Global: Powerful personal testimony and video highlight criminalisation concerns

IPPF (the International Planned Parenthood Association) has been campaigning against the criminalisation of HIV non-disclosure, alleged exposure and non-intentional transmission for the past few years, and this World AIDS Day they are highlighting their ‘Criminalise Hate Not HIV’ Campaign.

They have produced a beautifully shot two minute video highlighting their ongoing campaign, which you can watch below.

IPPF has also just launched Behind Bars – a collection of interviews that highlights the effect criminal laws are having on people’s working and private lives. I was particularly struck by two testimonials from individuals with whom I have had some prior contact.

Jan Albert is a Professor of Infectious Diseases and has worked at the Swedish Institute for Infectious Disease Control (SMI). Currently he works as an HIV researcher at the Karolinska Institute. He has been an expert witness in several trials; served as the expert reviewer for the ‘Proof’ chapter of NAM’s HIV and the criminal law; and contributed to my recent aidsmap.com news story on phylogenetic analysis. He was forced to do an about-turn in 2008 regarding the SMI helping police with their criminal investigations.

Here’s an exerpts of what he says in Behind Bars

Since I’ve been an expert witness in court trials, my personal opinion regarding people living with HIV (PLHIV) has changed. In my experience the accused persons are seldom ‘raw criminals’.  Instead, they are people who have been careless or even reckless. There  are many reasons for neglecting to inform sexual partners about HIV status, including denial. None, or very few, have had the intent to transmit HIV which is how these acts often are described by the media….I’ve seen prejudice in the media reporting of these cases, but that’s  how the media works and I have learnt how to deal with it. They often  want the sensational and spectacular news, especially tabloids. I wished  there was place in the media for a more nuanced view; sometimes we see  it, but not very often…Do we want to turn a proportion of our population into potential criminals every time they have sex?

Marama Pala from New Zealand also tells her story on Behind Bars.  She had actually emailed me more than a year ago wanting to tell her story on my blog, and I was happy for her to do so.  I prepared a version of her email for her approval but never heard back (I had especially wanted to know how to credit her – using her real name or a psedunoym).  Now that IPPF have published her name and story, I’d like to post what she wrote for me, which is similar, but a little more detailed.

Marama Pala was the key witness for the prosecution when Kenyan musician Peter Mwai was prosecuted for criminal HIV transmission in 1993.  Now an advocate for Māori living with HIV, she writes about her experiences and lessons learned exclusively for this blog.

KEY WITNESS FOR THE PROSECUTION

I was 22 years old when I had a sexual liaison with Peter Mwai that changed my life forever (23 July 1993). It was six weeks later that I saw a picture of his face on the front of a national newspaper with the caption, “Face of Fear”.  The article encouraged anyone that had contact with Peter Mwai to ring a detective in the New Zealand police. The detective asked, if I received a HIV-positive blood test would I help stop him from infecting other women? Not knowing what I was volunteering for, I said yes. The trial took over two years.

This was the first time that legislation written in 1963 was put to the test with charging someone with ‘wilfully infecting someone with a disease’ (maximum sentence 14 years). It was when the prosecution was unable to prove beyond a doubt that Peter Mwai was deliberately infecting people that charge was lessened to Grievous Bodily Harm (maximum sentence 7 years).

It was alleged that Peter Mwai infected an array of women before June 1993, and after six women – negative and positive – came forward and spoke to the police, they were able to charge him with reckless endangerment. I was the only one they could find who was infected after June – the date where the prosecution were able to provide evidence that he had knowledge of his HIV status. I’ve met 9 women infected by Peter Mwai.  It is presumed there are many more.

I had the condoms available, and during negotiating for safe sex, I was told that he was negative, he had a healthy child, he was healthy and why would he need to wear one and they hurt…  I trusted him. Bear in mind that 1993, negotiating for safe sex as a woman in New Zealand was almost non-existent, safe sex education was non-existent, and the only reason I had the condoms was because a friend had given them to me.

The court trial began. There was no doubt in my mind, should he be released back in to New Zealand society, that he would continue with his promiscuity, putting others at risk. He was found guilty.  He served five years in prison, was deported on release, and shortly after died in Uganda of TB.

RETHINKING CRIMINALISATION


I went in to hiding until 2005 due to unwanted and degrading media interference. It was when the situation within my ethnic community (Indigenous New Zealander Māori), was being threatened by HIV, that I became an advocate for Māori. We started a non-profit organisation called INA (Māori, Indigenous & South Pacific) HIV/AIDS Foundation.

On reflection, and spending time in the Pacific Islands reviewing the criminalisation of HIV in Papua New Guinea (my husband’s country) – first Pacific country to have HIV specific legislation – I began to recognise that the hyper-emotive ‘knee jerk’ reaction and subsequent dramas during the trial may have been a ‘tad’ heavy handed.

I started to become aware of how the criminalisation of HIV can cause stigma and discrimination for those living with HIV.  I then started to notice the differences that criminal law had on different cultural backgrounds, producing varied levels of severe to mild discrimination.  I also saw the agendas of all those who have a stake in this type of legislation. I’ve found the entire area to be a political minefield.  Whose rights are we wanting to protect? The rights of negative people wanting to be safe from infection? Or the rights of positive people to be protected from stigma and discrimination? It’s been said that the sway of the pendulum will always politically favour the majority. In Papua New Guinea’s HIV laws, they do have clauses for both sides: reckless infection of others, and discrimination of PLHWA.

INA has a philosophy that we are all responsible for HIV, and when all take responsibility, the fight will be won! Negative/Positive all have equal responsibility for HIV. HIV is an individual and public health concern.

In saying that, our women and men (Māori) have difficulty in negotiating safer sex and consensual sex. We have no programmes available to target either behavioural changes. Safer sex education is also lacking for all ages within cultural demographics. Sensitivity to cultural laws and beliefs on sex are not considered at all.

I’ve been quoted before saying that perhaps counselling and therapy would have been an option for Peter Mwai. Perhaps name, blame and shame, is not the best management of someone who puts others at risk.

I now believe that New Zealand’s criminal law is an ineffective and inappropriate tool used to address HIV risk behaviour. The psychological and mental state of a person who puts others at risk is not addressed in criminal law. Punishing them may have the opposite effect.  PLWHA are living longer with medication: would prison create a more calculating person that would be released eventually and continue to act with reckless disregard? There is no evidence to suggest that incarceration will offer any significant benefits in changing behaviours.

Criminal charges do little to stop the spread of HIV, within some cultures it dissuades people from being tested, having an attitude of ‘ignorance is bliss’, then they can’t be charged or fear of a positive test resulting in cultural violence, stigma and discrimination. Criminal charges do, however, divert resources and attention away from prevention initiatives already in place that are having an impact on reducing HIV transmission.

Most PLWHAs take responsibility for their bodies and their virus, practicing safer sex and disclosing to partners when necessary. I reiterate, it’s everybody’s responsibility to reduce exposure to any STI. Criminalising HIV puts the entire onus and responsibility on the PLWHA.

INFLUENCING NEW ZEALAND POLICY

My organisation, INA, would also like to acknowledge that ‘wilful’ or ‘reckless’ HIV infection continues to be an issue in New Zealand, with no criminal charges or spotlight placed on it in some communities. The cases mentioned above all involved women, with the most recent cases involving both men and women.  Sadly amongst our Men who have sex with men community, the prevention message targeting them the most as ‘High Risk’ has also created an acceptance of balancing the risk and life style. With many transmission of HIV being completely hidden with an acceptance attitude.

Mental illness, significant cognitive and/or psychological impairment, or a reasonable apprehension of harm adds to the compounding situation, with criminal charges doing nothing to respond to this reality or prevent further infection in such circumstances.

There has been no National Review of HIV in New Zealand, giving us a factual ‘picture’ of the situation in New Zealand. Even with recent criminal charges, there has been no directive on assessing the situation.  The complexities (homophobia, sexism, racism, stigma and discrimination) are being ignored and ‘panic’ is motivating decisions. That may be irreversible should these decisions become policy. All legal and policy responses would be best based on the best available evidence, HIV prevention, care, treatment, support and respect for human rights.

We support and advocate for a strong national policy response to HIV prevention and transmission.  We support a National Review of present criminal law in relation to HIV and review of support services available. And the exploration and development of alternatives to criminal charges and HIV, incorporating alternative responses addressing the individual, environment and social contexts involved.

Opinion: I Am HIV Positive and I Don’t Blame Anybody—Including Myself

A few months ago, I received an email from a young researcher and activist living with HIV.  Kirk Grisham said some very nice things about my work, and told me that I had inspired him to both write about the issues behind criminalisation, as well as to ‘come out’ publically about his HIV status.

The result is this fantastic analysis for ColorLines around personal responsibility for HIV prevention that really expresses many of my own thoughts on the issue, but in a much more accessible way than I could have ever achieved.

Kirk concludes that for him, criminalisation means that

I bore no responsibility for the epidemic, until I had HIV, when it became entirely my problem.

I’m including the opening paragraph here.  Click on the link to read the entire article at ColorLines.

I am HIV positive, and I don’t blame anybody for it—not myself or anybody else.

He didn’t rape me and he did not trick me. It was through our unprotected sex that I became HIV positive. Since seroconverting, I have been very conscious of the language I use to discuss transmission, particularly my own. To say “he gave me HIV” obscures the truth, it was through a mutual act, consensual sex, that I became HIV positive. When speaking to him a couple months after my diagnosis I gathered that he knew he was positive when we had sex. But that is beside the point; my sexual health is mine to control, not his.

Read the entire article at ColorLines.

US: Sean Strub blogs on why tackling criminalisation is crucial

POZ magazine founder, fellow anti-criminalisation advocate – and friend – Sean Strub, recently joined forces with the incredible Catherine Hanssens and her amazing team at the Centre for HIV Law & Policy to launch the Positive Justice Project.

In his latest blog post at POZ.com, Criminalization 101, he explains why the criminalisation of non-disclosure, exposure and non-intentional transmission has become one of the most pressing issues of our time.

I’m including his introduction here.  Read the entire post at POZ.com.

Over the last several years, as I’ve talked to a wider circle of advocates, people with HIV and policy leaders about HIV criminalization, it has become apparent to me that many people are not well-informed on the topic. Some instinctively favor prosecuting people with HIV for not disclosing their HIV status prior to intimate contact, but these opinions usually evolve quickly as a person learns more about the issue.

Here’s a background piece I have been using–and continuing to modify–to introduce the issue to others. It is a bit lengthy for a blog post. If you would like a footnoted and properly formatted version emailed to you, just shoot me a note at sstrub (at) hivlawanndpolicy.org. I look forward to any comments or suggestions.

(Read more at POZ.com)

How could she go on living as if weren’t there [Trailer] (Sweden, 2010)

It is 1986. Lillemor is 19 And goes to France. She falls in love there; a love which results in her becoming HIV infected. Lillemor represses the fact that she has a lethal infection. She gets married and has children. She cannot bring herself to tell her husband that she is HIV positive. One day he finds out. Tabloid press and tv channels refer to her as the “HIV woman”. Lillemor’s husband divorces her, she loses custody of their children, and she loses her freedom.

Lillemor has now served a 30-month prison sentence for attempted grievous bodily harm. She was convicted for having had unprotected sex with her husband and for having gone through pregnancy and given birth to two children without first informing medical staff of the fact that she was HIV positive. Neither her ex-husband nor their children, now 7 and 8 years old, have contracted HIV.

This full length (73 minute) feature documentary is a stunning, heartbreaking exposition of how the stigma of HIV leads to Lillemor’s functional denial and ultimately her criminalisation, prosecution, conviction and incarceration.

PRODUCER/DIRECTOR INGELA LEKFALK
CINEMATOGRAPHY ANDERS BOHMAN STEFAN LARSSON
EDITING KERSTI GRUNDITZ
MUSIC LOUISE HOFFSTEIN
LARS PAULIN  LASSE ENGLUND  PETER KVINT
CHRISTOFFER DEMBY RESEARCH JENNY SJUNNESSON

More information: http://lekfalkab.se/eng/film_hurkundehon.html and at IMDB

 

Canada: Video project highlights anger, frustration with criminalisation

A new video project by Canada-based filmmaker Orazio Caltagirone, AIDSphobia, is now available to watch on YouTube.

Mixing speeches by Edwin Cameron with TV footage and other existing media, the video explores various issues surrounding the criminalisation of people living with HIV. Although it can be confusing and difficult to watch at times, it is obvious that the filmmaker is passionate about the subject, and angry. “One of the main reasons why I decided to make this video is because this situation is getting out of control in my country,” Orazio tells me in an email.

The video totals 60 minutes, but is split into ten parts.

1 3:57 AIDSphobia INTRO

2 4:59 IN THE BEGINNING…

3 5:21 SPITTING

4 4:15 THE STIGMA

5 4:25 AIDS IS A MASS MURDERER

6 8:50 JOHNSON AZIGA

7 8:59 RELIGION

8 7:51 GTD: STATS

9 7:28 10 REASONS

10 4:41 CLOSING CREDITS

Canada: Xtra publishes its anti-criminalisation piece-de-resistance

Just a week after Canada’s national gay paper, Xtra, published a radically anti-criminalisation interview on their website, Xtra.ca, comes their piece-de-resistance, Beyond the Courts: a smart, well-written and researched 5,000 word essay from queer Canadian writer/advocate Shawn Syms, whose previous writing on criminalisation and the HIV-positive/negative divide was equally insightful and thought-provoking.

In the piece – which will also be published in shorter form as the cover story of next month’s print edition of Toronto’s Xtra – Syms asks (and tries to answer) the question: How do we stop the spread of HIV without dividing our [unspoken HIV-positive versus HIV-negative and untested gay] communities?

Syms brings together many voices from Canada and abroad – including mine – to illustrate the “growing chorus of activists, civil-society advocates and community members [who are] rallying evidence to show that jailing people with HIV only quenches the individual and public thirst for retribution and blame—while failing to prevent onward HIV transmission.”

There’s much to recommend in the piece, but a few things stand out for me.

First, he turns the argument that the law protects HIV-negative people by punishing HIV-positive people for ‘victimising’ HIV-negative people on its head.

The media and police would have us believe that irresponsible people with HIV are out there victimizing others—but we should never forget that the reality is the other way around. People with HIV are an oppressed minority subject to frequent acts of discrimination by others who have power over them—including the accusers in criminalization cases.

Earlier in the piece, he explains how Canada’s criminalisation of HIV non-disclosure does this.

A vindictive person could use their knowledge of someone’s HIV status as a weapon against them. Many believe this is what happened last year in the case of “Diane,” a Montreal woman whose partner suddenly alleged she had not disclosed her HIV status once she pressed charges against him for domestic assault.

Some people with HIV have been threatened by people they’ve never even been intimate with. Fred Meikle of London, Ontario, says he had an exchange last year with an acquaintance in a gay.com online chatroom where the person stated, “I should call the police, tell them you didn’t disclose.” Meikle replied “We’ve never even had sex; you sat on my sofa and drank a beer.” He says the man replied, “Well, who do you think they will believe?”—highlighting the rift in social power between HIV-negative and positive gay men.

Understandably, this creates a climate of literal “terror” for people with HIV, says Angel Parks, Positive Youth Outreach coordinator for the AIDS Committee of Toronto (ACT). “This is spiraling out of control,” she says about the upswing in criminal charges. At a recent forum in Ottawa in June, she reports, people with HIV from across the country responded to the criminalization threat with “fear, shame, humiliation, and most of all confusion.” And at the weekly support group she coordinates, “individuals are scared… they don’t know to protect themselves” from the risk of bogus charges.

Now, Syms is not saying that all charges are bogus, but that the law as it had been created and is currently practised by the criminal justice system, is open to abuse. That relatively few cases have involved sex between men is irrelevent. It is the climate of fear and mistrust (on both sides) that worries him (and me).

He analyses this further later in the piece, when he rips apart the too-commonly-believed gay community myth that HIV only affects “hardcore risk takers” whose unbridled ‘barebacking’ turns them into “sexual predators.”

The common perception goes something like this. HIV is extremely dangerous, inevitably fatal and not that hard to get. People with HIV have an obligation to tell all partners before any sexual activity at all—because it’s not possible to consent to sex without knowing if the other person has HIV.

To this way of thinking, anyone who doesn’t disclose is dishonest, untrustworthy and probably addicted to barebacking—after all, if their sense of ethics and responsibility were not so obviously lacking, they wouldn’t have contracted the virus in the first place. And someone like that wouldn’t think twice about giving someone else HIV, on purpose. So the solution is to avoid these people, like the plague.

[…]

But gay men haven’t done a good job of passing on the harm-reduction message to new generations, says Richard Berkowitz, one of the originators of safe-sex education in 1983 and subject of the recent documentary Sex Positive. “Today, even progressive gay people fall into the trap of imagining that we are talking about sexual predators who deserve to be locked up.”

The perspective Berkowitz points out hinges upon seeing negative and positive gay men as fundamentally different from one another. This is a mistake, noted Sigma Research’s Ford Hickson in an address to a UK sexual health conference in March. What most often distinguishes positive and negative guys is not ethics or behaviour, but bad luck.

“HIV risk is widespread. It is not the case that a small group of hardcore risk takers account for the new infections,” said Hickson. “The transmissions that occur over the next year will be the unlucky ones in a large population each taking a few risks.”

Finally, he follows the lead of last week’s Xtra interviewee, Bob Watkin, the outgoing Chair of the HIV and AIDS Legal Clinic of Ontario (HALCO), asking readers to get “angry and loud.”

As Justice Cameron of South Africa told those assembled at the Canadian HIV/AIDS Legal Network’s recent symposium, “some of the Canadian cases are so outrageous, I have wondered why there weren’t protestors outside the courtroom with t-shirts and placards and activists shouting inside the court room. Have you lost your activist fervour?”

Cameron is right. We need to rekindle the queer rage and sense of injustice that fuelled historic LGBT protests, from the response to the bathhouse raids, to the efforts of Gay CourtWatch in the eighties to protect gay men busted on sex-related charges, to the beginnings of the original AIDS activist movement.

And we need a coalition of negative, positive and untested queers and allies to carry out this effort. Criminalization is an extreme manifestation of HIV stigma—and it shouldn’t be only people with HIV who put themselves on the line to fight it. With tools ranging from placard and megaphones to Facebook and Twitter, we need to combat the abuses of the police, the justice system and the media, and demand access to appropriate testing resources and consistent and high-quality sex education for all, regardless of HIV status.

Kudos to Syms, and to Xtra‘s editorial director, Matt Mills, for this piece: the best I’ve seen yet on the issue as it relates to gay men in Canada (and light years ahead of how New Zealand’s gay press is dealing with the issue).

Read the full piece on Xtra.ca.

US: Gay Iowa man who faced 25 years for HIV exposure released from jail (updated)

Update: 17th September. Nick Rhoades was interviewed by Lynda Waddington in the Iowa Independent. He was released last Friday (11th) following a reconsideration hearing that had been allowed by District Court Judge Bradley Harris during Mr Rhoades’ sentencing.

He is courteous and remorseful to the complainant in his case.

“There is no denying the fact that there was a victim involved and that [this] derailed his life for several months of uncertainty,” said Rhoades, referencing the consensual encounter he had with another man in early summer 2008 that led to his ultimate conviction.

“It’s something that I think anyone who is infected has been through. It’s frightening — not only for him, but for his family and friends. It disrupts everything in your life while you are going through that time of just not knowing. It can be terrifying. I know what it was like, and I never would have wished it on anyone else. So, I do understand exactly why he would feel the way that he did and does.”

But he also questions the 25 year sentence handed down four months ago that gave him “a taste of prison”.

“When compared to other crimes and other laws on the books, it seems [my sentence was] a stiff penalty — especially considering the fact that it wasn’t considered a violent crime, that it was a consensual situation between two adults and that there was no infection [of the victim] showing up to this day,” he said. “It does seem that 25 years is excessive to me.”

He also says that although he has been humiliated by his HIV status being plastered all over the media, it is also somewhat liberating.

“It is the most stigmatized medical condition that I can think of,” said Rhoades, adding how humiliating it was for his status to be “strewn across the media” and become fodder for the gossip mill….“In some ways this has been liberating,” Rhoades said, indicating that before the court case he had only openly shared such private portions of his life with family and close friends. “I’m not at all proud and I do take responsibility for my own actions and mistakes. But there is no denying that it is all out there now.”

Original post: Sept 16th. Breaking news. An HIV advocate working to release Nick Rhoades, 34, from prison after he was sentenced in May to 25 years for HIV exposure following a one-night stand with another man, has just informed me that Mr Rhoades is out of jail!

The advocate, Donald Baxter, tells me in an email:

We wrote letters to the judge and something must have clicked—his “victim” wasn’t even allowed to give a victim’s impact statement. Nick still has a long hard row—five years probation, sex offender registry, unsure career future/path. But at least he’s not stuck in jail for 25 years.

Mr Baxter was co-incidentally featured in the Iowa Independent yesterday, arguing against Iowa’s draconian HIV-specific laws.

“I think the law we have here is a sledgehammer that is mostly looking for a thumbtack. I think the latest thumbtack was Nick Rhoades,” Baxter said in reference to a Black Hawk County case earlier this year where a 34-year-old man was sentenced to 25 years in prison following a one-time consensual encounter that did not result in transmission.

“I get no impression from him other than the fact that he is probably a 34-year-old man who is not a paragon of responsibility. He obviously has had some substance abuse issue, which is actually pretty common in the gay community. He is not a criminal, and his sentence angers me on a couple of fronts. He’s probably never transmitted HIV to anybody, let alone the person who made this complaint against him. As a taxpayer in the state of Iowa I also realize that we are probably spending between $65,000 and $70,000 per year to keep him behind bars. That pisses me off. That would piss me off if I weren’t HIV positive.”

I’ll update again with more details when I get them.

Africa: HIV Laws Do More Harm Than Good by Miriam Mannak (IPS)

I received an email last week from Miriam Mannak, a freelance writer based in Cape Town, South Africa who keeps on blog on AIDS in Africa. She recently contributed this excellent piece on the spectre of criminalisation on her continent to the Inter Press Service News Agency, whose mission is to give voices to the voiceless.

 

AFRICA: HIV Laws Do More Harm Than Good by Miriam Mannak (IPS)

CAPE TOWN, Jul 30 (IPS) – In Sierra Leone, a mother who transmits HIV to her child can be fined, jailed for up to seven years, or both. Human Rights Watch reports that in 2008, several men were arrested in Egypt simply for being HIV positive. New legislation is currently being discussed in Angola that could lead to a three to ten year jail sentence for those who knowingly pass on HIV.

The legislation is inspired by a September 2004 workshop organised by the influential reproductive health organisation Family Health International developed an “African Model Law” intended to protect those who are infected and exposed to HIV.

But various civil society organisations fear that these legislative measures will hurt more than help the fight against HIV/AIDS.

Discourages testing, delays treatment

“If being HIV positive is being regarded as a crime, people will be less likely to get themselves tested,” said Johanna Kehler, director of the Aids Legal Network (ALN) – a South African non-governmental organisation that aims to protect the human rights of people living with and affected by HIV/AIDS.

“This means that they are more likely to spread the disease unknowingly, and will not have access to antiretrovirals that may help to prolong their lives.”

Jennifer Gatsi Mallet – coordinator of the Namibian branch of the International Community of Women Living with HIV/AIDS (ICW), a global network run for and by HIV positive women – agrees with Kehler’s statements.

“The criminalisation of HIV will be yet another reason why people will stay away from testing facilities and clinics,” she said.

The International Planned Parenthood Federation, a global organisation that advocates sexual and reproductive health and rights, counts 58 countries around the world with laws in place to prosecute HIV transmission and 33 others that are considering passing such legislation. Of these, twenty are in Africa.

Women lose more

“Women will be the first ones in line to be prosecuted, as they are more likely to know their status compared to men, simply because they visit clinics more often, for instance during and after their pregnancy,” Kehler explained.

Gatsi Mallet added that in “many parts of Africa, clinics and men are like water in fire. While some accuse health facilities of being unfriendly to men because most of the health care workers are female, others consider visiting as unmanly, especially when it comes to HIV and other sexual related transmitted diseases,” she added.

“They therefore rather prefer to go to traditional healers, whom are in general more male orientated.”

Because women are more likely to discover they are HIV positive, their male partners often blame them for bringing the virus home – regardless of the fact that the infection may well have travelled the other way.

“Women across the world, including in Africa, experience difficulties negotiating safe sex,” Kehler said. “If a man does not want to use a condom, they often are left with no choice.”

Angela from Cape Town, who requested anonymity – contracted the virus a few years ago. “I never had sex with anyone else but my husband, but I suspected that he was sleeping around. I just knew. So sometimes I asked him to use a condom, but he always blatantly refused,” she explained.

“He said that a wife is supposed to trust her husband. When I went for prenatal care two years ago, I was told I was HIV-positive. After confronting my husband, he accused me of sleeping around and of infecting him. He threw me out of the house.”

In countries like Egypt, such an accusation could lead to prosecution. The same is true in Togo, where HIV-positive people are prohibited by law from having unprotected sex, regardless of whether they have disclosed their status to their partner.

“In case of prosecution, women are left in a terribly vulnerable position, as many do not have the resources to, for instance, prove that they were HIV negative before intercourse,” Kehler noted. “Neither can they prove if they did not do it deliberately.”

Laws against mother to child transmission (MTCT) should also be banned, the ALN argues.

An HIV-positive mother can pass the virus to her child during pregnancy, whilst giving birth, or through breast feeding. Of the 370,000 cases of MTCT each year, about 90 percent occur in Africa, according to UNAIDS.

In countries like Guinea, Guinea-Bissau, Mali and Niger, a mother can be criminally charged if she does not take steps to prevent HIV transmission to baby, including taking antiretrovirals during the pregnancy.

MTCT is almost entirely preventable, by taking antiretrovirals and giving birth in a sterile environment. Breast feeding poses certain risks: WHO studies indicate that a mother who is HIV positive risks passing the virus on to her child. But in certain situations – for example where a mother does not have access to clean water to mix formula and sterilise bottles, but is on antiretrovirals – exclusive breastfeeding is recommended.

Formula-fed babies in developing countries are six times more likely to die from diseases like diarrhoea and respiratory infections than breast-fed babies, according to WHO.

“The problem is that many African women do not have access to proper health care facilities and cannot afford formula,” Kehler said. “These are things governments should provide. If they fail, they should be the ones that are to be held accountable for MTCT.”

SIDEBAR: Who’s responsible for MTCT?Chantelle Heunis* from Overcome Heights – an informal settlement near Cape Town – was infected by her now ex-husband with the disease in 1999. At the time she was pregnant with her second daughter.

“I only found out after my baby was three months old, after I went for a check-up as she was ill due to lactose intolerance. The nurse offered to test me for HIV – which was not a routine procedure back in the days. The results came back positive.”

The next step was to test the baby. “It was dreadful, but thank god she was found HIV negative,” Heunis said. “She is ten years old now, and as healthy as can be.”

According to Heunis, it should not be allowed for women to be punished for MTCT. “I was lucky because I was in good hands, but many women do not have this privilege. They transmit the virus through unhygienic birthing practices, for instance, or because they do not have access to ARVs to prevent MTCT.”

She also rejects the notion that HIV positive women should not be allowed to have children. “It is within our rights to have children. Besides, if a mother is HIV positive, that does not mean the baby is also.”

* not her real name.

Africa: PlusNews publishes in-depth analysis of criminalisation throughout the continent

PlusNews, the global online HIV and AIDS news service of the United Nations Integrated Regional Information Networks (IRIN), has published an excellent in-depth analysis of criminalisation in Africa.

A collection of short articles focusing on various aspects of criminalisation in different parts of the continent can be downloaded as a pdf here, or read online here.

They include:

I reproduce here an article providing an overview of the situation alongside a criminalisation map of Africa which they say will be updated once they receive more accurate information from readers in Africa.

 

AFRICA: Will criminalising HIV transmission work?

IRIN/PlusNews

Monday 08 December 2008

Countries in sub-Saharan Africa are looking at a new way of preventing HIV infections: criminal charges. But experts argue that applying criminal law to HIV transmission will achieve neither criminal justice nor curb the spread of the virus; rather, it will increase discrimination against people living with HIV, and undermine public health and human rights.

UNAIDS has urged governments to limit criminalisation to cases “where a person knows his or her HIV-positive status, acts with the intention to transmit HIV, and does in fact transmit HIV”. The reality is that intentional and malevolent acts of HIV transmission are rare, so in most instances criminal prosecutions are not appropriately applied.

In Switzerland, a man was sent to jail earlier in 2008 for infecting his girlfriend with HIV, even though he was unaware of his HIV status, and a Texas court recently sentenced a man living with HIV to 35 years in prison for spitting on a police officer, although the chances of the officer being exposed to the virus were negligible.

Laws making HIV transmission an offence are not new to the developed world, but the trend has been growing in African countries, where higher prevalence levels make such laws all the more attractive to policymakers.

“Africa has burst into this whole frenetic spasm of criminalising HIV,” said South African Justice Edwin Cameron, who is also HIV positive, at the International AIDS Conference in Mexico earlier this year.

In Uganda, proposed HIV legislation is not limited to intentional transmission, but also forces HIV-positive people to reveal their status to their sexual partners, and allows medical personnel to reveal someone’s status to their partner.

Most legislative development has taken place in West Africa, where 12 countries recently passed HIV laws. In 2004 participants from 18 countries met at a regional workshop in N’djamena, Chad, to adopt a model law on HIV/AIDS for West and Central Africa.

The law they came up with was far from “model”, according to Richard Pearshouse, director of research and policy at the Canadian HIV/AIDS Legal Network, who maintains that the model law’s broad definition of “wilful transmission” could be used to prosecute HIV-positive women for transmitting the virus to their babies during pregnancy.

People living with HIV have expressed concerns that the growing trend to criminalise HIV infection places legal responsibility for HIV prevention solely on those already living with the virus, and dilutes the message of shared responsibility.

UNAIDS has warned that using criminal law in cases other than intentional transmission could create distrust in relationships with healthcare workers, as people may fear the information will be used against them in a criminal case. Such laws could also “discourage HIV testing, since ignorance of one’s status might be perceived as the best defence in a criminal law suit.”

Some policymakers have called for HIV legislation as a means to protect women from HIV infection, but the irony is that sometimes these laws may result in women being disproportionately prosecuted. Many women find it difficult to negotiate safer sex or to disclose their status to their partner.

What are the alternatives? UNAIDS recommends that instead of applying criminal law to HIV transmission, governments should expand programmes proven to have reduced HIV infection. At the moment, there is no information indicating that using criminal law will work.

Zimbabwe: Blame, responsibility, impact of criminalisation on women analysed

Excellent opinion piece in the Zimbabwean newspaper, The Herald, which discusses blame and responsibility and the impact of criminalisation of HIV transmission on women.

 

Blame Game Won’t Change a Thing

The Herald (Harare)

Beatrice Tonhodzayi

4 October 2008She is young and very striking. That type of girl that would give most of my male colleagues’ ideas; if she ever looked their way. She is very pretty, what my male colleagues term the “typical African queen.”

However when you look deeply into her eyes, you can tell she is sad.

But what would make such a pretty and young lady sad?

Mutsa (not her real name) is living with HIV. It is not that knowledge however that is responsible for the sadness that surrounds her very being.

It is anger and a sense of betrayal.

Anger and betrayal, that she feels towards her former lover, a medical doctor, who she says infected her with HIV.

When Mutsa got in touch with me about her story, I felt very betrayed on her behalf.

There she was, going out with a medical doctor, someone who has all the knowledge about HIV transmission. This was the first man she had ever been with and he had the nerve to infect her with HIV, I felt.

But then, I began to wonder!

Did he even know that he was HIV positive?

Yes, he may have slept with other women before or besides Mutsa but this does not mean he knew his status and therefore willingly infected his girlfriend.

And why did Mutsa have unprotected sex with him when she did not know his status?

I am a woman; I champion the women’s cause as much as I can because I sincerely believe that life has not been very kind to woman-kind.

However, I am a journalist and must look at both sides of the coin. I must be objective.

There are many women who are living angry lives unnecessarily. They are filled with so much bitterness at the fact that their husbands and partners have infected them with HIV.

This anger in some cases, is so intense that it eats up one’s very passion for life.

They wish these men could just be thrown into jail for committing such heinous crimes.

Is this necessarily fair to the men in question and the women themselves?

A cursory glance shows that most women who are living with HIV blame a man for their status and this is understandable.

It is a fact that most men sleep with several women at the same time. How many women can safely say they have never been played?

Definitely not me!

But if we know we are or have been played, should we not begin to look out for ourselves?

Another interesting truth is that even women, who have had other sexual encounters before marriage, are quick to point a finger to the man when they test positive.

This is despite the fact that some of them would not have tested before entering this relationship.

Ever think for a moment that you could actually have been positive before, sisters?

If the truth be told, there are some men who have also been infected by women. But how many times do you hear people sympathising with a man?

Is this because men do admit to having been around and done that, unlike their female counterparts?

Multiple concurrent partnerships, especially the “small house” syndrome, are very popular in southern Africa and this is a documented fact.

Such partnerships have been identified as a key driver of HIV in the region.

Because men keep the majority of small houses, whenever transmission occurs, a finger is pointed at them and quite rightly so, mostly.

But what does just blaming them achieve if women do not stand up and begin to look out for themselves.

For argument’s sake, let us say the man is responsible, does this mean by pointing a finger, the virus would disappear?

If we could even go on to punish someone for infecting someone, would we solve anything?

Some would argue that it is high time we criminalised HIV transmission but will this prevent the spread of HIV?

Would it make people more sexually responsible?

Justice Edwin Cameron of South Africa’s Supreme Court of Appeal at the just ended XVII International AIDS Conference in Mexico said criminalisation of HIV transmission makes for bad policy direction around the epidemic.

He said laws and prosecutions don’t prevent the spread of HIV but may actually continue to distract us from reaching our goals of ending deaths, stigma, discrimination and suffering.

He also said something else that I like.

“The prevention of HIV is not just a technical challenge for public health. It is a challenge to all humanity to create a world in which behaving is truly feasible, is safe for both sexual partners, and genuinely rewarding.

“When condoms are available, when women have the power to use them, when those with HIV or at risk of it can get testing and treatment, when they are not afraid of stigma, ostracism and discrimination, they are far more likely to be able to act consistently for their own safety and that of others.”

The responsibility lies with all of us surely?

At the International AIDS Conference Regional Feedback Meeting held at the Harare International Conference Centre, Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS) Executive Director, Mrs Lois Chingandu also echoed the same comments.

She said the challenge with sexual matters were that they were mostly a “heat of the moment” thing and therefore clearly ascertaining that someone has an intention of infecting someone would be difficult.

“One could look for a condom in the dark and fail to find it. Both parties would go ahead to have consensual sex. Could we blame someone here?” she asked.

Today my message is simple. I am just appealing to Mutsa and others like her who are failing to move on because of the anger and sense of betrayal they feel that someone infected them to let go of it and live their lives.

She once felt like taking him to court but then, she says, she realised there was really no point for her status would not change.

I am also inviting my readers out there to contribute their thoughts and comments to this issue of blame and criminalising HIV transmission. My e-mail address is beatrice@safaids.org.zw

Please note:

Each of us has the responsibility and right to protect ourselves from HIV infection and re-infection

Failing to manage one’s anger is one way of increasing stress levels

You can still enjoy a full and productive life, even if you are HIV positive

Beatrice Tonhodzayi is a Programme Officer-Media with SAfAIDS