EATG seeks to ensure that Europe-wide standards of up-to-date scientific evidence limit overly broad HIV criminalisation

EATG’s new position paper on prosecutions for HIV non-disclosure, exposure and/or transmission published last week recommends that the criminal law should only be used in extremely rare and unusual cases where HIV is maliciously and intentionally transmitted and that Europe-wide standards of up-to-date scientific evidence limit overly broad use of the crimnal law.

Prosecutions for HIV non-disclosure, exposure and non-intentional transmission have been reported in 28 countries in Europe and Central Asia, but only eight of these countries have a specific criminal law relating to HIV.  The remaining 20 countries use laws not created to deal with HIV, such as those dealing with physical or sexual assault or, inappropriate laws relating to homicide or attempted murder.

According to the Global Criminalisation Scan, the following countries have reported at least one criminal case (countries in bold have used an HIV-specific criminal law): Austria, Azerbaijan, Belarus, Belgium, Cyprus, Czech Republic, Denmark, Estonia, England & Wales, Finland, France, Georgia, Germany, Greece, Hungary, Italy, Malta, Netherlands, Norway, Poland, Portugal, Romania, Scotland, Spain, Sweden, Switzerland, Turkey and Ukraine.  In addition, the following countries have an HIV-specific criminal law but there have been no reported prosecutions: Armenia, Moldova, Russia and Slovakia.

Many of these laws and prosecutions – as well as inflammatory media coverage of these cases – misrepresent and overstate the risks of HIV transmission and the harm of living with HIV, contributing to increasing HIV-related stigma and perpetuating myths about HIV. Important scientific developments, including the significant impact of treatment on infectiousness – reducing the risk to nearly zero and improving life expectancy – are rarely taken into account. In turn, this may be deterring people with undiagnosed HIV from wanting to know their HIV status.

These laws and prosecutions are also having a negative impact on people aware they are living with HIV by creating confusion and fear over rights and responsibilities under the law, creating and sustaining disincentives to disclose HIV-positive status to sexual partners, and creating and sustaining disincentives to disclose HIV-related risk behaviours to healthcare professionals. These unintended negative impacts of the overly broad use of the criminal law are highlighted in the HIV Justice Network’s new documentary, ‘More Harm Than Good‘.

Earlier this year, the Joint United Nations Programme on HIV/AIDS (UNAIDS) released updated, detailed guidance to limit the overly broad use of criminal laws to regulate and punish people living with HIV who are

  • alleged not to have told a sexual partner of their HIV-positive status (‘HIV non-disclosure’)’ and/or
  • perceived to have placed another person at risk of HIV transmission (‘HIV exposure) and/or
  • deemed to be criminally liable for a new infection (‘HIV transmission’).

EATG supports the UNAIDS position that all HIV-specific criminal laws should be repealed and that prosecutorial and police guidance be created to limit the overly broad application of other criminal laws applied to HIV non-disclosure, exposure or transmission to only the most egregious cases, where malicious intent to transmit HIV can be proven, taking into account scientific, legal and human rights principles.

EATG applauds recent developments in several Western European countries in response to increased advocacy and attention to the above mentioned concerns, including Denmark and Switzerland, where HIV-related criminal laws have been suspended or modernised; in England and Wales, and Scotland where prosecutorial guidelines have been implemented, and in Norway and Sweden where there is significant political interest in reassessing their HIV-related criminal policies.

However, despite signs of progress there continue to be problematic developments within Europe, such as the arrest, forcible HIV testing and attempted prosecution for HIV transmission of 26 women in Greece in May 2012; Romania’s new HIV-specific criminal statute implemented in October 2011;and new prosecutions setting legal precedent for further prosecution under existing laws in Belgium in July 2011. In addition, many jurisdictions throughout Europe and Central Asia continue to inappropriately prosecute people living with HIV for non-disclosure, alleged exposure and non-intentional transmission.

In order to improve the situation in Europe and Central Asia, EATG

  • Supports the UN position(s) and will work with members and other stakeholders to help support change in-country, such as by working with the criminal justice system and the media on education and training, and by lobbying any relevant EU institutions.
  • Seeks to ensure that Europe-wide standards of up-to-date scientific evidence are used appropriately in criminal cases, including the impact of antiretroviral therapy (ART) on infectiousness and life expectancy.
  • Recommends that legal assessment of risk should follow epidemiological conclusions.
  • Considers as equally important education for the population at large to dismantle stigma in relation to HIV and to ensure that there truly is an equitable concept of shared responsibility.
  • Recommends adopting clear prosecutorial and police guidelines for appropriate criminal intervention in cases of HIV transmission.
  • Recommends the use of evidence-informed public health interventions rather than criminal law and adopting evidence-informed, human rights-based public health interventions rather than using criminal law sanctions.

EATG argues that while there may be a limited role for criminalising HIV transmission in terms of achieving justice and/or punishment for wrongdoing in exceptional cases of malicious and deliberate HIV transmission that causes actual harm, the criminal law is too blunt and rigid a tool for dealing effectively with public health initiatives, controlling the spread of HIV, and deterring harm-risking conduct and is, therefore, detrimental to contemporary public health goals and human rights.

The full position paper is below

EATG Position on Criminalisation of HIV transmission, exposure and non-disclosure, October 2013

Australia: South Australia Government plans mandatory HIV testing following blood or saliva exposure to police

ANY offender whose blood or saliva comes into contact with a police officer will be compelled to undergo a mandatory blood test, under new laws to be introduced by the State Government. Premier Jay Weatherill will today outline the measure – and another significant community safety initiative involving police – at the Police Association of SA annual delegates conference.

The move will ensure any officer faced with the risk of contracting a communicable disease is made aware of the possible threat much faster, instead of having to rely on their own test results – often many months later. Mr Weatherill said police needed to be protected. “We know that there are some instances where police officers are exposed to infectious diseases, such as hepatitis C or HIV when an officer is arresting, restraining or detaining an offender,” he said.

“These laws mean that if an officer is exposed to a risk of contracting these diseases, the offender will be required to undertake a blood test. While officers are already blood-tested in these situations, some diseases are not detectable for months. This means officers can be left waiting for a considerable amount of time, which can be stressful for them and their families. Test results from the offender will provide early information to reduce the anxiety about risk of infection.”

Police say that over the past year, there were 279 incidents where officers came into contact with blood, 118 incidents involving officers being spat on and two occasions where an officer suffered a needle-stick injury.

Southern African leaders warned that mandatory HIV testing is both a violation of human rights and a hinderance to public health

Windhoek, 22 August 2013 – The AIDS and Rights Alliance for Southern Africa (ARASA), a partnership of 73 non-governmental organizations working in southern and east Africa, has noted with concern reports that several SADC leaders lauded mandatory HIV testing as a viable strategy to curb the spread of HIV during a meeting of Heads of State and Government on AIDS Watch Africa, held on 17 August on the sidelines of the 33rd SADC summit in Lilongwe, Malawi.

The battle of civil society against reinstatement of mandatory HIV testing legislation in Greece

The day after he was appointed, Greek Health Minister Adonis Georgiadis brought back in to force health regulation 39A on July 1, 2013. The regulation forces mandatory testing for HIV and other communicable diseases. It specifies certain groups like people who inject drugs, sex workers and undocumented migrants as a priority, with the argument that this is in the interest of public safety.

US: House Appropriations Committee passes amendment that would fund review of HIV-specific criminal laws

The United States is closer than ever before in ensuring that their HIV-specific laws are reviewed and amended in order to be consistent with current medical and scientific knowledge.

Earlier this week, the U.S. House Appropriations Committee passed an amendment proposed by Congresswoman Barbara Lee to the FY2014 Commerce-Justice-Science Appropriations Act that would require the Attorney General to initiate a review of Federal and State laws, policies, and regulations regarding criminal and related civil commitment cases involving people living with HIV.

This wording is very similar to the content of Lee’s REPEAL HIV Discrimination Act, which was re-introduced in May with bi-partisan support, and which currently has 32 co-sponsors.

“HIV criminalization laws breed, discrimination, distrust, and hatred. These laws are based on fear, not science. This is an important first step in ensuring that our laws reflect current scientific understandings of HIV.” notes Congresswoman Lee in a press release. This amendment passed on a voice vote as part of the manager’s amendment.

The amendment reads as follows:

Modernizing laws with respect to people living with HIV/AIDS.

The Committee is aware of the position of the President’s Advisory Council on AIDS (PACHA) that current criminal laws require modernization, should be consistent with current medical and scientific knowledge and avoid imposition of unwarranted punishment based on health and disability status.  The Committee directs the Attorney General, within 90 days following enactment of this Act, to initiate a review of Federal and State laws, policies, and regulations regarding criminal and related civil commitment cases involving people living with HIV/AIDS. The Committee further directs the Attorney General, no later than 180 days from initiating the review, to make best practice recommendations to ensure such policies do not place unique or additional burdens on individuals living with HIV/AIDS and reflect contemporary understanding of HIV transmission routes and associated benefits of treatment.

The Appropriations Act (officially titled ‘S.1329 : An original bill making appropriations for Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2014, and for other purposes’) has now been placed on Senate Legislative Calendar.

The Sero Project has issued a press release welcoming the amendment and explaining what it means for advocacy against overly-broad HIV-specific criminal laws in the United States.

SERO. Appropriations Amendment Release

Uganda: Advocates oppose mandatory HIV testing, disclosure of status to partners, of pregnant women in draft HIV law

Civil society organisations have opposed a proposal in the HIV Prevention and Control Bill providing for mandatory testing of pregnant women and others. The proposal of the coalition of civil society organisations, led by the Uganda Network on Law, Ethics and HIV/AIDS, was presented during a dialogue on the Bill with members of the Uganda Parliamentary Women Association at Protea Hotel in Kampala yesterday.

The meeting aimed at assisting the legislators in coming up with a common position on the Bill to be forwarded to the committee on HIV/AIDS under whose docket the Bill falls for onward submission to Parliament for approval. The civil society organisations and activists contended that international standards require HIV/AIDS testing to be confidential accompanied by counselling and to be conducted with voluntary and informed consent.

They further argued that mandatory testing of drug users and workers would discourage them from seeking treatment and care. The civil society organisations are also against a provision that allows a medical practitioner to disclose HIV test results without the consent of the affected person. “Mandatory disclosure obligations run the risk of deterring people, especially women, from getting tested,” they stated, arguing that where due caution is not exercised, informing a woman’s partner of her HIV status may expose her to the risk of violence, eviction, disinheritance and severe abuses.

The MPs agreed to do further consultations on the Bill and to study the law enacted by the East African Community assembly on the subject. The Bill has also been heavily criticised by international human rights organisations.

Uganda: Female lawmakers propose compulsory couples testing to counter proposal for mandatory testing and disclosure to partners of pre-natally tested women in draft HIV law

Female lawmakers have proposed amendments to the controversial 2010 Prevention of HIV/Aids Bill, which if adopted, will make it compulsory for male partners to test for HIV/Aids with their spouses during antenatal care visits. The MPs also proposed that negligent health workers who cause the transmission of HIV/Aids to others while in their line of duty be liable to a five-year jail penalty. The Bill, which seeks to criminalise people who intentionally infect others with HIV/Aids, is before the Parliamentary Aids Committee for consideration.

The Committee began fresh consultations on the proposed law yesterday after the 8th Parliament failed to pass it. The MPs, in consultation with the hospices of the Uganda Network on Law, Ethics and HIV/Aids , during a workshop yesterday said women have always fallen victims of sexual offences. They say many men have not been going for routine HIV/Aids counselling and testing with their spouses.

Ms Betty Amongi, the Uganda Women Parliamentary Association chairperson, said the proposed law mandates health workers to disclose the status of tested pregnant women to their husbands. “In order to prevent domestic violence and ensure stable marriages, we are proposing that both couples must test together so that they jointly receive the results,” Ms Amongi said.

Ms Amongi said women shy away from attending antenatal clinics for fear of losing their marriages if their status is disclosed to their spouses without them testing together. Ms Noreen Kareeba, the founder of The Aids Support Organisation, urged the government to invest in voluntary testing and purchase of ARVs. Currently, the Ministry of Health programme for prevention of Aids requires that tests are conducted for pregnant women to reduce the risk of being abused.

Greece: Scientists and human rights campaigners condemn the reinstatement of Provision 39A allowing forced HIV testing of suspected sex workers, drug users and undocumented migrants

Reinstatement of controversial Health Provision slammed by HIV and Human Rights Groups, by Zoe Mavroudi

[Republished from the radiobubble blog, with thanks to Zoe Mavroudi]

A legal provision that led to mass arrests of HIV-positive women in Greece in 2012 has been reinstated, causing widespread condemnation by local and international organizations and human rights advocates.

Provision No 39A was voted by former socialist Health Minister Andreas Loverdos in April 2012 and led to an unprecedented case of HIV criminalization a few weeks later when the Greek police in cooperation with the country’s Center for Disease Control and Prevention, KEELPNO, rounded up hundreds of women from the center of Athens and force-tested them for HIV inside police stations. A total of 30 who tested positive were imprisoned on charges of felony and prostitution, in spite of a lack of significant evidence that they had been working as prostitutes or that they had infected anyone with the virus. Their mug-shots and personal data were then published upon order by a prosecutor on the Greek police website as well as on major TV channels.

The arrests prompted an international backlash against the Greek government when organizations like Amnesty International, Human Rights Watch, the European AIDS Treatment Group and UNAIDS called for the withdrawal of laws that enabled the targeting of HIV-positive people labeling them unproductive and in violation of international conventions.

The women were held in prison for a months-long detention period under inhumane conditions. The charges have since been dropped or reduced in the courts. After months of negotiations following Loverdos’ exit from the government and socialist PASOK party, non-governmental organizations and activist groups in Greece scored a victory in May 2013, when former Deputy Health Minister Foteini Skopouli finally repealed the provision.

The move was welcomed as a step toward correcting the damage inflicted on the country’s medical services by the 2012 arrests. Drug rehabilitation groups, which have been hit hard by austerity cuts, have repeatedly complained that the arrests had serious implications in the exercise of their outreach work among vulnerable groups.

But last Tuesday, newly-appointed health minister Adonis Georgiadis (pictured above), formerly a member of the far-right LAOS partly and currently a New Democracy majority party MP, reinstated the provision unexpectedly, the day after his swearing-in ceremony that followed a cabinet reshuffle of the country’s coalition government. In a short announcement, KEELPNO welcomed the reinstatement citing a necessity to “cover the country” until revisions to the provision were agreed on. Georgiadis addressed the reinstatement on twitter, saying the repeal by Skopouli had left a “legal void.”

But the legal grounds upon which the provision was voted into law were questionable. Last year, Loverdos signed 39A alone, in spite of a legal requirement for a minimum of four official signatures in order for a provision to be enacted into law.

At the time, he claimed that its content had originated in a 1940 regulation, which allowed for sanitation measures in public places for the protection of public health. However, new language included in 39A, pointed at immigrants, homeless people, intravenous drug users and sex workers as possible sources of epidemics. 39A also cited a need to perform mandatory tests on individuals from these groups as part of controlling diseases that are currently not endemic in Greece, such as malaria, polio and sexually transmitted diseases, including HIV.

Greece has seen a spike in HIV infections among injecting drug users during the crisis, mostly in the country’s capital, although there is no official data on a significant rise among sex workers or undocumented immigrants. Men who have sex with men remain the main population group that suffers most of the country’s new HIV infections.

In spite of citing a need for mandatory testing, the provision is also unclear about the nature of measures that the police and health authorities should take in order to test individuals without their informed consent. A law-suit has been brought by some of the women arrested in 2012 and by Greek NGOs against police officers present in the arrests as well as KEELPNO doctors for sharing test results with the police and violating patient confidentiality.

Calls to take back the measure came from abroad almost immediately after the reinstatement was announced. In her closing speech at the annual convention of the International Aids Society in Kuala Lumpur on Wednesday, French Nobelist Françoise Barré-Sinoussi, the scientist accredited with co-discovering the HIV virus, expressed her “strong disappointment.”

“As President of the IAS I strongly condemn this move and urge the Greek Government to rethink its position. HIV infections are already increasing in Greece due to the economic crisis and a mandatory policy of detainment and testing will only fuel the epidemic there.” Barré-Sinoussi added: “As we keep repeating over the years, there will be no end to the HIV epidemic without advancing human rights in parallel.”

Sinoussi’s concerns were echoed in a damning announcement by Human Rights Watch, which called the reinstatement “a big step backward for human rights and public health.“

“Addressing infectious diseases such as HIV, hepatitis, and tuberculosis requires investing in health services, not calling the police. If the government is serious about addressing HIV and other infectious diseases, it should focus on access to health care and public information,” wrote HRW in a statement earlier this week. “Any detention for public health reasons must have a lawful basis, be demonstrably necessary and proportionate, and be nondiscriminatory. Anyone detained, irrespective of the grounds, is entitled to guarantees of due process.”

On their part, local Greek NGOs and human rights initiatives saw the reinstatement as a betrayal of their year-long battle for its repeal. HIV NGOs and LGBT and human rights initiatives chided the new leadership in a joint statement, for ignoring the unanimous decision that prompted its repeal as well as the recent report by the Greek Ombudsman citing the provision’s unconstitutionality.

“We cannot allow the implementation of practices that lead our society to the Middle Ages,” the statement by Positive Voice, Center for Life and Praksis, among other groups, said. “Access to free and public health services, access to medical coverage and a respect for human rights are non-negotiable for us. Since the leadership of the Health Ministry obviously does not share this view, we have a responsibility to make it clear with our actions.”

Protests against the reinstatement of 39A are continuing with a gathering outside the Ministry of Health in Athens [on Monday July 8th].

Latest update July 16th:  Greek Health Minister says he will not repeal health provision that led to forced HIV tests, says he welcomes proposals.

In a Parliamentary question to Minister Georgiadis on Friday July 12, SYRIZA opposition party MP Vassiliki Katrivanou asked for a new repeal of the provision. On the same day, four Greek NGOs (Positive Voice, Praksis, Act Up Hellas and Center for Lsife) said in a joined announcement that they requested that a health committee assigned by Georgiadis with negotiating changes to the provision provide them with documentation that substantiates the urgency of the provision’s recommendations to protect public health, before they can return to the negotiations.
Read more here

A new documentary produced by radiobubble about the 2012 arrests called “Ruins: Chronicle of an HIV witch-hunt,” is due for release this September. It features interviews by women who were arrested and their families. You can watch a trailer here:

Global Commission newsletter highlights recent developments on HIV and the law around the world

Dear subscribers, We are delighted to share issue 2 of the Global Commission on HIV and the Law Newsletter – Issue 2 for 2013. Since the last Newsletter was released, there have been a number of significant developments on HIV and the law some of which are briefly described below in digest format.

United States Conference of Mayors calls for “the elimination of HIV-specific criminal laws”

Today, the U.S. Conference of Mayors passed a resolution calling for “the elimination of HIV-specific criminal laws and implementation of approaches to HIV within the civil and criminal justice systems that are consistent with the treatment of similar health and safety risks.”

It goes on to support the REPEAL HIV Discrimination Act and endorses the recommendations of the Presidential Advisory Council on HIV/AIDS for ending federal and state HIV-specific criminal laws, prosecutions, and civil commitments.

Full text below.

HIV DISCRIMINATION AND CRIMINALIZATION

WHEREAS, The U.S. Conference of Mayors has been a national leader on strategies to address HIV/AIDS for three decades, establishing in 1984 an HIV/AIDS Program and implementing a HIV/AIDS Prevention Grants Program with funding from the Centers for Disease Control and Prevention (CDC); and

WHEREAS, The National HIV/AIDS Strategy (NHAS) released by the White House includes a statement on the problem and public health consequences of HIV criminalization and notes that many state HIV-specific criminal laws reflect long-outdated misperceptions of HIV’s modes and relative risks of transmission; that criminal law has been unjustly used in the United States to prosecute and disproportionately sentence people with HIV; and that legislators reconsider whether these laws further the public interest and support public health approaches to preventing and treating HIV; and

WHEREAS, nearly all HIV-specific criminal laws do not consider correct and consistent condom use and effective antiretroviral therapy that reduces the risk of HIV transmission to near-zero as evidence of a lack of intent or ability to harm; and behaviors that according to the Centers for Disease Control and Prevention (CDC) have negligible risk of transmitting HIV, such as spitting and biting, have resulted in sentences as long as 35 years: and

WHEREAS, sound criminal justice and public health policy toward people living with HIV is consistent with an evidence-based approach to disease control and research demonstrates that HIV-specific laws do not reduce transmission or increase disclosure and may discourage HIV testing; and

WHEREAS, The Presidential Advisory Council on HIV AIDS, the Centers for Disease Control, and the United Nations Global Commission on HIV and the Law have conducted extensive scientific research and evidence reviews, finding that public health is endangered by HIV discrimination and criminalization and calling for comprehensive revision of state and federal laws and regulations,

NOW, THEREFORE, BE IT RESOLVED, that the U.S. Conference of Mayors calls for the elimination of HIV-specific criminal laws and implementation of approaches to HIV within the civil and criminal justice systems that are consistent with the treatment of similar health and safety risks; and supports legislation, such as the REPEAL HIV Discrimination Act, that advances these objectives: and

BE IT FURTHER RESOLVED, that the U.S. Conference of Mayors endorses the recommendations of the Presidential Advisory Council on HIV/AIDS for ending federal and state HIV-specific criminal laws, prosecutions, and civil commitments.

Projected Cost: Unknown

US Conference of Mayors HIV Criminalization Resolution, June 25 2013