In an era where the term ‘lockdown’ is used to limit our movements, spare a thought for the many prisoners living with HIV (some of whom have been unjustly convicted under HIV criminalisation laws) who are experiencing real lockdowns and severe isolation.
With community support interventions becoming increasingly formalised, and NGOs pushed to operate in terms of strategic plans, deliverables, outputs and outcomes, Sero’s Holiday Card Project stands as a rare example of an organisation recognising the worth of a project focused solely on gestures of basic human kindness.
Last year, the project delivered Holiday cards to around 900 incarcerated people, most of whom are living with HIV. For some, it was the only mail they received all year.
So how did the Holiday Card Project come to be, has it made a difference, and how can you help this year?
Back in the 1980s and ’90s, Cindy Stine lost a lot of friends to HIV. In 1996, just before effective treatments became available, she lost a close friend who was like a son. She made a promise to him that she would continue to be involved in the AIDS response. That’s a promise she’s kept.
Cindy Stine of the Sero Project
In 2011, Cindy was serving on the board of a local LGBT centre when she invited two speakers from the fledgling Sero Project to speak at an event. The speakers were Sean Strub, Sero’s Executive Director, and Robert Suttle. Sean introduced the audience to the concept of HIV criminalisation, a new issue for most, including Cindy. Robert talked about what it means to live as an HIV criminalisation survivor, explaining that as the result of an HIV non-disclosure charge, he served six months in the Louisiana state prison and would be registered as a sex offender for 15 years. Robert showed an image of his driver’s license, with ‘sex offender’ stamped in bold red lettering: ID he has to show often and in many different circumstances.
Cindy approached Sean and Robert to let them know that she wanted to help. A few days later, Sean rang Cindy and invited her to his office where he showed her a stack of letters that Sero had received from people in prison. Sean asked Cindy if she’d volunteer to take on the task of answering the letters. She agreed.
Things could have ended there, with Cindy answering people’s individual letters, but as Cindy read those letters week after week, each letter more heart-breaking than the last, she began to really appreciate the isolation, loneliness and desperate need for connection experienced by many of those inside. She talked it over with her Sero colleagues, and they decided their efforts to build a movement against HIV criminalisation needed to expand to be more inclusive of those who were incarcerated; those directly impacted by HIV criminalisation. They decided to explore how they could support development of a prisoners’ network, starting by compiling a database of contact details of those who’d written.
As Sero grew, Cindy was employed to take on community education and other projects but her work answering prisoners’ letters continued. Cindy says of those letters, “sometimes the people writing didn’t even have access to paper, so they’d write on any scrap of paper they could find – recycled envelopes or bits of paper torn off something else. Many of those sending letters weren’t really literate but they wanted to communicate.”
As the 2015 Holiday season approached, Cindy found the letters got harder to read. “A lot of people wrote about loneliness and about their families disowning them after finding out they had HIV, or were gay, or were transgender. People felt they’d been thrown away and forgotten.” Then she had a simple thought, “Wouldn’t it be nice for them to know that they’re not alone.” Then another, “We should send Holiday cards”. She took the idea to Sean, who agreed.
By then, Cindy’s database was so large that she realised Sero would need to prioritise who got cards, focusing on those who were incarcerated as a result of HIV, or they had HIV or another debilitating illness. Cindy also wanted to ensure each person got at least three or four cards but … how to go about it? Cindy put out a call to the 900 or so people on the Sero list-serve asking if anyone was interested in writing some Holiday cards. The response was overwhelming. Many offered to help, with some asking to do 20 cards, some asking to do 200.
The Holiday Card Project has continued each year since then. People express an interest, Cindy sends them a list of first names; they write message on the cards, put them in blank envelopes and return them to Sero; Cindy sorts them, addresses them, and mails them off.
Those who write cards come from all different parts of the community, including some working in other HIV advocacy organisations, some parents of prisoners, and some people living with HIV. People are asked not to ask personal questions but to write messages of support: things like ‘hope you’re doing well’, ‘we’re thinking of you’, and ‘you’re not forgotten’. Some write about themselves, their experience living with HIV, their thoughts and prayers. Some write, ‘we’re thinking of you when we fight HIV criminalisation’.
Sero’s staff and volunteers
One group gets together and spends a day each year writing Holiday cards. People come from all over, saying it feels really good coming into a non-judgemental space and writing messages from the heart. Sometimes Sero will set up a table at a conference and invite people to write cards. Others write cards at home. People feel involved. Each step in the process has meaning: the choice of card, the choice of words, with many people sending their cards with stamps to send them on, to further support the project.
Last Holiday season, about 900 people received cards in facilities across the US, including people on death row. The responses from those who received cards is humbling. Some said, it was the only card they’d received all year, but those cards meant that they knew they were not forgotten. They couldn’t describe the feeling of hearing someone from the mailroom say, ‘You’ve got mail’. They knew that somebody out there had thought enough of them to send a card. Recently Cindy received a letter from a man who’s recently been released. He said that for the last three years he’d so looked forward to those cards as it was the only mail he got. It meant a lot that people had taken the time to write.
The project is not without its challenges. Cindy spends considerable time keeping track of people, as prisoners are often moved. There are also major issues regarding mail screening. Although Cindy has worked to build a rapport with those managing mail distribution at many of the prisons, that hasn’t guaranteed mail is always received. Mail screening rules differ from state to state, institution to institution, and the rules keep changing. Some prisons have now banned cards altogether, some won’t allow glue or glitter or coloured paper, etc. If mail is considered contraband it may be thrown out or returned to Sero. That process has at times driven Cindy to photocopy returned cards, sending the copies in the hope the person will still receive the good wishes.
The Holiday Card Project may have modest goals – to show compassion and care to those who feel abandoned, but it has delivered far more. It has made a difference to the lives of many, letting them know that there are people outside of prison ready to provide support. It has raised awareness about HIV criminalisation and provided a mechanism for people to show they care. It has also helped build trust between prisoners and Sero, a facor that has proven critical to the development of a stronger prisoners’ network and greater engagement with Sero. A stronger prisoners’ network has meant more support for those inside, and it has also resulted in other great projects, like Turn It Up, the health magazine that includes information about HIV for those in prison, largely written by people who are, or have been, incarcerated.
Some of Sero’s Holiday cards
While Sero is best known for its HIV criminalisation reform programmes, its efforts to support network building and empowerment have proven equally important. Sero operates from the belief that those most directly impacted should be at the centre of this work, which is why facilitating the creation and strengthening of networks of People Living with HIV and allies, particularly those representing key populations, remains critical and a priority.
Every year the Holiday Card Project has grown, with prisoners writing to Cindy to let her know if they’ve been moved to another facility. Others write saying, “a friend of mine got cards. Can I be put on the list?” Parents get in touch too, asking for their children to be added to the list, and also writing letters of thanks for cards received.
Still, Cindy thinks there is room for the project to grow; sending cards for holidays celebrated by other religions at other times of the year, and also considering whether cards could be sent for some non-religious events, such as Halloween or Thanksgiving. That way the project can become more inclusive and people won’t have to wait an entire year for mail. Of course, that will mean attracting more people to write cards so that more people can receive them.
If you’re interested in supporting the work of the Holiday Card Project, please contact Cindy at cindy.stine@seroproject.com, Subject – Holiday Card Project.
Uganda: HIV activists ask government to review the HIV/AIDS law and remove clauses that criminalise HIV
Activists, chief justice call for review of HIV/AIDS law
The majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status.
HIV/AIDS activists have asked the Government to review the HIV and AIDS Prevention and Control Act 2014, saying it is fuelling stigma and discrimination.
The activists, while speaking at the Philly Bongole Lutaaya memorial lecture, said the law has clauses in it that if left unchanged could undo the country’s gains in the fight against the disease.
Dora Musinguzi, the executive director of Uganda Network on Law and Ethics (UGANET), said clauses that criminalise HIV, especially intentional transmission are causing more harm because it’s scaring people away from testing, disclosing their status to the spouses or seeking treatment.
She pointed out clauses such as sections 41 and 43 which spell out punishments for attempted transmission of HIV and intentional transmission, respectively.
“We need to do everything it takes to repeal this law, especially the punishment for exposure to HIV/AIDS. We need to remove the criminalisation under the law because it is causing more harm,” Musinguzi said.
The activists said the majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status to their significant others for fear of prosecution. This, they said, has fuelled self-stigma.
Justice Alfonse Owiny-Dollo, in his keynote address as the guest speaker, agreed that the law needs to be amended if Uganda is to achieve its goal of ending the AIDS epidemic by 2030. His address was read by the Judiciary’s Chief Registrar, Sarah Langa.
Owiny-Dollo called on Parliament to enact and review laws that will improve the wellbeing of the society especially the people living with HIV.
“The HIV and AIDS Prevention and Control Act 2014 may need to be reviewed,” he said.
“Ending HIV requires enabling legal and social environments that guarantee the health, dignity and security of all people living with or at risk of HIV. This is the only way to ensure that all those in need of HIV prevention, treatment, care, and support have access to these services without fear of discrimination, exclusion or bias,” Owiny-Dollo said.
He said much as there are enabling laws on non-discrimination on the basis of one’s HIV status, the HIV-positive still face limitations when seeking justice. These include lengthy proceedings and an unfriendly court environment.
The lecture was held under the theme Access to HIV services during COVID-19 pandemic. It was held at the Office of the President auditorium and was notably attended by the late Lutaaya’s children, friends, activists, musicians living with HIV. The HIV prevalence is 6.2% amongst adults aged 15-64 years; 7.6% in women and 4.7% in men.
Tezra Lutaaya, a daughter of the deceased, said although her father championed the fight against the disease, stigma and discrimination against HIV-positive persons is still rife.
“I strongly believe that an end to HIV is in sight if we continue to fight stigma, make sure seamless information and access to all interventions are available and that we continue to have dialogue with the young people both infected and affected by HIV,” she said.
Esther Mbayo, the Minister for the Presidency, said if AIDS is to be ended by 2030, there is need to exhibit the spirit of Philly Lutaaya.
“We need to get out of our comfort zones, especially now that we are dealing with two pandemics — HIV and COVID-19. On an individual level, we need to test for HIV with our partners and together irrespective of the results, decide to prevent HIV,” she noted.
She called for deliberate efforts to reach those at most risk of getting infected with HIV in order to reduce the high HIV prevalence and towards ending stigma and discrimination.
Owiny-Dollo urged the Government to prioritise creating awareness, promoting advocacy that reaches the young people and all generations with messages on HIV and AIDS.
Canada: HIV Legal Network publishes new guide to assist journalists in reporting responsibly about HIV criminalisation cases
This guide is an evidence-based resource to assist journalists in Canada in reporting responsibly and accurately about alleged HIV non-disclosure and resulting criminal cases.
People living with HIV in Canada can be prosecuted for “aggravated sexual assault” (one of the most serious charges in the Criminal Code) if they don’t tell their sexual partners, in advance of intimate contact, that they have HIV. The criminalization of “HIV non-disclosure” is severe and rooted in stigma: people face charges even in cases where there is little or no risk of transmitting HIV. The maximum penalty is life imprisonment, and a conviction carries with it a mandatory designation as a sex offender. This approach has been criticized, both domestically and internationally, as being contrary to human rights and principles of public health, including by United Nations experts. Instead of reducing HIV transmission, HIV criminalization is now recognized by many experts as a driver of the epidemic.
There have been dramatic advances in treating and preventing HIV, which have resulted in a gradual change in public discourse and understanding. But there’s still a lot of misinformation. Media can play a vital role by modernizing the discussions we’re having about HIV and by reporting about HIV non-disclosure in an evidence-based and responsible way that doesn’t perpetuate stigma.
THE National AIDS Trust has moved to quell fears that anyone could contract HIV via bloodied clothing after a woman was fined for threatening to infect a police officer in Newtown last week.
This week C. pleaded guilty to assaulting an emergency worker when she appeared at Welshpool Magistrates Court.
The 35-year-old was brought in to custody at Newtown Police Station on August 26 covered in blood – which she claimed belonged to someone else – and became abusive, eventually stripping and throwing the bloodied clothes at custody sergeant Grace Coburn, telling her the clothes had hepatitis and HIV on them.
Sgt Coburn was told by C. that she probably also “had Covid as well”.
But the trust – the UK charity dedicated to transforming society’s response to HIV – has responded to the “misinformation” presented by the case, moving to reassure people that HIV cannot be transmitted in this way.
Danny Beales, head of policy and campaigns at the National AIDS Trust, said: “It’s disappointing to read that HIV is still being used as a threat in 2020.
“The stigma and misinformation that surrounds HIV mean that cases like this are far too common. We would reassure readers that there is no risk from HIV on bloodied clothing as the virus is very fragile and does not last long outside the body.
“Also, the majority of people living with HIV in the UK are on effective treatment which means they cannot pass on the virus in any way.”
C. was given a £200 fine and will pay compensation of £50 to the officer. She will also pay £85 costs.
We Are People, Not Clusters! Why public health surveillance using blood taken for HIV resistance testing risks doing more harm than good
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.
PHILADELPHIA (September 8, 2020) – HIV prevention remains a public health priority in the United States. Pre-exposure prophylaxis (PrEP) is a drug regimen recommended for individuals who have engaged in behaviors that place them at elevated risk for HIV. When used consistently, daily oral PrEP has been shown to reduce HIV transmission by 99 percent. However, despite increases in PrEP awareness and uptake over the past several years, data show that four of five people who could benefit from PrEP did not access the medication in 2018.
In an article for the September issue of Health Affairs, researchers from the University of Pennsylvania School of Nursing (Penn Nursing) explored associations between state-level policies and PrEP uptake. They found that states with HIV criminalization laws (i.e., statutes that criminalize status non-disclosure) had a lower PrEP-to-need ratio, and states with comprehensive nondiscrimination laws for sexual and gender minorities had a higher PrEP-to-need ratio.
“Our study corroborates the growing consensus that HIV criminalization laws offer little to no public health benefit and inhibit HIV prevention efforts,” says Stephen Bonett, PhD, RN, the first author of the article, and postdoctoral fellow at Penn Nursing’s Program for Sexuality, Technology and Action Research (PSTAR).
“Given the evolving state of HIV prevention and the growing body of evidence showing that HIV criminalization may hinder public health efforts, state governments should move toward repealing HIV criminalization laws,” the authors write. “In addition, legislative efforts should be directed toward improving access to HIV treatment and prevention and reducing stigma and discrimination against people living with HIV.”
The article, “State-Level Discrimination Policies and HIV Pre-exposure Prophylaxis Adoption Efforts in the U.S.” is set for publication this fall. Co-authors of the article include Steven Meanley, PhD, MPH, and José Bauermeister, PhD, MPH, both of Penn Nursing; Steven Elsesser, MD of Penn Medicine.
About the University of Pennsylvania School of Nursing
The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing. For the fifth year in a row, it is ranked the #1 nursing school in the world by QS University and is consistently ranked highly in the U.S. News & World Report annual list of best graduate schools. Penn Nursing is currently ranked # 1 in funding from the National Institutes of Health, among other schools of nursing, for the third consecutive year. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice.
US: “Institutionalized discrimination gives people a reason to avoid getting tested or having open conversations around the disease”
The HIV Pandemic Is Still Raging—and Won’t Stop Until We End the Stigma
One of the hardest lines I’ve ever had to deliver was, “I’m going to die.” It was the initial response of my character Ricky after being diagnosed with HIV during the height of the epidemic in season two of the 1990s drama POSE.
Ricky, like me, is a young Black queer man. I, the actor, had to contend with how true this statement must have felt for him, because an HIV diagnosis was largely a death sentence in 1990. Today, despite all the advances in science and medicine, as a Southerner, I am more likely than the average American to contract HIV, less likely to receive treatment, and more likely to die from HIV.
Tens of thousands of people are diagnosed every year, and in some states, annual diagnoses are on the rise. This is particularly true in the South, which accounts for 51 percent of HIV diagnoses despite only making up 38 percent of the U.S. population. There is a level of complacency around HIV that troubles me. Most people don’t understand that we’re still in the midst of the HIV epidemic.
It is true that HIV is no longer a death sentence, but fear, misinformation, and shame surrounding the disease remain and make the epidemic harder to contain. Stigma makes it harder to educate people about the disease, and stops people from seeking crucial treatment that saves lives and prevents its spread.
Americans are still seriously misinformed about HIV. The GLAAD and Gilead Science’s ‘State of HIV Stigma’ Survey found that the public’s knowledge of HIV is dangerously inaccurate and that they hold significant feelings of stigma towards people living with the disease. According to their study, only 60 percent of Americans believe that “HIV is a medical condition that can be treated,” despite the fact that drugs treating HIV have been on the market for over a decade. Even more troubling, nearly 6 in 10 Americans wrongfully believe that “it is important to be careful around people living with HIV to avoid catching it.”
Scientists have proven that HIV cannot be passed through healthy, unbroken skin, and people with HIV who take HIV medicine as prescribed and keep an undetectable viral load have virtually no risk of sexually transmitting HIV to their HIV-negative partners. Yet, this is not widely understood by the public and contributes to more people unnecessarily contracting the disease. A study in Toronto, where HIV is criminalized, found that men who had sex with men were less likely to get tested because of the laws, creating an exponential 18.5 percent increase in HIV transmission.
Around the same time Ricky found out he had HIV, I was born in Florida, a state that still criminalizes HIV and uses the law to punish people and perpetuate stigma. Engaging in consensual sex or donating blood or organs without disclosing one’s HIV status is a third-degree felony in the Sunshine State. This could lead to five years in prison and a $5,000 fine. Florida isn’t alone; today 34 states have HIV-specific criminal laws or sentence enhancements that apply to people living with HIV. This kind of institutionalized discrimination gives people a reason to avoid getting tested or having open and honest conversations around the disease.
US: Interview with JoAnn Wypijewski on the Nushawn Williams’s case, a “signpost on the road to the criminalization of HIV”
Sex panics keep happening because they tap into Americans’ deepest fears about the need to protect innocents from the threat of evil — fears that are endemic among the Left as well as the Right. Meanwhile, lives are destroyed in the process.
JoAnn Wypijewski’s new book, What We Don’t Talk About When We Talk About #MeToo: Essays on Sex, Authority and the Mess of Life, is a collection of her writing over several decades about sex, class, and liberation – and what we all lose when we surrender to moral panic. In the book, she explores and complicates narratives surrounding AIDS, the “pedophile priest” scandals that have plagued the Catholic church, #MeToo, and many others.
What is a sex panic?
JW – It’s a social eruption fanned by the media and characterized by alarm over innocence imperiled. That innocence, historically and stereotypically, has belonged to white women and children. The sex panic always involves some form of bad actor. Usually the bad man, the predator, is a lurking, mutable, social presence, a menace against which the population can be mobilized. Anthropologist Roger Lancaster calls this a “poisoned solidarity.” You can go back to Birth of a Nation. You can go back to the white slavery panic of the 1880s. Or a more modern period: the 1950s, where the Red Scare was a form of moral panic, and there was a “lavender panic” at the same time.
“Superpredators,” the priests scandal, the Satanic panic — all have featured a tremendous amount of media attention and repetition of a storyline that cannot be questioned: a narrative of good versus evil where the evil one is out there doing something to the good, and the evil authorizes all the bad that the good can do.Anything can be done to the bad man. And those doing it can feel a tremendous sense of vindication and social validation. That has accomplished something very practical: it has helped to build the prison state. According to a terrific book called The War on Sex, sex crimes are the fastest-growing cause of people being imprisoned. As leftists, we have to be concerned about that. But it’s also culturally developed a turn of mind that there are some people against whom anything is justified.
LF – Let’s talk about one of those people. Tell us about Nushawn Williams.
JW – Nushawn Williams was a young man from Brooklyn in the 1990s who was a petty drug dealer involved in various criminal activities, who, along with a number of other young people at the time, went upstate to sell drugs and to have what would be probably a better life. He went to the town of Jamestown, about seventy miles southeast of Buffalo, where I grew up. He was very popular with women and very successful as an entrepreneur. He was arrested at one point and tested for HIV, and he was told he was HIV-positive.
Perhaps he didn’t believe it or was in denial — we don’t know — but he continued to have sex with young women. A bunch of them turned up HIV-positive, and the state did something it had never done before. It took his mugshot and put it on a poster that said, “Public health threat, warning, warning, danger. If you’ve had sex with this man, come down immediately for a test.” And then it counseled those looking at this poster that their identity would be completely confidential. Of course, they had just busted his confidentiality! But the fact is that Williams did everything that the state wanted. When he was told he was HIV-positive, they asked him, “Who did you have sex with?” He gave them all the names.
LF – There’s a contemporary resonance here. As we’re rediscovering now with COVID-19, contact tracing is hard because people often do not cooperate with the authorities to the extent that he did. Nushawn Williams was a model participant in this process.
JW – He was a model participant!
This case was a signpost on the road to the criminalization of HIV, a blaring alarm: “There is an HIV predator among you.” He was on the cover of all the tabloids and the New York Times, and on CNN and in the world press.And all the stories were the same. He was a “lethal Lothario.” He was the devil himself. He was a monster, he was a demon, he was an HIV predator, and this was just declared. These young women were all interviewed. They’d said a variety of things which came down to, “I thought I was in love. He gave me gifts. I thought he would be around. I’m so sad and broken now.” And that was pretty much the story, except for one woman who said, “I don’t know, I won’t join in on this. I loved him once. I’m not going to demonize him.” This woman was eighteen years old.I thought, “She’s the one I want to talk to.” And I met her in jail. She was in jail for breaking probation. And then I met some other people who either had been with him or had been in the same world as he was, and I explored that.The whole town was suddenly embracing young women who it never had any interest in, at all. They were “trash.” I mean, I would not call them that, but that’s how they were perceived. But suddenly they were the flower of Jamestown. Suddenly they were innocent girls who had been defiled by this awful monster, this animal, this predator. And suddenly they were humanized. They were humanized as victims.Some had no way of certainly knowing [that they got the virus from Williams]. And the authorities were completely uninterested in how he may have contracted the virus.I always think of every story I do as a class story. That’s my background. Before I started writing about sex, I was mostly writing about labor and class and unions and union politics, but always, I was interested in the people involved and their particularities. I couldn’t talk to Williams. [His lawyers declined to make him available for interviews.] But I was interested in the world of the women and the world of the town. After that story appeared, people in Jamestown were upset. They said, “You make it out as if the whole town is terrible.”
LF – Well, it did sound like a depressing place, but you also make clear that it was no more depressing than many other American cities.
JW – The guy who became mayor, Sam Teresi — he was then the development director — was straightforward about what deindustrialization had done to the country. This was the mid-’90s, but while people tend to see deindustrialization as an effect of NAFTA, in that part of New York state and in New York City, it had all started much sooner, in the late ’60s. Then, by the late 1970s, everything starts shutting down. So, in Buffalo, where I grew up, where my uncle worked in the steel mill, my father worked in a factory as a tool and die maker — for the company that invented the windshield wiper — all of us were affected. Catastrophe hit these towns and these cities. Teresi was saying, even with the best plans that we have here in Jamestown trying to make something happen, no one’s going to make an oasis in the desert of deindustrialized America.
I think that’s pretty heavy, and I think people ought to have paid attention to that part of it, because why were these guys involved as [drug drealers]? There were no other avenues, certainly, for good wages. And the young women, if they weren’t in the business, they were working in screw factory making $6 an hour, and that’s the reality. And so sex in that context, and sex with Nushawn Williams in that context, was not the worst deal. He presented the best deal. And that should raise questions for all of us.It should also, as in every story, force us to recognize the humanity of every actor. That’s what I’ve tried to do. My whole career is to look at, even people who’ve done the worst thing, and try to see them not as monsters, not as demons, but products of a culture, of a society. They were once some little bitty baby in some mother’s arms, and something brought them to some point where, say, they kill Matthew Shepard out at the fence, or they do something heinous to prisoners at Abu Ghraib. Figures in the book exist within historical time and within social, cultural, and economic time. Their choices are confined the way all our choices are confined. There was no way for a Nushawn Williams to get a fair shake in this situation, He’d been declared a monster. He’d been declared public enemy. He’d been declared a criminal and had to be put away, and the state didn’t have particular laws criminalizing HIV, but it found other means. He was convicted of having sex with two underage women (statutory rape) and served twelve years in prison. Hard time.When he got out, the state decided that it was going to bring a case for civil commitment against him and declared him a “sexually dangerous” person. Then there was the kangaroo-type trial to prove that, which occurs all over this country. He was found indeed to be a sexually dangerous person, not for what he did, but for what he might do, and he joined some six thousand other people who are confined to mental institutions, detained indefinitely, without hope of getting out, supposedly for “treatment.”I think we need to look at the social mechanisms that organize consent for punishment.What’s always disturbing to me is that this ecstatic, panicky, moralizing approach is also embraced by the Left, by people who might shun, for instance, the Times reporting on terrorism.
LF – Yes, what about the sex exception on the Left? It seems especially jarring now, when ideas like the abolition of prisons and of police have so much traction, and restorative justice is a mainstream concept. The idea of due process would be taken for granted if someone was accused of murder, yet even people on the Left still demand the blood of anyone accused of a sexual violation.
JW – If we’re serious about culture and its formative power, then you have to look at the dominant culture that is the cauldron of current damaged life. We have to be serious about that, because it does form what James Baldwin called the “habits of thought” that reinforce and sustain the habits of power. I mean, toward authoritarianism. How we resist those habits of thought means separating yourself — or trying to — from them. That’s the work of a lifetime, because the propagandizing power of the culture is nonstop.
ABOUT THE AUTHORJoAnn Wypijewski is a journalist and the author of What We Don’t Talk About When We Talk About #MeToo: Essays on Sex, Authority and the Mess of Life.ABOUT THE INTERVIEWERLiza Featherstone is a columnist for Jacobin, a freelance journalist, and the author of Selling Women Short: The Landmark Battle for Workers’ Rights at Wal-Mart.
US: Criminalizing and stigmatizing HIV only leads to more HIV infections
For transgender Floridians, stigma and fear of arrest could lead to new HIV crisis | Opinion
There’s another public health crisis laying in the shadows of COVID-19, and it’s completely preventable: HIV. More than 20,000 people are living with HIV in Fort Lauderdale – and more than 100,000 across Florida. New HIV infections have been increasing in Florida every year since 2013, and the state’s budget for combating HIV increased 15% between 2015 and 2018.
HIV currently has a disproportionate impact on certain communities. Only one in four people in Fort Lauderdale are Black, but they represent nearly half the city’s population of people living with HIV. Latinas are twice as likely as white women in Fort Lauderdale to be living with HIV. Transgender people are 49 times more likely than cisgender people to have HIV.
Transgender people also face high rates of violence, with transgender people of color being particularly impacted. In 2019, more than 20 transgender people were killed, virtually all of them Black or Latinx. Far too often, their names don’t make the news, names like Tony McDade or Bree Black, both of whom were killed in Florida this year.
Transgender people of color, and in particular transgender women of color, face layers of stigma. Transphobia, racism, and sexism all take a toll on a person and make them more vulnerable in many aspects of their life, including being more likely to contract HIV.
We have the tools and knowledge to stop HIV in its tracks. Taking simple precautions greatly minimizes transmission. Testing can offer quick results. And drug regimens can treat people living with HIV and prevent it from spreading. But a lack of understanding and prejudice against people living with HIV prevents us from taking advantage of these tools. Money is not the issue – the law is.
Florida’s very tough HIV criminalization laws have made a bad situation worse. In Florida, having consensual sex, donating blood or organs, or engaging in sex work without disclosing one’s HIV status is a third-degree felony, which could lead to five years in prison and a $5,000 fine. The law doesn’t take into account whether protection is used, if people maintain a drug regimen that virtually eliminates any chance of passing on the disease, or the fact that blood is screened – for many diseases, including HIV – before being donated.
Not only are HIV criminalization laws antiquated and discriminatory, they have a devastating impact on public health and the perception of HIV. When our own state government is labeling those living with HIV as criminals, it perpetuates stigma. It creates a fear of basic education, getting tested or talking about HIV, even with friends and family. It’s hard to blame them considering five years in jail is a possibility.
Our state has created a vicious cycle: people choose to not know their status out of fear of repercussions. Therefore, they don’t receive treatment, leading to more people unknowingly spreading the disease. Criminalizing and stigmatizing HIV only leads to more HIV infections.
Earlier this month, the results of the “GLAAD-Gilead State of HIV Stigma Survey” were published, measuring attitudes towards HIV, and the results showed we still have a long way to go. Nearly 6 in 10 Americans wrongfully believe that “it is important to be careful around people living with HIV to avoid catching it.” That’s not true and the medical community has known this for decades. But when it’s difficult to educate people on the disease, misinformation spreads and has a damaging impact on public health.
Knowing that transgender people are more likely to be affected by HIV, at TransInclusive, we spend a considerable amount of time reaching out to that community. When you add the stigma transgender people face to the stigma that surrounds HIV, it makes our outreach efforts that much harder. Moreover, it becomes even more difficult to ensure transgender people have the resources needed to prevent the spread of HIV.
The survey found that one in two Americans would be uncomfortable with a partner or spouse living with HIV, which only increases the disproportionate impact HIV has on transgender people, considering they have the highest rates of infection. Ignoring these disparities will only continue to harm the communities most at risk of contracting HIV.
Training and resources from allies are part of the solution. Grants from private-sector partnerships like the Gilead COMPASS Initiative have helped us build a grassroots effort to prevent the spread of HIV by going into the Fort Lauderdale community to educate people and hosting group sessions where individuals can learn without fear of judgment. During the social distancing measures of the COVID-19 pandemic, we’ve held our “Open Night Thursday” series virtually to allow people from our community to talk to one another, learn about the resources available to them, and feel a sense of belonging.
But we must reach beyond our community, and to our lawmakers, to make the impact we need.
Changing misperceptions has to happen on the frontlines of health care and in the halls of state houses. Stigma will not go away if laws that criminalize HIV remain. Florida can’t end the HIV epidemic overnight, but the state can take steps now to stop the rise of HIV infections and avoid another health crisis. Ending the criminalization of HIV and educating our state about how to prevent its spread will help fight the pervasive stigma that still exists – and gets us that much closer to ending HIV in Florida.
Tatiana Williams is the co-founder and executive director of Transinclusive Group in Fort Lauderdale.
HIV criminalisation presentations and posters at AIDS2020
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.
You can select your preferred language from the 'Select Language' menu at the top of the page.
Continue
We use cookies to ensure that we give you the best experience on our website. By continuing to use our site, you are agreeing to our use of cookies. You can change your cookie settings at any time if you want. Find out more in our Privacy & Cookie Policy.
