US: HIV Medicine Association calls for repeal of HIV-specific laws

The HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) has issued a strong statement urging the repeal of HIV criminalisation statutes in the United States.

The HIVMA statement, which represents physicians, scientists and other health care professionals across the United States, demands the following:

An end to punitive laws that single out HIV infection and other STIs and that impose inappropriate penalties for alleged non-disclosure, exposure and transmission
All state and federal policies, laws and regulations to be based on scientifically accurate information regarding HIV transmission routes and risk;
A federal review of all federal and state laws, policies, and regulations regarding the criminal prosecution of individuals for HIV-related offences to identify harmful policies and federal action to mitigate the impact of these laws, including the repeal of these laws and policies or guidance for correcting harmful policies; and
Promotion of public education and understanding of the stigmatising impact and negative clinical and public health consequences of criminalisation statutes and prosecutions.

The HIVMA statement is another extremely important development in the Positive Justice Project’s campaign to repeal HIV-specific criminal laws in the United States.

In March 2011, the National Alliance of State and Territorial AIDS Directors (NASTAD) – a highly-respected organisation of public health officials that administer state and territorial HIV prevention and care programmes throughout the US – issued a similar statement.

The full HIVMA statement, which can be downloaded here, is published below.

HIVMA URGES REPEAL OF HIV-SPECIFIC CRIMINAL STATUTES

(Approved: October 16, 2012)

The HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) represents physicians, scientists and other health care professionals who practice on the frontline of the HIV/AIDS pandemic. HIVMA strongly advocates public policies that are grounded in the science that has provided the tools and knowledge base to envision a world without AIDS.

Stigma and discrimination continue to be major impediments to the comprehensive response necessary to address the HIV public health crisis. Policies and laws that create HIV-specific crimes or that impose penalties for persons who are HIV- infected are unjust and harmful to public health around the world.

In the U.S., HIV criminalization has resulted in unacceptable human rights violations, including harsh sentencing for behaviors that pose little to no risk of HIV transmission. Thirty-two states and two U.S. territories have HIV-specific criminal statutes. Thirty-two states have arrested or prosecuted individuals with HIV infection for consensual sex, biting and spitting. These laws and prosecutions unfairly target individuals with HIV infection and are not based on the latest scientific knowledge regarding HIV transmission, including the finding that transmission risk from biting or spitting is negligible.

Individuals with HIV infection can live healthy lives and approach near normal life expectancies with access to HIV care. Early diagnosis and effective management of HIV infection not only improves clinical outcomes for infected individuals but significantly reduces their risk of transmitting the virus to others. Laws that criminalize HIV infection discourage individuals from learning their HIV status and from receiving care. In doing so, they jeopardize the lives of HIV-infected individuals and place more individuals at risk of contracting an infectious disease that remains fatal if untreated.

HIV-specific criminalization fuels the stigma associated with HIV infection that slows efforts to combat the disease. Despite the availability of highly effective treatment for HIV infection, of the 1.1 million individuals living with HIV infection in the U.S., nearly 20 percent remain undiagnosed, only 37 percent are in care and just 25 percent have undetectable levels of the virus in their blood which makes it unlikely for them to be infectious to others.

All individuals must take responsibility for protecting themselves from HIV infection and other sexually transmitted infections (STIs). All persons engaging in unprotected or potentially risky sexual behavior are encouraged to discuss and disclose HIV and STI status except in situations where disclosure poses a risk of harm.

HIVMA Position:

HIVMA urges a coordinated effort to address and repeal unjust and harmful HIV criminalization statutes. We support the following:

An end to punitive laws that single out HIV infection and other STIs and that impose inappropriate penalties for alleged nondisclosure, exposure and transmission;
All state and federal policies, laws and regulations to be based on scientifically accurate information regarding HIV transmission routes and risk;

A federal review of all federal and state laws, policies, and regulations regarding the criminal prosecution of individuals for HIV-related offenses to identify harmful policies and federal action to mitigate the impact of these laws, including the repeal of these laws and policies or guidance for correcting harmful policies; and

Promotion of public education and understanding of the stigmatizing impact and negative clinical and public health consequences of criminalization statutes and prosecutions.

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Canada: Judge says disease risk from spitting is an ‘irrational, urban myth’

Read the entire ruling R. v. Ratt [2012] SKPC 154, S.J. No. 590

A Canadian judge in the province of Saskatchewan has ruled that spitting in the face of a police officer is a simple assault that does not result in a risk of serious diseases such as HIV, hepatitis C or herpes.

“When we in the justice system perpetuate this myth without question, without evidence of the risk, without any fact-based analysis, we are feeding into this irrational anxiety,” noted Judge Felicia Daunt during sentencing of a 36 year-old woman following her guilty plea for impaired driving and assaulting a police officer (by spitting into the right into the eye of a female arresting officer).

According to a CBC report

The Crown argued that there was a risk, although minimal, that the officer could have become infected with HIV, hepatitis C or herpes. She underwent considerable anxiety, visited a doctor and had to wait two weeks before she found out she was going to be OK.

The Crown pointed to previous cases where people who spat at police officers received jail sentences. The prosecutor pushed for the maximum sentence of six months for Ratt.

Instead, earlier this week La Ronge provincial court Judge Felicia Daunt sentenced her to time already served — five days — and six months probation.

“I want to be clear that I am in no way trivializing the well-being of police officers or minimizing the very real risks they face on a daily basis,” Daunt wrote in her nine-page decision. “They have an extremely stressful job.” However, it’s an “urban myth” that police get serious injuries after being spat at and the intense anxiety that officers and their families feel about saliva is not justified, she said.

Canada and the United States have far outpaced most other countries in attempting to prosecute HIV-positive people for spitting, notably for spitting at arresting officers. The most notorious case comes from the United States (the 2008 Willie Campbell case in Texas) but between 1993 and 2006, there were six arrests or prosecutions of people living with HIV for spitting in Canada, representing 10% of all criminal potential or perceived ‘HIV exposure’ cases during that period.

Laboratory studies have found that saliva may contain HIV, and transmission via saliva is therefore biologically plausible. However, there is absolutely no epidemiological evidence to suggest that spitting on someone could expose them to enough HIV for infection to result. Levels of HIV in saliva are not high enough to allow transmission, even if the saliva comes into contact with a mucous membrane such as that of the eye. Spitting into someone’s mouth would create the same risk as kissing – zero. The CDC recently updated its website to highlight HIV-related risks in the context of criminal prosecutions, and notes that spitting poses a ‘neglible’ risk of HIV exposure.

In this particular case, however, there was no evidence that the accused had HIV or any other communicable disease. Instead, the Crown wanted to use her as an example and have the judge sentence her to six months in prison to deter others from spitting on cops during their arrest.

Instead, Judge Daunt noted the following:

“Those who get arrested on a regular basis know the police are terrified of getting spit on. That’s why they do it. They use that fear against the officers. A detainee can threaten a police officer, he can try to hit him, and not bother that officer one bit. So if a detainee can put the fear of death into an officer simply by spitting on him or her, he is going to do it. In other words, these spitting incidents are increasing because of the fear. If we want to deter suspects from spitting on police officers, we need to educate these officers about the real risks involved, and not perpetuate their anxiety by repeating urban myth.”

Judge Duant’s reliance on science and not stigma is very much appreciated. Let us hope that Canada’s Supreme Court is similarly enlightened when it delivers its judgments in the Mabior and DC appeals this Friday, October 5th. The decision will be available as of 9:45 am 9.45 EST (15.45 CET) on the Supreme Court’s website at http://scc.lexum.org/en/index.html.

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