientific progress that has been made to make living with the virus manageable. Under the proper antiviral medication, one’s risk of transmitting the disease is incredibly low. This stigma is rooted in an antiquated understanding of what HIV is and the associated risks—much of that fear having emerged primarily as a result of homophobia.

Further, with over 185 cases having been brought to court, Canada is leading in terms of criminalizing HIV non-disclosure. This pushes marginalized communities farther away. According to estimates from 2014, indigenous populations have a 2.7 higher incidence rate than the non-indigenous Canadian average. Gay men have an incidence rate that is 131 times higher than the rest of the male population in Canada.

As of Sept. 19, doctors in Saskatchewan are calling on the provincial government to declare a public health state of emergency, with a spike in HIV/AIDS cases around the province.

In 2010, it’s reported that indigenous people accounted for 73 per cent of all new cases in the province. Outreach and treatment for these communities are at the forefront of Saskatchewan’s doctor’s recommendations for the government.

With such a highly treatable virus, however, the problem should never have gone this far. It is an excerpt from a much bigger issue.

As we can see from the available statistics, HIV—both the virus and its criminalization—is a mirror for broader inequalities that exist within society. HIV related issues disproportionately affect racialized people, gender non-conforming people, and other marginalized groups.

Discussions around HIV also must include discussions around drug use. The heavy criminalization of injection drugs has created a context where users are driven deep underground, thus putting them at an incredibly high risk for contracting the virus. Treating drug use as a health rather than a criminal issue is an integral part of any effective HIV prevention strategy. Safe injection sites, such as Vancouver’s InSite, have made staggering differences in their communities and prove to be a positive way of combating the spread of HIV.

This is just one of the many ways that we can control the spread of HIV without judicial intervention, without turning the HIV-positive population into criminals.

Using community-based research enables us to not only understand the needs of the affected population—particularly when it comes to understanding the almost inherent intersectionality associated with the spread of HIV—but also allows us to better target our resources towards those who need it most.

Often times, that stretches to include those closest to HIV-positive individuals. Spreading awareness, and developing resources and a support network for them is just as important in fighting the stigmatization of the virus.

The Link stands for the immediate decriminalization of HIV non-disclosure, and the move towards restorative justice systems in non-disclosure cases. As always, those directly affected by an issue are the ones with who are best positioned to create a solution—something that the restorative justice framework embraces.

The disclosure of one’s HIV status is important. Jailing those who don’t disclose it, however, won’t make the virus go away. It simply isolates the problem, places it out of site and out of mind.

Criminalizing HIV patients is less about justice than it is about appeasing the baseless fears of the general population. It’s time for a more effective solution.