Uruguay: Feminist organisation opposes amendment to penal code that would imprison citizens who do not comply with health measures

MYSU (Women and Health in Uruguay) opposes a project that raises imprisonment for those who violate health provisions in the face of the coronavirus

Google translation, for original article in Spanish please scroll down.

MYSU (Women and Health in Uruguay) opposes a project that raises imprisonment for those who violate health provisions in the face of the coronavirus

A delegation of Women and Health in Uruguay (MYSU) participated in the Senate Constitution and Legislation Commission to express their opposition to the bill that penalizes those who violate health provisions in the face of the coronavirus, presented in March by two deputies of the National Party . The feminist organization, whose mission is the promotion and defense of sexual and reproductive rights, has a field of practice specifically associated with identifying advances, obstacles and gaps in laws and public policies.

The delegation that appeared in Parliament was made up of Lilián Abracinskas, director of MYSU, Santiago Puyol, head of the Organization’s Sexual and Reproductive Health Policy Observatory, and Bárbara Strauss, head of communication, who presented their position against the amendment of article 224 of the Penal Code. The new wording proposes that “whoever, through violation of sanitary provisions issued and published by the competent authority in order to avoid the introduction into the country or the spread of an epidemic or contagious disease of any nature, puts human or animal health in actual danger, will be punished with three to twenty-four months in prison.The application of the maximum of the aforementioned penalty will be especially justified when the fact is a health emergency declared by the competent authorities ”.

Abracinskas said that although this project has the approval of the Chamber of Deputies, the proposal “did not have a treatment in which organized citizenship could be issued.”

Part of her argumentation was based on the Universal Declaration of Bioethics and Human Rights (UNESCO 2005), which provides a universal framework of principles and procedures that serve as a guide for states in the formulation of legislation, policies and other instruments in the field of bioethics. She particularly pointed out Article 27, which warns that “if limitations must be imposed with laws relating to public security and the rights and freedoms of others must be safeguarded, said law must be compatible with international human rights law.” She added that Uruguayan legislation includes these principles in Law 18,335 on the rights and obligations of patients and users.

For Abracinskas, the current wording of article 224 is already a regulatory framework that allows health authorities to act in the face of the pandemic. “The proposal to modify article 224, which aims to prevent the violation of sanitary provisions in order to prevent the introduction or spread in the country of epidemic or contagious diseases, in its modification of 2001 stipulates the crime of harm, in order to make it applicable. Insisting on modifying the crime of harm, again, for that of danger, generates uncertainties and a feeling of vulnerability, ”he said.

“What would be the legal asset that seeks to protect itself with this modification proposal?” She asked. And she added: “It would not seem to be the health of the person or the guarantees of their rights the center of concern, since people could be accused of committing a crime in the face of sanitary provisions that could become arbitrary or based on other interests that are not there to preserve the health of the population. Or, even from good intentions, to charge crimes without knowing exactly what the affected legal interest is ”.

For MYSU, the situation of the pandemic “has plunged us into profound perplexity”, but “our country is going through the situation without having the adverse impacts of neighbouring countries or other regions.” Although they welcomed the treatment of the pandemic by the authorities, they explained that they appeared before the Commission to “draw attention” since, “in the face of a temporary situation, modifying the Penal Code to apply a prison sentence for non-compliance with measures related to health care exceeds the context and exposes us to a multiplicity of situations that can violate human rights ”.

According to Puyol, “Uruguay has undergone a transition in recent decades towards a health model focused on promotion and prevention, with people as the focus.” For this reason, they consider “contradictory to run the axis of people’s health to pass to a sentence in case of not obeying health decrees”. “The State must guarantee the conditions for the prevention of contagions instead of criminalizing its citizens if they do not comply with the measures,” he said.

For Puyol, this measure could have an impact on different areas of public health. He gave as an example the treatment of gender violence. “What consequences would the implementation of this reformed article have in the face of the declaration of national emergency for gender-based violence that was carried out in December of last year? Has it been considered how this modification would be articulated with the non-compliance with the precautionary measures that protect the victims?

He also questioned the scope of this measure on other issues, such as sexually transmitted infections: “What happens in situations that happen in privacy, such as refusing to use preventive methods, which can generate sexually transmitted infections, including HIV ? Will people be penalized for not using a barrier method to prevent the transmission of a virus that is a global pandemic?

According to data from the observatory that Puyol directs, 33% of men (one in three) are willing not to use a condom in a sexual relationship with someone who does not want to use it. However, 63% never had an HIV test. “What would be done in these cases?” He asked.

The other example he gave was associated with the prevention of dengue: “Will people who have containers with stagnant water in their houses go to jail?”

He also pointed out that the government contradicts itself, since the explanation given by Luis Lacalle Pou, President of the Republic, for not declaring the mandatory quarantine in the face of the pandemic was “not to force what is not going to be fulfilled” and “not to become a Police state ”. “We are struck by the fact that, given the orientation of government policy, in whose measures none makes reference to criminal sanction, the Legislature and its own political force go in the opposite direction,” he explained.

For Strauss, “Uruguay has been an example for the countries of the region both in the way in which the spread of the virus has been contained and in its approach, based on what President Lacalle Pou has called” responsible freedom.

He pointed out that “the model that seems to demonstrate its efficiency and effectiveness has been able to combine respect for individual freedoms with care measures that made it possible to control the circulation of the virus and reduce the impacts of the pandemic.” He stressed that, “as an Argentine resident in Uruguay,” the neighboring country looks closely at the steps followed on this side of the river.

“The reason why legislators who make up the government coalition decide to opt for the modification of the Penal Code with a punitive approach is not understood then. The Executive Power has promoted, in public interviews given to international media, an approach that prioritizes freedom and appeals to citizen responsibility. Decisions that go in the opposite direction to this bill and, particularly, the grounds contained in its explanatory memorandum ”, he expressed.

In this sense, “and without ignoring the legitimacy and autonomy of the Legislative Power in its initiatives,” he said that “it is striking that the same coalition emits contradictory messages.” “We are concerned as an organization that this generates confusion among citizens and undesirable collateral effects,” he added.

He expressed concern that “the amendment of the Penal Code is used, imprisoning those who do not comply with the measures due to the health emergency” and also that “the arguments are not supported by scientific evidence.” “This has been the pillar of the government’s action based on the recommendations of the Honorary Scientific Committee, which has intervened to ensure the prevention of the circulation of the virus,” he said.

For the closing, Abracinskas returned to take the floor and resumed her concern about “these contradictory positions.”

She also emphasized “two substantive issues.” On the one hand, she stressed that modifying the Penal Code is “a long-term solution to a circumstantial problem by definition. “This type of legislative changes with lasting effect cannot be subject to the contingencies of a health emergency with particular characteristics,” she explained.

On the other hand, she questioned: “If it is not guaranteed that the population has sufficient and quality information to comply with the measures imposed on it for the prevention of any epidemic or any health emergency, how will it be ensured that the rights of the citizens are not violated by these decisions? How to ensure that different authorities can issue relevant sanitary measures? Will broad impact dissemination campaigns be carried out to ensure that the measures to be complied with are effectively known? Will this punitive amendment be widely publicized if approved? Who would make it public?

According to the director of MYSU, “it is necessary that the institutions of the State, both the Executive Power and the Parliament, issue clear signals and messages to the population, based on arguments and evidence that reassure and provide security.” She said that, “otherwise, it is fertile ground for worrying reactions to emerge.” In this sense, “we must avoid the proliferation of conspiracy theories and the circulation of false news that, taking advantage of the general confusion, achieve a destabilization of our democratic society.”

She conveyed the concern of the organization she represents, since they verified “the presence in the region of groups that support this type of theories and communicational forms that contribute to the general confusion”. “Given the risk that this presupposes, it is necessary to have clear minds, security in decision-makers, confidence in the measures, personal freedom and the promotion of an awareness of collective well-being. We do not need confusion, irrationality, perplexity or fear, but guaranteeing messages and joining efforts to reassure the population and allow the critical capacity to identify differences ”, he expressed.

That no final sanction be given

MYSU does not have an alternative text to contribute to the change to Article 224. Their suggestion is that the Senate not give it the final sanction it needs to be law. “What we recommend is that, in the event of an exacerbation of the pandemic, a permanent link be maintained with the Executive to provide the regulations that can be resolved by other means, other than the modification of the Penal Code.” For the organization, actions that “give security to the entire population, promoting awareness and not incarceration” should be promoted.

MYSU se opone al proyecto que plantea encarcelamiento para quienes violen las disposiciones sanitarias ante el coronavirus

Una delegación de Mujer y Salud en Uruguay (MYSU) participó en la Comisión de Constitución y Legislación del Senado para manifestar su oposición al proyecto de ley que penaliza a quienes violen las disposiciones sanitarias ante el coronavirus, presentado en marzo por dos diputados del Partido Nacional. La organización feminista, cuya misión es la promoción y defensa de los derechos sexuales y reproductivos, tiene un campo de práctica asociado específicamente a identificar avances, obstáculos y vacíos en leyes y políticas públicas.

La delegación que compareció en el Parlamento estuvo integrada por Lilián Abracinskas, directora de MYSU, Santiago Puyol, responsable del Observatorio de Políticas en Salud Sexual y Reproductiva de la organización, y Bárbara Strauss, responsable de comunicación, quienes expusieron su posicionamiento contrario a la modificación del artículo 224 del Código Penal. La nueva redacción propone que “el que mediante violación de disposiciones sanitarias dictadas y publicadas por la autoridad competente en aras de evitar la introducción al país o propagación de una enfermedad epidémica o contagiosa de cualquier naturaleza, pusiere en peligro efectivo la salud humana o animal, será castigado con tres a veinticuatro meses de prisión. La aplicación del máximo de la pena referida anteriormente estará especialmente justificada cuando el hecho se suscitare declarada una emergencia sanitaria por las autoridades competentes”.

Abracinskas manifestó que si bien este proyecto cuenta con la media sanción de la Cámara de Diputados, la propuesta “no tuvo un tratamiento en el que la ciudadanía organizada pudiese expedirse”.

Parte de su argumentación estuvo basada en la Declaración Universal de Bioética y Derechos Humanos (UNESCO 2005), que proporciona un marco universal de principios y procedimientos que sirven de guía a los estados en la formulación de legislaciones, políticas y otros instrumentos en el ámbito de la bioética. Señaló particularmente el artículo 27, que advierte que “si hay que imponer limitaciones con leyes relativas a la seguridad pública y salvaguardar los derechos y libertades de los demás, dicha ley deberá ser compatible con el derecho internacional relativo a los derechos humanos”. Agregó que la legislación uruguaya recoge estos principios en la Ley 18.335 sobre los derechos y obligaciones de pacientes y usuarios.

Para Abracinskas, la redacción actual del artículo 224 ya es un marco normativo que permite a las autoridades sanitarias actuar ante la pandemia. “La propuesta de modificar el artículo 224, que apunta a evitar que se violen disposiciones sanitarias con el fin de impedir la introducción o la propagación en el país de enfermedades epidémicas o contagiosas, en su modificación de 2001 estipula el delito de daño, para poder hacerlo aplicable. Insistir con modificar el delito de daño, nuevamente, por el de peligro, genera incertidumbres y sensación de desprotección”, señaló.

“¿Cuál sería el bien jurídico que busca protegerse con esta propuesta de modificación?”, se preguntó. Y agregó: “No parecería ser la salud de la persona ni las garantías de sus derechos el centro de la preocupación, dado que las personas podrían ser acusadas de cometer delito ante disposiciones sanitarias que podrían llegar a ser arbitrarias o basadas en otros intereses que no fuese preservar la salud de la población. O, aún desde buenas intenciones, imputar delitos sin saber exactamente cuál es el bien jurídico afectado”.

Para MYSU, la situación de la pandemia “nos ha sumido en una profunda perplejidad”, pero “nuestro país transita por la situación sin tener los impactos adversos de países vecinos o de otras regiones”. Si bien saludaron el tratamiento de la pandemia por parte de las autoridades, explicaron que comparecían ante la Comisión para “llamar la atención” ya que, “frente a una situación coyuntural, modificar el Código Penal para aplicar pena de cárcel ante el incumplimiento de medidas sanitarias excede el contexto y nos expone a multiplicidad de situaciones que pueden vulnerar los derechos humanos”.

Según Puyol, “Uruguay ha atravesado en las últimas décadas una transición hacia un modelo de salud centrado en la promoción y prevención, con las personas como foco”. Por esto consideran “contradictorio correr el eje de la salud de las personas para pasar a una condena en caso de no obedecer decretos sanitarios”. “El Estado debe garantizar las condiciones para la prevención de los contagios en lugar de criminalizar a su ciudadanía si no cumple con las medidas”, expresó.

Para Puyol esta medida podría tener impacto en distintos ámbitos de la salud de la ciudadanía. Puso como ejemplo el tratamiento de la violencia de género. “¿Qué consecuencias tendría la implementación de este artículo reformado frente a la declaración de emergencia nacional por violencia basada en género que se realizó en diciembre del año pasado? ¿Se ha considerado cómo se articularía esta modificación con el no cumplimento de las medidas cautelares que protegen a las víctimas?”.

También cuestionó el alcance de esta medida en otras cuestiones, como las infecciones de transmisión sexual: “¿Qué pasa frente a situaciones que suceden en la intimidad, como negarse a utilizar métodos preventivos, lo que puede generar infecciones de transmisión sexual, incluyendo el VIH? ¿Se penalizará a las personas por no usar un método de barrera para evitar la transmisión de un virus que es pandemia mundial?”.

Según los datos del observatorio que Puyol dirige, 33% de varones (uno de cada tres) está dispuesto a no utilizar el preservativo en una relación sexual con alguien que no quiere usarlo. Sin embargo, 63% nunca se realizó el test de VIH. “¿Qué se haría en estos casos?”, preguntó.

El otro ejemplo que puso estuvo asociado a la prevención del dengue: “¿Irán presas personas que tengan recipientes con agua estancada en sus casas?”.

Señaló también que el gobierno se contradice, ya que la explicación que dio Luis Lacalle Pou, presidente de la República, para no declarar la cuarentena obligatoria ante la pandemia fue “no obligar aquello que no se va a cumplir” y “no convertirse en un Estado policial”. “Nos llama la atención que frente a la orientación de la política de gobierno, en cuyas medidas ninguna hace referencia a la sanción penal, el Legislativo y su propia fuerza política vayan en sentido contrario”, explicó.

Para Strauss, “Uruguay ha resultado ejemplo para los países de la región tanto por la forma en que se ha logrado contener el avance del virus como por su enfoque, basado en lo que el presidente Lacalle Pou ha denominado la “libertad responsable”.

Señaló que “el modelo que parece demostrar su eficiencia y eficacia ha podido conjugar el respeto a las libertades individuales con medidas de cuidado que permitieron controlar la circulación del virus y reducir los impactos de la pandemia”. Resaltó que, “como argentina residente en Uruguay”, el vecino país mira con atención los pasos seguidos de este lado del río.

“No se entiende entonces la razón por la cual legisladores que integran la coalición de gobierno deciden optar por la modificación del Código Penal con un enfoque punitivista. El Poder Ejecutivo ha promovido, en entrevistas públicas brindadas a medios internacionales, un abordaje que prioriza la libertad y apela a la responsabilidad ciudadana. Decisiones que van en sentido opuesto a este proyecto de ley y, particularmente, los fundamentos que contiene su exposición de motivos”, expresó.

En este sentido, “y sin desconocer la legitimidad y autonomía del Poder Legislativo en sus iniciativas”, dijo que “resulta llamativo que la misma coalición emita mensajes contradictorios”. “Nos preocupa como organización que esto genere confusión en la ciudadanía y efectos colaterales indeseables”, agregó.

Manifestó preocupación por que “se recurra a la modificación del Código Penal encarcelando a quien no cumpla con las medidas por la emergencia sanitaria” y también por que “los argumentos no se sostengan en evidencia científica”. “Este ha sido el pilar de la actuación del gobierno en base a las recomendaciones del Comité Científico Honorario, que ha intervenido para asegurar la prevención de la circulación del virus”, señaló.

Para el cierre, Abracinskas volvió a tomar la palabra y retomó la inquietud sobre “estas posturas contradictorias”.

Hizo énfasis además en “dos cuestiones sustantivas”. Por un lado, destacó que modificar el Código Penal supone “una solución de largo plazo para un problema circunstancial por definición”. “Este tipo de cambios legislativos con efecto duradero no pueden estar sujetos a las contingencias de una emergencia sanitaria con características particulares”, explicó.

Por otro lado, cuestionó: “Si no se garantiza que la población cuente con información suficiente y de calidad para cumplir con las medidas que se le imponen para la prevención de cualquier epidemia o cualquier emergencia sanitaria, ¿cómo se asegurará que los derechos de la ciudadanía no sean violentados por estas decisiones? ¿Cómo asegurar que distintas autoridades puedan emitir medidas sanitarias pertinentes? ¿Se realizarán campañas de difusión de amplio impacto para asegurar que se conozcan efectivamente las medidas que se deben cumplir? ¿Se difundirá ampliamente esta modificación punitiva en caso de ser aprobada? ¿Quién lo haría público?”.

Según señaló la directora de MYSU, “es necesario que las instituciones del Estado, tanto del Poder Ejecutivo como del Parlamento, emitan señales y mensajes claros a la población, basados en argumentos y evidencias que tranquilicen y den seguridad”. Dijo que, “de lo contrario, es tierra fértil para que surjan reacciones preocupantes”. En este sentido, “debemos evitar la proliferación de teorías conspirativas y la circulación de noticias falsas que, aprovechando la confusión general, logren una desestabilización de nuestra sociedad democrática”.

Transmitió la preocupación de la organización a la que representa, ya que constataron “la presencia en la región de grupos que sustentan este tipo de teorías y formas comunicacionales que aportan a la confusión general”. “Ante el riesgo que esto presupone, se necesita tener mentes claras, seguridad en los decisores, confianza en las medidas, libertad personal y promoción de una conciencia de bienestar colectivo. No necesitamos confusión, irracionalidad, perplejidades ni miedos, sino mensajes garantizadores y aunar los esfuerzos para tranquilizar a la población y permitir la capacidad crítica para identificar las diferencias”, expresó.

Que no se dé sanción final

MYSU no tiene un texto alternativo para aportar al cambio del artículo 224. Su sugerencia es que el Senado no le dé la sanción final que necesita para ser ley. “Lo que recomendamos es que, en caso de agudización de la pandemia, se mantenga un vínculo permanente con el Ejecutivo para aportar la normativa que pueda resolver por otras vías, que no sea la modificación del Código Penal”. Para la organización, se deben promover acciones que “den seguridad a toda la población, promoviendo conciencia y no encarcelamientos”.

HIV criminalisation presentations and posters at AIDS2020

There were a number of presentations, mostly e-posters, at AIDS2020:Virtual that focused on HIV criminalisation. We have compiled them all below given that access was (and remains) limited.

The only oral presentations specifically covering HIV criminalisation were delivered by HIV Justice Network’s Executive Director, Edwin J Bernard, presenting in three pre-recorded video sessions.

Below you will find the presentation ‘Bringing Science to Justice’ for the IAPAC 90-90-90 Targets Update, produced for the session, ‘Creating Enabling Environments for Optimal HIV Responses’. This eleven minute presentation, that also includes a number of video clips, covers the following:

The detrimental implications of HIV criminalisation on human rights and public health
The impact of the ‘Expert consensus statement on the science of HIV in the context of criminal law’
Lessons learned from HIV criminalisation on punitive responses to COVID-19
Conclusion: It is more critical than ever to commit to, and respect, human rights principles; ground public health measures in scientific evidence; and establish partnerships, trust, and co-operation between scientists, law- and policymakers and the most impacted communities.

Update (29 July): During a California HIV/AIDS Policy Research Centers virtual satellite session, Dr. Ayako Miyashita Ochoa of UCLA Luskin School of Public Affairs, Department of Social Welfare, interviewed activist Marco Castro-Bojorquez about the modernisation of California’s HIV-specific criminal law as an example of of evidence-based policymaking.

There were a number of poster presentations that also focused on HIV criminalisation in the following countries/jurisdictions:

PEF 1737 United States
PEF 1738 England & Wales
PEF 1739 Australia
PEF 1740 Niger
PEF 1742 Malawi
PEF 1781 Florida, USA
PEF 1794 Uganda
PEF 1841 Taiwan

The abstracts are below. Click on the title to download the pdf of the poster.

Amy Baugher, Centers for Disease Control and Prevention (PEF 1737) Men who have sex with men living in states with HIV-specific criminalization laws report high community stigma – NHBS, 2017.

BACKGROUND: In 2017, 36 states had laws penalizing persons with HIV (PWH) for sexual or no-risk behavior (e.g., spitting). Research shows these laws do not impact sexual risk behaviors or diagnosis rates. Citizens likely are unaware of these laws; we do not expect direct behavioral effects. However, laws reflect states’ values and may mirror community attitudes towards PWH. Understanding how structural factors relate to stigma is important for stopping HIV stigma.
METHODS: National HIV Behavioral Surveillance used venue-based sampling methods to interview men who have sex with men (MSM) in 23 U.S. cities from June-December 2017. Using Center for HIV Law and Policy reports, we categorized states’ HIV-specific laws as of June 2017. We compared MSM”s perceptions of community attitudes towards PWH between MSM living in states with versus without HIV laws. We obtained adjusted prevalence ratios using log-linked Poisson models assessing the relationship between law and four community stigma attitudes (discrimination, rights, friendship, punishment), which we then compared between black MSM in states with versus without laws.
RESULTS: Two-thirds of MSM lived in states with HIV-specific laws. MSM in states with laws were more likely to report black race (38% versus 15%), poverty (23% versus 12%), or incarceration (25% versus 19%). Multivariable models found laws were related to perceived community beliefs that PWH “got what they deserved” (aPR=1.13, 95% CI: 1.03-1.24), but not other attitudes. Compared to black MSM in states without laws, black MSM in states with laws were more likely to believe persons in their community would discriminate against PWH (64% versus 50%), not support PWH’s rights (25% versus 16%), not be friends with PWH (24% versus 13%), and believe HIV was deserved punishment (32% versus 22%).
CONCLUSIONS: MSM in states with HIV laws were disproportionately from marginalized groups. Laws were related to perceived community attitudes that HIV was deserved punishment; understanding specific stigma attitudes can inform interventions. Although black MSM reported high community stigma overall, stigma was significantly higher for black MSM in states with HIV laws. States may consider repealing or reforming HIV laws and focusing on effective prevention efforts to End the HIV Epidemic.

Deborah Gold, National AIDS Trust (PEF 1738) Improving the application of the law: Updating guidelines for prosecutors in England and Wales regarding sexual transmission of infection.

BACKGROUND: In England and Wales it is possible to be prosecuted for the sexual transmission of infection under the Offences Against the Person Act 1861 or the Criminal Attempts Act 1981. After the first prosecutions in 2003, National AIDS Trust (NAT) successfully advocated for legal guidance for prosecutors and worked with the Crown Prosecution Guidance (CPS) to develop this.
DESCRIPTION: In 2018 NAT requested that the guidance be updated. In January 2019 the CPS shared a draft of their revised guidance with NAT, who then coordinated a joint response from NAT and other key stakeholders. This successfully ensured that the new guidance reflects medical developments such as Undetectable=Untransmittable and clinical guidance. Developments in case law have led the CPS to take the view that HIV/STI status deception may be capable of vitiating consent to sex. NAT is concerned that this could result in people who lie about their HIV status being prosecuted for rape or sexual assault, even with safeguards used and no transmission occurring. NAT prepared a briefing articulating legal, policy and public health arguments against this position, and presented it at a meeting with the CPS. As a result the CPS have added several caveats, but we still believe their position to be unacceptable and discussions are ongoing.
LESSONS LEARNED: The successes we have had in improving the guidance demonstrate the importance of long-standing proactive engagement, relationship-building and collaboration. Collaborating with a range of key stakeholders including clinicians and lawyers enabled NAT to leverage wider authority and expertise. However, the issue of HIV status deception has illustrated the implications for HIV of legal developments in related but not directly transferable areas. Confidence in our understanding of the law and persistence in making our arguments heard has been crucial in ensuring ongoing engagement on this issue.
CONCLUSIONS: The updated guidance will help to ensure that prosecutions for reckless or intentional transmission are conducted in a way that minimises harm to both individuals and the wider community. Regarding the issue of HIV status deception, possible next steps include securing parliamentary engagement, pro bono legal opinions, and further representations from local government and public health bodies.

Alexandra Stratigos, HIV/AIDS Legal Centre (PEF1739) Crime and punishments – deportation proceedings against people convicted of criminal transmission of HIV .

BACKGROUND: A significant portion of people convicted of HIV transmission in Australia are not Australian citizens. Due to not holding citizenship, those convicted of serious criminal offences (which includes facing a prison term of 12 months or more), are at risk of having their visas cancelled and being removed from Australia. The HIV/AIDS Legal Centre (HALC) has represented a number of these clients in both their criminal and subsequent immigration proceedings to assist these clients in preventing their removal from Australia.
DESCRIPTION: Where a person is not an Australian citizen and commits a criminal offence they are at risk of detention and removal from Australia. In two recent case studies of people with HIV convicted of HIV transmission, following the completion of their custodial sentences steps were then taken to cancel their visas and place them into immigration detention. Both clients had their visas cancelled and had to take steps to appeal the decisions. Part of the reason for the cancellation was the perception of ongoing risk to the Australian community. Neither client had been convicted of intentionally transmitting HIV to their sexual partner. HALC continues to represent one of the clients mentioned and the other has now exhausted all appeal options.
LESSONS LEARNED: There are often many and varied reasons for HIV non disclosure and, from HALC”s experiences, following criminal and public health interventions it is unlikely that a person with HIV would continue to place their sexual partners at risk of contracting HIV. Decision makers in migration proceedings appear to be unwilling to accept that a person with HIV would no longer place their sexual partner at risk of HIV transmission as the decision makers note in their decisions that they there remains a risk to the community.
CONCLUSIONS: The outcomes of these cases demonstrates the need for ongoing advocacy and law reform in the removal of offences for HIV non-disclosure, exposure and transmission, except where actual intent can be established to a criminal law standard. The cases also demonstrate the ongoing need for continued robust representation of those, often vulnerable migrants, who are facing visa cancellation.

Kassoumou Ibrahim, Association des Jeunes Juristes du Niger (PEF1740) Decriminalization of HIV transmission: Advocacy experience of the Civil Society Coalition for the decriminalization of HIV in Niger.

BACKGROUND: To effectively fight against HIV, Niger adopted Law No. 2007-08 of April 30, 2007 related on HIV prevention, care and control. This law included problematic provisions, including the criminalization of exposure, HIV transmission, and the non-disclosure of HIV to the sexual partner. Actually, PLWHIV continue to be victims of the application of the provisions criminalizing the transmission of HIV through several criminal prosecution cases in 2017.
DESCRIPTION: In June 2018, 13 civil society organizations created the “National Coalition for the Decriminalization of HIV in Niger”. This one benefited from the technical and financial support of HIV JUSTICE WORLDWIDE. Its advocacy objectives, by 2021, are to : repeal of offenses criminalizing exposure and transmission of HIV ; research and disseminate reliable and convincing data on the impact of HIV criminalization on access to HIV-related services. Since its creation, the Coalition has carried out the following activities: National workshop for consulting civil society stakeholders on the exposure, transmission and non-disclosure of HIV in Niger; The development of the Memorandum of December 20, 2018 entitled ‘exploring ways and means to resolve the problems of legal proceedings against people living with HIV in order to reduce to zero the new infections, deaths and discrimination linked to AIDS; Organization of several advocacy meetings during the ‘zero discrimination’ day (March, 2019) for public decision-makers and partners.
LESSONS LEARNED: Judicial police officers and magistrates have to exercise greater caution when considering a criminal prosecution, and in particular, carefully assess the latest scientific data on the risks of transmission and the consequences of the infection; National AIDS Control Program needs a comprehensive assessment of the application of criminal legislation on the transmission, exposure and non-disclosure of HIV status in order to measure its impact on the effectiveness of national response.
CONCLUSIONS: The criminalization of HIV transmission undermines public health efforts and does not take into account the reality of PLWHIV and especially women who are not always able to disclose their HIV status without fear of reprisals or violence, or to impose the wearing a condom. The threat of possible criminal prosecution only increases their vulnerability.

Laura Ferguson, University of Southern California (PEF1742) Removing legal barriers to accessing HIV services in Malawi: Impact of regional- and national-level interventions.

BACKGROUND: Building on the work of the Global Commission on HIV and the Law, and in order to promote an enabling environment for achieving the 90-90-90 targets, UNDP has supported regional-and national-level work on removing legal barriers to accessing HIV services in sub-Saharan Africa. Covering over 20 countries, this work consists of regional-level capacity building for duty-bearers and rights-holders from the different countries and in-country activities tailored to local realities.
DESCRIPTION: In 2019/20, we evaluated the impacts of this work through a review of project documents and key informant interviews with stakeholders including civil society representatives, government officials, and UNDP staff, and conducted an in-depth case study in Malawi.
LESSONS LEARNED: Participation in regional spaces empowered national-level stakeholders in their country level work. A participatory legal environment assessment (LEA), jointly owned by government and civil society, served as the starting point and the resulting document, providing an overview of the strengths and weaknesses of HIV-related national laws and policies, has served as a cornerstone for subsequent activities. For example, national advocacy efforts informed by the LEA, and participation by the Chair of the Parliamentary Committee on HIV in regional activities, were key to shaping a revised HIV law to better align with international human rights law. The new law has led to the reform of the institutional framework for the national HIV response. Judges participated in regional judges’ fora where they could request information on HIV-related science, discuss lived experiences with key populations’ representatives and hear about how legal issues were being addressed across the region. Lawyers from across the region took part in joint training. After one such training, and with technical support from regional partners to create a strong case, a lawyer chose to appeal the conviction of a woman under Malawi’s law criminalizing HIV transmission. The presiding judge had attended regional judges’ fora and, drawing on a firm understanding of HIV transmission dynamics, overturned the original ruling.
CONCLUSIONS: A mix of regional and national level activities allows for tailoring of activities to national contexts while also providing space for peer networking and support where ‘difficult’ issues might more easily be discussed.

Wyatt Deihl, Rollins College (PEF 1781) Racial and gender disparities in Florida newspaper coverage of HIV related arrests.

BACKGROUND: According to the Centers for Disease Control and Prevention (CDC), as of 2016, 108,003 people live with HIV (PLHIV) in Florida, which also has the highest rates of new HIV diagnoses in the country. Numerous complexities worsen Florida’s HIV risk environment, including sex work, human trafficking, injection drug use, and sex tourism. These topics are often bases for HIV-related arrests that journalists cover. HIV criminalization describes statutes that criminalize otherwise legal conduct or that enhance penalties for illegal conduct based on a person’s positive HIV status.
METHODS: This study employed a systematic review of Florida news articles on HIV-related arrests published between 2009-2019. Through qualitative content analysis, our study analyzed how race, gender, and journalistic tone coalesce in reports of HIV-related arrests.
RESULTS: A 2018 report from the Williams Institute indicated that white Floridian women are primarily arrested for HIV-related crimes. The systematic review found zero news reports on HIV-related arrests of white Floridian women, and only one article identified a female perpetrator whose race was undisclosed. Sixty-four other articles reported solely on the HIV-related arrests of men, predominantly black men. We identified two categories of articles where HIV was either central to the arrest, or the person’s HIV-positive status was reported but exhibited little pertinence to the arrest.
CONCLUSIONS: Journalistic and police reporting behaviors risk inadvertently stigmatizing PLHIV at a time when public awareness of HIV depends on perceptions of HIV. This information will be used to shape equitable local nonprofit campaigns for community prevention, and HIV decriminalization efforts, while also combating the perpetuation of HIV misinformation.

Richard Mayanja, Uganda Martyrs University (PEF1794) Protective shield or punitive sword?: A critique of the Uganda HIV and AIDS control and prevention Act, 2014 from a human rights perspective.

BACKGROUND: The purpose of the research: To assess the compliance of the Uganda HIV and AIDS Control and Prevention Act, 2014 (the Act) with international human rights law standards.
Problem: In 2014, the Government of Uganda enacted a law to control and prevent HIV and AIDS. However, human rights advocates contest that the law contains provisions that don”t comply with international human rights law standards.
METHODS: Study period: August 2014 – August 2015 Study design: Qualitative design. Data collection: The study used a document analysis method. Method of analysis: The study identified international human rights law standards related to HIV and AIDS and used them as benchmarks for the review, analysis and synthesis of the literature.
RESULTS: The study established that: The Act carries provisions that comply with international human rights law standards. These include HIV counselling, testing, and treatment; state responsibility in HIV and AIDS control; the establishment of the HIV and AIDS Trust Fund; HIV-related human biomedical research; and prohibition of discrimination in various settings on grounds of HIV status. The Act also contains provisions that are not compliant with international human rights law standards. These include mandatory HIV testing, disclosure without consent, criminalization of actual and attempted HIV transmission, and criminal penalties for vaguely defined conduct. The Act lacks provisions that would make it more effective in controlling and preventing HIV and AIDS. These include commitments by the state to be accountable for its obligations stated in the Act; definition of what constitutes discrimination in various settings; and addressing challenges such as the causes of discrimination, inadequate professional human resources at health facilities, lack of HIV-friendly services in health facilities, and unregulated informal sector in complying with the law.
CONCLUSIONS: The study identified the compliance and non-compliance of the Act to international human rights law standards. It made recommendations to the Government of Uganda, organisations of people living with HIV and AIDS, organisations that advocate for human rights, and national human rights institutions, on the need to eliminate, revise and add some provisions in the Act to create an enabling legal environment that conforms with international human rights law.

Yi Chi Chiu, Persons with HIV/AIDS Rights Advocacy Association of Taiwan (PEF 1841) Fight against virus or human being? Case study on human rights violation regarding HIV criminalization in Taiwan.

BACKGROUND: Taiwan ranks top amongst the most progressive Asian countries, including being the first to pass marriage equality in Asia. Yet, stigma and discrimination of certain sub-populations, specifically people living with HIV (PLHIV) continue to prevail, as reflected in the Article 21 of HIV special law which overly criminalizes HIV non-disclosure, exposure and transmission.
METHODS: Using qualitative and quantitative approaches, Persons with HIV/AIDS Rights Advocacy Association (PRAA) of Taiwan makes a case on how the current criminal justice system in Taiwan adapt the narrative of ‘HIV as a weapon’ to prevent PLHIV from asserting their rights.
RESULTS: Article 21 states that individuals with knowledge of their HIV-positive status, by concealing the fact, engage in unsafe sex with others or share injection syringes, diluted fluids, and thus infect others, shall be sentenced for 5 to 12 years. Data showed over 30 cases were identified from 2012 to 2019, the majority of prosecutions were associated with sexual activities. However, unsafe sex was often defined exclusively with use of condom, and the court rarely recognized scientific advancements in antiretroviral therapy and suppressed viral load. Cases included: prosecution from ex-partner whom knew defendant’s HIV status before their relationship; state prosecution without plaintiff by turning 14 HIV-positive witnesses into defendants; 13-year incarceration despite medical expert’s testimony on the unlikelihood of HIV transmission. Those who haven’t been prosecuted continued to face both physical and emotional health threats, such as a woman threaten by her admirer to disclose her status if she turns him down. Bias and prejudice, worsen by difficulties in proving self-disclosure or condom use commonly resulted in convictions.
CONCLUSIONS: Article 21 and out-of-date judicial interpretation of HIV transmission risks gravely deprive the rights of PLHIV and further perpetuates stigma against PLHIV and affected communities through special criminal law on HIV. There’s a strong case to be made for abolishing Article 21 under the Constitution of Taiwan and the International Bill of Human Rights. Training and support on HIV advancements shall be given to all members of judicial and criminal law system to further inform any application of criminal law in cases related to HIV.

Russia: Names of released prisoners suffering from certain diseases to be passed to authorities of regions where they live

FSIN ordered to report the release of dangerously ill prisoners

Source: Pravo – Translated automatically by Deepl.com. For original article in Russian, please scroll down.

The exact list of diseases to be reported will be determined by the government.
On 20 July, President Vladimir Putin signed a law obliging prison administration staff to inform about the diseases of released prisoners. The relevant information will have to be passed by the FSIN bodies to the authorities of the region where the prisoner lives.

The author of the initiative was the Cabinet of Ministers. The State Duma adopted the document in its final reading on 7 July, and the Council of Ministers approved it on 15 July. The law will come into force only in six months.

Control over the provision of medical care to prisoners who have served their sentence is necessary due to lack of understanding of the gravity of the disease, “low educational and cultural level, mental disorders and asocial behavior,” as follows from the explanatory note to the bill.

At the same time, the exact list of diseases to be informed about has yet to be determined by the government. According to the authors of the initiative, in the case of newly released prisoners, different types of hepatitis, tuberculosis and HIV pose the greatest danger. Tens of thousands of people are released each year with these diseases, the explanatory note says.

ФСИН обязали сообщать об освобождении опасно больных заключенных
Точный список заболеваний, о которых нужно будет информировать, определит правительство.
Президент Владимир Путин 20 июля подписал закон, обязывающий сотрудников администрации исправительных учреждений информировать о заболеваниях вышедших на свободу заключённых. Соответствующую информацию органы ФСИН должны будут передавать властям региона, в котором проживает отбывший наказание.

Автором инициативы выступил кабмин. Госдума приняла документ в окончательном чтении 7 июля, Совфед одобрил его 15 июля. В силу закон вступит только через полгода.

Контроль за оказанием медицинской помощи заключённым, отбывшим наказание, необходим из-за непонимания ими тяжести заболевания, «низкого образовательного и культурного уровня, психических расстройств и асоциального поведения», следует из пояснительной записки к законопроекту.

При этом точный список заболеваний, о которых нужно будет информировать, еще только предстоит определить правительству. По мнению авторов инициативы, в случае только что освободившихся заключённых наибольшую опасность представляют разные типы гепатита, туберкулёз и ВИЧ. С этими заболеваниями ежегодно выходят на свободу десятки тысяч человек, говорится в пояснительной записке.

Watch all the videos of Beyond Blame @HIV2020 – our “perfectly executed…deftly curated, deeply informative” webshow

Earlier this month, advocates from all over the world came together for two hours to discuss the successes and challenges of the global movement to end HIV criminalisation.

All of the recordings of Beyond Blame: Challenging HIV Criminalisation for HIV JUSTICE WORLDWIDE are now available on the HIV Justice Network’s YouTube Channel.

“HUGE pleasure 2B at #BeyondBlame2020 conference – deftly curated, deeply informative; speakers were great; the passion & commitment to #HIVjustice was palpable. Much progress yet a sober reminder that the work is far from over.”

Kene Esom, Policy Specialist: Human Rights, Law and Gender, United Nations Development Programme (UNDP)

The full-length director’s cut version – with enhanced audio and video – is now available in English as well as with the audio track of the recorded simultaneous translation in French, Spanish, Russian, and Portuguese.

The English version is also available as a YouTube playlist in ‘bite-size’ chunks, with each segment of the webshow available as standalone videos. This means, for example, if you just want to watch (or share) the segment on ‘women challenging HIV criminalisation in Africa‘, or on ‘bringing science to justice, and justice to science‘, it’s now possible.

“That webinar was perfectly executed. Great sound, engaging transitions (they actually played people on and off!), and multiple speakers in various collections. Having ALL OF THEM back at the end showed the breadth of this technical accomplishment and the depth of the speakers’ field of expertise. Not everyone may notice these things but boy, I sure do, and it was totally pro. I’ve seen big name conferences who couldn’t get this right… Congratulations all around, and especially to [director] Nicholas Feustel.

Mark S King, My Fabulous Disease

We have also made available for the first time the standalone recording of Edwin Cameron’s closing speech, which inspired so many. The transcript is included in full below.

“We have been being battling this fight for many years. Since the start of the HIV epidemic we as gay men, as gay women, as queers, as transgender people, as sex workers, as people using drugs, have been persecuted by the criminal law. And I’m here to say, “Enough! Enough!

We have achieved a great deal with our movement, with the HIV Justice Network. We have achieved a great deal in conscientizing law makers, law givers and the public. It is now time for us to join in unison to demand the end of these stigmatising, retrograde, unproductive, hurtful, harmful laws.

It is a long struggle we’ve engaged in. And it’s one that has hurt many of us. Some of us here today, some of us listening in, some of us who have spoken, have felt the most brutal brush of the law. They have been imprisoned, unjustly prosecuted, unjustly convicted, and unjustly sent away.

HIV is not a crime. But there is more to it. Criminalising HIV, criminalising the transmission or exposure of HIV, as many countries on my own beautiful continent Africa do, is not just stupid and retrograde. It impedes the most important message of the HIV epidemic now, which is that this epidemic is manageable. I’ve been on antiretroviral treatment now for very nearly 23 years. My viral load has been undetectable for more than 20.

We can beat this, but we have to approach this issue as public health issue. We have to approach it rationally and sensibly, and without stigma, and without targeting people, and without seeking to hurt and marginalise people.We’ve made calamitous mistakes with the misapplication of the criminal law over the last hundred years, in the so-called ‘war on drugs’. We continue to make a calamitous mistake in Africa and elsewhere by misusing the criminal law against queer people like myself. We make a huge mistake by misusing the criminal law against people with HIV.

Let us rise today and say, “Enough!”

Criminalization laws impact public health and perpetuate discrimination

HIV and LGBTQ Criminalization Laws are Both Human Rights and Public Health Issues, Experts Say

A panel at the 23rd International AIDS Conference (AIDS 2020, gone virtual this year due to COVID-19) discussed the growing right-wing populist movements around the world that threaten advances made by activists toward ending criminalization of people living with HIV and LGBTQ people.

Poland just re-elected President Andrzej Duda, whose party, PiS, declared “The LGBT and gender movement threatens our Polish identity, the nation, and the state.” PiS wants to “protect children from the LGBT ideology,” defines marriage in strictly heterosexual terms, and aims to outlaw adoptions by LGBTQ people. Around 100 localities in the country have declared themselves to be “LGBT-free zones.”

Botswana goes even further, reported Tebogo Gareitsanye of BONELA, a legal and advocacy organization in that country. Consensual sex between same-sex partners is illegal and prosecuted as “unnatural offenses” and “indecent practices.” That statute originally applied only to men who have sex with men. Sex between women was not outlawed until 1998.

Botswana law distinguishes between sexual orientation per se—which is, in fact, a protected category under employment discrimination law—and acting on one’s orientation, which is illegal. After a campaign by BONELA and others, the country’s High Court recently decriminalized private, consensual sex acts. However, Botswana’s government has appealed that decision, and a final ruling is still pending.

Beyond human rights implications, such laws also impact public health, since LGBTQ people will not seek health services for fear of being prosecuted, Gareitsanye noted. Similarly, laws that criminalize certain acts if someone is living with HIV impede public health, said Edwin J. Bernard of the HIV Justice Network. “Communicable diseases are public health issues, not criminal issues.”

HIV criminalization laws generally require the person in question to know their status. They therefore discourage people from being tested. Sean Strub of the Sero Project summed this up in a video shared by Bernard at the conference: “Take the test and risk arrest.” Another interviewee in that video, Patrick O’Byrne, Ph.D., RN-EC, of the University of Ottawa, reported that participants in their study were unable to distinguish between the public health department and the police. “That’s problematic,” O’Byrne commented.

In California, for example, people living with HIV (PLWH) can be prosecuted for four HIV-specific “offenses,” explained Ayako Miyashita Ochoa, J.D., of the University of California Los Angeles: solicitation while seropositive, exposure with intent to transmit HIV, exposure to a communicable disease, and an enhanced sentence for forced sex, if the rapist lives with HIV. Sex workers account for 95% of HIV-related prosecutions in the state, Ochoa reported.

Exposure to a communicable disease could, of course, be applied to many different viruses—including SARS-CoV-2, the virus that causes COVID-19. So far, there are no reports of people refusing to wear masks being prosecuted under that law. Nonetheless, in many countries, human rights have taken a backseat to the pandemic response, noted Thokozile Phiri Nkhoma of Facilitators of Community Transformation in Malawi. Civil society must address criminalization as well as rights and resource issues in the wake of the pandemic, Nkhoma demanded.

Beyond their effect on individual persons prosecuted under them, criminal laws perpetuate structural inequalities, discrimination, and xenophobia, argued Susana T. Fried of CREA, an international feminist organization based in India. To counter such effects, we need to strengthen solidarity between and with affected people. We also must be aware of the unintended effects some laws meant to protect vulnerable communities might have. For example, raising the age of marriage can protect young girls. However, it can also be used to outlaw consensual sex between young people, if it ties age of consent to age of marriage.

The consequences of these and other laws regulating sex and sexuality are quite intentional, concluded Marco Castro-Bojorquez of HIV Racial Justice Now: “The systems of oppression that we have created specifically to oppress certain communities were working very well in the criminalization of PLWH.”

Australia: Proposed mandatory HIV testing in New South Wales is neither necessary nor useful

HIV testing people who spit at police or health workers won’t actually protect them

People who expose a police officer or emergency worker to body fluids would be compelled to have their blood tested for HIV, hepatitis B and hepatitis C, under a proposed law in NSW.

But this law isn’t needed to protect first responders. We already have evidence-based protocols that are working well to protect them from blood-borne infections.

Rather, the proposed law is a political reaction to a problem that doesn’t need fixing. It is also not supported by scientific evidence or Australian government policy on HIV testing.

What is NSW proposing?

In November last year, the NSW government proposed legislation which gives authorities the power to test a person for HIV, hepatitis B or hepatitis C if they have deliberately exposed a front-line worker to their body fluids (saliva or blood).

Examples might be if a person bites a police officer restraining them during an arrest or protest; someone biting or scratching a youth justice or corrections officer; or a person behaving unpredictably, exposing ambulance officers to their body fluids.

The mandatory testing order would come from senior officers within the worker’s own agency. If the person does not comply, they can be forced to do so. They have 48 hours to appeal to the NSW chief health officer. Anyone who refuses a mandatory testing order will be committing an offence, with a maximum 12 months prison term or an A$11,000 fine, or both.

Is this happening elsewhere?

Five states have legislation that allows mandatory testing, according to a report by the National Association of People Living with HIV.

The proposed NSW model is closest to the one Western Australiaintroduced in 2014, where police can order testing. This resulted in 377 testing orders in the first four years.

In contrast, in Victoria the chief health officer has the power to order a test or issue a public health order to enforce it if necessary. In those same four years, not a single person was ordered to be tested.

What’s the risk of transmission anyway?

Outside of sexual transmission, HIV is transmitted through blood. Police and corrections officers are far less likely to be exposed to a blood-borne virus than hospital workers. When exposure does occur, it tends to be less serious.

There does not appear to be any recorded case of an Australian police officer being infected with HIV in the course of their duties.

Rates of HIV infection in the community are dropping anyway. Around 0.1% of the Australian population is living with HIV. The vast majority are on effective treatment which reduces transmission to zero. By 2022, Australia’s aiming for virtual elimination.

As hepatitis C and HIV are blood-borne viruses, saliva alone cannot transmit them. Sometimes, the mouth can be contaminated with blood, particularly if there has been traumatic injury. But contact between bloody saliva and intact skin does not transmit hepatitis C or HIV.

A 2018 study bringing together more than 30 years of studies in HIV transmission concluded:

There is no risk of transmitting HIV through spitting, and the risk through biting is negligible.

A similar 2018 study looked at the risk of hepatitis C transmission and concluded the risk “appears to be very low”.

Of the blood-borne viruses, hepatitis B, the most transmissible of these viruses, is completely preventable through a vaccine all front-line workers receive.

What’s happening now?

In NSW and nationally, if someone is exposed to another person’s body fluids at work, they are assessed by health care workers in their agency.

The nature of the exposure, the possibility the other person could have a blood-borne virus (or if known, whether they are infected) and the resulting risk are considered when evaluating both the injury and the need for testing. If needed, they are tested according to policies informed by scientific evidence.

But the overwhelming majority of injuries, including bites, do not carry a risk of transmision.

In the rare scenario, where the risk of HIV infection cannot be ruled out, the worker may be offered medications to prevent infection, and follow-up blood tests. These medicationsdramatically reduce risk of transmission but must be taken within 72 hours of the exposure.

Workers potentially exposed to hepatitis C can be monitored for infection, and given medications with near 100% cure rate if required.

So current measures are more than adequate to deal with all situations a police officer or other front-line worker will confront, and have been so since these issues were first addressed in the early 1990s.

Compulsory testing could cause harm

Front-line workers deserve our support and protection. But if these workers feel anxiety or distress related to their risk of contracting blood-borne viruses then their health services must more adequately reassure them.

New measures won’t help reduce their already low risk of transmission and therefore don’t provide any additional reassurance. Focussing on getting the other person tested might increase their anxiety when the risk is negligible, irrespective of the person’s status.

In the rare higher risk situations, perhaps an ambulance officer injured while at a car accident where there is massive blood loss, the risk of a blood-borne infection needs to be assessed and preventive medicine offered. Delaying this assessment while waiting for the results of compulsory testing has the real potential to harm the worker.

The proposed legislation also stigmatises people living with blood-borne viruses, incorrectly depicting them as dangerous, creating unnecessary fear, leading to discrimination.

We are working with the board of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (the peak body representing HIV, viral hepatitis and sexual health workers) and oppose mandatory testing measures as neither necessary nor useful.

When considering the criminalisation of COVID-19, lessons from HIV should be retained

Marginalised communities will not get justice from criminalising Covid-19 transmission

The criminalisation of the virus would create greater barriers to accessing healthcare systems already preventing many people from getting treatment.

After it was announced that no further action would be taken by police regarding the death of Belly Mujinga, a railway worker who contracted coronavirus after reportedly being spat on, there was national outcry. Her name has been plastered on placards at Black Lives Matter protests, while the public has pointed out that a man in Scotland who spat on a police officer while “joking” about coronavirus in April has been jailed for a year. But while this outrage is valid in the face of a government who continues to show their blatant disregard for black lives, criminalisation of diseases has been proven to be an ineffective tool for justice.

Over the past few months, parallels have been drawn between the Covid-19 pandemic and the HIV epidemic. Both viruses are communicable (they can be passed between people); both have been racialised, leading to racist and xenophobic attacks and stereotyping; community mobilisation has demanded adequate government public health responses for both health emergencies; and the impact of both viruses has highlighted the need for a global health approach which transcends borders.

When the World Health Organisation (WHO) declared Covid-19 a pandemic, many HIV organisations and activists advocated that the transmission of the novel coronavirus should not be criminalised. As public fear of Covid-19 grew, HIV advocates predicted the negative impact on public health and possibility of human rights violations, similar to those seen for people living with HIV.

“Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself”

This strain of coronavirus is new and scientists are developing their understanding of it. In the past few weeks, there has been confusion about the probability of asymptomatic transmission (transmitting the virus when a person does not have Covid-19-like symptoms), as the WHO had previously commented that it was “very rare” and later stated that this wording had misled people. Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself. Globally, countries have implemented or have proposed laws against Covid-19 transmission and even exposure, without transmission, including Canada, France, India, and South Africa.

Often, the aim of criminalisation is to facilitate a tool for prevention and deterrence (to discourage people from passing on a virus) or as punishment for those who have or may have passed on a virus. HIV advocacy has illustrated over the years that the criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health.

In their Statement on Covid-19 Criminalisation, published in March, the HIV Justice Worldwide Steering Committee wrote that hastily drafted laws, as well as law enforcement, driven by fear and panic, are unlikely to be guided by the best available scientific and medical evidence – especially where such science is unclear, complex and evolving. “Given the context of a virus that can easily be transmitted by casual contact and where proof of actual exposure or transmission is not possible, we believe that the criminal justice system is unlikely to uphold principles of legal and judicial fairness, including the key criminal law principles of legality, foreseeability, intent, causality, proportionality and proof.”

Since that statement was issued, internationally coronavirus laws have been weaponised against the most marginalised within society, as is the case with HIV criminalisation laws. The Ugandan government, for example, has used coronavirus laws to target marginalised LGBTQI+ groups, and in the UK, people of colour are fined more than the white population under coronavirus laws, in some cases leading to unlawful charges. In some cases people were even charged under the wrong law (e.g. enforcing Welsh law in England).

The director of legal services at the Crown Prosecution Service (CPS), the public agency that conducts criminal prosecutions in England and Wales, found that 24% of cases reviewed had been charged incorrectly. In May a CPS press statement cited the speed and pressure to implement the laws as the cause of the wrongful charges. Across the Global North, it has been well documented that racialised communities are disproportionately impacted by Covid-19 and the Human Rights Campaign Foundation anticipates that LGBTQI communities will be disproportionately impacted by the virus. This is due to a myriad of reasons underpinned by systemic discrimination.

“Criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health”

HIV research has shown little evidence that criminalisation laws prevent transmission, in fact, it’s evidenced that such laws are bad for public health and fuel reluctance to get tested and treated. In the UK, testing and treatment of Covid-19 is free, as is the case with many other communicable diseases to remove the barrier to testing and treatment. Free testing and treatment access, irrespective of immigration status, is important, however, a briefing paper from Medact, Migrants Organise and New Economics Foundation (NEF), has shown that migrant communities blocked from healthcare because of the hostile environment, that “the coronavirus ‘exemption’ from charging and immigration checks is not working” and people have been asked to show their passports, and that people face additional obstacles such as language barrier and digital exclusion from emergency services.

Criminalisation exacerbates public health issues: in a Channel 4 report, Migrants Organise spoke of a man who died at home for fear of being reported to immigration authorities if he accessed healthcare. The threat of immigration enforcement disproportionately impacts those in precarious work and those with precarious migration status, all of whom are more likely to come from racialised groups and in some cases groups which are hyper-surveilled and criminalised.

The role of healthcare and access to it needs to be reimagined, where people are viewed as patients not passports and healthcare professionals are not the extended arm of the Home Office. Governments must implement better employment rights, so that employers are held to account and do not put staff such as Belly Mujinga, in harmful positions. Governments must provide better statutory sick pay so those in precarious work do not have to choose between their health and putting food on the table. We need to overhaul systemically discriminatory processes that don’t look after the most vulnerable, rather than implementing laws – such as criminalisation – that will systematically punish them.

HIV criminalisation laws affect women negatively and impede the effectiveness of implementing state programmes

Can HIV criminalisation protect women from becoming infected?

Translated from Original article in Russian via Deepl.com – For article in Russian, please scroll down.

In many countries, HIV-related criminal liability still exists. At least 68 countries have laws that specifically criminalize hiding information about HIV infection from your sex partner, putting another person at risk of HIV infection, or transmitting HIV. The leaders in the number of criminal cases related to HIV in the region of Eastern Europe and Central Asia are Belarus and Russia.

In 2018, 20 scientists from around the world developed an Expert Consensus Statement on the Science of HIV in the context of Criminal Law. It describes a detailed analysis of the available scientific and medical research data on HIV transmission, treatment efficacy, and evidence to better understand these data in a criminal law context.

Legislation regarding HIV transmission should be reviewed. I point out various facts to this – HIV treatment is available, antiretroviral therapy (ART) effectively reduces the viral load to undetectable and reduces the risk of HIV transmission during sexual contact to zero [1,2,3,4], criminalization initially stigmatizes people who are HIV-positive people and violates their human rights.

One of the arguments in favour of criminal liability for HIV transmission is the alleged protection of women in situations where their husbands or partners become infected with HIV. This argument is often used in Central Asian countries. Let’s look at real-life examples and statistics on how much women are actually protected by existing laws.

In early 2018, thanks to human rights defenders and human rights defenders, the article “Vikino Delo” appeared in the media, about a 17-year-old pupil of an orphanage, who was convicted under subsection 122 (1) of the Criminal Code of the Russian Federation for knowingly putting another person at risk of HIV infection. In 2017, Vika met a man F. (31 years old) on a social network. When they had an intimate relationship, the girl offered to use a condom, but F. refused. Vika did not tell F. that she had HIV. From the girl’s testimony provided in court, it was clear that she did not want to put the victim at risk of infection, and did not say the diagnosis because she was afraid. She tried to hint at him, telling about her HIV-infected friend. F. proposed to be tested for HIV together. As a result, he has a minus, she has a plus. F. filed a complaint with Vic to the police. The man decided to punish the girl for insufficient, in his opinion, sincerity. Following the verdict, Vicki’s lawyer filed a complaint with the Supreme Court. On the recommendation of the Supreme Court, given that at the time of the commission of the “crime” she was a minor, apply a sentence of warning to her. At the same time, no one took the blame from her. The leading role in protecting and supporting Vicki was played by the female community in the guise of Association “EVA”.

The situation with the Vicki case is commented on by human rights activist Elena Titina, head of the Vector of Life Charity Fund, who acted as a public defender in court: “Women are subjected to even greater stigma, condemnation, and therefore do not protect themselves. Vicki’s case is very revealing in this. For three years, during the whole trial, the girl simply had to listen to insults, humiliation against her, the remarks were incorrect – and on the part of the plaintiff, this 31-year-old man, on the part of judges, prosecutors, even lawyers sometimes behaved like elephants in a china shop. She, in my opinion, is the heroine. I’m not sure that an adult woman would have endured what Vick had endured and come to the end, defending her rights. Her criminal record was removed. A unique thing, I am very proud that I participated in it. “This is the only thing that has ended so far because I don’t know of any more such precedents with a conditional happy ending. ”

In the Criminal Code of the Russian Federation , in which almost one and a half million cases of HIV infection among citizens are only officially registered, there is article 122 “Transmission of HIV infection”. Disaggregation of data began in 2017, from 01/01/2017 to 12/31/2019, in total, within the framework of 122 articles, 150 sentences were sentenced according to the main qualification in parts 1-4. 93 sentences were pronounced against men (62%), 57 (38%) – against women. It is noteworthy that in Part 1, “Knowingly putting the other person at risk of HIV infection” is condemned by more women: 56.4% versus 43.6% of men.

According to the Ministry of Health of the Republic of Tajikistan for 2018, there were 10.7 thousand people with HIV in the whole country, of which about 7 thousand were men. It was noted that in 54.6% the virus was transmitted sexually, and in some regions, the proportion of such cases reaches 70%.

For reference: since July 2015, to register a marriage in Tajikistan, you must undergo a medical examination, which includes an HIV test.

Tajikistan became one of the few countries (and the only one in the EECA region) to which CEDAW issued a recommendation dated November 9, 2018: “Decriminalize the transmission of HIV / AIDS (Article 125 of the Criminal Code), and repeal government decrees of September 25, 2018 and October 1, 2004 years prohibiting HIV-positive women from getting a medical degree, adopting a child, or being a legal guardian. ”

Instead, on January 2, 2019, President Emomali Rahmon signed a series of laws, including those aimed at “strengthening the responsibility of doctors, beauty salons, hairdressers and service enterprises, which are due to non-compliance with sanitary, hygiene, anti-epidemic rules and regulations caused HIV / AIDS. ” From that moment, a lot of publications appeared in the media, illustrating not only the widespread informing of Tajik citizens about the requirements being followed but also the increase in the number of publications on criminal penalties related to HIV.

According to the results of media monitoring conducted by the Eurasian Women’s AIDS Network, in 2019, 23 publications on HIV were registered in the electronic media of Tajikistan. Among them, two topics were divided equally: general information on the responsibility for HIV transmission and statistics, as well as publications that women are accused of, such as:

“27-year-old woman suspected of having HIV / AIDS deliberately infecting”,

“Two women in northern Tajikistan convicted of HIV infection”,

“In Tajikistan, a woman convicted of“ deliberate HIV infection ”by 23 men was sentenced”,

“A resident of Kulyab of Tajikistan is suspected of intentionally acquiring HIV”,

“Two women in Khatlon have infected dozens of men. ”

Among these publications, there is not one that describes particular cases of men. We already wrote about the vulnerability of women in August last year in our interview with attorney Zebo Kasimova.

We could not obtain statistical data on the number of cases brought under article 125 of the Criminal Code of the Republic of Tajikistan, “HIV infection”. Particularly important would be information disaggregated by sex – that is, disaggregated data, the collection of which makes special sense, in view of the state’s argument for the protection of women. The importance of disaggregated statistics is stated in the Sustainable Development Goals – the Resolution adopted by the UN General Assembly in 2015: only accurate, reliable, comprehensive thematic data will help us understand the problems we are facing and find the most suitable solutions for them.

Olena Stryzhak, one of the founders of the Eurasian Women’s AIDS Network and the head of the Positive Women BO, is actively promoting the decriminalization of HIV in Ukraine “I have been on the committee for the second year in the validation of elimination of mother-to-child transmission of HIV and syphilis at the Ministry of Health of Ukraine, and actively participate not only in the activities of the committee in our country but also attend international meetings of the Committee at WHO, communicate with many people working in this field.

One of the obstacles for women to seek medical help and treatment on time is the fear of prosecution, the fear of possible criminal liability. In Ukraine, I was able to obtain statistics on the number of criminal cases under article 130 of the Criminal Code of Ukraine, disaggregated by sex. I was surprised by the statistics, because, starting in 2015, only women were convicted under this article. This negatively affects not only the women themselves but also the effectiveness of implementing state programs, including the process of validating the elimination of mother-to-child transmission of HIV. ”

From the last case in Ukraine, for 2018: “… Since the defendant refused, the specialist for child services extended her hands to the child in order to pick her up, but the defendant bit her left hand.” From the conviction: “The court decided to qualify the actions of the defendant … Part 4 of Art. 130 of the Criminal Code of Ukraine as a complete attempt on intentional infection of another person with human immunodeficiency virus. “

Does it mean that if only women were convicted, the fact that only women are sources of infection? From an alternative shadow report of the Tajikistan Network of Women Living with HIV, presented at the 71st session of the UN Committee on the Elimination of All Forms of Discrimination against Women in November 2018: “In violation of their rights, as a rule, women do not go anywhere. During the study of the situation when writing this report, violations of the rights of women living with HIV and women from affected groups were identified, only a few decided to defend their rights and because they were provided with a lawyer at the expense of the project. The reasons for this behaviour are different. One of the main reasons is the lack of financial resources to pay for the services of a lawyer. Secondly, many women living with HIV and women from HIV-affected groups have low legal literacy; they do not have information about who to contact on a particular issue. Thirdly, self-stigmatization and the fear of confidentiality also prevent women living with HIV and women from HIV-affected groups from defending their rights. ”

It is clear from the report that women do not defend their rights, especially on such sensitive issues, for fear of feeling even more condemned and becoming even more vulnerable. In addition, in the countries of Central Asia, families have traditions when a daughter-in-law must tell her husband or mother-in-law where she goes and what she is going to spend or spent money on (by the way about paying a lawyer). Women depend on other family members, and often do not have their own money.

Violence against women increases their risk of HIV infection, while the very presence of HIV infection in a woman also increases the risk of violence, including from relatives, due to her vulnerability and low self-esteem.

The criminalization of HIV does not work, either as a preventive measure nor as a way to protect women from infection, as decision-makers try to imagine. On the contrary, with specific examples, we observe that women are more vulnerable.

Sources:

[1] – Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11; 365: 493-505.

[2] – Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016; 316: 171-81.

[3] – Grulich A, Bavinton B, Jin F, Prestage G, Zablotska, Grinsztejn B, et al. HIV transmission in male serodiscordant couples in Australia, Thailand and Brazil. Abstract for 2015 Conference on Retroviruses and Opportunistic Infections, Seattle, USA, 2015.

[4] – Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016 Sep 1; 375 (9): 830-9.

Может ли криминализация ВИЧ защитить женщин от инфицирования?

Во многих странах все еще существует уголовная ответственность, связанная с ВИЧ. По меньшей мере 68 стран имеют законы, которые специально предусматривают уголовную ответственность за сокрытие информации о наличие ВИЧ-инфекции от своего партнера по сексу, поставление другого лица в опасность инфицирования ВИЧ или передачу ВИЧ. Лидерами по количеству уголовных дел, связанных с ВИЧ, в регионе Восточной Европы и Центральной Азии являются Беларусь и Россия.

В 2018 году, 20 ученых из разных стран мира разработали Заявление об экспертном консенсусе в отношении использования научных данных о ВИЧ в системе уголовного правосудия. В нем описан подробный анализ имеющихся данных научных и медицинских исследований о передаче ВИЧ, эффективности лечения и доказательства, позволяющие лучше понять эти данные в уголовно-правовом контексте.

Законодательные нормы в отношении передачи ВИЧ должны быть пересмотрены. На это указываю различные факты — лечение ВИЧ-инфекции доступно, антиретровирусная терапия (АРТ) эффективно снижает вирусную нагрузку до неопределяемой и снижает риски передачи ВИЧ при сексуальном контакте до нуля [1,2,3,4], криминализация изначально клеймит людей ВИЧ-положительных людей и нарушает их права человека.

Один из аргументов в пользу существования уголовной ответственности в отношении передачи ВИЧ — это якобы защита женщин, в тех ситуациях, когда их мужья или партнеры инфицируют их ВИЧ. Этот аргумент довольно часто используют в странах Центральной Азии. Давайте рассмотрим на реальных примерах и статистических данных, насколько женщины на самом деле защищены существующими законами.

В начале 2018 года, благодаря правозащитницам и правозащитникам, в СМИ появилась статья «Викино дело», о 17-ти летней воспитаннице детского дома, которую осудили по части 1 статьи 122 УК Российской Федерации за заведомое поставление другого лица в опасность заражения ВИЧ-инфекцией. В 2017 году Вика познакомилась в социальной сети с мужчиной Ф. (31 год). Когда у них была интимная связь, девушка предложила использовать презерватив, но Ф. отказался. Вика не сказала Ф., что у нее ВИЧ. Из показаний девушки, предоставленных в суде, было видно, что она не желала ставить потерпевшего в опасность заражения, и не сказала о диагнозе, потому что боялась. Она пыталась намекнуть ему, рассказывая о ВИЧ-инфицированной подруге. Ф. предложил вместе сдать анализы на ВИЧ. В результате у него — минус, у нее — плюс. Ф. подал на Вику заявление в полицию. Мужчина решил наказать девушку за недостаточную, на его взгляд, искренность. После вынесенного приговора адвокатом Вики была подана жалоба в Верховный Суд. По рекомендации Верховного Суда, учитывая, что на момент совершения «преступления» она была несовершеннолетней, применить к ней наказание в виде предупреждение. При этом вину с неё никто не снял. Ведущую роль в защите и поддержке Вики сыграло женское сообщество в лице Ассоциации “ЕВА”.

Ситуацию с делом Вики комментирует правозащитница Елена Титина, руководительница БФ «Вектор жизни», которая выступала общественой защитницей в суде: «Женщины подвергаются еще большей стигме, осуждению, поэтому не защищают себя. Дело Вики очень показательно в этом. Девочке пришлось в течение трех лет, пока длился весь судебный процесс, просто выслушивать оскорбления, унижения в свой адрес, реплики некорректные — и со стороны истца, этого 31-летнего мужчины, со стороны судей, прокуроров, даже адвокаты порой вели себя как слоны в посудной лавке. Она, на мой взгляд, героиня. Я не уверена, что взрослая женщина выдержала бы то, что выдержала Вика, и дойти до конца, защищая свои права. С нее сняли уголовную статью. Уникальное дело, я очень горжусь, что я в нем участововала. Это единственное на сегодняшний момент дело, которое так закончилось, потому что больше таких прецедентов, с условным хэппи-эндом я не знаю».

В Уголовном кодексе Российской Федерации, в которой только официально зарегистрировано почти полтора миллиона случаев ВИЧ-инфекции у граждан, существует статья 122 “Заражение ВИЧ-инфекцией”. Дезагрегация данных начата в 2017, с 01.01.2017 по 31.12.2019 всего в рамках 122 статьи вынесено 150 приговоров по основной квалификации по частям 1-4. 93 приговора вынесено в отношении мужчин (62%), 57 (38%) — в отношении женщин. Примечательно, что по части 1 “Заведомое поставление другого лица в опасность заражения ВИЧ-инфекцией” осуждается больше женщин: 56,4% против 43,6% мужчин.

По данным Министерства здравоохранения Республики Таджикистан за 2018 год, всего по стране насчитывалось 10,7 тысяч людей с ВИЧ, из них порядка 7 тысяч — мужчины. Отмечено, что в 54,6% вирус передался половым путем, а в некоторых регионах доля таких случаев достигает 70%.

Для справки: с июля 2015 года для регистрации брака в Таджикистане необходимо пройти медицинское обследование, которое включает тест на ВИЧ.

Таджикистан стал одной из немногих стран (и единственной в регионе ВЕЦА), которой КЛДЖ дал рекомендацию от 09 ноября 2018 года: “Декриминализировать передачу ВИЧ/СПИДа (статья 125 Уголовного кодекса), и отменить постановления правительства от 25 сентября 2018 года и 1 октября 2004 года, запрещающие ВИЧ-положительным женщинам получать медицинскую степень, усыновлять ребенка или быть законным опекуном”.

Вместо этого, 02 января 2019 года президент страны Эмомали Рахмон подписал ряд законов, в том числе направленных на «усиление ответственности врачей, работников салонов красоты, парикмахерских и предприятий по обслуживанию, которые из-за несоблюдения санитарно-гигиенических, санитарно-противоэпидемических правил и норм стали причиной заражения вирусом ВИЧ/СПИД». С этого момента в СМИ появилось множество публикаций, иллюстрирующих не только широкое информирование граждан Таджикистана о выполняемых предписаниях, но и увеличение количества публикаций об уголовных наказаниях в связи с ВИЧ.

По результатам медиа-мониторинга, который проводит Евразийская Женская сеть по СПИДу, в 2019 году в электронных СМИ Таджикистана зарегистрировано 23 публикации по теме ВИЧ. Среди них поровну разделили места две темы — это общая информация относительно ответственности за передачу ВИЧ и статистика, а также публикации, в которых обвиняются женщины, как, например:

“27-летняя женщина подозревается в преднамеренном заражении ВИЧ/СПИД”,

“Двух женщин на севере Таджикистана осудили за заражение ВИЧ-инфекцией”,

“В Таджикистане вынесли приговор женщине, обвиняемой в «умышленном заражении ВИЧ» 23 мужчин”,

“Жительница Куляба Таджикистана подозревается в преднамеренном заражении ВИЧ”,

“Две женщины в Хатлоне заразили десятки мужчин”.

Среди этих публикаций нет ни одной, описывающей частные случаи в отношении мужчин. Об уязвимости женщины мы уже писали в августе прошлого года в нашем интервью с адвокатессой Зебо Касимовой.

Статистические данные о количестве дел, возбужденных по статье 125 УК Республики Таджикистан, “Заражение ВИЧ-инфекцией”, нам получить не удалось. Особенно важной была бы информация с разбивкой по полу — то есть дезагрегированные данные, сбор которых имеет особый смысл, ввиду аргументации государства о защите женщин. О важности дезагрегированной статистики говорится в Целях устойчивого развития — Резолюции, принятой Генеральной Ассамблеей ООН в 2015 году: только точные, достоверные, всесторонние тематические данные позволят понять проблемы, стоящие перед нами, и найти для них самые подходящие решения.

Елена Стрижак, одна из основательниц Евразийской Женской Сети по СПИДу и руководительница БО “Позитивные женщины”, активно продвигает тему декриминализации ВИЧ в Украине: “Я уже второй год состою в комитете по валидации элиминации передачи ВИЧ и сифилиса от матери к ребенку при Министерстве здравоохранение Украины, и активно принимаю участие не только в деятельности комитета в нашей стране, но и посещаю международные заседания Комитета в ВОЗ, общаюсь со многими людьми, работающими в этой сфере.

Одним из препятствий к тому, чтобы женщины вовремя обращались за медицинской помощью и за лечением, служит страх обвинения, страх перед возможной криминальной ответственностью. У нас в Украине я смогла получить статистические данные о количестве уголовных дел по статье 130 УК Украины, с разбивкой по полу. Была удивлена статистикой, потому что, начиная с 2015 года, по этой статье были осуждены исключительно женщины. Это негативно отражается не только на самих женщинах, но и на эффективности реализации государственных программ, в том числе на процессе валидации элиминации передачи ВИЧ от матери к ребенку”.

Из последнего кейса по Украине, за 2018 год: «…Так как подсудимая отказалась, специалист службы по делам детей протянула руки к ребенку с целью забрать ее, но подсудимая укусила ее за левую руку». Из обвинительного приговора: «Суд принял решение квалифицировать действия подсудимой … ч. 4 ст. 130 УК Украины как оконченное покушение на умышленное заражение другого лица вирусом иммунодефицита человека».

Означает ли, что если осужденными оказались только женщины, тот факт, что только женщины являются источниками инфицирования? Из альтернативного теневого доклада Таджикистанской сети женщин, живущих с ВИЧ, представленного на 71-й сессии Комитета ООН по ликвидации всех форм дискриминации в отношении женщин в ноябре 2018 года: “При нарушении их прав, как правило, женщины никуда не обращаются. В ходе изучения ситуации при написании данного отчета выявлены нарушения прав женщин, живущих с ВИЧ, и женщин из затронутых групп, только единицы решились защищать свои права и то, потому что им был предоставлен адвокат за счет проекта. Причины такого поведения различны. Одна из основных причин, это отсутствие финансовых средств на оплату услуг адвоката. Во-вторых, многие женщины, живущие с ВИЧ, и женщины из затронутых ВИЧ групп имеют низкую правовую грамотность, у них нет информации о том, к кому обратиться по тому или иному вопросу. В-третьих, самостигматизация и боязнь разглашения конфиденциальности также мешает женщинам, живущим с ВИЧ, и женщинам из затронутых ВИЧ групп защищать свои права.”

Из доклада ясно, что женщины не защищают свои права, особенно по таким чувствительным вопросам, из-за страха почувствовать еще больше осуждения и стать еще более уязвимыми. Кроме того, в странах Центральной Азии, в семьях есть традиции, когда невестка должна сказать мужу или свекрови, куда она идет, и на что она собирается тратить или потратила деньги (к слову об оплате адвоката). Женщины зависят от других членов семьи, и часто не имеют своих собственных денег.

Насилие в отношении женщин увеличивает для них риск инфицирования ВИЧ, в то же время само наличие ВИЧ-инфекции у женщины также увеличивает опасность насилия, в том числе и со стороны родственников, из-за ее уязвимости и заниженной самооценки.

Криминализация ВИЧ, ни как превентивная мера, ни как способ защиты женщин от инфицирования не работает, как это пытаются представить люди, принимающие решения. Наоборот, на конкретных примерах мы наблюдаем, что женщины оказываются более уязвимыми.

Источники:

[1] — Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11; 365:493-505.

[2] — Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016; 316:171-81.

[3] — Grulich A, Bavinton B, Jin F, Prestage G, Zablotska, Grinsztejn B, et al. HIV transmission in male serodiscordant couples in Australia, Thailand and Brazil. Abstract for 2015 Conference on Retroviruses and Opportunistic Infections, Seattle, USA, 2015.

[4] — Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016 Sep 1; 375(9):830-9.

Uzbekistan: Careless and distorted headline highlights why HIV criminalisation law must be reformed

Why HIV is no longer a sentence for medicine, but still a scourge for society

Automatic Deepl translation. For article in Russian, scroll down.

Attitudes towards people with the immunodeficiency virus in Uzbekistan remain difficult, if not discriminatory. The problem lies not only in public intolerance and the negligence of the media, but also in the imperfection of legislation in this area.

TASHKENT, June 8 – Sputnik. In early June, an article on the problem of the spread of HIV infection among young people was published on the website of the Tashkent police department. It focused on the fact that the threat of infection is considered a criminal offence, and a case from 2019 was cited for clarity.

The aim of the publication is to draw the attention of parents and young people themselves to this topic so that they are responsible for their health and are not frivolous in sexual relations. However, a good cause has turned out to be a scandal. A local publication published an article titled “In Tashkent, a schoolchild infected his girlfriend with HIV”. As a result, the participants in last year’s story suffered twice because of the notorious positive status of one of the partners: first the young man was given a suspended sentence for an act that had no serious consequences, and then journalists with an easy hand “gave” his girlfriend an unconfirmed diagnosis of HIV.

Love against HIV
The trial of the young man took place in 2019, but it has only now become known. The young man was charged with a crime under Part 4 of Article 113 of the Uzbek Criminal Code – “Knowingly putting a person at risk of HIV infection”. The young people (he is 17 years old, she is 16) have known each other since childhood, and started dating as teenagers. The defendant fully confessed and explained that he knew about his diagnosis and since 2009 (from the age of seven) has been registered with the AIDS Centre and has been regularly examined.
The couple did not plan a family relationship, but, as usual, everything happened spontaneously, without using contraception. According to the young man, he warned his girlfriend about possible danger. It wasn’t until the fifth month that she was pregnant. As a result, neither the mother nor the child born later was diagnosed with HIV. The couple, of course, registered their marriage, but the husband got a suspended sentence for doing it.
An already unpleasant story, though with a happy ending, could have ended there, but the careless mentioning and distorted headline in the media, which is called, added oil to the fire. This example revealed a long overdue problem of the imperfection of the judicial system with regard to HIV-positive people, who are almost discriminated against twice.

A new perspective on the disease
According to experts, the law as it stands only contributes to the stigma and harassment of HIV-positive people in society, in particular adolescents. The legislation on HIV/AIDS is morally outdated. When it was drafted, it was indeed a fatal disease and there was no antiretroviral therapy. A few years ago, WHO officially declared HIV to be a chronic and non-fatal disease.

In Uzbekistan, free antiretroviral therapy has been available since 2006. There is scientific evidence that a person with a depressed (undefined) viral load (the amount of the virus in the blood), as a convicted young man, has a risk of transmitting the virus to zero. But practice shows that the law is sometimes not heeded to science.

Azizbek Boltayev, a psychotherapist from Bukhara, was one of the first to react to the publication of the GUVD and then reprint it in an Internet publication with an ignorant headline.

“Special attention should be paid to the age when the guy was registered – 7 years old, i.e. he was very likely to be infected in one of the medical institutions of the country. It turns out that the person was punished for the condition he had because of the lack of supervision of state controlling bodies. After all, if the guy had not been infected as a child, today’s problem simply would not have happened. Who would want to register with the AIDS Center after such news?” – noted the expert.
Today medicine allows HIV-positive people to really live a full life, have families without any risk for their partner and have absolutely healthy children. This is why amendments to the legislation are so necessary.

“According to international practice, having a separate article on HIV only reinforces stigma, so it is recommended to apply common articles on harm to health. In addition, only wilfully malicious infections or attempts to infect should be criminalized. If no infection has occurred, the act will usually be decriminalised,” said lawyer Timur Abdullayev.
Article 113 of the Uzbek Penal Code consists of five parts, with HIV being devoted to part of the Criminal Code. 4 и 5. And in one part, two notions are combined: “infection” and “knowingly put in danger.

“The latter refers to any action that involves any risk above zero. So, protected sexual intercourse with contraception does not exclude liability, because it does not protect 100%. Thus, all that is not equal to zero is in any case an article, and it does not matter whether there is a transmission or not, whether there is intent or not. In addition, the Code does not explain what “known” means and what intention it means – direct, indirect or no intention at all,” explains the lawyer.
Thus, the outcome of the trial depends on the interpretation of the law by the investigation bodies and the court.

“In Russia, Belarus and Kazakhstan, notes were added to the article that if the HIV-negative partner was warned and agreed to the risk and there is a receipt, then the liability is cancelled,” Abdullayev continues. – However, the Uzbek Criminal Code does not have such a note, which means that all HIV-positive partners in discordant couples (where only one of them is infected) are de jure criminals”.

A humane approach
Over the past few years, Uzbekistan has achieved impressive results in the fight against HIV infection. In addition, the most comfortable conditions for people with status are being created. For example, within the limits of the decision of the president of Uzbekistan “About measures on the further perfection of system of counteraction to distribution of the disease caused by a virus of immunodeficiency of the person, in the Republic of Uzbekistan” pre-contact prophylaxis by antiretroviral preparations for HIV-negative persons in discordant pairs is already practiced.

However, the judicial and legal system requires immediate reforms, dictated by international recommendations and human rights organizations. In the experts’ view, article 113 of the Convention on the Elimination of All Forms of Discrimination against Women. 4 of the Criminal Code contradicts several provisions of the Constitution – articles 18 and 27, as well as article 4 of the Family Code. Lawyers are convinced that amendments to the current legislation will contribute to a humane approach to the HIV response.
In the case of the described pair of infected girls did not occur, HIV activists have achieved the correction of the scandalous false title, but how to deal with its consequences now? One indiscreet word crosses out years of work by specialists in eliminating discrimination against HIV-positive people.

“We still find it shameful to stigmatize people already suffering from a serious chronic disease who face restrictions because of their status. Happening of such a situation among healthy teenagers is unlikely to cause public resonance,” believes Zulfiya Tairova, international expert on public health and HIV/AIDS programs.
Hardened stereotypes and a craving to denounce the culprit, to punish it and to make it public so that others would not be harmed, she said.

Imaginary phobias and real barriers
The prevailing opinion in society is still that HIV is a problem exclusively for risk groups (drug addicts, sex workers, prisoners, etc.). Did the convicted young person, who was infected at the age of 7, belong to any of these categories? Was it his or her fault for the infection? Why does he now have to live with the label of a person with a criminal record?

Another problem is related to the restriction of the rights of young people with HIV: the inability to study at a foreign university, a ban on entering foreign countries for a long period of time for work or study, where a certificate of absence of this diagnosis is required.
Even physicians avoid such patients once they are diagnosed with HIV status, sometimes refusing to provide services or transferring the patient to another doctor.

With regard to youth education, Tairova said it is time to stop covering up real problems and not ignore the physiology of adolescents.

“We need to talk to children in their language and teach them how to protect their health, and stop covering up sexual education with a veil of “comfort” (shame, shame). Teenagers should know how to use a condom and that this is the safest way to protect themselves from infection and unwanted pregnancy,” she said.
In 2019 Moldova hosted the first Regional Forum of Eastern European and Central Asian Judges on HIV. Unfortunately, representatives of Uzbekistan were not there. A second meeting is planned this year. Due to the coronavirus pandemic, the format of the meeting is still unknown. HIV activists hope that this time the republic will not be left out of discussion on a very important topic. The purpose of this forum is to raise awareness of judges and change their attitude towards HIV-positive defendants.

Почему ВИЧ – уже не приговор для медицины, но все еще бич для общества

Отношение к лицам с вирусом иммунодефицита в Узбекистане остается сложным, если не сказать дискриминационным. Проблема кроется не только в нетерпимости общества и неосторожности СМИ, но и в несовершенстве законодательства в этой сфере.

ТАШКЕНТ, 8 июн — Sputnik. В начале июня на сайте ГУВД Ташкента была опубликована статья, посвященная проблеме распространения ВИЧ-инфекции среди молодежи. В ней был сделан упор на то, что угроза заражения считается уголовно наказуемым преступлением, а для наглядности приведено дело 2019 года.

Цель публикации – обратить внимание родителей и самих молодых людей к этой теме, чтобы они ответственно относились к своему здоровью и не были легкомысленны в половых отношениях. Однако благое начинание обернулось скандалом. Одно из местных изданий опубликовало статью с заголовком “В Ташкенте школьник заразил свою девушку ВИЧ-инфекцией”. В результате участники прошлогодней истории дважды пострадали из-за пресловутого положительного статуса одного из партнеров: сначала молодой человек получил условный срок за не имевшее тяжелых последствий деяние, а затем еще и журналисты с легкой руки “поставили” его девушке неподтвержденный диагноз ВИЧ.

Любовь против ВИЧ

Судебное разбирательство в отношении молодого человека проходило в 2019 году, однако известно о нем стало только сейчас. Юноше инкриминировалось преступление по части 4 статьи 113 УК Узбекистана — “Заведомое поставление человека в опасность заражения ВИЧ-инфекцией”. Молодые люди (ему 17 лет, ей – 16) знакомы с детства, еще подростками начали встречаться. Обвиняемый полностью сознался в содеянном и пояснил, что о своем диагнозе знает и с 2009 года (с семилетнего возраста) состоит на учете в Центре по борьбе со СПИДом, а также регулярно проходил обследование.

Семейных отношений пара не планировала, но, как водится, все произошло спонтанно, без использования контрацептивов. По признанию молодого человека, он предупредил свою девушку о возможной опасности. Беременность выявили лишь на пятом месяце. В итоге ни у матери, ни у родившегося позже ребенка не был обнаружен ВИЧ. Пара, конечно, зарегистрировала свой брак, но супруг получил за содеянное условный срок.

И без того неприятная история, хоть и со счастливым финалом, на этом могла бы закончиться, но неосторожное упоминание и искаженный заголовок в СМИ, что называется, подлили масла в огонь. Этот пример выявил давно назревшую проблему несовершенства судебной системы в отношении ВИЧ-инфицированных, которые подвергаются чуть ли не двойной дискриминации.

Новый взгляд на заболевание

По мнению экспертов, закон в нынешнем виде только способствует укреплению в обществе стигмы и притеснениям по отношению к ВИЧ-положительным, в частности, подросткам. Законодательство по ВИЧ/СПИДу морально устарело. Когда оно составлялось, это действительно было смертельным заболеванием, отсутствовала антиретровирусная терапия. Несколько лет назад ВОЗ официально объявила ВИЧ хронической и несмертельной болезнью.

В Узбекистане бесплатная АРВ-терапия доступна с 2006 года. Есть научные данные, что у человека с подавленной (неопределяемой) вирусной нагрузкой (количество вируса в крови), как у осужденного молодого человека, риск передачи вируса равен нулю. Но практика показывает, что закон порой к науке не прислушивается.

Одним из первых на публикацию ГУВД, а затем ее перепечатку в интернет-издании с невежественным заголовком отреагировал Азизбек Болтаев, психотерапевт из Бухары.

“Особое внимание общественности должен привлечь возраст, когда парень встал на учет – 7 лет, т. е. с большой вероятностью его заразили в одном из медучреждений страны. Получается, что человека наказали за состояние, которое возникло у него по причине недосмотра государственных контролирующих органов. Ведь если бы парня не заразили в детстве, сегодняшней проблемы попросту бы не было. Кто после подобных новостей захочет вставать на учет в Центр по борьбе со СПИДом?” — заметил эксперт.

Сегодня медицина позволяет ВИЧ-положительным людям действительно жить полноценной жизнью, заводить семьи без какого-либо риска для своего партнера и иметь абсолютно здоровых детей. Вот почему поправки в законодательстве так необходимы.

“В соответствии с международной практикой, наличие отдельной статьи о ВИЧ лишь усиливает стигму, поэтому рекомендуется применять общие статьи о причинении вреда здоровью. Кроме того, уголовная ответственность должна быть предусмотрена только за случаи предумышленного злонамеренного инфицирования либо попытки инфицировать. Если инфицирования не произошло, деяние, как правило, декриминализируют”, — отметил юрист Тимур Абдуллаев.

Статья 113 УК РУз состоит из пяти частей, ВИЧ посвящены ч. 4 и 5. Причем в одной части объединены два понятия: и “заражение”, и “заведомое поставление в опасность”.

“Последнее обозначает всякое действие, предполагающее любой риск выше нуля. Получается, защищенный половой контакт с использованием контрацептива не исключает ответственность, потому что он не защищает на 100%. Таким образом, все, что не равно нулю, – это в любом случае статья, и не важно, есть факт передачи или нет, есть умысел или нет. Кроме этого, Кодекс не объясняет, что значит “заведомое” и какой умысел оно означает – прямой, косвенный или вообще его отсутствие”, — объясняет юрист.

Таким образом исход судебного разбирательства зависит от трактовки закона органами следствия и судом.

“В России, Беларуси, Казахстане были добавлены примечания к статье, что в случае если ВИЧ-отрицательный партнер был предупрежден и согласился с риском и об этом имеется расписка, то ответственность отменяется, — продолжает Абдуллаев. — Однако в УК Узбекистана нет и такого примечания, а значит, все ВИЧ-положительные партнеры в дискордантных парах (где лишь один из них инфицирован) – де-юре преступники”.

Гуманный подход

За последние несколько лет Узбекистан достиг внушительных результатов в борьбе с ВИЧ-инфекцией. Кроме этого, создаются максимально комфортные условия для людей со статусом. Например, в рамках постановления президента Узбекистана “О мерах по дальнейшему совершенствованию системы противодействия распространению заболевания, вызываемого вирусом иммунодефицита человека, в Республике Узбекистан” уже практикуется доконтактная профилактика антиретровирусными препаратами для ВИЧ-отрицательных лиц в дискордантных парах.

Однако судебно-правовая система требует незамедлительных реформ, продиктованных международными рекомендациями и правозащитными организациями. По мнению экспертов, статья 113 ч. 4 УК РУз противоречит ряду положений Конституции – статье 18 и 27, а также статье 4 Семейного кодекса. Юристы убеждены, что поправки в текущее законодательство поспособствуют гуманному подходу в противодействии ВИЧ.

В случае с описанной парой заражения девушки не произошло, ВИЧ-активисты добились исправления скандального неправдивого заголовка, но как теперь быть с его последствиями? Одним неосторожным словом перечеркивается многолетняя работа специалистов по искоренению дискриминации ВИЧ-положительных.

“До сих пор мы констатируем факты позорного клеймения и без того страдающих тяжелым хроническим заболеванием людей, которые сталкиваются с ограничениями из-за статуса. Случись подобная ситуация среди здоровых подростков, вряд ли это вызвало бы общественный резонанс”, — убеждена Зульфия Таирова, международный эксперт по вопросам общественного здравоохранения и программ по борьбе с ВИЧ/СПИДом.

По ее словам, в обществе еще сильны закостенелые стереотипы и жажда обличить виновника, наказать, предать огласке, чтобы другим не повадно было.

Мнимые фобии и реальные барьеры

В социуме все еще доминирует мнение о том, что ВИЧ – это проблема исключительно групп риска (наркозависимых, лиц, оказывающих платные секс-услуги, заключенных и т. д.). Относился ли осужденный молодой человек, зараженный в 7-летнем возрасте, к какой-то из этих категорий? Есть ли его вина в заражении? Почему теперь он вынужден жить с ярлыком человека с уголовным прошлым?

Другая проблема связанна с ограничением прав молодых людей с ВИЧ: невозможность учиться в иностранном вузе, запрет на въезд в иностранные государства на длительный срок по работе или учебе, где требуется сертификат об отсутствии этого диагноза.Даже медики сторонятся таких пациентов после выявления у них ВИЧ-статуса, порой отказывая в предоставлении услуг или передавая больного другому врачу.

Что касается воспитания молодежи, то, по словам Таировой, пора перестать прикрывать реальные проблемы и не игнорировать физиологию подростков.

“Нужно говорить с детьми на их языке и учить их способам защиты своего здоровья, прекратить прикрывать сексуальное воспитание завесой “уят” (стыд, позор). Подростки должны знать, как пользоваться презервативом и что это самый надежный способ защиты от инфекций и нежелательной беременности”, — уверена она.

В 2019-м в Молдове впервые прошел Региональный форум судей Восточной Европы и Центральной Азии по ВИЧ. К сожалению, представителей Узбекистана там не было. В этом году планируется второе заседание. В связи с пандемией коронавируса формат его проведения пока неизвестен. ВИЧ-активисты надеются, что на этот раз республика не останется в стороне от обсуждения очень важной темы. Цель этого форума – повысить информированность судей и изменить их отношение к ВИЧ-положительным подсудимым.

Australia: Director of Public Prosecutions uses HIV case to argue in favour of lowering burden of proof for prosecutions

Easing proof for violent crime would bring legal ‘turmoil’, court told

A push to make it easier to obtain convictions in serious violence cases would throw criminal law into “turmoil”, the Court of Appeal has heard.

Director of Public Prosecutions Kerri Judd last year took the unusual step of challenging the precedents that set the threshold to prove the offence of recklessly causing serious injury after a man was acquitted of a near-fatal assault on an English backpacker in Melbourne.

The 28-year-old backpacker was kicked in the head when a fight broke out between two groups of men in Southbank in February 2017. His skull was fractured when his head hit a hard surface, leaving him on life support for three weeks.

The 18-year-old accused of kicking the backpacker was acquitted last year of both intentionally and recklessly causing serious injury, after he argued his actions were in self-defence. Prosecutors also couldn’t prove the probability the teenager knew he was going to cause serious injury by kicking the backpacker.

Now Ms Judd wants to lower the standard so prosecutors would have to prove an accused person was “possibly” aware their actions would cause serious harm, rather than “probably”.

Chris Boyce, QC, acting on behalf of the DPP, said the burden of proof was set at an unreasonably high level.

“We have to prove a state of mind that is verging on intent for an offence which was intended to be of a lesser morality in terms of culpability, yet the definition merges between the two,” Mr Boyce told the Court of Appeal on Monday.

But Dermot Dann, QC, acting for the acquitted teenager, said no other DPP has “complained” about the definition before, nor has Parliament sought to change it.

He said such a change would affect any offence that contains recklessness.

“This root and branch alteration … would result in turmoil in terms of the operation of the criminal law and expansion of criminal liability,” Mr Dann said.

Justice Phillip Priest, one of the judges hearing the appeal, said: “My impression, I must say, [is that] it’s been applied satisfactorily for 25 years.”

The precedent that defines predicting consequence as a probability, rather than a possibility, was set by the High Court in 1985 in a case of a truck driver who drove his vehicle into a building and fled the scene.

Five people died and he was convicted of murder but on appeal the High Court found that “the question is whether the accused knew or foresaw that his actions would probably cause death or grievous bodily harm”.

This position was solidified in a 1997 Victorian case against a man accused of attempted murder and recklessly causing injury after a gun went off and injured someone nearby.

The DPP asked the Court of Appeal to instead look to another High Court case, that of a NSW man who knew he had HIV and infected a sexual partner.

In that case, it was sufficient to establish an accused foresaw the possibility that sex would result in contraction of a grievous bodily disease.

A decision in the case, heard by Court of Appeal President Chris Maxwell and justices Stephen McLeish, Stephen Kaye, Karin Emerton and Justice Priest, will be made at a later date.