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.

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.

Senegal: HIV advocates push to update country’s HIV law to reflect scientific advances

HIV/AIDS campaigners call for revision of HIV law

Translated via Deepl.com. Scroll down for article in French. 

More than 10 years after the law on HIV was passed, those involved in the fight against the disease are calling for it to be revised. They believe that the law is obsolete and needs to be updated to take account of new issues. According to Massogui Thiandoum, Executive Director of the National Alliance of Communities for Health (ANCS), the law on HIV needs updating. ‘It is over 10 years old. There have been many advances in the fight against HIV, as well as scientific developments that show that certain aspects of the law need to be updated, or that new issues have emerged that need to be taken into account’, he explains.

A request has been made to this effect. Mr Thiandoum said: ‘We have already contacted the National Assembly to organise a training session to present the limitations of the law and the new scientific advances that it has not taken into account. We will be proposing amendments to MPs to update the law on HIV in Senegal.

He also advocates the decentralisation of HIV care services, saying: ‘We have trained community players, with the support of the health districts, so that they can help the health system to distribute antiretrovirals (ARVs) at community level. In some very remote areas, or depending on the context and particular situations, certain categories of people do not go to health facilities. The mediators we have trained, under the supervision of the health districts, have the responsibility and the opportunity to bring the treatment to these people and provide them with the medicines under the supervision of qualified health professionals’.

Les acteurs de la lutte contre le VIH/Sida demandent une révision de la loi sur le VIH

Plus de 10 ans après le vote de la loi sur le VIH, les acteurs de la lutte contre cette maladie réclament sa révision. Ils estiment que le texte est obsolète et nécessiterait une mise à jour pour prendre en compte les nouvelles problématiques. Selon Massogui Thiandoum, directeur exécutif de l’Alliance nationale des communautés pour la santé (ANCS), la loi sur le VIH nécessite d’être actualisée. “Elle date de plus de 10 ans. Il y a eu beaucoup d’avancées dans la lutte contre le VIH, ainsi que des évolutions scientifiques qui montrent que certains aspects de la loi doivent être mis à jour, ou que de nouvelles problématiques ont émergé et nécessitent d’être prises en compte”, explique-t-il.

Une demande a été formulée en ce sens. M. Thiandoum a déclaré : “Nous avons déjà pris contact avec l’Assemblée nationale pour organiser une session de formation afin de présenter les limites de la loi et les nouvelles avancées scientifiques qu’elle n’a pas prises en compte. Nous proposerons aux députés des modifications pour mettre à jour la loi sur le VIH au Sénégal.

Il plaide également pour la décentralisation des services de prise en charge du VIH, en déclarant : “Nous avons formé des acteurs communautaires, avec l’encadrement des districts sanitaires, pour qu’ils puissent aider le système de santé dans la distribution des antirétroviraux (ARV) au niveau communautaire. Dans certaines zones très éloignées ou en fonction des contextes et des situations particulières, certaines catégories de personnes ne se rendent pas dans les structures de santé. Les médiateurs que nous avons formés, sous l’encadrement des districts sanitaires, ont la responsabilité et la possibilité d’amener le traitement à ces personnes et de leur fournir les médicaments sous la supervision de professionnels de santé qualifiés”.

Tajikistan: Rising HIV cases among migrants highlight urgent need for testing and repeal of HIV criminalisation law

Every third person with HIV in Tajikistan is a labour migrant

Translated with Deepl.com. For article in Russian, please scroll down. 

There are more and more people living with HIV among migrants

In Tajikistan, every third person with HIV is a labour migrant. Over the past five years, 5,463 cases of HIV infection have been detected, according to data from the Republican Centre for HIV/AIDS Prevention and Control. Of these, migrants account for 22 per cent of those infected. While in 2019 migrants accounted for only 17 per cent of those infected, by 2023 that figure had risen to 32.5 per cent.
Balajon Davlatov, a specialist of the dispensary department of the Republican HIV Centre, strongly recommends to take a free test at one of the HIV prevention and control centres in Tajikistan immediately after arrival.

“Every migrant, after returning home, should be tested for HIV infection if they have doubts about it,” Davlatov said.
More than 300 migrants are already on the Republican HIV Centre’s dispensary register, he said. Their identities and test results are not disclosed to third parties.
“Any information about each person should be confidential. It is possible to get express tests, which within 15 minutes by analysing saliva report the patient’s HIV status – completely anonymously,” he says.
Such tests are available free of charge at one of the 67 government HIV prevention and control centres in all regions of Tajikistan.
In addition to testing through blood at AIDS centres, self-testing using near-blood fluid is now available. Self-test kits are available in Dushanbe, Rudaki, Khujand and B.Gafurov through online ordering at hivtest.tj.

The ordering process involves filling out a simple form with a few questions. This platform helps people confidentially find out their HIV status and provides up-to-date information on protection and prevention methods.
Those who test positive for HIV can learn more about their result and get a follow-up confirmatory test at the AIDS Centre.

We had a case with a woman who tested positive for HIV,” says Balajon Davlatov, “after treatment with antiretrovirals, she gave birth to two HIV-negative children. Now she lives in Russia, and we send her the necessary medication and counselling.
This proves that HIV-infected people can give birth to healthy children and live a full life.

It is an offence to infect another person with HIV

However, a positive HIV status can carry certain risks, which are not only related to the state of health. If a person knows that he or she is HIV-positive but hides it from his or her sexual partner, he or she can be fined from 720 to 1440 somoni under Article 120 of the Code of Administrative Offences (CAO).

Evasion of treatment for HIV or other infectious diseases is also punishable by a fine of 1,440 to 2,160 somoni. This liability is stipulated in Article 119 of the Code of Administrative Offences.

If a person deliberately infects another person with HIV, he or she may be punished with restriction of freedom for up to 3 years or imprisonment for up to 2 years. If, knowing his/her HIV status, he/she infects another person, he/she may face 2 to 5 years in prison. The term of imprisonment can be longer, from 5 to 10 years, if more than one person was infected or if the victim was a minor. This punishment is already stipulated in article 125 of the Criminal Code, which characterises these actions not as an offence but as a criminal offence.

Therefore, it is very important to periodically take tests and check your status, especially if you are in a risk group.

Среди мигрантов всё больше людей, живущих с ВИЧ

В Таджикистане каждый третий человек с ВИЧ – это трудовой мигрант. За последние 5 лет выявлено 5463 случая заражения ВИЧ инфекцией, говорят данные Республиканского центра по профилактике и борьбе с ВИЧ/СПИД. Из них 22% инфицированных приходится на мигрантов. Если в 2019 году мигранты составляли всего 17% зараженных, то к 2023 году эта цифра увеличилась до 32,5%.
Баладжон Давлатов, специалист диспансерного отделения Республиканского центра ВИЧ, настоятельно рекомендует сразу после прибытия пройти бесплатный тест в одном из центров по профилактике и борьбе с ВИЧ-инфекцией в Таджикистане.

«Каждый мигрант после возвращения на родину должен пройти обследования на факт заражения ВИЧ, если у него есть сомнения по этому поводу», – говорит Давлатов.
По его словам, уже более 300 мигрантов находятся на диспансерном учете республиканского центра ВИЧ. Их личность и результаты теста не разглашаются третьим лицам.
«Любая информация о каждом лице должна быть конфиденциальной. Можно получить экспресс-тесты, которые в течение 15 минут путем анализа слюны сообщают о ВИЧ-статусе пациента – полностью анонимно», – говорит он.
Такие тесты можно получить бесплатно в одном из 67 государственных центров по профилактике и борьбе со ВИЧ во всех регионах Таджикистана.
В дополнение к тестированию через кровь в Центрах СПИД, сегодня доступно самотестирование с использованием околодесновой жидкости. Наборы для самотестирования можно получить в городах Душанбе, Рудаки, Худжанд и Б.Гафуров через онлайн-заказ на сайте hivtest.tj.
Процесс заказа включает заполнение простой формы с несколькими вопросами. Эта платформа помогает людям на конфиденциальной основе узнать свой ВИЧ-статус и предоставляет актуальную информацию о методах защиты и профилактики.
Те, у кого тест на ВИЧ оказался положительным, могут узнать о своем результате подробнее и пройти повторное подтверждающее тестирование в Центре СПИД.

«У нас был случай с женщиной с положительным ВИЧ статусом, – рассказывает Баладжон Давлатов, – после лечение антиретровирусными препаратами она родила двоих детей с отрицательным ВИЧ-статусом. Сейчас она живёт в России, и мы отправляем ей нужные медикаменты и даём консультации».
Это доказывает, что ВИЧ инфицированные люди могут рожать здоровых детей и полноценно жить.

Заражение ВИЧ другого человека – это преступление

Однако положительный ВИЧ-статус может нести определенные риски, которые связаны не только с состоянием здоровья. Если человек знает, что у него положительный ВИЧ-статус, но скрывает это от своего сексуального партнера, то в рамках статьи 120 Кодекса об административных правонарушениях (КоАП) РТ ему могут выписать штраф от 720 до 1440 сомони.

За уклонение от лечения от ВИЧ или других инфекционных заболеваний тоже выписывается штраф от 1440 до 2160 сомони. Эта ответственность предусмотрена статьей 119 КоАП.
Если человек умышленно заражает другого ВИЧ, он может быть наказан ограничением свободы до 3 лет или лишением свободы до 2 лет. Если, зная о своем ВИЧ-статусе, он заразил другого человека, ему может грозить от 2 до 5 лет тюрьмы. Срок лишения свободы может быть больше – от 5 до 10 лет, если было заражено более одного человека или жертвой стало несовершеннолетнее лицо. Это наказание предусматривается уже в статье 125 Уголовного кодекса РТ, что характеризует эти действия не как правонарушение, а как уголовное преступление.
Поэтому очень важно периодически сдавать анализы и проверять свой статус, особенно, если человек находится в группе риска.

UK: Court weighs privacy and fair trial rights in disclosure of HIV status in family care case

Disclosure of HIV status in public law care proceedings

Disclosure of HIV status in public law care proceedings: the court’s approach to the inextricable link between one party’s right to privacy and another party’s right to fair trial

Summary:

In this law report, Darnell Lawrence, intern at Wilson Solicitors LLP and Alexandra Wilks, Senior Associate in Family Department, review the case of London Borough of Barking & Dagenham and (1) RM (2) LS (3() The Children (via Guardian), which was a case which, on appeal,  came before the President of the Family Division, Sir Andrew Macfarlane, in March 2023.

During the course of care proceedings, the court had to grapple with a thought-provoking and finely balanced analysis of a mother’s article 8 rights to privacy and the fathers right to information in proceedings relating to the welfare of their children.

The need for care proceedings initially arose due to concerns about the mother’s alcohol use whilst the children were in her care.

During the care proceedings, an issue emerged as to whether the mother’s HIV positive status should be disclosed to the father.  The mother had been HIV positive since birth, having inherited the condition from her own mother. Her condition had been treated positively for some time and was managed well by her use of anti-viral medication and regular testing. The children, who were not HIV positive, had from time to time, been tested,  albeit the father was not aware. However, in October 2022 during the proceedings, it was considered the mother’s HIV status should be disclosed to the father. This issue was then considered on appeal before the President.

The starting point arose from the mothers right to her private life under Art.8 of the European Convention on Human Rights. The court noted the highly personal nature of the mother’s medical information, and that this should attract substantial weight. There was also recognition of the mother’s justifiable fears of the consequences of the  father learning of her HIV positive status and how he would respond to this, and in particular her fears as to how this information may be perceived and treated in her wider community.

The court noted the approach to be taken before the enactment of Human Rights Act, in Re D (Minors) (Adoption Reports: Confidentiality) [1996] AC 593 in which Lord Mustill stated;

‘Non-disclosure should be the exception and not the rule. The court should be rigorous in its examination of the risk and gravity of the feared harm to the child and should order non-disclosure only when the case for doing so is compelling.’

At that stage, the focus was on the interests of the children, however In Re B (Disclosure to Other Parties) [2001] 2 FLR, Munby J enumerated principles to be considered in balancing the interests of all parties, but essentially noted:

“Non-disclosure can be justified only when the case for doing so is….’compelling’ or where it is…’strictly necessary’ “.

In this case, the court took  a pragmatic approach and concluded that the information relating to the Mother’s HIV status had to be disclosed to all parties, including the Father. The court’s reasoning on this matter goes to the children’s welfare and whether the information was ‘relevant’ and material to the care proceedings.

On balance it was considered this was relevant information which needed to be shared with the father, who held parental responsibility for the children. He would therefore have to be involved in monitoring the HIV status of his children, in case they were to be HIV positive. The court also noted the need for the mother’s health to be protected by way of regular monitoring and regular taking of her medication. The judgment does however highlight that had this information not been considered as ‘relevant’ then the mother’s right to privacy would have taken precedence.

Global experts converge in Munich to share strategies on HIV criminalisation at AIDS 2024 pre-conference

AIDS 2024: Activists and experts debate tactics to combat HIV criminalisation

Translated with DEEPL. For article in Portuguese, please scroll down. 

On Sunday (21), during the AIDS 2024 Pre-Conference in Munich, Germany, a group of experts from the United Kingdom, Mexico and the United States met for a crucial dialogue on the criminalisation of HIV. The panel, entitled “Everything you ever wanted to know about challenging the criminalisation of HIV: HIV Justice Network”, was moderated by Julian Hows, from the HIV Justice Network, an organisation that works to build a coordinated global response against punitive laws and policies that affect people living with HIV.

HIV criminalisation refers to the inappropriate use of criminal law to punish individuals on the basis of their HIV-positive status. This includes a range of acts, such as not disclosing one’s HIV status, potential exposure to the virus, soliciting sex while HIV positive, as well as practices such as spitting, biting, donating blood or breastfeeding.

This criminalisation not only intensifies the stigma associated with the virus, but can also limit people’s access to health services, damaging the relationship between them and the health professionals who treat them. It also creates a false sense of security, leading many to believe that laws offer protection, which is not actually the case.

The global movement to combat this criminalisation, led by HIV Justice Worldwide, aims to transform the discourse on HIV, share information and resources, and strengthen advocacy. The fight is fundamental to guaranteeing justice and human rights for everyone living with the virus.

Edwin Bernard, executive director of HIV Justice Network, highlighted a serious concern: “The US repealed its HIV-specific law at the end of the 20th century, but is now using a number of problematic laws”. He mentioned a shocking case of a homeless man with HIV sentenced to 35 years in prison for spitting at a police officer, a situation in which his saliva was considered a deadly weapon. Bernard stressed the need to understand the applicable laws for an effective defence.

Robert Suttle, from The Elizabeth Taylor AidsFoundation, shared his personal experience of criminalisation. “As a black, gay man living with HIV, I was registered as a sex offender for 15 years in Louisiana,” said Suttle. He pointed out that many newly diagnosed people are unaware of the risk of criminalisation because the focus of advocacy is mainly on prevention and biomedical treatment.

Sofía Varguez, from the HIV Justice Network in Mexico, gave an overview of the situation in Latin America and the Caribbean. “In our region, 26 countries have laws that criminalise HIV. We have registered 157 cases of criminalisation in 23 of the 32 countries in the region, including Brazil,” said Varguez. She also mentioned successes in repealing these laws, such as in Colombia, where a law student succeeded in having the law ruled unconstitutional.

Ricardo Hung, director of Alianza Lambda de Venezuela, brought a worrying perspective from his country with the rise of neo-Pentecostalism in public organisations. “In Venezuela, the government is trying to informally change the law to criminalise people with HIV, with the support of the Ministry of Health,” Hung revealed. He asked for materials to help educate and raise awareness about the criminalisation of HIV in his nation.

The event also covered tools and strategies developed by the HIV Justice Network and partners in the HIV Justice Worldwide coalition, offering valuable resources for initiating and sustaining HIV decriminalisation campaigns. The hope is that participants will feel motivated to use and share these tools and engage in the quest for justice for all people living with the virus.

To close, Julian Hows invited everyone to explore the HIV Justice Academy portal, a free global hub of learning and resources, available to beginners and experts alike. The portal, accessible in English, Spanish, Russian and French, is designed to help everyone join the movement to end the criminalisation of HIV. To access it, click here.

Aids 2024: Ativistas e especialistas debatem leis discriminatórias e táticas para combater a criminalização do HIV

Nesse domingo (21), durante a pré-Conferência da Aids 2024 em Munique, Alemanha, um grupo de especialistas do Reino Unido, México e Estados Unidos se encontrou para um diálogo crucial sobre a criminalização do HIV. O painel, intitulado “Tudo o que você sempre quis saber sobre desafiar a criminalização do HIV: HIV Justice Network”, foi moderado por Julian Hows, diretor da HIV Justice Network, uma organização que trabalha para construir uma resposta global coordenada contra leis e políticas punitivas que afetam pessoas vivendo com HIV.

A criminalização do HIV refere-se ao uso inadequado da lei penal para punir indivíduos com base no seu status HIV positivo. Isso inclui uma série de atos, como não revelar o status sorológico, potencial exposição ao vírus, solicitar sexo sendo positivo para HIV, além de práticas como cuspir, morder, doar sangue ou amamentar.

Essa criminalização não só intensifica o estigma associado ao vírus, mas também pode limitar o acesso das pessoas a serviços de saúde, prejudicando a relação entre elas e os profissionais de saúde que as atendem. Além disso, gera uma falsa sensação de segurança, fazendo com que muitos acreditem que as leis oferecem proteção, o que na verdade não é o caso.

O movimento global para combater essa criminalização, liderado pela HIV Justice Worldwide, visa transformar o discurso sobre o HIV, compartilhar informações e recursos, e fortalecer a advocacy. A luta é fundamental para garantir justiça e direitos humanos para todos que vivem com o vírus.

Edwin Bernard, diretor executivo da HIV Justice Network, destacou uma preocupação grave: “Os EUA revogaram sua lei específica para o HIV no final do século XX, mas agora estão usando diversas leis problemáticas”. Ele mencionou um caso chocante de um homem sem-teto com HIV condenado a 35 anos de prisão por cuspir em um policial, uma situação em que sua saliva foi considerada uma arma mortal. Bernard ressaltou a necessidade de compreender as leis aplicáveis para uma defesa eficaz.

Robert Suttle, da The Elizabeth Taylor AidsFoundation, compartilhou sua experiência pessoal com a criminalização. “Como homem negro, gay e vivendo com HIV, fui registrado como agressor sexual por 15 anos na Louisiana”, contou Suttle. Ele destacou que muitas pessoas recém-diagnosticadas desconhecem o risco de criminalização, pois o foco da advocacia está principalmente na prevenção e no tratamento biomédico.

Sofía Varguez, da HIV Justice Network no México, apresentou um panorama da situação na América Latina e no Caribe. “Na nossa região, 26 países têm leis que criminalizam o HIV. Registramos 157 casos de criminalização em 23 dos 32 países da região, entre eles o Brasil”, disse Varguez. Ela também mencionou sucessos na revogação dessas leis, como na Colômbia, onde um estudante de direito conseguiu que a lei fosse considerada inconstitucional.

Ricardo Hung, diretor da Alianza Lambda de Venezuela, trouxe uma perspectiva preocupante de seu país com a ascensão do neopentecostalismo nos órgãos públicos. “Na Venezuela, o governo está tentando mudar informalmente a lei para criminalizar as pessoas com HIV, com o apoio do Ministério da Saúde”, revelou Hung. Ele pediu materiais para ajudar na educação e na sensibilização sobre a criminalização do HIV em sua nação.

O evento também abordou ferramentas e estratégias desenvolvidas pela HIV Justice Network e parceiros da coalizão HIV Justice Worldwide, oferecendo recursos valiosos para iniciar e sustentar campanhas de descriminalização do HIV. A esperança é que os participantes se sintam motivados a utilizar e compartilhar essas ferramentas e se engajar na busca por justiça para todas as pessoas que vivem com o vírus.

Para encerrar, Julian Hows convidou todos a explorar o portal HIV Justice Academy, um hub global gratuito de aprendizado e recursos, disponível para iniciantes e especialistas. O portal, acessível em inglês, espanhol, russo e francês, foi desenvolvido para ajudar a todos a se unirem ao movimento para acabar com a criminalização do HIV. Para acessar, clique aqui.

Marina Vergueiro (marina@agenciaaids.com.br)

US: CHLP and Oklahoma advocates successfully oppose sweeping STI criminalisation Bill

STI Criminalization Bill stopped in Oklahoma

CHLP collaborates with advocates in Oklahoma to oppose a bill that would have criminalized thousands of Oklahomans living with sexually transmitted infections.

The recent adjournment of the legislative session for the 59th Oklahoma Legislature marked the end of House Bill 3098 (HB 3098), which would have dramatically increased the number of health conditions criminalized under Oklahoma law.

The existing statute, Oklahoma Statutes Title 21 Section 1192 (Section 1192), imposes felony punishment, including a two-to-five-year prison sentence, on people living with smallpox, syphilis, or gonorrhea who intentionally or recklessly “spread or cause to be spread to any other persons . . . such infectious disease.” HB3098 would have added Hepatitis B virus, genital herpes, Human Papillomavirus (HPV), and Trichomoniasis to the list of criminalized conditions, potentially opening up more than 85% of the population to criminalization.

CHLP’s Positive Justice Project, including Staff Attorneys Jada Hicks and Sean McCormick and National Community Outreach Coordinator Kytara Epps, worked collaboratively with local and national advocates to oppose the legislation. Local efforts were led by Nicole McAfee, Executive Director of Freedom Oklahoma.

In testimony with the House Judiciary – Criminal Committee, CHLP emphasized that the bill would criminalize nearly all Oklahomans and worsen criminal legal system disparities for Black, Latine, Indigenous, and 2SLGBTQ+ Oklahomans.

CHLP also met with the National Coalition of STD Directors (NCSD) to broaden national awareness of the issue. In a state policy notice, NCSD noted the bill would potentially worsen barriers to STI testing and treatment and undermine efforts to expand expedited partner therapy. Oklahoma already has some of the highest diagnosis rates for sexually transmitted infections, including the fourth-highest rate of primary and secondary syphilis and the fifth-highest rate of congenital syphilis.

Hicks and McCormick also provided a virtual briefing to the members of the Oklahoma Senate Minority Caucus, offering talking points and countering the argument made by the bill’s sponsor Rep. Toni Hasenbeck that the legislation would reduce intimate partner violence.

“Laws that criminalize people living with STIs likely worsen the threat of intimate partner violence by providing another tool for abusers to force people to stay in abusive relationships,” observed McCormick. “We continue to hear stories from people living with STIs whose partners threaten to file a police report alleging a violation of an STI criminalization statute. The possibility of criminal prosecution and public disclosure of their status causes many survivors to stay in abusive relationships.”

Hicks addressed misinformation about the statute criminalizing only intentional transmission. “Under Section 1192 people who ‘recklessly [are] responsible’ for transmitting these conditions could face prosecution, but the term ‘recklessness’ is not defined in the statute, which poses significant risks of broad and subjective interpretations,” she explained. “Rather than promoting public health, it instills fear and discourages people from getting tested or disclosing their health status. We believe in education and support, not punishment, as the path to managing communicable diseases effectively.”

In addition to opposing HB 3098, the Oklahoma coalition worked with Rep. Mauree Turner to introduce House Bill 4139, which would have repealed four statutes that criminalize people living with certain medical conditions, including Section 1192. The bill would have also allowed individuals convicted of these offenses to apply for resentencing and records expungement.

“While the repeal legislation was unsuccessful, the defeat of HB 3098 prevented a more hostile environment for people living with or affected by stigmatized conditions,” said Epps. “The collaborative HB 3098 efforts are also a shining example of how local and national advocates come together to disrupt criminalization. We look forward to continuing to work with Oklahoma advocates and fighting against the ongoing criminalization of people living with stigmatized conditions.”

Navigating injustice: the struggle for fair treatment of HIV non-disclosure in Canada

Resetting the code on HIV and crime

Zoysia Bielskithe –

AIDS is not the death sentence it once was, but Canada still has strict punishments for people who don’t disclose their HIV status to sexual partners. Critics say that’s unfair and out of step with the rest of the world. What could be done differently?

Before Michelle was diagnosed with HIV, her life was marred in ways unfathomable to most.

In the home where she grew up, drugs were dealt and intoxicated men came and went. As a young child, Michelle was sexually abused by a family member.

In the years that followed, she used alcohol, cocaine and heroin to cope. She believes she was infected with HIV in 2000 through a contaminated needle.

Struggling with addiction, Michelle turned to sex work in Vancouver’s Downtown Eastside. In 2006, a man accused Michelle of having unprotected sex with him without disclosing her HIV-positive status. Michelle alleges she was in an abusive, coercive relationship with the man, a former client, and that he sexually assaulted her without a condom. (The Globe and Mail does not typically name victims of sexual assault, but Michelle consented to use her first name.)

After the man brought his story to police, Michelle was charged with aggravated sexual assault. In cases involving alleged “HIV non-disclosure,” it is the charge most often laid in Canada, and the most serious sexual offence in the Criminal Code. Fearing a lengthy prison term, Michelle pleaded guilty and was sentenced to 2½ years. Only after pleading did she learn that her name had been put on the National Sex Offender Registry, something no one discussed with her in court, she said.

“I have a life sentence tied to my name,” said Michelle, now 45. “I have a label but I’m not that person. The whole label of a sex offender – I was raped at the age of 5. I know what sexual abuse is. I’m a victim of sexual abuse.”

An estimated 62,790 people were living with HIV in Canada in late 2020. Michelle is one of hundreds who’ve been prosecuted for alleged HIV non-disclosure.

Between 1989 and 2020, approximately 206 people were prosecuted in 224 criminal cases, according to a 2022 report from the HIV Legal Network. Of 187 cases where the outcome is known, 130 cases – 70 per cent – ended in conviction, the vast majority with prison time. A significant number of those convicted prior to 2023 were also registered as sex offenders, before courts ended the practice of making this mandatory for all sex offences.

In Canada, the law focuses not on actual transmission of the virus, but on “non-disclosure” – the act of not telling a sexual partner that one is HIV-positive prior to sex that poses a “realistic possibility” of transmission. This means that people who did not pass HIV to anyone have been charged, convicted and imprisoned. Of 163 cases where complainants’ HIV status was known, 64 per cent didn’t involve actual transmission of HIV. Courts have convicted HIV-positive people who took precautions before sex, as well as those who were sexually assaulted.

It is a sweeping, punitive approach that sets Canada apart from many other jurisdictions internationally.

Now, a push to limit HIV criminalization is intensifying. For years, critics have argued the laws are discriminatory and unscientific – driven by fear, misconceptions about people living with HIV and a lack of knowledge about the basic scientific realities of this virus. Thanks to significant medical advances, HIV can be managed effectively with antiretroviral medication that makes the virus undetectable and untransmittable to others.

The Canadian Coalition to Reform HIV Criminalization – a group that includes people living with HIV, community organizations, lawyers and researchers – is pushing for amendments to the Criminal Code that would limit criminal prosecution to a measure of last resort, reserved for rare cases of intentional transmission. Among other changes, the group also wants to see an end to charging these cases under sexual assault law.

“People have been prosecuted, many of whom are still living with the consequences of that prosecution, including in cases where there never should have been a charge in the first place,” said Richard Elliott, a Halifax lawyer and former executive director of the HIV Legal Network.

While the federal government has published reports, engaged in public consultations and issued some directives on limiting HIV prosecution, some advocates fear the push for broader legal reform is stalling: to date, there remains no legislation to amend this country’s HIV non-disclosure law. In the absence of legal reform, Canadians living with HIV face a lingering threat of criminal liability as they navigate their intimate lives.

Alison Symington heard about the life-altering impact of this from HIV-positive women for two documentaries she co-produced on HIV criminalization. For many of these women, the legal perils were too high to chance relationships with partners who might later turn out to be misinformed or vindictive and take them to court.

“It’s sad,” said Ms. Symington, a senior policy analyst at the HIV Justice Network. “People used to be fearful that they might pass the virus on. But now that they know they won’t pass the virus on – and that they could have a happy, healthy relationship – there’s still this outdated criminal law hanging over their heads.”

At the height of the HIV/AIDS crisis in the early nineties in Canada, thousands were dying of AIDS-related illnesses, many not long after a diagnosis. In 1995 alone, more than 1,700 people died, according to Statistics Canada. It was a period that would usher in some of Canada’s earliest prosecutions for HIV non-disclosure.

With the virus shrouded in panic, misinformation and stigma, some grew fearful of disclosing. But as HIV prevention campaigns took hold and AIDS activism movements began educating people on safer sex, those failing to use condoms became a minority.

The advent of effective antiretroviral treatments in 1996 transformed the landscape, with deaths dropping dramatically a year later. The drugs suppress an HIV-positive person’s viral load, making the virus undetectable and untransmittable to others. By 2020, 87 per cent of those diagnosed with HIV in Canada were on treatment, with 95 per cent of them achieving viral suppression, according to the Public Health Agency of Canada.

Though the science progressed, both the law and public understanding of HIV failed to advance alongside.

Advocates argue the overreach in Canada’s HIV law stems partly from a 2012 Supreme Court of Canada decision, R. v. Mabior. The court ruled that HIV-positive people have a legal duty to disclose their status before having sex that poses a “realistic possibility” of HIV transmission – and decided that only a combination of condom use and a low viral load at the time of sex negate that possibility.

Critics say this legal stance diverges from well-established guidance from the World Health Organization and the Public Health Agency of Canada that a suppressed viral load or correct condom usage are each, on their own, highly effective methods of preventing transmission.

There is serious disconnect between science, public health and the law in Canada, said André Capretti, a Montreal policy analyst at the HIV Legal Network.

“Scientists have been saying undetectable equals untransmittable for many years now,” Mr. Capretti said. “But it takes a lot of time for that to permeate into the public consciousness, including at the prosecutorial level, police level and individual level. If a complainant isn’t aware that there wasn’t a risk in having sex with a partner who was undetectable, they’re still going to go to the police and want to press charges.”

Since being enacted, the laws have been used to prosecute HIV-positive people who used condoms properly and didn’t infect anyone, who engaged in oral sex – where the risk of spreading HIV is exceedingly low – and who unwittingly transmitted while being sexually assaulted. The net has caught people who are vulnerable, or who applied due diligence to not infecting others, and treated them the same as a smaller minority who transmitted recklessly.

While some court rulings are beginning to reflect the modern science on HIV transmission, other decisions have not kept up.

In 2009, an HIV-positive man in Hamilton was charged with aggravated sexual assault after his ex-partner alleged they had oral sex without the man disclosing his status. The ex-partner did not test positive; the charge was stayed in 2010.

Four years later, a Barrie, Ont., a woman was convicted of aggravated sexual assault, sentenced to more than three years in prison and registered as a sex offender for not disclosing her HIV-positive status before having vaginal sex without a condom. The woman was on antiretroviral medication, her viral load undetectable and untransmittable; her partner did not test positive. Nine years passed before her conviction was overturned, the Ontario Court of Appeal ruling that given the woman’s effective medical treatment, she was not legally obliged to disclose her status.

In 2020, the Ontario Appeals Court upheld three convictions of aggravated sexual assault for an Ontario man accused of having vaginal sex with three women without disclosing his status. There was no finding that the man infected any of the women; he wore condoms during each incident but didn’t have a low viral load during a number of those acts. The man was sentenced to 3½ years in prison.

For HIV-positive people, the prosecutions can be catastrophic.

Alexander McClelland, an assistant professor at the Institute of Criminology and Criminal Justice at Carleton University, spent time with people prosecuted for his forthcoming book, Criminalized Lives: HIV and Legal Violence.

The stories are disturbing: One man recalled being interrogated and beaten by police; another woman spoke of being locked in solitary confinement, naked. Others were vilified as HIV-positive “rapists” by prison guards, then brutalized by inmates. Some were denied HIV medication while incarcerated, growing seriously ill.

“The criminalization haunts every aspect of their lives,” said Prof. McClelland, chair of the coalition’s steering committee.

With their names broadcast through news stories and public safety warnings issued by police, many become alienated from family and friends. Others encounter employers unwilling to hire them and landlords refusing to rent to them, Prof. McClelland found.

“It isolates them in their community, where they face daily forms of harassment and violence,” he said. “These conditions ruin people’s lives.”

While prosecutions target Canadians of all genders and sexual orientations, 89 per cent of those charged were men, 63 per cent in relation to encounters they had with women. Black and Indigenous people have been disproportionately charged, convicted and incarcerated compared with white defendants. Numerous newcomers have also been deported following prosecution.

A significant proportion of those charged are heterosexual men from African, Caribbean and Black communities, according to Toronto’s Colin Johnson, who consults with Black Coalition for AIDS Prevention and the Prisoners with HIV/AIDS Support Action Network.

Some are newcomers or migrants who find themselves advised by duty counsel to plead guilty for the sake of a lesser sentence, not grasping the full scope of consequences – including the sex offender label that can follow them for the rest of their lives.

“Because in African, Caribbean and Black communities, homophobia, transphobia and HIV phobia are rampant, a lot of these people get ostracized by the very communities they would normally go to for help,” Mr. Johnson said, adding that the same stigmas keep people from getting tested and seeking treatment.

With little hope of reintegrating into society, many of these men follow a pattern from unemployment and halfway homes to isolation and depression, he said: “It’s not a pretty picture.”

Globally, Canada remains an outlier in criminalizing HIV non-disclosure. Most other countries focus instead on prosecuting people who knowingly, intentionally transmit the virus.

To lay a charge in California, for instance, prosecutors need to prove a person had specific intent to transmit HIV, and then actually transmitted the virus. In England and Wales, there is no legal obligation to disclose one’s HIV-positive status to a partner, although “reckless transmission” is illegal.

“In the case of a person who has no intent to transmit, it goes back to this notion of moral blameworthiness,” said Mr. Capretti, a human-rights lawyer. “Is this the kind of person we think is worthy of condemnation and punishment because they have this diagnosis – because they have an illness?”

Canada further deviates from other jurisdictions by charging these cases as sexual assaults.

A 1998 Supreme Court of Canada decision, R. v. Cuerrier, ruled that failing to disclose an HIV-positive status can amount to a fraud that invalidates consent – the idea being that a person can’t give consent if that consent isn’t informed. In this way, Canadian courts decided that the act of not telling is a deception on par with the violence and coercion that more often marks sexual assault.

By contrast, other countries apply general criminal law – including laws related to bodily harm – or have HIV-specific laws, according to the HIV Justice Network.

Canada has seen some movement in how these cases are handled. After former justice minister Jody Wilson-Raybould raised concerns about the overcriminalization of HIV non-disclosure, the Justice Department published a 2017 report that examined curbing such prosecutions.

Following that, in 2018, Ms. Wilson-Raybould directed federal prosecutors working in three territories to limit HIV criminalization. The directive stated officials should not prosecute HIV-positive people when they maintain a suppressed viral load because there is no realistic possibility of transmission, and that they should “generally” not prosecute when people use condoms or engage in oral sex only, because there is likely no risk of transmission. The directive also asked prosecutors to consider whether criminal charges are in the public interest.

Quebec, Ontario, Alberta and British Columbia have also issued instructions not to prosecute HIV-positive people who maintained a suppressed viral load at the time of sex, though there remains no clarity on condom use.

Beyond this patchwork of directives, advocates are pushing for greater uniformity in courtrooms across Canada. They argue that the Criminal Code must be reformed – and that only this avenue will prevent courts from relying on a tangle of inconsistent and unscientific past rulings.

In 2022, the government engaged in online consultations with experts, people living with HIV and others on reviewing the law.

In March, Justice Minister Arif Virani told The Globe and Mail editorial board that his office was working on a policy response.

“What we’re trying to do is ensure that current, modern science is reflected in terms of the way the Criminal Code is applied in cases of transmission of HIV/AIDS,” Mr. Virani said, though he would not provide a timeline for legal reform.

On May 15, Mr. Virani met with the coalition to discuss law reform efforts, saying the policy work was still continuing.

Paradoxically, the blunt instrument of the law makes HIV disclosure more fraught, critics say.

“You’re starting a relationship with a new partner – you might like to know if they’re living with HIV or any other sexually transmitted diseases. But that doesn’t mean an aggravated sexual assault charge is the appropriate response,” Ms. Symington said.

In her documentaries on HIV criminalization, Ms. Symington illuminated the challenges involved in disclosing a positive status. She’s seen numerous women charged after abusive ex-partners who knew the women had HIV reported them to police for non-disclosure.

“People can make those allegations whether they’re true or not,” Ms. Symington said. “People live in fear that any relationship that goes wrong, this could be a tool of revenge by a bitter ex-partner.”

Some abusive partners exploit the law while in relationships with HIV-positive people: “Sexual partners threaten to go to the police and claim that disclosure did not take place, as a way to control the relationship,” said Eric Mykhalovskiy, a York University professor who led early research on the public-health implications of HIV non-disclosure in Ontario.

Since judges and juries tasked with deciding whether disclosure occurred have little to work with beyond complainants’ and defendants’ competing accounts, Prof. Mykhalovskiy described HIV-positive people going to great lengths to document that a disclosure had taken place, getting their partners to sign documents, disclosing with a witness present, or alongside counsellors at HIV organizations.

Inserting criminal law into nuanced discussions about negotiating consent and HIV disclosure has undermined public-health efforts, experts say: It can deter some people from getting tested or seeking out treatment, fearful that information shared with social workers, nurses and doctors could be used against them.

“We’ve seen this in so many cases of criminalization where those medical notes end up as part of the evidence used to criminally convict a person,” Mr. Capretti said.

“There is no evidence that this assists public health,” he added. “Criminal law and public-health policy are not natural partners.”

Years of criminalization has left some living with HIV fearful and frequently second guessing their intimate relationships.

It’s a calculus Toronto’s Mr. Johnson navigated in his personal life, after being diagnosed with HIV in 1984.

“I remember for years, I did not have sex with anybody unless they were HIV positive,” he said.

While he came to accept these limitations, he watched others who were just coming out struggle. News of HIV-positive people being charged in the late 80s and early 90s heightened fear, he said: “It had a negative impact on our psyche in so many ways.”

Mr. Johnson said it took him close to 20 years to accept that he would not die of AIDS-related illness. The arrival of effective antiretroviral treatments greatly improved quality of life for HIV-positive people. On the prevention front, the advent of PrEP (pre-exposure prophylaxis) significantly decreased the risk of infection among the HIV-negative.

Mr. Johnson continues antiretroviral treatment, as he has for decades. The people he dates are typically on PrEP; everyone in his circles is well aware of the modern medical realities of the virus. On his positive status, he’s transparent: “I’m very open and upfront.”

It’s a contemporary experience of living with HIV that stands in stark contrast to the public’s understanding of the virus, which remains limited.

“The average person doesn’t know about undetectable equals untransmissable, and unfortunately, with sex education these days, people aren’t going to know about that,” Ms. Symington said. “People still have Philadelphia, they still have Rock Hudson in their heads. These are the images. It causes a panic.”

These erroneous, outdated ideas should be purged from Canadian law, she said.

“This is a relic from the past. We need to stop the injustice in HIV non-disclosure and start thinking about how to educate people on healthy relationships and healthy sexual lives.”

Health and the law in Canada: More reading

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