US: Nevada advisory task force to review antiquated laws on HIV exposure and issue recommendations

Panel to take on reforming Nevada’s antiquated HIV criminalization laws

During the height of the HIV/AIDS epidemic in the late 1980s, more than 67 laws were enacted across the country to criminalize and prosecute people living with HIV.

“The majority of these laws were passed before antiretroviral therapies, which can reduce the HIV transmission risk to zero, were developed,” said Democratic state Sen. David Parks. “In case you’re not aware, it is possible to be HIV positive and have no detectable presence of the virus.”

Senate Bill 284 mandates an examination of Nevada’s HIV laws. It passed both the Senate and Assembly and is headed to Gov. Steve Sisolak’s desk. The legislation creates the Advisory Task Force on HIV Exposure Modernization to review laws and punishments, and make recommendations ahead of the 2021 Legislative session.

With more understanding around HIV, states like California are taking steps to amend antiquated statutes. Parks said he has been trying to move legislation to tackle HIV criminalization in Nevada for three sessions without any progress.

Calls for states to consider HIV decriminalization come as science and medical advancements develop.

Organizations such as the Centers for Disease Control and Prevention note that those on medications who achieve an undetectable viral load — when the copies of HIV per milliliter of blood are so low, it can’t be detected on a test — have no risk of transmitting the virus. A recent study by The Lancet medical journal further confirmed that the risk of passing on the virus is eliminated when people living with HIV are on effective drug treatments.

Yet, many laws still don’t reflect the medical advancements.

In a statement of support for the legislation, Nevada Attorneys for Criminal Justice add that current laws are discriminatory and counterproductive.

“NACJ would particularly like to highlight one such law, NRS 212.189, which imposes a life sentence on a person with HIV in lawful custody who exposes another person to their bodily fluids,” the group wrote. “This is dramatically overbroad – a person with HIV who spits on a police officer as they are being arrested faces a life sentence, because HIV is sometimes present in saliva even though there is no actual risk of transmission.”

SB284 passed the Senate unanimously April 16 and the Assembly 37-3 on Thursday — Republican Assemblymen Chris Edwards, John Ellison and Jim Wheeler were opposed.

Colombia: Constitutional court to examine whether the law criminalising HIV transmission is discriminatory

Source: El Tiempo, April 27, 2019 – Google translation, for article in Spanish, please scroll down.

Is Penalising HIV infection discriminating?

Should a person who transmit HIV or hepatitis B go to jail for 6 years? That is the debate that the Constitutional Court will have to settle in the coming days, by resolving a lawsuit against the law that criminalizes the transmission of these diseases.

The plaintiff considers that Article 370 of the Criminal Code violates the rights to equality and restricts the free development of personality, in particular, sexual freedom. This law establishes that there will be imprisonment of 6 to 12 years for those who, knowing that they have HIV or hepatitis B, “perform practices through which they may contaminate another person, or donate blood, semen, organs or, in general, anatomical components”

According to the lawsuit, this penalizes the fact that a person living with these diseases has sex, and makes it a crime regardless of whether preventive measures, such as antiretroviral treatments and others, are taken that make the transmission of diseases unlikely.

Thus, the plaintiff says that although the purpose of this mechanism is to protect public health, this does not justify prohibiting a population group from freely expressing their sexuality, and adds that there would be no harm when there are consensual relationships in which measures are taken to prevent infections.

On the violation of equality, the plaintiff says that the article only refers and penalizes people with HIV or hepatitis B, and not others with potentially contagious and sensitive diseases.

The debate is broad, in total the Court received 15 statements of opinion from different organizations, ministries, universities, and even the Constitutional Court of South Africa, to feed its considerations. And there are almost as many arguments in favour as there are against.

For example, the Colombian Anti-AIDS League supported the demand because it considered that rights were violated, adding that laws that criminalize exposure to HIV leave the burden of prevention to the people who live with it and said that the real challenges are more education and better access to medical testing services and counselling

The statement sent by Edwin Cameron, magistrate of the Constitutional Court of South Africa and who lives with HIV since 1985, points out the harm of criminalizing people living with HIV, as it increases the stigma and makes it harder for them to dare to seek medical help and prevention information

He also said that to resort to norms that criminalize HIV, the UN recommends to governments that they address only those who intentionally spread the virus and concluded that if the goal is to safeguard public health, it is more effective to have better prevention and care programmes.

The statement sent by the Ministry of Justice gives the plaintiff reason that the rule is discriminatory because it is directed only to people with HIV – who have also been recognized as subjects of special constitutional protection – or hepatitis B and adds that there is no justification for the rule to be for people with these two diseases and not for others who are aware of having different infectious-contagious diseases

However, with regard to the restriction on sexual freedom, the Justice Department considered that the rule “does not violate the right to the free development of personality, but is limited to establishing the criminal consequences resulting from its abusive and harmful exercise against the rights of other people and the community “ For all this, it asks the Court to study the lawsuit and decide.

The Ministry of Health indicated, on the contrary, that the rule does not violate either the right to equality or the free development of the personality, but rather that the demand is based on an inference from the plaintiff that this restricts sexual freedom, and therefore asks to leave the rule as it is.

The Attorney General agrees that the plaintiff interpretation is that the law punishes the fact of having sex even when there is no transmission of the disease, which, says the Public Ministry, is not true. For the Attorney General’s Office, the rule is clear that in order for the offense to be established there must be an intention to cause harm by carrying out practices that could end in transmission. Because of this, the reasons for the claim are not valid and the Court is being asked not to study it and declare itself inhibited

In any case, the decision will be made by the Court, the lawsuit was handed over to Judge Cristina Pardo, who has already made a presentation that will be debated in the next few days by the Court’s full chamber.

¿Penalizar el contagio de VIH es discriminar?

Demanda dice que tipificar la propagación del virus discrimina a personas con VIH o hepatitis B.

Por: María Isabel Ortiz Fonnegra

27 de abril 2019 , 08:00 p.m.

¿Debe ir a la cárcel por 6 años una persona que contagie a otra de VIH o hepatitis B? Ese es el debate que deberá zanjar la Corte Constitucional en los próximos días, al resolver una demanda contra la ley que penaliza la propagación de estas enfermedades.

El demandante considera que el artículo 370 del Código Penal vulnera los derechos a la igualdad y restringe el libre desarrollo de la personalidad, en particular, la libertad sexual. Esta ley establece que habrá prisión de 6 a 12 años para quien, sabiendo que tiene VIH o hepatitis B, “realice prácticas mediante las cuales pueda contaminar a otra persona, o done sangre, semen, órganos o en general componentes anatómicos”.

De acuerdo con la demanda, esto penaliza el hecho de que una persona que viva con estas enfermedades tenga sexo, y lo convierte en delito sin importar si se toman las medidas preventivas que hacen improbable la transmisión de enfermedades, como tratamientos antirretrovirales y otros.

Así, el demandante dice que aunque el fin de esta media es proteger la salud pública, esto no justifica prohibirle a un grupo poblacional expresar libremente su sexualidad, y agrega que no habría afectación cuando se tienen relaciones consensuadas en las que se toman medidas para prevenir contagios.

Sobre la vulneración a la igualdad, dice que el artículo solo se refiere y penaliza a personas con VIH o hepatitis B, y no a otras con enfermedades también potencialmente contagiosas y delicadas.

El debate es amplio, en total la Corte recibió 15 conceptos de diferentes organizaciones, ministerios, universidades, e incluso de la Corte Constitucional de Sudáfrica, para alimentar sus consideraciones. Y hay casi tantos argumentos a favor como los hay en contra.

Por ejemplo, la Liga Colombiana de Lucha contra el Sida apoyó la demanda pues consideró que sí se vulneran los derechos, agregó que leyes que penalizan la exposición al VIH dejan toda la carga de la prevención a las personas que viven con él y dijo que los verdaderos desafíos son más educación y mejor acceso a servicios de pruebas médicas y consejería.

El concepto enviado por Edwin Cameron, magistrado de la Corte Constitucional de Sudáfrica y quien vive con VIH desde 1985, señala los perjuicios de criminalizar a las personas que viven con esa enfermedad, pues incrementa el estigma y hace más difícil que se atrevan a buscar ayuda médica e información sobre prevención.

También dijo que de recurrir a normas que criminalicen el VIH, la ONU recomienda a los gobiernos que estas se dirijan solo a quienes intencionalmente propagan el virus y concluyó que si el objetivo es salvaguardar la salud pública, es más efectivo tener mejores programas de prevención y atención.

El concepto enviado por el Ministerio de Justicia le da la razón al demandante en que la norma es discriminatoria pues está dirigida únicamente a personas con VIH –que además han sido reconocidas como sujetos de especial protección constitucional– o hepatitis B y agrega que no se advierte justificación para que la norma sea para personas con esas dos enfermedades y no para otras que son conscientes de tener enfermedades infectocontagiosas riesgosas distintas.

Sin embargo, frente a la restricción a la libertad sexual, la cartera de Justicia consideró que la norma “no vulnera el derecho al libre desarrollo de la personalidad, sino que se limita a establecer las consecuencias penales que acarrea su ejercicio abusivo y lesivo frente a los derechos de las demás personas y la comunidad”. Por todo esto, le pide a la Corte que estudie la demanda y decida.

El Ministerio de Salud indicó, al contrario, que la norma demandada no vulnera ni el derecho a la igualdad ni el libre desarrollo de la personalidad, sino que la demanda se basa en una inferencia del accionante de que esto restringe la libertad sexual, por lo que pidió dejar la norma tal y como está.

La Procuraduría coincide en que el demandante interpreta que la norma castiga el hecho de tener sexo aun cuando no exista transmisión de la enfermedad, lo cual, dice el Ministerio Público, no es cierto. Para la Procuraduría, la norma es clara en que para que se configure el delito debe existir una intención de causar daño realizando prácticas que podrían terminar en contagio. Por esto, las razones para la demanda se caen y le pidió a la Corte no estudiarla y declararse inhibida.

En todo caso, la decisión será de la Corte, la demanda le correspondió por reparto a la magistrada Cristina Pardo, quien ya hizo una ponencia que será debatida en los próximos días por la sala plena de la Corte.

Canada: Advocates recommend amending the criminal code to limit the overcriminalisation of non-disclosure and the inconsistency of provincial prosecutorial policies

Criminal Code changes needed to curb HIV non-disclosure prosecutions, experts say

The chair of the federal government’s justice committee is hoping input from various stakeholders will lead to Criminal Code changes limiting prosecutions of HIV non-disclosure across Canada.

On April 9, the House of Commons Standing Committee on Justice and Human Rights began inviting medical professionals, advocates and those living with the immunodeficiency virus to submit briefs on how to deal with the overcriminalization of non-disclosure and a “patchwork” of prosecutorial policy among the provinces.

The committee’s study comes almost five months after Canada’s Department of Justice directed its Crowns to limit their prosecutions of HIV non-disclosure in light of evolving science around risk of transmission.

But the Dec. 1 directive applies only to Crowns in Canada’s territories. Provincial prosecutors, on the other hand, follow their own set of prosecutorial policies.

Soon after this, Ontario directed its Crowns to limit non-disclosure prosecutions. And on April 16, British Columbia brought forth a revamped policy.

Most other provinces lack directives.

Defence lawyers and advocates have long been said that criminal law dealing with non-disclosure has lagged scientific findings that the risk of transmission can be quite low, depending on individual circumstances and sexual practices.

The committee will be hearing from stakeholders on the adequacy of the federal directive, how the justice system can work with the health sector to better understand the science of transmission and how to attain a uniform policy across the land.

As of April 17, the committee had heard from the Ontario AIDS Network and the Canadian HIV/AIDS Legal Network, as well as other organizations and several experts.

All submissions are due April 30 and a report will go before Parliament sometime in May, according to the committee’s chairman, Liberal MP Anthony Housefather.

“We’re looking at how do you create a system that can apply across the country, and, for me, that would only be through adjustments to the Criminal Code itself,” Housefather told The Lawyer’s Daily.“Now, we could come out with recommendations, theoretically, to the minister of justice to meet with his provincial and territorial counterparts to try to agree on a directive that would be applied in every province and territory. But, from what I understand right now, the best approach would be amendments to the Criminal Code.”

Housefather spoke of different policies currently in existence.

“Right now, we only have a federal directive that applies to very few Canadians,” said Housefather. “We have an Ontario directive that is slightly different from the federal directive. There is a directive in B.C. that was quietly put forward. And then most [other] provinces have no such directive. So, people are being prosecuted differently depending on the province or territory that they live in right now.”

Canadian HIV/AIDS Legal Network executive director Richard Elliott said the consultations will drive home the need for consistency.

“It should make clear that, in so far as it goes, the [federal] directive … issued in December, is OK,” said Elliott. “In our view — and [in] the view of other advocates with whom we work across the country on this — it doesn’t go far enough, but it is a step forward. What I think it should also make clear is even if the directive at the federal level went as far as it should go, and even if every provincial [attorney general] were to adopt an equally satisfactory directive applicable in their jurisdiction … we would still need an additional part of the solution here, which … is to amend the Criminal Code.”

Elliott noted differences in the federal, Ontario and B.C. directives and said uniform, coast-to-coast policy would “sweep away a patchwork of different policies in different jurisdictions.”

None of the policies is quite where it should be when it comes to limiting criminalization, said Elliott, who, like many, is calling for sexual assault and aggravated sexual assault charges to be taken off the table as charges for HIV non-disclosure.

Criminal charges, he said, should be limited to intentional transmission.

Criminal lawyer Cynthia Fromstein has been approached by people “frightened [and] concerned about their legal jeopardy and wanting to know what is and is not lawful behaviour.”

“These are people who have no intention of harming others by their actions,” said Fromstein, a sole practitioner in Toronto. “That is one reason it is truly necessary for there to be consistency across the country in policy and application of the criminal law.”

Like Elliott, Fromstein hopes the consultations will kick-start change.

“Amending the Criminal Code is going to be complex,” she said. “I think there is wide support for taking any kind of prosecution of non-disclosure out of the sex assault provisions. I think there is broad agreement [this] needs to be done. But then there are real questions: Should there be a specific law for HIV transmissions? Should there be a specific law for ‘causing a person to be infected with a serious illness,’ which is not necessarily [classified as] HIV? There are a lot of questions that have to be fine-tuned.”

US: Bipartisan list of lawmakers sponsor bill to modernise HIV laws in Georgia

Georgia lawmaker wants to decriminalize HIV

A Republican lawmaker introduced a bill that would modernize Georgia’s HIV laws, which activists say are outdated and stigmatize people living with HIV.

Under House Bill 719, a person charged with exposing someone to HIV — whether through sex or sharing needles — would have to show an “intent to transmit” the virus in order to be prosecuted, according to the bill. Current Georgia law makes it a crime for people living with HIV to have sex without disclosing their status.

The bill would also downgrade the punishment for people found guilty of the offense to a misdemeanor punishable by up to a year in prison. It’s currently a felony punishable by up to 10 years in prison.

“[The bill] moves these archaic laws created out of the HIV panic of the 1980s and brings them up-to-date with our current understanding of HIV,” Eric Paulk, HIV policy field organizer for Georgia Equality, told Project Q Atlanta. “Additionally, this bill will aid in reducing stigma and discrimination against people living with HIV, which it is not just fair, but good for public health.”

“Lastly, reforming these laws is an important step to health and HIV prevention justice, especially for black gay, bisexual, and transgender Georgians, who are disproportionately impacted by HIV and prosecutions under these laws,” he added.

HB 719 would also make employees of syringe services programs immune from being charged with possession, distribution or exchange of needles or syringes as part of the program. The measure would also remove a provision in state law that makes it a crime for people living with HIV to spit on people.

Rep. Deborah Silcox (photo), a Republican from Sandy Springs who sponsored the measure, introduced HB 719 on April 2, the final day of this year’s legislative session. It will come back up for consideration during the 2020 session.

HB 719 has a bipartisan list of co-sponsors. The Republicans include Reps. Sharon Cooper of Marietta and Mark Newton of Augusta. The Democrats who signed on to the measure are Reps. Michele Henson of Stone Mountain and Karla Drenner of Avondale Estates. Drenner is one of the five openly LGBTQ members of the legislature.

Cooper sponsored a measure that created a study committee to examine the state’s HIV criminalization laws in 2017.

The committee published its findings in December 2017, and some of those recommendations became part of HB 719. The committee found that “criminal exposure laws had no effect on detectable HIV prevention” and that these laws should be eliminated unless there was a clear intent to transmit the virus, according to the report.

Cooper, Silcox and Rep. Houston Gaines are the group of Republicans who introduced a package of HIV legislation during the 2019 session.

Cooper’s bill to create a pilot program to provide PrEP to people at high risk of contracting HIV passed both chambers and awaits Gov. Brian Kemp’s signature. Gaines’ bill to create a needle exchange program to help reduce HIV rates passed both chambers, and Kemp signed it into law on April 2. Silcox’s bill to make it easier for HIV-positive Medicaid recipients to receive the most effective medications passed unanimously in the House but got held up in the Senate over cost issues. It will return in 2020.

Georgia is one of three-dozen states that criminalize a lack of HIV disclosure. HIV criminalization laws are one of the reasons Georgia ended up in the lowest-rated category on the Human Rights Campaign’s annual State Equality Index.

US: HIV criminalisation laws that require people convicted to be on the sex offender registry are ineffective and stigmatising

THE PUSH TO END ‘PUNISHMENT FEVER’ AGAINST PEOPLE WITH HIV

Advocates say laws that land people with HIV on the sex offender registry are outdated and dangerous.

Every five years, Mark Hunter has to pay around $300 to have his picture displayed in the newspaper and notices mailed to his neighbors, informing them that he is a sex offender. While on parole, he said, he pays about $60 a month in fees and has to attend a sex offender treatment class. His crime? In 2008, he was convicted of failing to tell two ex-girlfriends that he was HIV-positive.

Though neither partner contracted HIV, Hunter was still convicted under Arkansas’s HIV exposure law, which requires those who know they are HIV-positive to disclose their status to sexual partners. Sentenced to a dozen years in prison, he was released in 2011 after serving almost three.

But now, he must register as a sex offender, incurring the same obstacles, humiliation, and costs many others on registries face.

In Louisiana, where he now lives, Hunter’s driver’s license has “sex offender” written in capital letters under his photo, per the state’s registry requirements.

“When I saw it on my license, that was one of the most hardest things ever,” said Hunter, now 44. “Those two words on my license are still a hindrance to the life I want to live.”

Lousiana, Arkansas, Ohio, South Dakota, Tennessee, and Washington State require, or authorize courts to require, those convicted under HIV criminalization laws to be on the sex offender registry, according to the Center for HIV Law and Policy. Advocates, who condemn the statutes as ineffective, stigmatizing, and unscientific, are working to modernize the laws in the courts and state legislatures.

But even some of the fixes fall short, they say, including an amendment to Louisiana’s law that was enacted last year that removed biting and spitting as specifically identified means of transmission. Disclosure of HIV status is still required.

“We do not need to be punishing people through the criminal law,” said Robert Suttle, assistant director of the Sero Project, which advocates HIV criminalization law reforms. “This is a public health issue.”

Hunter, a hemophiliac, was diagnosed with HIV in 1981, at age 7. He said he and his family largely kept his status a secret.

“People were treated harshly who had this disease,” said Hunter. “They were treated like outcasts.”

But though the public’s perception of HIV has evolved, being on a sex offender registry carries a similar stigma. After he was released from prison in 2011, Hunter settled in Louisiana. He has found it difficult to find work, he said. Louisiana’s sex offender registry law requires him to register any address where he stays longer than seven days.

In the 1980s and 1990s, a flurry of HIV criminalization laws were enacted, many of which remain on the books. Today, 26 states have HIV-specific laws that criminalize exposure, according to the Centers for Disease Control and Prevention.

HIV became “swept up” in the era’s “punishment fever,” explained Trevor Hoppe, author of “Punishing Disease: HIV and the Criminalization of Sickness.”

“Legislators around the country were already in the mode of punishment,” said Hoppe. “It was kind of a general approach they were taking to many social problems.”

Because there is no national database that tracks prosecutions, it is difficult to know how many people have been charged, convicted, or placed on the registry as a result of HIV criminalization laws, according to Catherine Hanssens, executive director of the Center for HIV Law and Policy. A comprehensive study of Florida’s criminalization laws found that more than 600 people had been arrested for an HIV-related offense between 1986 and 2017.

Scientists, psychologists, healthcare providers, and HIV-positive advocates have condemned the laws over the decades since they were enacted, noting that there has been no association found between criminalization statutes and lower transmission rates.

“People with HIV are not out there passing HIV along in some intentional way,” said Dorian-gray Alexander, a member of the Louisiana Coalition on Criminalization and Health who is living with HIV. More than a third of the time, the transmission of HIV is between people who don’t know their status.

HIV criminalization statutes rarely take into account advances in treatment, condom use, or actual risk of transmission, according to advocates. For instance, in Arkansas, where Hunter was convicted, it is a felony to sexually penetrate another person without first disclosing one’s HIV-positive status. However, penetration is broadly defined as an “intrusion, however slight, of any part of a person’s body or of any object into a genital or anal opening of another person’s body.”

Cheryl Maples, an Arkansas attorney, plans to file a petition in federal court in the coming weeks that challenges the law’s constitutionality, she told The Appeal. Maples, whose uncle died of AIDS-related complications, has defended several people charged with HIV exposure. The state attorney general’s office did not respond to a request for comment.

“It is basically a crime that is against the LGBT community and other communities that are in disfavor,” said Maples. “People that are being charged with this are not predators.”

In Tennessee, sexual contact is not even required under the state’s aggravated prostitution statute. A person is in violation of the law if he or she knows they are HIV-positive and works “in a house of prostitution or loiters in a public place for the purpose of being hired to engage in sexual activity.” Those convicted are placed on the sex offender registry and face up to 15 years in prison.

People convicted of aggravated prostitution can petition to be removed from the registry if they were victims of sexual violence, domestic abuse, or human trafficking. Last year, then-Governor Bill Haslam signed into law a bill that allows those convicted as juveniles with aggravated prostitution to have their records expunged if they were victims of human trafficking.

But regardless of why or when someone engages in sex work, sex workers living with HIV need “services, not handcuffs,” said Alex Andrews, co-founder of Sex Workers Outreach Project (SWOP) Behind Bars.

“When you put someone on a registry for having HIV, that’s public information,” said Andrews. “Put sex work on top of that and you have a really bad situation for survival.”

The state’s aggravated prostitution statute and HIV exposure law are both felonies that require sex offender registration. That’s different from the way Tennessee law governs the disclosure of other infectious diseases. It is a misdemeanor to engage in “intimate contact” without disclosing a diagnosis of Hepatitis B or C, but failure to disclose those diseases does not require sex offender registration.

As attempts are made to reform HIV criminalization laws, advocates worry about changes that tie criminalization solely to a person’s risk of transmission. Doing so, they warn, could marginalize those without access to treatment and those with detectable viral loads. (Those with undetectable viral loads, like Hunter, have “effectively no risk” of transmitting the virus, according to the CDC.)

Repealing HIV-specific laws is often insufficient, they add, because people can still be exposed to harsh punishments. People in states without such laws have been charged with attempted murder or assault with a deadly weapon for a range of incidents including spitting. (HIV cannot be transmitted through saliva.)

Modernizing statutes should focus on a person’s intent, and conduct likely to cause harm, not a failure to disclose, said Hanssens, the HIV law and policy center executive director. Any reform must also cease placing people on the registry, a practice she called “irrational and unconscionable.”

“You cannot treat consensual sexual contact as a criminal wrong simply because that particular person happens to have one or another disease,” said Hanssens. “It’s a pointless and dangerous and stigmatizing response to what is a public health issue.”

Hunter has joined HIV-positive advocates from across the country in speaking out about the harms of criminalization and the sex offender registry in particular. He also works to reduce the persistent stigma and fear surrounding HIV by helping young people tell their families they are HIV-positive.

“They need to understand that it’s not a death sentence,” said Hunter. “I’m married. My wife is not HIV-positive, and we are trying to have a child.”

He has started a nonprofit organization dedicated to HIV and AIDS education in his brother’s name, the Dr. Michael A. Hunter Foundation. His brother, like Hunter, was a hemophiliac who contracted HIV from a blood transfusion. He died from AIDS-related complications in 1994.

“I’m Mark, and I happen to be HIV-positive,” said Hunter. “I had to embrace that, and once I embraced it, I let go of a lot of the pain.”

[update]US: Bill aiming to modernise HIV legislation in Florida clears its second hurdle

Source: South Florida Gay News, Published on March 25, 2019

HIV Modernization Bill Continues to Make Progress in Florida House

An HIV modernization bill, the (HB 79), cleared its second hurdle this week passing the Florida House’s Appropriations Committee overwhelmingly 26-3.

This is the second committee to give the bill a favorable recommendation. It recently passed the House’s Criminal Justice Subcommittee, 10-3.

“We’re really excited by the bipartisan momentum that we’ve seen for this HIV modernization legislation,” said Jon Harris Maurer, Equality Florida’s Public Policy Director. “This is long overdue and it’s exciting to see this being addressed as a criminal justice reform issue and a public health issue.”

Michael Rajner, an HIV rights activist, attributes the newfound support to advocates, stakeholders and people living with HIV meeting with lawmakers to tell their stories.

Rajner said he’s been working toward a bill like this for at least 8 years.

This is the third year this bill has been introduced and there’s been a surge in support. This is also the furthest an HIV modernization has gotten in the Florida Legislature.

“Regardless of which side of the aisle you sit on people want better public safety and better health outcomes and that’s what this bill does,” said Justin Klecha, Deputy Director of SAVE and a member of the Florida HIV Justice Coalition. “This is a fantastic bill that takes a huge step forward reducing stigma around HIV.”

Klecha said most of the opposition comes from a lack of knowledge.

“Legislators don’t know the current science around HIV, or how far we’ve come with the treatments,” Klecha said.

HB 79 must now pass through the Judiciary Committee. While in the Senate, Jason Pizzo (D – Miami), has filed similar legislation (SB 846), but no hearings have been scheduled as of yet.

“This is the first year the legislature is actually taking any actions and votes. We have a tremendous bill sponsor this year, Nick Duran out of Miami, who is incredibly passionate about this,” Rajner said. “We also owe a great deal of thanks to Dr. Hansel Tookes and the medical students at the University of Miami who have been doing a tremendous job of advocating for needle syringe exchange programs statewide and in that process have been educating legislators on HIV.”

The current law does not take into account whether a person actually transmitted HIV. Nor does it matter if a condom was used, or if the person with HIV is on treatment and undetectable.

This new bill would revise the existing law such as defining “Substantial risk of transmission” as “a reasonable probability of disease transmission as proven by competent medical or epidemiological evidence.” The bill would also update outdated language such as changing “sexual intercourse” to “sexual conduct.”

“I think the most profound change is that there would have to be actual intent and transmission of HIV to another individual during sex,” Rajner said.

Other changes include allowing a person who has HIV to donate blood, plasma, organs, skin, or other human tissue as long as a medical professional deems it appropriate. Currently, there are no exceptions so if someone did make such a donation they would be committing a third-degree felony. HB 79 would downgrade the penalty to a first-degree misdemeanor.

“This bill would help modernize Florida’s HIV laws that were written in the mid-80s at the height of the HIV epidemic and haven’t been updated to align with current science on treatment and prevention for HIV,” Maurer said. “I think most strikingly is that the law currently doesn’t account for whether in fact there is any transmission of HIV. So under the current law, a person could be incarcerated for up to 30 years with a third-degree felony, even though there is no transmission of HIV, and scientifically there is no risk of transmission.”

Source: South Florida Gay News, published on March 7, 2019

HIV Modernization Bill Moves Forward In Florida House

An HIV modernization bill, the HIV Prevention Justice Act (HB 79), cleared its first hurdle passing 10-3 in the Florida House’s Criminal Justice Subcommittee.

Five Republicans and five Democrats voted for the bill.

The current law does not take into account whether a person actually transmitted HIV. Nor does it matter if a condom was used, or if the person with HIV is on treatment and undetectable.

The bill must also pass through the Appropriations Committee and Judiciary Committee.

Senator Jason Pizzo (D – Miami) has filed similar legislation (SB 846) in the Florida Senate.

Nicholas Duran bill aims to modernize HIV law

Equality Florida applauds legislation catching law up to modern science.

Count it a leftover of the AIDS scare in the 1980s: Florida law treats those who knowingly transmit HIV different than any other sexually transmitted disease.

But a bill advancing through the Florida House could de-stigmatize HIV without decriminalizing irresponsible transmission entirely.

“There’s a longstanding stigma with respect to this based on a years-ago understanding as opposed to current health and medical science on the disease,” state Rep. Nicholas Duran said.

He credits it to law written in a time when people worried spitting or sharing a toilet seat with an HIV-positive individual.

This year, the Miami Democrat filed the HIV Prevention Justice Act (HB 79) in hopes of reforming the law. The bill already has favorably passed through the House Criminal Justice Subcommittee.

If it becomes law, the legislation will reclassify a failure to notify a sexual partner of HIV-positive status as a misdemeanor, instead of a felony.

“This legislation will save lives and take care of the whole community,” said Alejandro Acosta, coordinator for Equality Florida’s HIV Advocacy Project. “It will help decrease HIV stigma, encourage people to get tested, and get into treatment.”

Acosta, who is HIV-positive, said Florida “has a responsibility to match our law with current science.”

That means acknowledging HIV, far from the death sentence it was in the 1980s, can be treated as a chronic condition more on par with asthma or diabetes.

While there are 115,000 people living with HIV in Florida, there were less than 900 deaths from HIV-related causes in the state in 2016.

But the spread of the virus remains a concern, particularly in Florida. The state saw 4,957 documented new transmissions in 2016, according to Equality Florida.

But the impact of the disease remains demographically uneven. Only 22 percent of new transmissions in Florida were for women. Meanwhile, 42 percent were for black individuals and 32 percent were Latino.

And date from the Centers for Disease Control shows the condition still impacts the LGBTQ more than the public as a whole. Gay and bisexual men make up 55 percent of Americans living with HIV.

At current rates, a quarter of all gay and bisexual Latino men will get HIV at some point in their life. Half of gay and bisexual black men will contract the virus.

All this may indicate an importance in being open with sexual partners about having the virus, and Duran doesn’t want failure to disclose information completely decriminalized.

But the severe legal consequence for failing to share information has led to a high number of individuals refusing to get tested for HIV. CDC data suggests 20,000 Floridians have contracted HIV but remain unaware of their status.

In an interview with HIV Plus Magazine in 2017, Acosta declined to say how long he’d had HIV, noting the current laws in Florida open individuals up to legal risk for years.

HIV-positive people can face up to 30 years in prison for failure to disclose their status with a consensual partner, and that risk comes whether the virus gets transmitted or not.

Further, current medical treatments can make HIV medically undetectable, and in turn can make the virus virtually non-transmittable.

It raises the question what obligation should exist for an individual employment safe sex practices has to a partner when there’s virtually no risk of catching HIV from an encounter.

Duran’s bill also addresses some specific issues, like acknowledging the low risk of ever transmitting HIV through oral sex.

States like California have already reduced the penalties for HIV-positive individuals withholding their status.

Efforts to change the law failed in Florida in the past. But Duran hopes a conversation based on current science can catch the law up with modern knowledge.

He notes Hepatitis C poses a greater risk and threat to public health today than HIV. Treating HIV patients as criminals at this point does more harm than good.

“We are going to create smart policy with HIV and STDs,” he said.

Published in FLAPOL on Feb 25, 2019

Zimbabwe: Government plans to repeal overly broad, vague HIV-specific criminal law

Sources: New Zimbabwe and ZimEye – Published on March 20, 2019

Ziyambi: Government to decriminalise wilful transmission of HIV (New Zimbabwe)

JUSTICE Minister Ziyambi Ziyambi has revealed plans by government to repeal clauses in the Sexual Offences Act which criminalise the deliberate transmitting of HIV by positive sexual partners.

Addressing backbenchers during parliament’s question and answer session on Wednesday, Minister Ziyambi said the law has not served its intended purpose of reducing the spread of the virus.

“…Indeed when the legislation came into effect, the thinking there was that, we need to control the spread of HIV by criminalising those who transmit it to partners willingly.

“But global thinking is that the law stigmatises people living with HIV and AIDS. Studies have shown that it does not produce the intended results that it is intended to achieve and so what the ministry is going to do is repeal that section of the law,” said Ziyambi.

The Minister was responding to a direct question by Zengeza West MP Job Sikhala who had asked what government was doing in terms of decriminalising the deliberate spread of HIV by sexual partners.

The MDC legislator had also asked if the government was willing to reverse the law arguing it stigmatises people living with HIV and AIDS.

Minister Ziyambi said the envisaged changes could come through the Marriage Bill Act.

“We are looking at perhaps introducing that amendment through the Marriage Bill Act that is due to come,” he said.

Zimbabwe in 2001 introduced the Sexual Offences Act which came with criminalisation on deliberate transmission of HIV either through rape cases or by those who do not inform their sexual partners about their HIV positive status in cases of unprotected sex.

Government Repeals Law On Intentional Transmission Of HIV (Zim Eye)

The Minister of Justice, Legal and Parliamentary Affairs Ziyambi Ziyambi has revealed that Government is working on repealing the willful HIV transmission law.

Section 79 (1) of the Criminal Codification and Reform Act on deliberate transmission of HIV reads: “Any person who knowingly that he or she is infected with HIV, or realising that there is a real risk or possibility that he or she is infected with HIV, intentionally does anything or permits the doing of anything which he or she realises involves a real risk or possibility of infecting another person with HIV, shall be guilty of deliberate transmission of HIV, whether or not he or she is married to that other person and shall be liable to imprisonment for a period not exceeding twenty years.

“It shall be a defence to a charge under subsection (1) for the accused to prove that the other person concerned knew that the accused was infected with HIV and consented to the act in question, appreciating the nature of HIV and the possibility of becoming infected with it.”

Ziyambi, during a Question and Answer session in Parliament today, said the law will be repealed.

Calls for the law to be repealed have been made since about 3 years ago. In 2016, Elizabeth Tailor Human Rights Award winner and HIV activist, Ms Martha Tholanah said this law must be scrapped because it stigmatised and discriminated against people living with HIV.

Ms Tholanah, who has been living with HIV for the past 17 years, said criminalisation of wilful HIV transmission was done a long time ago on the advent of the disease, when no one wanted to be associated with it.

She, however, said owing to developments in the medical field, HIV is now just like any other disease hence the law must be informed by science trends.

“Evidence has shown that chances of transmitting HIV to another person if you are on treatment are slim. The law must then speak the same language with science to achieve our national and global goals and targets,” said Ms Tholanah.

She said the current law discouraged people from getting tested thereby delaying them from accessing treatment early, reversing global efforts to end Aids by 2030.

France: Highest Court confirms that people living with HIV with an undetectable viral load can never be prosecuted as the risk of transmission is nul

Source TETU, Published 20/03/2019 – Google translation, for article in French please scroll down.

Can a person living with HIV be prosecuted if she is under treatment? The Court of Cassation (French Highest Court) delivers a landmark decision.

In a decision handed down on 5 March, the Court of Cassation ruled that it was impossible to prosecute an HIV-positive man on treatment who had sex without a condom and without informing his partner of his HIV status.

That’s a first. In a decision handed down on 5 March, the Court of Cassation recognised the preventive nature of HIV treatment. Thus, any person whose viral load is undetectable, who has sex without a condom with another person without the latter being aware of the HIV status of his or her partner, cannot be prosecuted.

In this case, a woman who had sex with a man who was HIV-positive and undergoing treatment sued the man on the grounds that he had not previously informed her of his HIV status. The partner was not infected. However, the man was prosecuted on the grounds of “administration of a harmful substance”, i.e. alleged exposure to the virus.

Non-harmful bodily fluids

The investigating judge did not give rise to prosecution. A decision from which the civil party has appealed. But the woman was once again dismissed. According to the Court of Appeal, it has been proven that the “HIV viral load” was “constantly undetectable since 3 September 2001”. The man was “strictly and permanently compliant with the treatment, so that his HIV status was only potential but not current”.

And the judges of the Court of Appeal ruled: “The carrier’s bodily fluids cannot be considered harmful on the date of the alleged acts”.

A significant reminder from the judges, who stated that it takes “a detectable viral load in an infected person for him/her to infect any partner”.

A purely mathematical margin of error

Moreover, the judges of the Court of Appeal acknowledged that there was indeed a margin of error, but that it was purely mathematical. Thus, they conceive of the idea of the “non-zero risk” of HIV transmission by a person undergoing treatment. A risk they call “very small” since it is about one in 10,000. And according to them, this margin of error does not make it possible to condemn the carrier of the virus.

The civil party has appealed to the Supreme Court. The High Court dismissed the appeal, aligning itself with the judges of first instance.

Peut-on poursuivre une personne séropositive sous traitement ? La Cour de cassation rend un arrêt historique

Dans un arrêt rendu le 5 mars dernier, la Cour de cassation a affirmé qu’il était impossible de poursuivre un homme séropositif sous traitement, ayant eu des relations sexuelles sans préservatif et sans informer sa partenaire de son statut sérologique.

C’est une première. La Cour de cassation a reconnu, dans un arrêt rendu le 5 mars dernier, le caractère préventif du traitement contre le VIH. Ainsi, ne saurait être poursuivie toute personne dont la charge virale est indétectable, qui aurait des relations sexuelles sans préservatif avec une autre personne sans que celle-ci ne soit au courant du statut sérologique de sa/son partenaire.

Dans cette affaire, une femme ayant eu des relations sexuelles avec un homme, porteur du VIH et sous traitement, a engagé des poursuites contre ce dernier au motif qu’il ne l’avait pas prévenue au préalable de son statut sérologique. Sa partenaire n’a pas été contaminée. Pourtant, l’homme était poursuivi au motif « d’administration d’une substance nuisible », c’est-à-dire à une prétendue exposition au virus.

Des fluides corporels non nuisibles

Le juge d’instruction n’a pas donné lieu aux poursuites. Une décision de laquelle la partie civile a fait appel. Mais la femme s’est fait une nouvelle fois débouter. Selon la Cour d’appel, il a été prouvé que « la charge virale de VIH » était « constamment indétectable depuis le 3 septembre 2001 ». L’homme a fait « compliance stricte et permanente au traitement, de sorte que la séropositivité n’était plus que potentielle mais non actuelle ».

Et les juges de la Cour d’appel de statuer : « Les fluides corporels du porteur ne sauraient être tenus pour nuisibles à la date des agissements qui lui sont reprochés ».

Un rappel non négligeable des juges, qui affirment qu’il faut « une charge virale détectable chez une personne infectée pour qu’elle puisse contaminer quelque partenaire ».

Une marge d’erreur purement mathématique

Par ailleurs, les juges de la Cour d’appel ont reconnu qu’il existait bel et bien une marge d’erreur, mais qu’elle était purement mathématique. Ainsi, ils conçoivent l’idée du « risque non nul » de la transmission du VIH par une personne sous traitement. Un risque qu’ils qualifient d’ »infime » puisqu’il est d’environ un sur 10.000. Et selon eux, cette marge d’erreur ne permet pas de condamner le porteur du virus.

La partie civile s’est pourvue en cassation. La haute juridiction a rejeté le pourvoi, s’alignant sur les juges de première instance.

Nigeria: Akwa Ibom State intends to put in place HIV criminalisation law

Source: The Sun Nigeria on March 18, 2019

HIV status: Akwa Ibom plan law against spread

Akwa Ibom State government has expressed an intent to enact a law that would enable it prosecute persons found to wilfully infect or transmit HIV virus to another person.

This comes in the wake President Muhammadu Buhari unveiling the Nigeria AIDS Indicator Survey and Impact Survey (NAIIS) last week, which revealed that the state is top on the HIV prevalence scale with 5.5% against the national prevalence of 1.4% for the age group of 15 to 64 years.

The state Commissioner for Health, Dr Dominic Ukpong, while speaking with the press on Monday in Uyo in reaction to the NAIIS result, said other long term measures to be adopted to bring the prevalence down in the state would be to lead advocacy to the legislative arm of government to put in place laws to protect PLHIV and to curb transmission of new infections by expeditiously deliberating and passing the bill on Anti-stigma and Discrimination against PLHIV/AIDS.

“We will lead advocacy to local government councils in the state to lend regular and dedicated support for HIV intervention and other health programmes in their respective local government areas,”Ukpong said as one of the long term measures.

But for the time being, he said the state government would increase access to testing services by providing enough rapid-test kits so that all primary and secondary health facilities in the state would be able to provide free HIV testing services to the citizens.

The state government, Ukpong said, would also increase “access to treatment by creating new comprehensive treatment centres in one senatorial district to be fully supported by the state government; this will complement other comprehensive treatment centres supported by international partners.

The commissioner attributed the high prevalence of HIV in the state to many factors.

“The location of the state with a long coast line of 129 km stretching from Ikot Abasi to Oron, an airport, good road network, peaceful environment, friendly disposition of our people, good cuisines and fast-developing economy have made our state the destination of choice for both national and international visitors. All these are not without attendant public health consequences, like transmission of communicable diseases which HIV/AIDS cannot be excluded,” he said.

He also said the seemingly scaling down of HIV/AIDS campaign in the state was due to limited healthcare resources shared to other equally compelling demands like Ebola and Lassa fever, which were no issues some years ago.

“The current HIV/AIDS situation in the state calls for a more robust multi-sectoral response towards curbing the epidemic in the state. Consequently, the state government will step up collaboration through the Akwa Ibom State Agency for the Control of AIDS (AKSACA) and Akwa Ibom State HIV/AIDS and STI Control Programme (SASCP) with implementing partners. Faith based organisations, PLHIV/AIDS, and other stakeholders towards proffering immediate and long-term interventions for the state.

“We all know HIV is transmitted mainly by unprotected sexual contact with infected persons hence, Akwa Ibomites should imbibe the simple ABCs of HIV prevention – Abstinence, being faithful to one’s partner, correct and consistence condom use and refraining from the use of illicit drugs which could be injectable or otherwise.

“I therefore urge Akwa Ibomites to stand up and fight to stop the transmission of HIV virus; we have a part to play no matter how little,” Ukpong said.

Kazakhstan: Women living with HIV submit report to CEDAW, recommending repeal of HIV criminalisation provision in Kazakhstan penal code

Source: EWNA, published on March 11, 2019

For the first time, HIV+ women in Kazakhstan submitted a shadow report to CEDAW

Today in Geneva, at the pre-sessional working group of the 74th meeting of the UN Committee on the Elimination of All Forms of Discrimination against Women (CEDAW) , representatives of the community of women living with HIV, women who use drugs and sex workers from Kazakhstan presented for the first time a shadow report from civil society on rights situations for women from key groups.

In July 2018, civil society organizations submitted the Shadow Civil Society Report on Discrimination and Violence against Women Living with HIV, Women Using Drugs, Sex Workers and Women from Prisons, to the UN Committee on the Elimination of All Forms of Discrimination against women. The report is based on studies of cases of violation of rights registered by non-governmental organizations in 2015-2017. The full report is available on the EZSS website, in Russian and English .

Here is the text of the oral statement presented by Lyubov Vorontsova, Kazakhstan Union of People Living with HIV (english text below):

“Thank you, Madam Chair.

I am a woman living with HIV from Kazakhstan and I represent the voices of women from my community.

We consider it extremely important to solve the problems of institutionalized discrimination that violates the rights of women and impedes access to health and social services, as well as contribute to social and economic vulnerability.

Women living with HIV have limited access to residential services in existing crisis centers designed to help women affected by violence. In the capital of Kazakhstan, a young girl with a child who was abused by her husband in winter is refused to be placed in an orphanage, since there is such a law and she has HIV. Article 118 of the Criminal Code of Kazakhstan provides for criminal penalties for putting people at risk of HIV infection, which has the opposite effect – this contributes to a higher risk of HIV infection, violence and gender inequality in the family, in the health care system, in society.

According to a study of the Stigma Index, 24.2% of women living with HIV, medical workers forced to terminate a pregnancy (abortion), 34% of women living with HIV never received advice on reproductive opportunities.

We recommend:

Revise Article 118. “Infection with Human Immunodeficiency Virus (HIV / AIDS)” of the Criminal Code of the Republic of Kazakhstan dated July 3, 2014 No. 226-V SA-RC to abolish the provision criminalizing the risk of acquiring HIV
To set up offices in crisis centers to work with drug addicts and HIV-positive women. Mobilize state efforts to expand the network of crisis centers and other emergency services for women who have experienced domestic violence, and to ensure adequate public funding for these institutions.
Introduce changes to the Order of the Minister of Health and Social Development of the Republic of Kazakhstan dated December 21, 2016 No. 1079 “On approval of the standard for providing special social services to victims of domestic violence”, limiting the possibility of women living with HIV in crisis centers.

Women who use drugs report the extreme prevalence of police brutality. Due to stigmatization, pregnant drug-addicted women cannot take advantage of necessary medical services, including drug treatment, antenatal care and post-natal care. Opioid substitution therapy is not available for women when they are hospitalized in any medical institution (including maternity hospitals, tuberculosis dispensaries, etc.).Immediately after childbirth, women are forced to travel independently to the substitution therapy program in order to receive drug support with methadone.

The rights of sex workers by medical personnel are violated, in particular, the humiliation of dignity, the infliction of physical and psychological violence, and the disclosure of HIV-positive status to third parties. For this reason, sex workers refuse timely diagnosis in medical institutions.

We recommend:

Develop and adopt a humanization policy for women who use drugs, laws and practices based on respect for human rights, which will protect and eliminate any discrimination and violence against women.
Include in the complex of preventive programs to combat HIV and AIDS at the local and national levels, training for police officers to reduce stigma and discrimination against women from vulnerable groups.
Actively investigate incidents of violence and any unlawful acts committed by law enforcement officers against sex workers, women who use drugs, and reported by public organizations.
Develop mechanisms for ensuring personal security and confidentiality that will allow women to report incidents of violence without fear for their safety.
Provide government funding for the provision of free family planning services, in particular contraception for marginalized and vulnerable women.
Provide training for medical personnel in providing quality sexual and reproductive health services for women living with HIV, sex workers and women who use drugs.
Include a substitution therapy program in the national health care system and drug practice, with further expansion and scaling in Kazakhstan, as well as develop mechanisms for access to treatment of opioid substitution therapy in hospitals (tub dispensary, maternity hospitals and others)

In Kazakhstan, there are no studies and disaggregated data in open sources regarding women prisoners. In the fifth periodic report, the state provides data on legislation that provides access to medical services for female prisoners. But this does not answer the question of whether it meets the needs of female prisoners.

We recommend:

Conduct research on the degree of satisfaction with women’s sexual and reproductive health services in places of detention, including data on women living with HIV and drug addicts, characterizing their access to antiretroviral treatment and drug treatment, including opioid substitution therapy. ”

ВПЕРВЫЕ ВИЧ+ ЖЕНЩИНЫ КАЗАХСТАНА ПРЕДСТАВИЛИ ТЕНЕВОЙ ОТЧЕТ В КЛДЖ

Сегодня в Женеве, на предсессионной рабочей группе 74 заседания Комитета ООН по ликвидации всех форм дискриминации в отношении женщин (CEDAW), представительницы сообщества женщин, живущих с ВИЧ, женщин употребляющих наркотики и секс-работниц из Казахстана, впервые представили теневой отчёт от гражданского общества о ситуации с нарушением прав в отношении женщин из ключевых групп.

В июле 2018 г. организациями гражданского общества был подан «Теневой отчет гражданского сообщества о дискриминации и насилии в отношении женщин, живущих с ВИЧ, женщин, употребляющих наркотики, секс — работниц и женщин из мест лишения свободы» в Комитет ООН по ликвидации всех форм дискриминации в отношении женщин. Отчет основан на исследованиях, случаях нарушения прав, зарегистрированных неправительственными организациями в 2015-2017 гг. С полным отчетом можно ознакомиться на сайте ЕЖСС, на русскоми английском языках.

Приводим текст устного заявления, которое представила Любовь Воронцова, Казахстанский Союз Людей, Живущих с ВИЧ (english text below):

«Спасибо, госпожа Председатель.

Я женщина, живущая с ВИЧ из Казахстана, и представляю голоса женщин из своего сообщества.

Мы считаем крайне важным решить проблемы институционализированной дискриминации, которая нарушает права женщин и препятствует доступу к медицинским и социальным услугам, а также способствуют социальной и экономической уязвимости.

Женщины, живущие с ВИЧ, имеют ограниченный доступ к услугам проживания в существующих кризисных центрах, предназначенных для помощи женщинам, пострадавшим от насилия. В столице Казахстана молодая девушка с ребенком, которая зимой подверглась насилию со стороны мужа, получает отказ быть помещенным в приют, поскольку существует такой закон и у нее ВИЧ. Cтатья 118 Уголовного Кодекса Казахстана предусматривает уголовное наказание за постановку в риск заражения ВИЧ, что имеет обратный эффект — это способствует более высокому риску заражения ВИЧ, насилия и гендерного неравенства в семье, в системе здравоохранения, в обществе.

По результатам исследования Индекс Стигмы 24,2% женщин, живущих с ВИЧ, медицинские работники принуждали к прерыванию беременности (аборту), 34% женщин, живущих с ВИЧ, никогда не получали консультацию по репродуктивным возможностям.

Мы рекомендуем:

Пересмотреть Статью 118. «Заражение вирусом иммунодефицита человека (ВИЧ/СПИД)» Уголовного кодекса РК от 3 июля 2014 года № 226-V ЗРК, чтобы отменить норму, устанавливающую уголовную ответственность за риск заражения ВИЧ.
Создать отделения в кризисных центрах для работы с наркозависимыми и ВИЧ-положительными женщинами. Мобилизовать усилия государства по расширению сети кризисных центров и других служб экстренной помощи женщинам, пережившим домашнее насилие, гарантировать адекватное государственное финансирование для этих учреждений.
Внести изменения в Приказ Министра здравоохранения и социального развития Республики Казахстан от 21 декабря 2016 года № 1079 «Об утверждении стандарта оказания специальных социальных услуг жертвам бытового насилия», ограничивающий возможность пребывания в кризисных центрах женщин, живущих с ВИЧ.

Женщины, употребляющие наркотики, сообщают о крайней распространенности жестокости полиции. Из-за стигматизации беременные наркозависимые женщины не могут воспользоваться необходимыми медицинскими услугами, в том числе наркологической, дородовой и послеродовой помощью. Опиоидная заместительная терапия не доступна для женщин при госпитализации в любые медицинские учреждения (включая родильные дома, противотуберкулезные диспансеры и т.д.). Сразу после родов женщины вынуждены самостоятельно добираться до программы заместительной терапии, чтобы получить лекарственную поддержку метадоном.

Нарушаются права секс-работниц со стороны медицинского персонала, в частности, унижение достоинства, причинение физического и психологического насилия, раскрытие ВИЧ-положительного статуса третьим лицам. По этой причине секс-работницы отказываются от своевременной диагностики в медицинских учреждениях

Мы рекомендуем:

Разработать и принять политику гуманизации в отношении женщин, употребляющих наркотики, законов и практик, основанных на уважении прав человека, которые обеспечат защиту и исключают любую дискриминацию и насилие в отношении женщин.
Включить в комплекс профилактических программ по противодействию ВИЧ и СПИД на местном и национальном уровнях обучающие мероприятия для полицейских о снижении стигмы и дискриминации по отношению к женщинам из уязвимых групп.
Активно расследовать случаи насилия и любых незаконных действий, совершенных сотрудниками правоохранительных органов против секс-работниц, женщин, употребляющих наркотики, зарегистрированных и сообщенных общественными организациями.
Разработать механизмы обеспечения личной безопасности и конфиденциальности, которые позволят женщинам сообщать о случаях насилия без страха за свою безопасность.
Обеспечить государственное финансирование на предоставление бесплатных услуг по планированию семьи, в частности контрацепции для маргинализированных и уязвимых женщин.
Обеспечить подготовку медицинского персонала по предоставлению качественных услуг по сексуальному и репродуктивному здоровью для женщин, живущих с ВИЧ, секс-работниц и женщин, употребляющих наркотики.
Включить программу заместительной терапии в национальную систему здравоохранения и наркологическую практику, с дальнейшим расширением и масштабированием в Казахстане, а так же разработать механизмы для доступа к лечению опиоидной заместительной терапии в условиях стационаров (тубдиспансер, родильные дома и другие)

В Казахстане отсутствуют исследования и дезагрегированные данные в открытых источниках в отношении женщин-заключенных. В пятом периодическом докладе государство приводит данные о законодательных актах, которые обеспечивают доступ к медицинским услугам для женщин-заключенных. Но, это не отвечает на вопрос о том, удовлетворяет ли это потребности женщин-заключенных.

Мы рекомендуем:

Провести исследования о степени удовлетворения услугами по сохранению сексуального и репродуктивного здоровья женщин в местах лишения свободы, включая данные о женщинах, живущих с ВИЧ и наркозависимых, характеризирующие их доступ к антиретровирусному лечению и наркологической помощи, включая опиоидную заместительную терапию.»