Introducing Positive Destinations:
Information and Advocacy on Travelling
and Relocating with HIV

Today, on International Migrants Day, the HIV Justice Network is thrilled to announce the relaunch of The Global Database on HIV-specific Travel and Residence Restrictions (HIVtravel.org) under a new name: Positive Destinations (www.positivedestinations.info). This rebranding reflects a bold vision for the future — empowering people living with HIV through accessible information, advocacy, and resources to promote freedom of movement and challenge stigma worldwide.

Positive Destinations represents hope, progress, and the belief that every journey should be free of archaic barriers and unjust discrimination. This enhanced platform provides up-to-date, accurate information on restrictions affecting people living with HIV who want to travel, relocate or migrate, and serves as a vital advocacy portal to push for the removal of discriminatory laws, policies and practices.

“This rebrand to Positive Destinations reflects our commitment to a world where people living with HIV, in all our diversities, can enjoy our human rights and live in dignity, without fear of unjust criminalisation, regulation or control,” said HIV Justice Network’s Executive Director, Edwin J Bernard. “With this platform, we aim to amplify the voices of those most affected and build a movement that challenges and changes unjust, unscientific policies. Travel or relocation for love, work, family or pleasure should be available to everyone, regardless of HIV status, and we are dedicated to ensuring that every destination is a truly positive destination for all.”

Why the change?

HIVtravel.org has been a trusted resource for more than two decades. The name Positive Destinations better reflects its mission to provide expanded information and tools to promote freedom of movement and uphold human rights, paving the way for a world where people living with HIV can explore, connect, and thrive without prejudice.

  • Expanding our vision: Positive Destinations goes beyond providing entry, stay and residence restrictions information to also covering information on access to HIV services for non-nationals.
  • Accessible advocacy tools: The platform equips users with news and resources to challenge unjust restrictions.
  • Community-focused: It highlights stories of successful advocacy and personal testimonies of lived experience to foster understanding and solidarity.

What’s new on Positive Destinations?

  1. Redesigned website: A completely redesigned user-friendly interface – optimised for mobile phones – that makes accessing critical travel and treatment access information seamless.
  2. Latest news: News stories about advocacy or information relating to HIV-related travel or migration curated from reliable sources around the world.
  3. Advocacy resources: Practical tools for individuals and organisations to advocate for change.
  4. Links to local organisations: Where available we link to organisations in-country that can help migrants with HIV to access services.
  5. Global perspectives: Personal stories highlighting the challenges and triumphs of navigating the world as people living with HIV in all our diversities.

Visit the new platform at www.positivedestinations.info.

About the HIV Justice Network

The HIV Justice Network (HJN) is the leading community-based NGO building a co-ordinated, effective global response to punitive laws and policies that impact people living with HIV in all our diversities. In 2024, HJN took over the running of the hivtravel.org website, rebranding it as Positive Destinations.

Acknowledgments

This project has been made possible with the provision of a financial grant from Gilead Sciences Europe Ltd.

We acknowledge previous funders and contributors to The Global Database on HIV-specific Travel and Residence Restrictions (hivtravel.org) including Deutsche Aidshilfe, European AIDS Treatment Group (EATG), the International AIDS Society (IAS), Positive Council (Switzerland). We would especially like to thank the original authors David Haerry and Peter Wiessner.

Australia: Migration policies for People with HIV perpetuate criminalisation and expose them to harm

David Carter Delivers Keynote at the Australasian HIV&AIDS Conference

Health+Law’s research lead David Carter, delivered a keynote address at the recent ASHM HIV Conference in Sydney, exploring the controversial past and present of HIV criminalisation in Australia. His urgent, provocative address challenged us to consider how current legal and policy processes in migration law recreate conditions of criminalisation, producing serious health and other harms for people living with HIV. 

Talking to Health+Law researchers in an interview about legal issues, Sergio*, a man in his thirties originally from South America and living with HIV, described the experience of migration to Australia:

I didn’t have to face any court, but I [did] have to prove that I wasn’t a bad person just because I have HIV […] I [had] to prove myself to someone else, who probably is not living with HIV, that I was not a bad person, and I was a good citizen and I deserve to be here.

The migration process is a complex one – and this complexity is amplified for people living with HIV.  Sergio’s reflections express a particularly grim aspect of this process for migrants, especially those living with HIV.

Indeed, as Scientia Associate Professor David Carter, Health+Law’s research lead, argued in an invited keynote at the 2024 Australasian HIV&AIDS Conference hosted by ASHM Health in September this year, the experience of people living with HIV seeking to migrate to Australia is part of Australia’s long history of the criminalisation of HIV.  Speaking to delegates from Australia, New Zealand, Asia and the Pacific at Sydney’s International Convention Centre on Gadigal Country, David reminded the audience that criminalisation is a policy approach, that doesn’t just use the criminal law. To show this he set out five stages of criminalisation that are also evident in the migration process for those living with HIV.

First, as he explained, criminalisation characterises specific behaviour as harmful or carrying a risk of harm to the community. In this case the harm presented is, to quote Australian migration law, that a person’s HIV care represents a ‘significant cost to the Australian community or prejudice [to] the access of Australian citizens or permanent residents to health care or community services’.

Second, criminalisation creates a suspect population, made up of people thought to warrant suspicion because they come to be associated with the potential harm.

Third and fourth, this suspect population attracts surveillance from the state, with a hierarchy created within the suspect population whereby some members are subject to further and intensified surveillance.

Fifth, and finally, some members of this suspect population are subjected ‘to the most severe forms of the state’s coercive and punitive authority’, including investigation, more intensive supervision, detention or arrest, and in some cases, criminal or civil proceedings.

The criminalisation of HIV has a long and storied history, going back to the very early days of the AIDS crisis. Vocal members of HIV-affected communities, legal and human rights advocates and many others have argued strongly against criminalisation, viewing it as draconian and as an approach to public (health) policy with very negative consequences for HIV epidemics.

In Australia, arguments against HIV-specific criminal offences have been broadly successful, and yet the ‘temptation’ to criminalise – as the very first Australian National HIV Strategy described it – continues to emerge in some policy responses to HIV and other communicable diseases.

In 1987, when the authors of the first national HIV strategy were writing, they were warning against measures including compulsory universal HIV testing, the closure of gay venues, criminal penalties for HIV transmission, and limitations on the movement of HIV positive people, including forced quarantine. Today, HIV criminalisation is operating in Australian migration policy and law.

‘This contemporary criminalisation of HIV begins’, David argued, ‘like all criminalisation, with the characterisation of behaviour in terms of harm and risk of harm’. He continued, arguing that:

This characterisation of migrating while HIV positive as harmful establishes, and in-turn enlivens, the suspect population management and criminalising processes of our medical border […] This criminalising logic establishes an adversarial relationship between the person living with HIV and the state, and between them and members of the Australian community, whose access to health care it is alleged may be prejudiced by providing care for a person living with HIV who wishes to migrate.

Among the many negative effects of this process is that it can discourage migrants living with HIV from engaging in testing, treatment and HIV care. Interviews conducted by Health+Law as part of our national legal needs (LeNS) study confirm that this is happening. They show that many migrants living with HIV in jurisdictions across Australia experienced an alienating and hostile environment: a ‘threat environment so elevated’, as David described it in his keynote, that they frequently described withdrawing from HIV care and community life as a coping mechanism.

Unfolding the history of ‘unjust and unhelpful’ HIV criminalisation in Australia, David outlined how the current legal and policy conditions that prospective migrants living with HIV face in Australia today work to recreate conditions of criminalisation and expose both individuals and the community to multiple health harms.

You can read more about David’s keynote in The Medical Republic’s coverage of the conference.

Canada: Human Rights groups denounce the use of anti-spit masks

Canada: The anti-spit mask, a controversial tool

Translated from French with Deepl.com – Scroll down for original article

Human rights groups that have set up the Tracking (In)Justice project are denouncing the use of the anti-spit mask, which police forces such as the Royal Canadian Mounted Police (RCMP) regard as an ‘essential’ tool.

The mask, which is placed over the head of an arrestee who wants to spit or bite police officers, is causing controversy. The mask has been used during certain interventions after which the arrested person died, although no link has been formally established between the use of the mask and the person’s death.

A useful and used tool

The Calgary Police Service uses the anti-spit mask.

According to its data (New Window), this tool was used 70 times in 2022 and 2023, more often than pepper spray, but less often than conducted energy weapons.

Members of the RCMP also use them, but their use is not systematically recorded, because the RCMP considers the mask to be a restraint device in the same way as handcuffs,’ she said in an email to Radio-Canada.

According to the RCMP, the mask prevents biological contamination from diseases and infections such as hepatitis and HIV. It says that this type of injury is the most frequently mentioned by officers.

A controversy

Alexander McClelland, Associate Professor at the Institute of Criminology and Criminal Justice at Carleton University in Ottawa, believes that the personal protection argument does not hold water.

We don’t know of many diseases that are transmitted solely by saliva. For example, HIV and hepatitis C are not transmitted by saliva. COVID-19 is an airborne disease. So you need a mask to prevent it, not a mesh fabric,’ says the member of Tracking (In)Justice, which brings together several organisations and collects data on the application of the law and criminal law.

Alexander McClelland believes that the mask is a dehumanising tool that serves no purpose other than to prevent a person from spitting, which could be avoided by de-escalation measures.

A dangerous tool?

I know that there have been about nine cases in Canada [between 2014 and 2022] where people have died after using balaclavas,’ says Alexander McClelland. They are used when a person is forcibly immobilised on the ground, a bonnet is applied and they are sprayed with pepper spray.

The RCMP is clear on this point: the bonnet must not be used to control a prisoner. To this end, it cites studies showing that the use of the mask, according to the manufacturer’s instructions, is safe.

However, in an internal memo (New Window), Alberta Health says the following: [Anti-choking] bonnets interfere with airway assessment and management and present a considerable risk, for example if the patient vomits or chokes. Agitation is also increased by interference with the patient’s vision.

Supervision measures

Masks are safe if staff follow a precise protocol.

They are supposed to be used in a context where no other type of force is applied and when the person [to whom the bonnet is applied] is seated and able to breathe effectively and normally,’ says Alexander McClelland.

When other types of force are applied, such as ground restraint, or if someone is handcuffed, or if someone is in a heightened state of anxiety because they are being held by the police, they may not be able to breathe effectively,’ he adds.

What’s more, the measures surrounding the use of this bonnet vary from one police force to another.

In the RCMP, the bonnet is considered a restraint device. It is therefore not subject to the same requirements as tools that fall into the Intervention Options category, which includes pepper spray, for which there are strict training and recertification requirements.

Prohibited use

In Australia, the anti-spit mask has been abolished.

Alexander McClelland explains that Australia made this decision following the death of a man in custody. It’s because [the masks] can be damaging and cause a lot of harm to people who are arrested or incarcerated,’ says McClelland.

For its part, the RCMP says it has no intention of stopping using them, but that if objective medical evidence shows the tool to be dangerous, it will take it into account.

Le masque anti-crachat, un outil controversé

Des groupes de défense des droits de la personne qui ont créé le projet Tracking (In)Justice dénoncent l’utilisation du masque anti-crachat, alors que les corps de police tels que la Gendarmerie royale du Canada (GRC) le perçoivent comme un outil « essentiel ».

Ce masque, qui est mis sur la tête d’une personne en état d’arrestation qui veut cracher ou mordre les policiers, suscite la controverse. Le masque a été utilisé durant certaines interventions après lesquelles la personne arrêtée est morte,bien qu’aucun lien n’ait été formellement établi entre l’utilisation du masque et la mort de la personne.

Un outil utile et utilisé

Le service de police de Calgary a recours au masque anti-crachat.

Selon ses données (Nouvelle fenêtre) (en anglais), cet outil a été employé 70 fois en 2022 et en 2023, soit plus souvent que les aérosols capsiques (gaz poivre), mais moins que les armes à impulsion électrique.

Les membres de la GRC y ont aussi recours, mais son usage n’est pas systématiquement répertorié, car elle considère le masque comme un dispositif de contrainte, au même titre que des menottes, dit-elle dans un courriel envoyé à Radio-Canada

Selon la GRC, le masque permet d’éviter la contamination biologique de maladies et d’infections comme des hépatites et le VIH. Elle affirme que ce type de blessures est le plus fréquemment mentionné par les agents.

Une polémique

Le professeur agrégé de l’Institut de criminologie et de justice criminelle à l’Université Carleton à Ottawa Alexander McClelland estime que l’argument de la protection individuelle ne tient pas la route.

Nous ne connaissons pas beaucoup de maladies qui se transmettent uniquement par la salive. Par exemple, le VIH et l’hépatite C ne se transmettent pas par la salive. La COVID-19 est une maladie qui se transmet par l’air. Il faut donc un masque pour l’éviter, pas un tissu en maille, affirme le membre de Tracking (In)Justice, qui regroupe plusieurs organisations et qui collecte des données sur l’application de la loi et du droit pénal.

Alexander McClelland juge que le masque est un outil déshumanisant, qui n’a d’autre utilité que d’empêcher une personne d’envoyer des crachats, ce qui pourrait être évité par des mesures de désescalade.

Un outil dangereux?

Je sais qu’il y a eu environ neuf cas au Canada [entre 2014 et 2022] où des personnes sont mortes après l’utilisation de cagoules, affirme Alexander McClelland. Elles sont utilisées lorsqu’une personne est immobilisée de force sur le sol, qu’on lui applique une cagoule et qu’elle est aspergée de gaz poivré.

Or, la GRC est claire sur ce point : la cagoule ne doit pas servir à contrôler un prisonnier. À cet effet, elle cite des études qui démontrent que l’usage du masque, selon les indications du fabricant, est sécuritaire.

Toutefois, dans une note interne (Nouvelle fenêtre) (en anglais), Service de santé Alberta dit ceci : Les cagoules [anti-crachat] gênent l’évaluation et la gestion des voies respiratoires et présentent un risque considérable, par exemple si le patient vomit ou s’étouffe. L’agitation est aussi accrue par l’interférence avec la vision du patient.

Des mesures d’encadrement

Le masque est sécuritaire, si les agents suivent un protocole précis.

Ils sont censés être utilisés dans un contexte où aucun autre type de force n’est appliqué et lorsque la personne [à qui on enfile la cagoule] est assise et capable de respirer efficacement et normalement, assure Alexander McClelland.

Lorsqu’on applique d’autres types de force, comme la contrainte au sol, ou si quelqu’un est menotté, ou si quelqu’un est dans un état d’anxiété accru parce qu’il est retenu par la police, il peut ne pas être en mesure de respirer efficacement, ajoute-t-il.

De plus, les mesures entourant l’usage de cette cagoule varient selon les corps policiers.

À la GRC, la cagoule est considérée comme un dispositif de contrainte. Elle n’est donc pas soumise aux mêmes exigences que les outils qui entrent dans la catégorie Options d’intervention, dont fait partie l’aérosol capsique, pour laquelle il y a des exigences strictes en matière de formation et de recertification.

Un emploi proscrit

En Australie, le masque anti-crachat a été aboli.

Alexander McClelland explique que ce pays a fait ce choix à la suite du décès d’un homme en détention. C’est parce que [les masques] peuvent être dommageables et causer beaucoup de tort aux personnes arrêtées ou incarcérées, affirme le spécialiste.

De son côté, la GRC déclare qu’elle n’a pas l’intention d’arrêter de l’utiliser, mais que, si des preuves médicales objectives démontrent la dangerosité de l’outil, elle va en tenir compte.

Uzbekistan: Successful advocacy is reshaping HIV legislation and profession bans

“‘A woman came to us, she asked for help with the legal process’” – Interview with Evgenia Korotkova

Translated from Russian with Google translate. Scroll down for the original article. 

Do you want to know how an activist living with HIV went from a public defender in cases under Article 113 of the Criminal Code to a community expert who, after speaking at a feminist forum, is influencing the humanisation of legislation on people living with HIV in Uzbekistan?

Read about it in Svetlana Moroz’s interview with Yevgeniya Korotkova on the significant reduction of the list of prohibited professions for people living with HIV in Uzbekistan.

S.M.: Zhenya, let’s start from the beginning. In 2020, a woman who faced criminal prosecution for working as a hairdresser came to your organisation for help. Tell us about this woman, why did she come to you specifically?

E.K.: I remember very well when we first started to focus on the issue of HIV criminalisation under Article 113 of the Criminal Code. At that time, we were actively collecting cases of people who had been prosecuted under this article. At some point we came across an article on the website of the Ministry of Internal Affairs. It said that an orphaned teenager living with HIV had sexual relations with a teenage girl and she became pregnant. The main message of the article was directed at parents – they should keep an eye on their children and have preventive conversations with them.

However, the article was full of stigmatising, incorrect and distorted information. Amidst the outrage, we decided to write a post on our organisation’s page, where I gave my comments. This post also included an appeal to people living with HIV who were affected by Part 4 of Article 113 of the Criminal Code of the Republic of Uzbekistan. We informed that they could contact us for legal assistance and counselling.

The response to the post did not take long. One of the first to appeal was a woman who worked as a hairdresser. She told us that her case had already been taken to court and at the time of the investigation she didn’t even have money for a lawyer. We started looking for ways to help and were able to find money to pay for a lawyer. The lawyer took on her case and filed a request to review the materials.

In the process of discussions with the woman, we came to the conclusion that I would participate in the court as a public defender from our organisation. It was the first such experience for me. We did not know that we even had the opportunity to represent someone’s interests in this way. So we prepared a motion in which we indicated that in addition to the lawyer, the interests of the woman would be represented by a public defender – that is me.

This case was a serious test for me. We discovered a new form of assistance that we had not even realised existed before.Now we know that the involvement of a public defender can be key in such cases and really helps people.

S.M.: How did this case get to court? Who sued this woman? How did they find out about her HIV status?

E.K.: How exactly this case ended up in court, we learnt only during the trial. It turned out that a police officer came to the woman’s workplace with some list. He showed her that she was on the list and said that it included people who violated the law. In particular, it was about those who were HIV-positive and worked in a hairdresser’s shop, which was allegedly against the law.

In fact, it meant the transfer of health data to law enforcement agencies without the consent of the patient. And at the trial they did not even tried to hide this fact. During the trial, the prosecutor who was in charge of the case directly stated that the information about her HIV status had been obtained from the AIDS Centre.

S.M.: How was the trial? What was the verdict?

E.K.: The trial was held in closed mode, because the case concerned doctor-patient confidentiality and confidentiality of the diagnosis. We were very lucky that we managed to attract doctors who supported our side and defended the woman.She was strictly following the ARV regimen, so she had an undetectable viral load. In court, a doctor acted as an expert who clearly explained that under such conditions, infection was impossible. He also emphasised that there were no casualties at the time of trial.

Even the investigator pointed out in the case file that the woman did not use scissors or razors in her work – only a haircutting machine. She did not use cutting or stabbing objects that could theoretically create a threat of infection. It is important to note that the witnesses who were called from her work did not testify negatively. They confirmed that the woman performed her duties professionally and without impropriety.

In my arguments, I relied on this evidence to argue that our defendant could not have transmitted HIV infection while working as a hairdresser. During the hearing, the judge asked me, ‘As a public defender, would you, yourself,  have gone to this woman to cut your hair?’ I explained that HIV transmission would have required a number of unlikely conditions: she would have had to be off therapy, and she would have cut herself and me badly. Only then could there be a theoretical threat of infection. But even then, the probability of transmission would be extremely low.

I would like to note separately that the Makhali committee gave our defendant serious support. They filed many petitions in her defence, despite knowing her HIV status. The women’s committee also got involved in the process and filed additional motions in favour of our client.

However, the woman was still given a suspended sentence of two and a half years. This decision was taken because of the existence of Article 113, under which she was tried. The court took into account that she had a minor child, and this influenced the mitigation of the sentence.

I still remember how the judge, while announcing the verdict, emphasised the importance of our advocacy work. He said that our organisation should work on changing the list of prohibited professions because it contradicts modern legislation. These words were the starting point for a great advocacy process that took us three years. This case not only showed us the need to protect people in specific situations, but also gave a start to changes at the systemic level.

S.M.: How does this woman live now? How does she feel?

E.K.: You can imagine, she worked in her favourite profession for more than 30 years. It was a terrible blow for her – to lose the job on which she had built her whole life. Given that she had a minor child and was a single mother and the sole breadwinner in the family, all the responsibility fell on her shoulders. After the trial, it was very difficult for her to find a suitable job. She did everything she could: she cleaned houses, worked as a governess, tried a lot of professions.

It was not easy for her to recover from the trial. She underwent a long psychological rehabilitation, and we, on our part, also supported her by providing the services of a psychologist. This period was very difficult for her. When the legislation was finally changed, I was the first to send her the amended document. But unfortunately, she never returned to the profession. Instead, she started her own small business, determined to start her life with a clean slate.

We continued and still maintain a relationship with her. After the trial, she took part in the Judges’ Forum where she spoke openly and told her story. She shared how an unfair piece of legislation had affected her life and it was an act of courage and hope for change. She was motivated by the desire to help others who are HIV-positive so that they would no longer have to face the hardships and humiliation that she went through.

We realised that this case was not only about criminal law issues, but also touched on socio-economic rights. It showed how much stigma and restrictive laws can affect a person’s life, depriving them of a source of income and the ability to work in a profession. Nevertheless, her story has become an important part of our advocacy work and has helped draw attention to the need for change in the law.

S.M.: We have another milestone in this story – in 2022, Uzbekistan, the third country in Central Asia (after Tajikistan and Kyrgyzstan) to receive, among other things, a recommendation to decriminalise HIV transmission from the UN CEDAW committee. Your country received this recommendation, largely due to your participation and our joint shadow report from the community. Can we assume that the recommendations received have influenced the advocacy process in the context of HIV decriminalisation, namely the revision of the list of prohibited professions?

E.K.: I had only three minutes to address the CEDAW Committee and I remember very well how we prepared my oral statement. Every second mattered. It seems to me that all our efforts were interconnected, especially considering how seriously the state takes the recommendations of international structures. In recent years, the country has really seen progress in supporting women.

From 2019, laws have started to be adopted to ensure equal rights for men and women and to combat discrimination and violence against women. I see that the country is emphasising women’s economic independence and expanding our educational and professional opportunities. Special attention is being paid to women’s access to leadership positions, which opens up new perspectives for us.

I believe that the final recommendations of the CEDAW Committee may have played a role in the state’s attention to the list of prohibited professions. This list has long been in need of revision, as it restricted women’s rights and hindered their professional development. The work in this direction is ongoing, and I hope that our efforts will help more women to avoid such restrictions and achieve justice.

S.M.: So, the year is 2024. Something has happened that probably you and we ourselves did not expect – the list of prohibited professions for people living with HIV in Uzbekistan has been changed (reduced) by the order of the Minister of Health. How did this become possible?

E.K.: According to the new order, HIV-positive people can now work as dentists, as long as they are not involved in surgical interventions. This move was a significant change, especially for us, as we had a case where a man working as a dental technician was prosecuted just because of his HIV status.

In November 2023, there was a big feminist forum where I gave a speech that was well received. One of the newspapers wrote about me as a leader living with HIV. After this publication, the presidential administration became interested in my story. I was invited to a meeting to discuss the most pressing issues facing women and people living with HIV.

At the meeting, I tried to use this opportunity to draw attention to the list of prohibited professions. I explained that this piece of legislation is not only of no public benefit, but also destroys people’s lives by restricting their ability to work in their profession. My arguments resonated. I had the impression that I was able to convince them that this order had long ago lost its relevance.

In the course of the discussion, it became clear that the officials with whom I spoke had a progressive approach and were ready to support the initiative to review and amend the list of prohibited professions. Their readiness for dialogue and understanding of the importance of the issue inspired me and gave me hope for further positive changes.

S.M.: Do I understand correctly that officials of the Ministry of Health had no resistance to this initiative? Before that, doctors used to hand over data on people with HIV to the police. I can’t forget the case when a woman (nurse) was simply summoned to the district department in the middle of the working day, checked the list of her contacts in the phone book, asked who she was sleeping with, threatened with an article, etc. – such ‘preventive’ humiliating methods.

E.K.: After the adoption of the new, shortened list of prohibited professions, we started to conduct trainings for medical workers. In the process, we encountered some resistance – among the participants there were epidemiologists who did not support the changes. They argued that the risk of HIV transmission still existed despite the new data and international standards. Such statements rather demonstrated their lack of awareness of the issue. Later, their colleagues, doctors with more experience, even advised them to refrain from making such statements in order not to mislead other participants.

Particularly important for us was the participation of the chief epidemiologist of the Republican AIDS Centre in these trainings. He presented information about the changes in the list of professions in the most professional and accessible way possible, which helped to reduce mistrust and resistance among health workers. His presentations played an important role in disseminating correct knowledge.

We also held meetings with the staff of the Ministry of Internal Affairs, in particular with representatives of the moral department, which supervised cases related to Article 113 of the Criminal Code. They were the ones who had previously initiated cases against HIV-positive hairdressers, leading to their criminal prosecution. These discussions were important for us because they allowed us to convey to law enforcement officials that the old norms no longer meet modern realities and only contribute to the stigmatisation of people living with HIV.

S.M.: We know that you worked on the bill that has already been submitted from your NGO Ishonch va Haet to the parliament. You have also received a response, thankfully. How do you assess the prospect of amending the Criminal Code with regard to Article 113?

E.K.: I am an optimist and I am sure that the changes will definitely happen, it is only a matter of time. It is already evident that people involved in legislative reforms realise that some laws are outdated and need to be revised. It is good to see that the country is actively aiming to update the legislative systems and bring them in line with modern realities.

I believe that our voice will be heard. Especially since these changes are being called for not only by civil society, but also by the scientific and medical community, as well as international organisations. These are not just recommendations invented in a narrow circle of activists/v – they are a global agenda, reflecting progress and the realisation that HIV infection is now a chronic disease that can be lived with thanks to affordable and effective treatment.

Importantly, positive developments are already taking place in the country. Progressive initiatives on gender equality, protection of the rights of women and people living with HIV demonstrate the state’s commitment to improving the quality of life of its citizens. These changes give me confidence that the reform will also affect the legislative acts that still restrict people in their rights and freedom of choice of profession.

I believe in my state and its rational approach. I see that there is a dialogue going on and it is bearing fruit. We are moving towards change, and I am convinced that it will be positive for everyone.

S.M.: One last question. Looking back at your path from a public defender to a community expert who submits a draft of legislative changes to the parliament, tell us how you came to this? Who/what is behind it?

E.K.: Behind all our efforts there are always people – people who need help and support. I myself am a woman living with HIV, and although I have not experienced criminalisation directly, I have had many examples of stigma and discrimination in my life. One of the people I defended in court is now an employee of our organisation. It is stories like these that give me the strength and inspiration to keep going.

Deep down, I dream of a perfect world. No one can stop me from at least trying to make it so. My main motivation has always been to ensure that people living with HIV no longer face discrimination and stigma, that their rights are respected and not violated just because of their diagnosis.

I am convinced that the state should work in the interests of those who live in it. And today we really have good prospects.We see the existence of political will and civil society, which is actively involved in promoting change and has real weight.This is a favourable time for change.

The state is showing a desire to hear us and understand our problems. Moreover, we are not just talking about problems, we are helping to find solutions, and this process becomes an additional motivation for me. When we are listened to and really heard, it is inspiring. It means that our efforts matter and lead to change.

Order of the Minister of Health of the Republic of Uzbekistan

On approval of the List of types of professional activities prohibited for persons infected with the human immunodeficiency virus

[Registered by the Ministry of Justice of the Republic of Uzbekistan on May 07, 2014. Registration № 2581]

Order of the Minister of Health of the Republic of Uzbekistan

On approval of the List of types of professional activities prohibited for persons infected with the human immunodeficiency virus

[Registered by the Ministry of Justice of the Republic of Uzbekistan on February 19, 2024. Registration № 3497]

Types of professional activities prohibited for persons infected with the human immunodeficiency virus

List:

1. Professions related to the procurement and processing of blood and its components.

2. Professions related to the production of blood and its components, sperm and breast milk.

3. Professions related to blood transfusion.

4. Professions related to the following medical procedures: injections; dialysis; venesection;, catheterization.

5. Professions related to cosmetic and plastic surgery.

6. Professions related to dental procedures.

7. Professions related to childbirth.

8. Professions related to abortions and other gynecological operations.

9. Professions related to hair and shaving, piercing, manicure, pedicure and tattooing.

Types of professional activities prohibited for persons infected with the human immunodeficiency virus

List:

1. Professions related to the procurement, processing and transfusion of human blood and/or its components.

2. Professions related to all types of surgery.

3. Professions related to childbirth.

4. Professions related to the following medical procedures: dialysis; venesection; catheterization.

«К нам пришла женщина, она просила помощи с судебным процессом»

Интервью с Евгенией Коротковой

Хотите узнать, как активистка, живущая с ВИЧ, прошла путь от общественной защитницы по делам по 113-й статье Уголовного Кодекса до экспертки сообщества, которая после выступления на феминистском форуме влияет на гуманизацию законодательства в отношении людей, живущих с ВИЧ, в Узбекистане?

Читайте об этом в интервью Светланы Мороз с Евгенией Коротковой, посвященном существенному сокращению списка запрещенных профессий для людей, живучих с ВИЧ, в Узбекистане.

С.М.: Женя, давай начнем с начала. В 2020 году к вам в организацию за помощью обратилась женщина, которая столкнулась с уголовным преследованием за то, что она работала парикмахером. Расскажи про эту женщину, почему она пришла именно к вам?

Е.К.: Я хорошо помню, как мы только начали уделять внимание проблеме криминализации ВИЧ в рамках статьи 113 Уголовного кодекса. Мы тогда активно собирали кейсы людей, которые были привлечены по этой статье. В какой-то момент наткнулись на статью на сайте МВД. В ней говорилось о том, что подросток-сирота, живущий с ВИЧ, вступил в половую связь с подростком девочкой, и она забеременела. Основной посыл статьи был направлен на родителей — мол, следите за детьми и проводите с ними профилактические беседы.

Однако статья была переполнена стигматизирующей, некорректной и искаженной информацией. На фоне возмущения мы решили написать пост на странице нашей организации, где я дала свои комментарии. В этом посте также было обращение к людям, живущим с ВИЧ, которые пострадали по части 4-й статьи 113 УК РУз. Мы сообщали, что они могут обратиться к нам за юридической помощью и консультациями.

Реакция на пост не заставила себя долго ждать. Одной из первых обратилась женщина, работавшая парикмахером. Она рассказала, что ее дело уже передано в суд, а на момент расследования у нее даже не было средств на адвоката. Мы начали искать возможности помочь и смогли найти деньги на оплату адвокатских услуг. Адвокатка взялась за ее дело и подал запрос на ознакомление с материалами.

В процессе обсуждений с этой женщиной мы пришли к выводу, что я буду участвовать в суде как общественная защитница от нашей организации. Это был для меня первый такой опыт. Мы не знали, что у нас вообще есть возможность представлять чьи-то интересы таким образом. И мы подготовили ходатайство, в котором указали, что помимо адвоката интересы женщины будет представлять общественная защитница — то есть я.

Этот случай стал для меня серьезным испытанием. Мы открыли для себя новую форму помощи, о существовании которой раньше даже не догадывались. Теперь мы знаем, что участие общественного(ой) защитника/цы может оказаться ключевым в подобных делах и реально помогает людям.

С.М.: Как это дело попало в суд? Кто подал в суд на эту женщину? Как они узнали о ее ВИЧ статусе?

Е.К.: То, как именно это дело оказалось в суде, мы узнали только в ходе судебного процесса. Оказалось, что к женщине на работу пришел сотрудник милиции с каким-то списком. Он показал ей, что она числится в этом списке, и заявил, что туда включены люди, нарушающие закон. В частности, речь шла о тех, кто имеет ВИЧ-положительный статус и работает в парикмахерской, что якобы противоречит закону.

Фактически это означало передачу данных о состоянии здоровья правоохранительным органам без согласия пациентки. И на суде этот факт даже не пытались скрыть. В ходе разбирательства прокурор, который вел дело, прямо заявил, что сведения о ее ВИЧ-статусе были получены из Центра СПИДа.

С.М.: Как проходил суд? Какой был приговор?

Е.К.: Судебное разбирательство проходило в закрытом режиме, поскольку дело касалось врачебной тайны и конфиденциальности диагноза. Нам очень повезло, что удалось привлечь врачей, которые поддержали нашу сторону и встали на защиту женщины. Она строго следовала режиму приёма АРВ-терапии, благодаря чему у нее была неопределяемая вирусная нагрузка. В суде в качестве эксперта выступил врач, который ясно объяснил, что при таких условиях инфицирование было невозможно. Он также подчеркнул, что на момент разбирательства не было ни одного пострадавшего.

Даже следователь указал в материалах дела, что женщина не пользовалась в работе ножницами или бритвами — только машинкой для стрижки. Она не применяла режущие и колющие предметы, которые могли бы теоретически создать угрозу заражения. Важно отметить, что свидетели, которых вызывали с ее работы, не давали негативных показаний. Они подтверждали, что женщина выполняла свои обязанности профессионально и без нарушений.

В своих прениях я опиралась на эти доказательства, утверждая, что наша подзащитная не могла передать ВИЧ-инфекцию, работая парикмахером. Во время заседания судья задал мне вопрос: «Вы, как общественная защитница, сами бы пошли стричься к этой женщине?» Я объяснила, что для передачи ВИЧ потребовался бы целый ряд маловероятных условий: она должна была бы не принимать терапию, при этом и себя, и меня сильно порезать. Только в таком случае могла бы возникнуть теоретическая угроза заражения. Но даже тогда вероятность передачи была бы крайне низкой.

Отдельно хочу отметить, что махалинский комитет оказал нашей подзащитной серьезную поддержку. Они подали множество ходатайств в ее защиту, несмотря на знание ее ВИЧ-статуса. К этому процессу также подключился комитет женщин, который внес дополнительные ходатайства в пользу нашей клиентки.

Однако женщине все же назначили условный срок — два с половиной года. Это решение было принято из-за существования статьи 113, по которой ее судили. Суд учел, что у нее есть несовершеннолетний ребенок, и это повлияло на смягчение приговора.

До сих пор помню, как судья, оглашая приговор, подчеркнул важность нашего адвокационного направления. Он сказал, что наша организация должна работать над изменением списка запрещенных профессий, потому что он противоречит современному законодательству. Эти слова стали отправной точкой для большого адвокационного процесса, который занял у нас три года. Это дело не просто показало нам необходимость защиты людей в конкретных ситуациях, но и дало старт изменениям на системном уровне.

С.М.: Как сейчас живет эта женщина? Как она себя чувствует?

Е.К.: Представляешь, она проработала в своей любимой профессии более 30 лет. Для нее это было страшным ударом — лишиться работы, на которой она строила всю свою жизнь. Учитывая, что у нее был несовершеннолетний ребенок, а она — мать-одиночка и единственная кормилица в семье, вся ответственность легла на ее плечи. После суда ей было очень тяжело найти подходящую работу. Она бралась за все, что могла: убирала дома, работала гувернанткой, перепробовала массу профессий.

Восстановиться после судебного процесса ей было нелегко. Она проходила длительную психологическую реабилитацию, и мы со своей стороны также оказывали ей поддержку, предоставив услуги психолога. Этот период был очень непростым для нее. Когда наконец изменили законодательство, я первой отправила ей документ с поправками. Но, к сожалению, она так и не вернулась в профессию. Вместо этого она открыла свой маленький бизнес, решив начать жизнь с чистого листа.

Мы продолжали и до сих пор поддерживаем с ней отношения. После суда она приняла участие в Форуме судей, где выступила с открытым лицом и рассказала свою историю. Она поделилась тем, как несправедливая законодательная норма отразилась на ее жизни, и это стало для нее своего рода актом мужества и надеждой на перемены. Её мотивацией было желание помочь другим людям с ВИЧ-положительным статусом, чтобы они больше не сталкивались с теми трудностями и унижениями, через которые прошла она.

Мы понимали, что этот случай касался не только вопросов уголовного права, но и затрагивал социально-экономические права. Он показал, как сильно стигматизация и ограничительные законы могут повлиять на жизнь человека, лишив его источника дохода и возможности работать по профессии. Тем не менее, ее история стала важной частью нашей адвокационной работы и помогла привлечь внимание к необходимости изменений в законодательстве.

С.М.: У нас есть еще одна веха в этой истории — в 2022 году, Узбекистан, третья страна в ЦА (после Таджикистана и Кыргызстана), которая среди прочего получила рекомендацию декриминализировать передачу ВИЧ от комитета ООН CEDAW. Твоя страна получила эту рекомендацию, во многом, благодаря твоему участию и нашему совместному теневому отчету от сообщества. Можем ли мы считать, что полученные рекомендации повлияли на адвокационные процесс в контексте декриминализации ВИЧ, а именно пересмотр списка запрещенных профессий?

Е.К.: У меня было всего три минуты на выступление перед членами Комитета CEDAW, и я прекрасно помню, как мы готовили мое устное заявление. Каждая секунда имела значение. Мне кажется, что все наши усилия были взаимосвязаны, особенно с учетом того, насколько серьезно государство относится к рекомендациям международных структур. В последние годы в стране действительно заметен прогресс в вопросах поддержки женщин.

С 2019 года начали приниматься законы, направленные на обеспечение равноправия мужчин и женщин и борьбу с дискриминацией и насилием в отношении женщин. Я вижу, что в стране делается акцент на экономическую независимость женщин и расширение наших возможностей в образовании и профессиональной деятельности. Особое внимание уделяется доступу женщин к руководящим должностям, что открывает новые перспективы для нас.

Я верю, что заключительные рекомендации Комитета CEDAW могли сыграть свою роль в том, что государство обратило внимание на перечень запрещенных профессий. Этот список давно нуждался в пересмотре, так как он ограничивал права женщин и препятствовал их профессиональному развитию. Работа в этом направлении продолжается, и я надеюсь, что наши усилия помогут еще большему числу женщин избежать подобных ограничений и добиться справедливости.

С.М.: Итак, 2024 год. Случилось то, что, наверное, вы и мы сами не ожидали – приказом министра здравоохранения изменен (сокращен) список запрещенных профессий для людей, живущих с ВИЧ, в Узбекистане. Как это стало возможным?

Е.К.: Согласно новому приказу, ВИЧ-положительные люди теперь могут работать стоматологами, если они не занимаются хирургическими вмешательствами. Этот шаг стал значимым изменением, особенно для нас, поскольку у нас был случай, когда мужчину, работающего зубным техником, привлекли к уголовной ответственности только из-за его ВИЧ-статуса.

В ноябре 2023 года прошел большой феминистский форум, на котором я выступила с речью, вызвавшей широкий отклик. В одной из газет обо мне написали как о лидерке, живущей с ВИЧ. После этой публикации моей историей заинтересовались в администрации президента. Меня пригласили на встречу, чтобы обсудить наиболее острые проблемы, с которыми сталкиваются женщины и люди, живущие с ВИЧ.

На встрече я постаралась использовать этот шанс, чтобы привлечь внимание к списку запрещенных профессий. Я объяснила, что этот законодательный акт не только не приносит общественной пользы, но и разрушает жизни людей, ограничивая их возможности работать по профессии. Мои доводы нашли отклик. У меня сложилось впечатление, что я смогла убедить их в том, что этот приказ давно утратил свою актуальность.

В процессе обсуждения стало очевидно, что чиновники, с которыми я общалась, проявили прогрессивный подход и готовы поддержать инициативу по пересмотру и изменению списка запрещенных профессий. Их готовность к диалогу и понимание важности вопроса вдохновили меня и дали надежду на дальнейшие позитивные изменения.

С.М.: Я правильно понимаю, что у чиновников Минздрава не было сопротивления этой инициативе? До этого врачи передавали милиции данные о людях с ВИЧ. Не могу забыть случай, когда женщину (медсестру) просто посредине рабочего дня вызвали в райотдел, проверяли список ее контактов в телефонной книге, спрашивали с кем она спит, угрожали статьей, и т.д. — такие «профилактические» унизительные методы.

Е.К.: После принятия нового, сокращенного списка запрещенных профессий мы начали проводить тренинги для медицинских работников. В процессе мы столкнулись с определенным сопротивлением — среди участников встречались эпидемиологи, которые не поддерживали изменения. Они утверждали, что риск передачи ВИЧ все равно существует, несмотря на новые данные и международные стандарты. Такие заявления, скорее, демонстрировали их недостаточную осведомленность в вопросе. Позже их коллеги, врачи с большим опытом, даже советовали им воздержаться от таких высказываний, чтобы не вводить в заблуждение других участников.

Особенно важным для нас стало участие главного эпидемиолога Республиканского центра СПИД в этих тренингах. Он представил информацию об изменениях списка профессий максимально профессионально и доступно, что помогло снизить уровень недоверия и сопротивления среди медработников. Его выступления сыграли важную роль в распространении правильных знаний.

Мы также проводили встречи с сотрудниками МВД, в частности с представителями нравственного отдела, который курировал дела, связанные со статьей 113 УК. Именно они ранее инициировали дела против ВИЧ-положительных парикмахеров, приводя к их уголовному преследованию. Эти обсуждения были для нас важны, поскольку позволили донести до сотрудников правоохранительных органов, что старые нормы больше не отвечают современным реалиям и только способствуют стигматизации людей, живущих с ВИЧ.

С.М.: Мы знаем, что ты работала над законопроектом, который уже подан от вашей неправительственной организации «Ишонч ва Хает» в парламент. Вы еще ответ получили, с благодарностью. Как ты оцениваешь перспективу внесения изменений в УК в отношении 113-й статьи?

Е.К.: Я — оптимистка и уверена, что изменения непременно произойдут, это лишь вопрос времени. Уже сейчас видно, что люди, занимающиеся реформами в области законодательства, осознают, что некоторые законы устарели и требуют пересмотра. Приятно видеть, что страна активно нацелена на обновление законодательных систем и приведение их в соответствие с современными реалиями.

Я верю, что наш голос будет услышан. Тем более, что к этим изменениям призывает не только гражданское общество, но и научное и медицинское сообщество, а также международные организации. Это не просто рекомендации, придуманные в узком кругу активисток/в — это глобальная повестка, отражающая прогресс и понимание того, что ВИЧ-инфекция сегодня является хроническим заболеванием, с которым можно жить благодаря доступному и эффективному лечению.

Важно, что в стране уже происходят позитивные сдвиги. Прогрессивные инициативы в области гендерного равенства, защиты прав женщин и людей, живущих с ВИЧ, демонстрируют стремление государства к улучшению качества жизни своих граждан. Эти перемены дают мне уверенность, что реформа затронет и законодательные акты, которые до сих пор ограничивают людей в их правах и свободе выбора профессии.

Я верю в свое государство и его рациональный подход. Вижу, что идет диалог, и он приносит плоды. Мы движемся в сторону перемен, и я убеждена, что они будут положительными для всех.

С.М.: Последний вопрос. Оглядываясь на твой путь от общественной защитницы до экспертки сообщества, которая подает в парламент проект законодательных изменений, расскажи, как ты к такому пришла? Кто/что за этим стоит?

Е.К.: За всеми нашими усилиями всегда стоят люди — люди, которые нуждаются в помощи и поддержке. Я сама женщина, живущая с ВИЧ, и, хотя напрямую не сталкивалась с криминализацией, в моей жизни было немало примеров стигмы и дискриминации. Один из тех, кого я защищала в суде, теперь стал сотрудником нашей организации. И такие истории дают мне силы и вдохновение двигаться дальше.

В глубине души я мечтаю об идеальном мире. Никто не может запретить мне хотя бы пытаться сделать его таким. Моя главная мотивация всегда была в том, чтобы люди, живущие с ВИЧ, больше не сталкивались с дискриминацией и стигмой, чтобы их права уважались и не нарушались только из-за их диагноза.

Я убеждена, что государство должно работать в интересах тех, кто в нем живет. И сегодня у нас действительно есть хорошие перспективы. Мы видим наличие политической воли и гражданского общества, которое активно участвует в продвижении изменений и имеет реальный вес. Это благоприятное время для перемен.

Государство проявляет желание услышать нас и понять наши проблемы. Более того, мы не просто говорим о проблемах, мы помогаем находить решения, и этот процесс становится для меня дополнительной мотивацией. Когда нас слушают и действительно слышат — это вдохновляет. Это значит, что наши усилия имеют значение и ведут к изменениям.

Приказ Министра здравоохранения Республики Узбекистан

Об утверждении Перечня видов профессиональной деятельности, запрещенных для лиц, зараженных вирусом иммунодефицита человека

[Зарегистрирован Министерством юстиции Республики Узбекистан 07 мая 2014 года. Регистрационный № 2581]

Приказ Министра здравоохранения Республики Узбекистан

Об утверждении Перечня видов профессиональной деятельности, запрещенных для лиц, зараженных вирусом иммунодефицита человека

[Зарегистрирован Министерством юстиции Республики Узбекистан 19 февраля 2024 года. Регистрационный № 3497]

Виды профессиональной деятельности, запрещенные лицам, инфицированным вирусом иммунодефицита человека

СПИСОК

1. Профессии, связанные с заготовкой и переработкой крови и ее компонентов.

2. Профессии, связанные с получением крови и ее компонентов, спермы и грудного молока.

3. Профессии, связанные с переливанием крови.

4. Профессии, связанные со следующими медицинскими процедурами: инъекции; диализ; венесекция; катетеризация.

5. Профессии, связанные с косметическими и пластическими операциями.

6. Профессии, связанные со стоматологическими процедурами.

7. Профессии, связанные с родами.

8. Профессии, связанные с абортами и другими гинекологическими операциями.

9. Профессии, связанные с прической и бритьем, пирсингом, маникюром, педикюром и татуировкой.

Виды профессиональной деятельности, запрещенные лицам, инфицированным вирусом иммунодефицита человека

СПИСОК

1. Профессии, связанные с заготовкой, переработкой и переливанием крови человека и (или) ее компонентов.

2. Профессии, связанные со всеми видами хирургии.

3. Профессии, связанные с родами.

4. Профессии, связанные со следующими медицинскими процедурами: диализ; венесекция; катетеризация.

 

 

 

US: Advocates seek to modernise HIV laws and HIV prevention education

Experts call for modernized HIV education and decriminalization in Oklahoma

Experts said they hope to finally get legislation across the finish line to improve how students are taught about HIV and to decriminalize exposure.

Oklahoma’s current guidelines for HIV education were passed in 1987 and have not been updated since, but previous efforts to modernize them have fallen short amid misinformation and difficulties dispelling outdated stigmas surrounding the virus.

“A lot has happened since 1987 in the field of HIV that our education mandate just doesn’t include,” said Sara Raines, a sexual health educator with the Oklahoma City-County Health Department. “So not only was it written in a way that’s outdated, but it just leaves a lot out. … I think, especially when you look at Oklahoma’s current HIV epidemic, public school education is a great way that we can start making progress in other areas.”

Raines said Oklahoma is one of seven states the federal government has identified as having disproportionately high HIV diagnoses in rural areas. She also said most new HIV diagnoses in Oklahoma in 2022 were for people under the age of 34, which is on par with national trends.

“We tend to think of HIV being something that happens in other places, but it’s here as well,” she said. “Something that is unique about Oklahoma’s epidemic is that we have a pretty disproportionate rural burden of HIV.”

Oklahoma is also one of 34 states that have laws criminalizing HIV exposure, according to the Centers for Disease Control and Prevention.

Nicole McAfee, executive director of Freedom Oklahoma, said these laws are “not rooted in science.” Freedom Oklahoma is a group advocating for LGBTQ+ Oklahomans.

With modern advancements in medicine, people living with HIV who are receiving treatment can have “an undetectable viral load” which means they cannot transmit HIV sexually. Oklahoma’s state statute does not reflect these advancements.

McAfee, who uses they/them pronouns, said efforts to decriminalize the virus usually come with two parts: repealing criminalization in statute and offering a pathway for those who have been incarcerated through the law, potentially through resentencing.

“I think as we think about how we address the harms of criminalization,” they said. “It’s been really important for us, rooted in work we’re doing with the community, that in addition to repealing and thinking about how the state goes forward, we also think about steps to begin to repair harm done to communities who’ve been disproportionately targeted by criminalization.”

State law requires prevention education on HIV and AIDS, but the language of the statute is outdated, Raines said.

The state Legislature has seen few efforts to update the curriculum standards, but most have been unsuccessful. In 2019, the Legislature sent a bill to the governor’s desk that would have modernized HIV education but Gov. Kevin Stitt vetoed it.

Since then, McAfee said, the state has seen efforts to lower standards for sexual education in general, or to remove it completely. When it comes to HIV education, McAfee said some lawmakers and law enforcement have demonstrated hesitation for change because of misinformation.

“I hope that as we continue to create spaces like this and folks continue to see the harm that we will see more legislators join in introducing bills specifically to address HIV modernization,” they said.

Freedom Oklahoma will be hosting an informational session at the Oklahoma Capitol Wednesday. McAfee said it’s intended to “share information and continue trying to educate folks, both in the Legislature and in the general public, about why HIV modernization is a priority.”

Sens. Julia Kirt, D-Oklahoma City, and Carri Hicks, D-Oklahoma City, are set to attend the session.

US: New report shows that most of Indiana’s HIV criminal laws have yet to account for decades of advances in HIV science

Indiana has six HIV criminalization laws. Most criminalize conduct that cannot transmit HIV

Indiana has six laws that criminalize people living with HIV (PLWH), spanning both the public health and criminal codes. A new report by the Williams Institute at UCLA School of Law evaluates whether these laws reflect current understandings of HIV science and criminalize conduct that poses negligible or no risk of transmitting HIV.

Results show that most of Indiana’s HIV criminal laws have yet to account for decades of advances in HIV science, and none are currently written with enough specificity to prevent criminalizing behaviors that have little to no risk of transmitting HIV.

In Indiana, HIV criminal laws make potential HIV exposure a crime under specific circumstances, such as sexual activity, blood or semen donation, or battery using bodily fluids, such as spitting. All of the laws were enacted between 1988 and 2002 before effective HIV treatment options were widely available and it was established that treating PLWH could prevent the transmission of HIV.

“Scientifically outdated laws work against public health goals regarding HIV testing, prevention, and treatment,” said lead author Nathan Cisneros, HIV Criminalization Project Director at the Williams Institute. “The criminalization of HIV could undermine Indiana’s efforts to end the HIV epidemic and reach the communities most impacted, including people of color, women, and LGBTQ people.”

Key Findings

  • None of Indiana’s laws require actual HIV transmission or the intent to transmit HIV. The laws also criminalize conduct that cannot transmit HIV, such as spitting.
  • Two laws criminalizing the donation of blood, plasma, or semen penalize conduct that does not transmit HIV. All bodily fluid donations are tested for HIV, and positive units are destroyed.
  • Two laws impose enhanced penalties for PLWH who knowingly expose another person to their bodily fluids or waste in an aggressive or malicious manner—conduct that poses no HIV transmission risk. HIV cannot be transmitted externally through contact with body fluids or waste.
  • Two laws that criminalize a person’s failure to disclose their HIV status have been partially modernized in recent years to reflect advances in HIV science. They limit criminal conduct to high-risk forms of sexual contact and needle sharing.
    • Nevertheless, these laws fail to clarify which sexual activities are considered low or no risk and whether a person who has an undetectable viral load—and therefore cannot transmit HIV through sex—is safe from prosecution.

In recent years, public health and medical experts, including the Indiana State Medical Association, have agreed that to effectively end the HIV epidemic, it is essential to update the state’s HIV criminal laws in line with current scientific understanding of HIV. A key aspect of Indiana’s plan to significantly reduce the number of new transmissions by 2030 involves prioritizing the modernization of these laws.

This report is part of a series by the Williams Institute examining HIV criminalization in Indiana.

Read the current report

US: Advocating for HIV decriminalisation and health equity at Indiana’s first HIV advocacy summit

HIV advocates, organizations talk legislative solutions at first advocacy summit

By Abigail Ruhman

Community health centers and Ryan White HIV AIDS Program centers play an important role in expanding services and care for vulnerable populations, including HIV prevention and wellness. The Damien Center – Indiana’s oldest and largest HIV service organization – hosted its first HIV advocacy summit Wednesday to develop strategies for the upcoming legislative session.

Carrie Foote, a professor of sociology at Indiana University-Indianapolis, has been living with HIV since 1988 and leads HIV Modernization Movement-Indiana. She said Indiana has several laws that lead to the inappropriate arrest or prosecution of people living with HIV — which wastes state resources and has no public health benefit.

“We can end the epidemic,” Foote said. “We can end it, so anything that’s a barrier to doing that — and these laws are — we want to get rid of and improve.”

Foote said these laws lead to stigma around HIV that act as a barrier to testing and care — which gets in the way of preventing new transmissions and optimizing wellness for people living with HIV.

There are six laws that criminalize HIV in Indiana — which include both public health and criminal codes.

Two relate to the donation, sale or transfer of semen for artificial insemination, blood or plasma when someone “knowingly” has HIV. Another two focus on alleged non-disclosure of someone’s HIV status. When the laws were originally written, they said people living with HIV have a “duty to inform” sexual and needle sharing partners of their states prior to “high-risk activity.”

“The disclosure law used to be called ‘Duty to Warn,’” Foote said. “We came with a warning label before we had sex. So first, I need to warn you that I have HIV. That’s the language. How stigmatizing is that?”

Advocates were able to work with lawmakers to revise the language to be less stigmatizing, but the disclosure law still exists in Indiana code.

The last two enhance punishments for battery or malicious mischief by bodily fluid or waste for people living with HIV. For example, Foote said for someone who doesn’t live with HIV, spitting on someone is considered a misdemeanor.

“For anybody living with viral hepatitis or HIV, it gets enhanced to a felony crime solely because of their HIV status, even though those diseases are not transmitted that way,” Foote said.

Foote said legislative reform around the issue focuses on efforts to repeal HIV specific criminal laws and remove enhanced penalties based solely on a person’s HIV status. Advocates also want to modernize or reform laws to reflect the current science of HIV transmission and HIV as a chronic manageable condition, as well as narrow the law to situations that involve the “intent to transmit” or a “substantial risk of transmission.”

Foote is collaborating with the University of California-Los Angeles School of Law’s Williams Institute to analyze the enforcement of HIV criminalization in Indiana. She said not all of the HIV criminalization laws have been used, but many have led to arrests.

“People also are being convicted under these laws, so that right there tells you that change needs to occur because we have these people being prosecuted in ways that are unfair and don’t reflect advances in modern science,” Foote said.

Foote said in addition to creating harmful stigma, HIV criminalization disproportionately affects Black people, sexual minorities and people who inject drugs, which makes health inequities worse.

The Damien Center event also focused on different challenges these community centers face when trying to provide services and how threats to a federal program can make care more complicated.

The 340B drug pricing program was created in partnership with pharmaceutical companies — which agreed to provide “significant” discounts to eligible health care providers in order to participate in the Medicaid program.

Community health centers, also known as federally qualified health centers, are designed to increase access to primary care by reducing barriers such as cost, lack of insurance and distance. Ryan White centers are a part of the federal program designed to increase access to care for HIV.

Colleen Meiman, the national policy advisor for state and regional associations of Community Health Centers, said the program allows these centers to stretch federal resources to reach more patients and provide comprehensive services to vulnerable populations.

“340B is about so much more than pharmaceuticals,” Meiman said. “340B is essential to the financial sustainability of many, many, probably the majority of health centers.”

She also said the 340B program is facing several threats at the federal level, but some states have been able to pass legislation to protect the program.

Damien Center President and CEO Alan Witchery said the event was meant to identify issues that advocates and organizations want to address moving forward.

“There really isn’t an opportunity for nonprofits to come together and think about just doing this kind of advocacy,” Witchery said.

Witchery said he wants there to be a continued conversation around lobbying, advocacy and education efforts for these organizations to promote their causes together as a group around the state.

India: Mizoram Legislative Forum on HIV/AIDS discusses possibility of mandatory HIV testing for all citizens

Mizoram legislators bat for mandatory HIV testing amid rising cases

A meeting of the Mizoram Legislative Forum on HIV/AIDS was held on Tuesday, chaired by Health Minister Lalrinpuii at the SAD Conference Hall, MINECO. The session focused on the state’s rising HIV cases and discussed the possibility of introducing a mandatory HIV testing policy for all citizens.

In her address, Lalrinpuii emphasized the importance of addressing the issue head-on, noting that HIV/AIDS, once perceived as a disease affecting certain groups, now impacts a broader section of the population. She urged legislators and MLAs to actively raise awareness in their constituencies and stressed the need for proactive measures to curb the spread of the virus.

The forum reviewed Mizoram’s HIV situation, referencing the 2023 HIV Estimation Report, which revealed the state’s adult HIV prevalence rate at 2.73%—much higher than the national average of 0.2%. Since the first detection of HIV cases in 1990, Mizoram has recorded 31,461 HIV-positive cases, including 2,541 children.

It was noted that 63.93% of HIV transmissions in the state are due to unprotected sexual intercourse, while 30.80% result from sharing needles and syringes. Currently, 16,661 people in Mizoram are receiving Antiretroviral Therapy (ART), with 5,277 deaths recorded due to HIV/AIDS complications.

The state has 39 Integrated Counselling and Testing Centres (ICTCs) and 14 ART centers providing treatment to HIV-positive individuals. However, challenges remain as many HIV-positive patients, despite being eligible for ART, stop taking their medication or lose contact with healthcare providers. To address this, the forum proposed linking patients’ treatment records to their Aadhar cards.

The meeting also discussed expanding HIV testing and treatment services. In consultation with the National AIDS Control Organisation (NACO), the forum suggested making HIV testing more accessible and floated the idea of implementing a mandatory testing policy to combat the virus’s spread.

The forum concluded that urgent action is needed to control Mizoram’s HIV epidemic and ensure better health outcomes for those affected.

Australia: Criminalisation fuels healthcare disparities for migrants living with HIV

HIV in Australia: shades of injustice remain

Elimination is the goal, but migrants living with the virus experience a criminalised environment that thwarts access to care.

Health Minister Mark Butler painted a largely rosy picture of the progress towards elimination of HIV in Australia today, speaking on the second morning of the ASHM HIV/AIDS Conference in Sydney.

A legal academic, however, said people with HIV in Australia were still living under a pall of criminalisation, none more so than migrants.

Mr Butler praised the Australian response to the epidemic, especially in NSW, which was most affected in the early days.

“Since HIV was first detected more than 40 years ago in Australia, Australia’s response has been one to be proud of,” he said.

“When you go back to those early years, AIDS was highly feared here as it was around the world. There was huge stigma, misinformation, homophobia and such loss and so much grief for communities.

“But Australia’s response early on was characterised by partnership and collaboration: governments, people living with HIV, communities affected by HIV, non-government organisations, health professionals and academics all came together and worked together.”

He said HIV notifications were declining in Australia, at one of the fastest rates in the world – “but as you have all heard, I’m sure, transmission has also gone up in 2023, reminding us there is always more work to be done”.

“Eliminating transmission of HIV here in Australia is ambitious, but I am absolutely assured it is now achievable,” he said today, citing inner Sydney – once the epicentre of the epidemic – as a place that had effectively achieved elimination.

Mr Butler set up the HIV Taskforce last year with a goal to “virtually” eliminate transmission by 2030. The Ninth National HIV Strategy covers from last year to 2030, continuing the work of the Eighth – whose goal was virtual elimination by 2022.

He said transmission rates had grown “among temporary residents who are here in Australia on work or study visas”.

“So we will provide subsidised access to PrEP to make healthcare more equitable for people who don’t have access to Medicare … We will make sure that at-risk populations can get free HIV self-testing kits through an expansion of the national HIV self-test mailout program [run by the National Association of People with HIV Australia (NAPWHA)] as well as HIV self-testing vending machine programs,” said Mr Butler.

For David Carter, Scientia Associate Professor at the faculty of Law & Justice at UNSW, the necessary changes for people on visas won’t be found in any vending machine but in immigration policy.

Professor Carter, who leads the Health+Law Research Partnership for social justice for people living with HIV or hepatitis B, walked through the history of “unjust and unhelpful” HIV criminalisation in Australia – a public policy environment that includes but is not limited to action by law enforcement and courts. It begins with the creation of a “suspect population”.

He quoted the very first National HIV Strategy in 1987, which warned of the “temptation” of criminalisation measures, including “universal or selective testing, closure of gay venues, criminal penalties for transmission, compulsory notification of HIV infection and restrictions on freedoms of infected people through limitations on employment, quarantine or compulsory detention”, and noted these would jeopardise health measures to prevent transmission.

A working party in 1992 concluded that “even in the face of decisions by individuals that generate harm, it was the wrong decision to restrict the free choice of individuals in modern society, as draconian measures would merely alienate people at risk of infection and deter them presenting for counselling, testing and treatment”.

While pressure to enforce such measures may have been largely resisted, and the situation for Australians has greatly improved, migrants living with HIV are still experiencing an alienating and hostile environment, said Professor Carter.

Characterising them as posing potential harm to Australians “establishes an adversarial relationship between the person living with HIV and the state” and compromises health care by promoting defensive behaviour.

He and his team have interviewed migrants in Australia living with HIV over the past two years, for whom “criminalisation is indeed very active, and it is producing serious, negative health and other impacts of individuals or communities and respects”.

He quoted one interviewee, “Sergio”, who told the team: “I don’t have to face any court, but I did have to prove that I wasn’t a bad person just because I have HIV.”

Others spoke of experience going through the migration process as being “subject to an unending interrogation”.

“Laurence” told his interviewer: “It’s like a tattoo on your mind. The government will treat you different for every single step of your life from here on out.”

“Manish”, who was on a temporary visa, avoided getting tested for 10 months after beginning to suspect he had HIV, for fear of having his visa revoked. His health deteriorated during this time.

“The elevated threat levels produced by the interaction of migration law and public health law … significantly harmed Manish’s health, caused psychological distress and steered him towards coping responses that denied him the testing and treatment, access to medical care and other supports that he deserves and that we all collectively affirm are essential and are his right,” said Professor Carter.

“Manish said to us: ‘I feel like if I had reassurance that nothing’s going to happen to me if I tested positive for this, I would not have been afraid to go and get a test for HIV’.”

Others described feelings of “hopelessness and depression, because there is no hope for us to stay permanently while living with HIV” (in fact there are pathways for permanent migration despite living with HIV). These people would go for weeks without medication in a form of self-sabotage “because they just don’t have hope for their future anymore”.

For these and other people like them, the Australian environment “is just a set of undifferentiated threats to autonomy, wellbeing and safety, to which they are forced to respond with adaptation, distancing and adopting a posture of self-defence”.

Professor Carter concluded that “it may be different today [from the 90s], but it is not over, and it won’t be over here or elsewhere until the stigma of HIV, unconventional sexuality and drug use are gone”.

The HIV/AIDS Conference is running in Sydney this week back-to-back with the 25th IUSTI World Congress.