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

Georgia lawmaker wants to decriminalize HIV

A Republican lawmaker introduced a bill that would modernize Georgia’s HIV laws, which activists say are outdated and stigmatize people living with HIV.

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

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

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

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

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

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

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

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

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

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

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

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

Russia: Criminalisation of HIV infection is a futile measure that creates a false sense of security

Source: Radio Liberty (Радио Свобода) – April 17, 2019 – Deepl translation. For original article in Russian please scroll down.

HIV as a crime. Mikhail Golichenko – about the case of Alexandra

Everyone diagnosed with HIV infection is warned of liability under Article 122 of the Criminal Code of the Russian Federation – “HIV Infection”. The presence of such an article in the Criminal Code is dictated by the concern for the protection of public health. In theory. Of course, the organization of health care, including legal measures (among which there are also methods of prohibition supported by criminal sanctions) is an important prerogative of any state. For example, actions such as the circulation of counterfeit medicines are perfectly justified under criminal prohibitions – here the purpose of health protection has a direct logical link with the method of legal regulation and criminal prosecution. However, the usefulness of some other criminal prohibitions in terms of their role in health care is not entirely clear, but appears to have been chosen arbitrarily. One of these prohibitions is the article “HIV infection”.

Emotionally, this article in the Criminal Code can be explained: HIV infection is a chronic disease that can lead to death if not treated in time. Responsibility for HIV infection was included in the Soviet Criminal Code, but then it was only about infection due to violation of sanitary and epidemiological rules (as, for example, in the case of mass hospitalization of children in Elista in 1988). In 1996, the Criminal Code of the Russian Federation introduced a list of new offences for people living with HIV: “knowingly endangering their exposure to HIV” and “contracting HIV by a person who knew he had HIV”. Responsibility for the health of other people began to be placed on HIV-infected people, placing them in a situation of constant risk of criminal liability due to their chronic state of health. All over the world this is called criminalization of HIV infection.

From a rational point of view, criminalization of HIV infection is a futile measure, as it does not help to prevent HIV infection. There are a lot of scientific studies that prove that criminalization of HIV from the point of view of disease prevention is flawed. Criminalization of HIV infection undermines efforts to involve citizens in testing; creates a false sense of security and the lack of need to protect their own health; and leads to violations of the rights of those living with HIV, as they become targets of stigmatization.

Every year in Russia, about 40 people are prosecuted for “endangering their health” and for HIV infection. In most cases, these are cases arising from relationships between partners, when one partner suddenly learns about the other’s HIV status and, for one reason or another (often out of revenge), files a criminal complaint. The main evidence is usually the acknowledgement of a person living with HIV that sex was without a condom. Convictions in such cases are rarely appealed, and convicts prefer to forget the shame of the trial as soon as possible. But sometimes there are people who feel that the very idea of criminal responsibility is unfair: you are punished, in fact, because you are HIV-positive.

Alexandra (name changed) grew up in an orphanage. Not an ideal teenager, judging by the characteristics of an orphanage. At the age of 15 – the first marriage, a quick death of her husband, and already a widow. Around this time, Alexandra is diagnosed with HIV. She left the orphanage and tried to live on irregular earnings, including cleaning of apartments. Once Alexey hired her to clean the apartment, he is over 30. Alexey showed interest in Alexandra; when he found out that she was an orphan, he offered her to stay with him. Alexandra stayed with Alexei overnight. Alexei did not want to use a condom, and Alexandra was afraid to report her diagnosis openly, although she hinted at the danger of HIV infection.

At some point, Alexei began to become suspicious, and he insisted that Alexandra be tested for HIV. The relationship collapsed, and soon Alexei found out about the results of the tests. Although he did not have HIV himself, he reported it to the police. She appealed the guilty verdict with the assignment of the mandatory works of Alexander up to the Supreme Court. In January 2019, the Supreme Court sent her complaint back to the regional court, which dismissed the case for review by the court of first instance. Aleksandra is not a lawyer, not a human rights defender, but she feels that justice is on her side. And here are the reasons.

The offence of “endangering one’s health” implies a high threshold for prosecution – a direct intent. This intention is characteristic of a situation where a person not only understands that he or she may infect a partner, but also wishes to do so. That is, for example, when a person actively insists that sex should be without a condom. Alexandra did not do this. In the situation with Alexei, the law indirectly obliges Alexandra to monitor her partner’s health and either ensure that he or she has a condom on his or her penis or report his or her HIV status. In a situation of equality, the partner may not be afraid to disclose his or her status or insist on using a condom. But Alexandra found herself in a position of dependence on Alexei because she lived in his apartment. Aleksey was almost twice her age, had a lot more experience and was physically stronger. The girl couldn’t say that she was HIV-positive, but actively hinted at the fact that HIV could be infected, as, for example, her girlfriend had been infected. In other words, there is a lack of direct intent for criminal responsibility for putting Alexandra in danger of infection in her actions.

Social justice considerations require that the highest degree of social censure – criminal responsibility – be imposed on citizens only for the most negative acts. Murder, intentional harm to health – such acts undoubtedly require criminal liability. HIV infection is the infliction of serious harm to health, and intentional actions leading to it deserve a criminal article. However, there is no need to have a special article of the Criminal Code in which HIV infection would be identified as an independent characteristic. There are general compositions of crimes related to causing harm to health. The existence of a special composition specifically against HIV infection is a legislative reflection of the special, legal stigma attached to people living with HIV, and this does not comply with the principle of social justice.

The prosecution’s obligation to prove the guilt of the accused has been significantly reduced: the very fact that a person is living with HIV is sufficient, as well as the confession that sex was without a condom. The probability of HIV transmission during unprotected sex from woman to man is less than one tenth of a percent. As such, sex without a condom in general is not so dangerous in terms of HIV transmission as to make it a criminal offence. It is important that there is a clear, direct intent without proof of which prosecuting a person for sex with an HIV-positive partner without a condom can be compared to prosecuting a person who holds a knife in close proximity to another.

Condom use is one of the most effective ways to protect people from HIV during sexual intercourse. Condom use is a matter of everyone taking care of their own health. People should understand this, and everyone should understand it, regardless of their HIV status. The “endangering infection” formulation does not take into account the fact that not everyone is ready to disclose their HIV status to a partner in situations of intimate contact. The existence of a specific crime for endangering people without HIV creates a false sense of security, when failure to inform the partner about your positive status essentially means that you can not use a condom. In this way, the basis for an effective method of protecting the population from HIV is undermined, i.e. the formation of the population’s habit of using condoms. When she complains about her sentence, Alexandra fights for the health of the population, not just for herself.

The tension around Alexandra’s accusation continues. Aleksandra may again have to appeal the sentence to the Supreme Court, hoping to restore justice for people living with HIV.

Mikhail Golichenko – lawyer, candidate of legal sciences

ВИЧ как преступление. Михаил Голиченко – о деле Александры

Каждый, кому поставлен диагноз “ВИЧ-инфекция”, предупреждается об ответственности по статье 122 Уголовного кодекса РФ – “Заражение ВИЧ-инфекцией”. Наличие такой статьи в Уголовном кодексе продиктовано заботой об охране здоровья населения. В теории. Конечно, организация охраны здоровья, включая меры правового характера (среди которых присутствуют и способы запрета, подкрепленные уголовными санкциями), – важная прерогатива любого государства. Под уголовным запретом совершенно обоснованно находятся такие, например, действия, как обращение фальсифицированных лекарственных средств – здесь цель охраны здоровья имеет прямую логическую связь с методом правового регулирования, уголовным преследованием. Однако польза некоторых других уголовных запретов с точки зрения их роли в здравоохранении не вполне очевидна, они избраны, как представляется, произвольно. Одним из таких запретов является статья “Заражение ВИЧ-инфекцией”.

С эмоциональной точки зрения появление такой статьи в Уголовном кодексе можно объяснить: ВИЧ-инфекция является хроническим заболеванием, которое при отсутствии своевременного лечения может привести к смерти. Ответственность в связи с ВИЧ-инфекцией была включена еще в советский УК, однако тогда речь шла только о заражении в связи с нарушением санитарно-эпидемиологических правил (как, например, в случае с массовым внутрибольничным заражением детей в Элисте в 1988 году). В 1996 году в Уголовном кодексе Российской Федерации появился перечень новых составов преступления для людей, живущих с ВИЧ: “заведомая постановка в опасность заражения” и “заражение ВИЧ-инфекцией лицом, знавшим о наличии у него ВИЧ”. Ответственность за здоровье других людей стали возлагать на ВИЧ-инфицированных, поставив их в ситуацию постоянного риска уголовной ответственности в связи с хроническим состоянием здоровья. Во всём мире это называется криминализация ВИЧ-инфекции.

С рациональной точки зрения, криминализация ВИЧ-инфекции – мера бестолковая, так как профилактике ВИЧ-инфекции она не помогает. Есть множество научных исследований, доказывающих порочность криминализации ВИЧ с точки зрения профилактики заболевания. Криминализация ВИЧ-инфекции подрывает усилия по привлечению граждан к тестированию; создает у населения ложное чувство защищенности и отсутствия необходимости самостоятельно защищать своё здоровье; приводит к нарушениям прав тех, кто живёт с ВИЧ, поскольку они становятся объектами стигматизации.

Ежегодно в России за “постановку в опасность заражения” и за заражение ВИЧ-инфекцией к уголовной ответственности привлекают около 40 человек. В большинстве случаев речь идет о делах, возникающих из отношений партнеров, когда один из партнеров внезапно узнает о ВИЧ-статусе другого и по тем или иным причинам (часто из мести) обращается с заявлением о возбуждении уголовного дела. Главным доказательством является, как правило, признание человека, живущего с ВИЧ, о том, что секс был без презерватива. Обвинительные приговоры по таким делам редко обжалуют, осуждённые предпочитают поскорее забыть позор процесса. Но иногда встречаются люди, которые чувствуют несправедливость самой идеи уголовной ответственности: тебя наказывают, по сути, из-за того, что ты болен ВИЧ.

Александра (имя изменено) выросла в детдоме. Не идеальный подросток, судя по характеристикам из детского дома. В 15 лет – первый брак, быстрая смерть мужа, и уже вдова. Примерно в это время у Александры диагностируют ВИЧ. Она покинула детский дом и пыталась прожить на непостоянные заработки, в том числе занимаясь уборкой квартир. Однажды её для уборки квартиры нанял Алексей, ему уже за 30. Алексей проявил к Александре интерес; узнав, что она сирота, предложил девушке пожить у него. Александра осталась у Алексея на ночь. Алексей не хотел использовать презерватив, а Александра боялась сообщить о своём диагнозе открыто, хотя и намекала на опасность ВИЧ-инфекции.

В какой-то момент у Алексея начали возникать подозрения, и он настоял на том, чтобы Александра сдала анализы на ВИЧ. Отношения развалились, вскоре Алексей узнал о результатах анализов. Хотя у него самого ВИЧ выявлен не был, он обратился в полицию с заявлением. Обвинительный приговор с назначением обязательных работ Александра обжаловала вплоть до Верховного суда. В январе 2019 года Верховный суд направил ее жалобу обратно в областной суд, который спустил кейс на пересмотр в суд первой инстанции. Александра не юрист, не правозащитник, но она чувствует, что справедливость на её стороне. И вот по каким причинам.

Состав преступления “постановка в опасность заражения” предполагает высокий порог для привлечения к ответственности – прямой умысел. Такой умысел характерен для ситуации, когда человек не только понимает, что может заразить партнёра, но и желает этого. То есть, к примеру, для ситуации, когда человек активно настаивает на том, чтобы секс был без презерватива. Александра этого не делала. В ситуации с Алексеем закон косвенно возлагает на Александру обязанность следить за здоровьем партнёра и либо обеспечить наличие у него презерватива на половом члене, либо сообщить о своём ВИЧ-статусе. Возможно, в ситуации равенства партнёр с ВИЧ не побоится раскрыть свой статус или настоять на использовании презерватива. Но Александра оказалась в зависимом от Алексея положении, поскольку проживала у него в квартире. Алексей был почти в два раза старше неё, имел значительный больший жизненный опыт, был физически сильнее. Девушка не нашла в себе сил сказать, что у неё ВИЧ, но активно намекала на то, что ВИЧ можно заразиться, как, к примеру, заразилась её подруга. Иными словами, для уголовной ответственности за постановку в опасность заражения в действиях Александры недостает прямого умысла.

Соображения социальной справедливости требуют, чтобы наивысшей степени общественного порицания – уголовной ответственности – граждане подвергались только за наиболее негативные поступки. Убийства, умышленное причинение вреда здоровью – такие поступки, без сомнения, требуют уголовной ответственности. Заражение ВИЧ-инфекцией – нанесение тяжкого вреда здоровью, и ведущие к этому умышленные действия заслуживают уголовной статьи. Однако для этого нет необходимости иметь специальную статью Уголовного кодекса, в которой ВИЧ-инфекция была бы выделена в качестве самостоятельного признака. Есть общие составы преступлений, связанных с причинением вреда здоровью. Наличие специального состава именно против заражения ВИЧ-инфекцией является законодательным отражением особой, возведенной в закон стигмы по отношению к людям, живущим с ВИЧ, а это не соответствует принципу социальной справедливости.

Существенно снижена обязанность стороны обвинения доказывать вину обвиняемого: достаточно самого факта того, что человек живет с ВИЧ, а также признательных показаний, что секс был без презерватива. Вероятность передачи ВИЧ во время секса без презерватива от женщины к мужчине составляет менее одной десятой доли процента. Сам по себе секс без презерватива в целом не настолько опасен с точки зрения передачи ВИЧ-инфекции, чтобы возводить его в ранг уголовного преступления. Важно, чтобы было наличие чёткого прямого умысла, без доказательства которого привлечение к ответственности за секс с партнёром с ВИЧ без презерватива можно сравнить с привлечением к ответственности человека, который держит в руках нож, находясь в непосредственной близости от другого.

Использование презервативов – один из наиболее эффективных способов защиты от ВИЧ при половых контактах. Использование презерватива – вопрос заботы каждого о своем здоровье. Люди должны это понимать, причём должен понимать это каждый человек, вне зависимости от своего ВИЧ-статуса. Состав “постановка в опасность заражения” не учитывает, что в ситуациях интимного контакта далеко не каждый готов раскрыть партнёру свой ВИЧ-статус. Наличие специального состава преступления за постановку в опасность заражения создает у людей без ВИЧ ложное ощущение защищенности, когда несообщение партнером о своём положительном статусе по сути означает, что можно не использовать презерватив. Таким образом подрывается основа эффективного метода защиты населения от ВИЧ – формирование привычки населения использовать презервативы. Обжалуя свой приговор, Александра борется за здоровье населения, а не только за себя.

Тяжба вокруг обвинения Александры продолжается. Возможно, Александре снова придется обжаловать приговор вплоть до Верховного суда в надежде восстановить справедливость в отношении людей, живущих с ВИЧ.

Михаил Голиченко – адвокат, кандидат юридических наук

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

 

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

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

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

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

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

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

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

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

US: Closing session of CDC's national HIV Prevention conference highlights stigma and HIV-specific criminalisation laws as barriers to improving outcomes in prevention and care

HIV Stigma in Focus at Closing Session of CDC’s National HIV Prevention Conference

HIV-related stigma and its impact on HIV-related health disparities were the topic of the final plenary session at CDC’s National HIV Prevention Conference. The March 21 session examined social and cultural factors that have contributed to stigma as well as efforts to combat the effects of HIV-related stigma on specific populations. Moderator Johanne Morne, director of the New York State Department of Health AIDS Institute, reminded the conference participants that stigma is an historic and continuing theme that must be addressed to improve outcomes along both the HIV prevention and care continuums.

HIV Stigma and What Can Be Done to Combat It

Greg Millett, vice president and director of public policy at amfAR, delivered the keynote address, “Progress: Same or Different? HIV Stigma at 37.” He noted that while many of the most extreme forms of stigma from the early days of the HIV epidemic have dissipated over time, inaccurate beliefs about the HIV risk of casual social contact persist.

Such stigmatizing beliefs are supported by societal factors such as HIV criminalization laws, Mr. Millett said. He pointed to the fact that 29 states still have HIV-specific criminalization laws on the books and while over 800 people have been prosecuted using these laws, none of the prosecutions were for any actual HIV transmission. He highlighted a CDC assessment that found that HIV criminalization laws have no detectable HIV prevention effect given there was no association with HIV diagnosis rates or AIDS diagnoses in states with such laws.

Further, he observed that not only are people with or at risk for HIV too often stigmatized, but the effective tools to prevent HIV such as PrEP are also stigmatized. A recent study found that individuals who experienced a high degree of stigma around their choice to use PrEP were 50% less likely to be on PrEP at their next clinical visit. Additionally, he pointed to syringe services programs (SSPs) that are known to reduce the risk of HIV transmission among people who inject drugs. Yet, stigma related to both HIV and people who use drugs limits public support for SSPs, limiting their expansion in many communities that could benefit from them, he said.

One factor that may enable this enduring stigma, Mr. Millett posited, is Americans’ lack of personal knowledge of people living with HIV. A Kaiser Family Foundation study found that only 45% of Americans say they know someone with HIV. To counter that, he encouraged more people living with HIV to be open about their status since that would contribute to stigma reduction. He also applauded creative efforts from the HIV community to combat stigma. These included public announcements by people living with HIV of their status on social media, anti-stigma campaigns, and even a series of social media videos about living with HIV.

Combatting HIV-related Stigma and Improving Outcomes for Specific Populations

A series of presentations followed, each discussing unique approaches to combating HIV stigma and offering recommendations on how to help reduce it to improve HIV prevention and care outcomes.

  • Daniel Driffin, co-founder of THRIVE SS, discussed building innovative, community-driven solutions to address HIV disparities among African American men living with HIV. Originally founded as a support group in Atlanta, the program has grown to an online platform that engages and offers support to more than 3,500 people across the southeast United States. Among THRIVE SS’s innovations are programs to re-engage and retain men in HIV care, a mental health group, and a photo campaign. Mr. Driffin shared results of a 2018 program participant survey that revealed that 92% of the men surveyed self-reported being virally suppressed. “Black men living with HIV are achieving viral suppression,” Mr. Driffin declared. “I challenge you to no longer say these men are ‘hard to reach.’” His advice for others seeking similar outcomes included: using the lived experiences of people living with HIV to inform HIV care and prevention, re-imagining everything, and supporting community-created approaches.
  • Omar Martinez, assistant professor at Temple University’s School of Social Work, examined HIV-related stigma among sexual and gender minority Latinx individuals. He observed that members of this community often experience stigma related to many aspects of their lives including culture, language, and immigration status, all of which impact their HIV risk. Dr. Martinez profiled several programs that have demonstrated success, including a number that engage non-traditional partners or that address legal and other needs. He advised stakeholders to focus on affirming models of care; to examine immigration status as a social determinant of health; and to continue to invest in the development and replication of “locally-grown” HIV prevention, treatment, and anti-stigma interventions that have proven effective.
  • Gail Wyatt, PhD, professor and director of the UCLA Sexual Health Program, discussed HIV stigma and disparities among African American women, reminding the audience of the importance of the inclusion of women’s perspectives in HIV prevention, care and treatment, and research. She discussed the impact of trauma on women’s health-seeking behaviors and treatment retention. She emphasized that an effective HIV response requires attention to holistic health, including mental health, to improve outcomes for women living with HIV. She also argued that some health care providers need to be re-educated about African American women given that many have biases about Black women that may hinder their delivery of effective health care services.
  • Cecilia Chung, co-director of programs and policy at the Transgender Law Center, shared her personal story as an Asian transgender woman living with HIV and discussed the power of personal storytelling to change hearts. She remarked, “Storytelling can help us get past differences, stigmas, and biases, and humanize individuals.” Being able to confidently tell one’s story affects the listener and also empowers the storyteller as they move forward on their path as a person living with HIV.

Dr. Eugene McCray, Director of CDC’s Division of HIV/AIDS Prevention, closed the session, thanking the participants from across the nation and the more than 500 of them who had shared results of their work with others in sessions, poster presentations, and exhibits during the conference. He noted that CDC was pleased to have been able to share more details of the Ending the HIV Epidemic Plan through several plenary session addresses and in a community engagement session. Implementing that Plan, he observed, will require ongoing dialogue and collaboration. With the powerful tools now available, the insights that data offer, leadership from all sectors, and community-driven and -developed plans, Dr. McCray indicated that he was confident that the nation could achieve the goal of reducing new HIV infections by 90% in ten years.

To view all or part of this plenary session, view CDC’s National Prevention Information Network video of Wednesday’s plenary session on their Facebook page .

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

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

HIV Modernization Bill Continues to Make Progress in Florida House 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

HIV Modernization Bill Moves Forward In Florida House

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

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

Five Republicans and five Democrats voted for the bill.

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

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

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

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

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

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

 

 

Nicholas Duran bill aims to modernize HIV law

Equality Florida applauds legislation catching law up to modern science.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Published in FLAPOL on Feb 25, 2019

Tajikistan: Criminal cases against people with HIV are on the rise, T. Khaidarova, Head of the network of women with HIV in Tajikistan, explains why

Source: Asia Plus on March 14, 2019

Google translation, for Russian article, please scroll down.

Why has the number of criminal cases for knowingly acquiring HIV infection suddenly increased in Tajikistan?

In Sughd Oblast, seven criminal cases against people living with HIV have been initiated since the beginning of 2019 alone.

Only seven per cent of HIV-positive women in Tajikistan are commercial sex workers, while the rest are ordinary women, wives of migrants and housewives. But against the backdrop of criminal cases related to deliberate HIV infection, which have noticeably increased, society only sees them as commercial sex workers.

And this is not the most important problem that people with HIV are facing,” said Takhmina Khaidarova, head of the network of women with HIV in Tajikistan.

– Takhmina, tell us how “deliberate infection” really happens, why do people go there?

– In practice, we meet with different people: some have three classes of education, others have graduated, and everyone needs a different approach. After a diagnosis is made, a person needs a detailed consultation in a language that is accessible to them. Unfortunately, we don’t have any specialized specialists who will do it.

People will find out that they are HIV-positive, and it is not a fact that they understand the seriousness of the situation. Or so – a person starts taking ARV therapy, and it often has very negative side effects, including hallucinations, and in order for the body to adapt, you need at least caloric food, which not everyone can afford, and people just quit taking medication.

Because they think, “I felt good, now I feel bad, so I’m better off not taking these drugs. Yes, after a person learns about his or her diagnosis, he or she is registered with the Republican Center for AIDS Prevention and Control, he or she signs a receipt stating that he or she has been warned about criminal responsibility, but who will guarantee that he or she understands the seriousness of what he or she is signing?

By the way, if a person who is HIV-positive and warns his or her sexual partner about the presence of an infection, and the latter agrees to have relations with him or her, then no criminal responsibility comes into play. However, it is impossible to prove it in court later on. Because partners do not give their consent in writing.

– Have such cases occurred in practice?

– Sometimes the partners are aware of it, but they refuse to be warned about it during the trial. In fact, all discordant couples (in which one partner is HIV-positive and the other is HIV-negative) can also fall under Article 125 Part 1 of the Criminal Code of Tajikistan. This part states: “Knowingly exposing another person to the risk of HIV infection”, i.e. it is not an actual infection, but a risk of infection. And all people with HIV-positive status who have a sexual partner, in fact, put them at risk of infection. But in reality this is not the case: if a person takes ARV therapy, their viral load is reduced, and even in the case of unprotected sex, their partner will not catch HIV.

Many high-profile criminal cases in Tajikistan have recently been initiated under the first part of Article 125 of the Criminal Code. This is very important to understand.

– So none of the victims were infected with HIV?

– The last sentences under this article were handed down in Khujand, and two women were sentenced to one year’s imprisonment: this is Article 125, Part 1 – it punishes by restriction of liberty for up to three years or imprisonment for up to two years. The second part of this article, “Infection of another person with HIV”, is punishable by two to five years’ imprisonment.

– How many women with HIV are commercial sex workers?

– According to statistics, only seven per cent of women work in the commercial sex industry, all other women are regular housewives, and more often they are wives of migrants who have contracted HIV from their husbands or contracted HIV through various medical procedures. But for some reason it still seems to everyone that a woman with HIV status is necessarily a commercial sex worker. And this leads to the fact that people are afraid to come to AIDS centers for help.

People with HIV cannot keep their confidentiality

– Why do you think the number of cases under Article 125 of the Criminal Code has increased recently?

– When the head of state visited the Tajik Medical University last September and raised the problems of infectious diseases, including HIV infection, which are important for the modern world, we were very grateful, because we believed that now they will be paid even more attention to. However, things have turned out a little differently. Previously, HIV infection issues were dealt with by the Republican Center for AIDS Prevention and Control, specialized NGOs, as well as other competent and informed structures, and now many other specialists are involved in this issue, who, unfortunately, do not always understand what HIV infection is.

In addition, after the introduction of mandatory testing for young couples before marriage, it has become much more difficult for people with HIV to maintain their confidentiality.

Here is how it happens: during testing it becomes clear that a person is HIV-positive, this is known to the administration at the polyclinic in their area of residence, which issues a marriage license, and then the civil register office, which will register the marriage, learn of the status. In the regions of the country, where the functions of the registry office are performed by jamoat departments, jamoats will also be recognized. Given the fact that in Tajikistan, it is the parents who decide everything for the young people, if they are HIV-positive, the entire family of the groom or bride will also learn about their HIV-positive status. While the confidentiality of a person who is HIV-positive is guaranteed by law, he or she should only tell his or her sexual partner about his or her status.

The law does not prohibit HIV-positive people from having a family. But when a civil register office receives information that a person is HIV-positive, what should they do? No one has the right to prohibit marriage of a person with HIV, and no one has the right to disclose information about the presence of infection, then why is this testing? In general, enforcement mechanisms have not been designed.

Fortunately, at the end of January this year, the Ministry of Health and Social Protection of Tajikistan together with international organizations, in accordance with the WHO recommendation, adopted methodological recommendations for the introduction of pre-exposure prophylaxis for HIV infection, which sets out all the mechanisms of action. I hope that something will change now.

“We already know about a third case of HIV cure..– How does information about cases of deliberate HIV infection affect people who are positive?

– This has a very negative impact on people’s lives because they see all this negativity and can simply refuse ARV therapy so that they do not have to go to AIDS centres again. Or people who have doubts about their health may simply not take the test and lose valuable time. Medicine is now so advanced that a person who is taking ARV therapy correctly, becomes safe even for his sexual partner, for his future child. HIV infection is no longer a deadly disease, but a chronic one, which is regulated by therapy; just a few days ago a the third case of HIV cure became known.

In Tajikistan, there are no problems with ARV treatment, all medicines are provided free of charge, and people can take them and live just like everyone else. If you look at the world experience, thanks to new medicines, restrictions for people with HIV are being removed, but here, in our country, on the contrary, they become more common.

– In Denmark, seven years ago, the punishment for unprotected sex with an HIV-negative person was abolished, because the life expectancy of a person with HIV does not differ from that of a person who is negative when receiving therapy.

– In October 2018, the CEDAW Committee, which oversees the implementation of the Convention on the Elimination of All Forms of Discrimination against Women (Tajikistan is a signatory to the Convention – note: Autumn 2018), presented an alternative report in which the topic of women with HIV status was seriously discussed. The report recommended that part 1 of article 125 of the Criminal Code of Tajikistan be repealed.

In addition, a recommendation was made to repeal a government decree of 2004, according to which people with HIV could not be guardians and foster parents of a child. Comments were also made on the 2018 decree, which states that people with HIV status cannot study in medical universities. The Committee recommends that the Government remove these restrictions within five years.

—————————————-

Почему в Таджикистане увеличилось число уголовных дел за осознанное заражение ВИЧ инфекцией?

В Согдийской области только с начала 2019 года было возбуждено уже семь уголовных дел в отношении людей с положительным статусом ВИЧ.

Только семь процентов ВИЧ положительных женщин в Таджикистане являются работницами коммерческого секса, все остальные – обычные женщины – жёны мигрантов, домохозяйки. Но на фоне уголовных дел, связанных с осознанным заражением ВИЧ, которых стало заметно больше, в обществе снова видят в них только работниц коммерческого секса.

И это не самая главная проблема, которая возникла у людей с положительным ВИЧ-статусом; о том, какие еще – нам рассказала Тахмина Хайдарова, руководитель сети женщин с ВИЧ в Таджикистане.

– Тахмина, расскажите, как на самом деле происходит «осознанное заражение», почему люди идут на это?

– На практике мы встречаемся с разными людьми: у кого-то образование – три класса, а кто-то окончил вуз, и к каждому нужен свой подход. После того, как ставят диагноз, человеку нужна подробная консультация на доступном именно для него языке. К сожалению, у нас нет профильных специалистов, которые этим будут заниматься.

Люди узнают, что у них ВИЧ-инфекция, и не факт что они понимают всю серьезность ситуации. Или бывает так – человек начинает принимать АРВ-терапию, (терапия, которая замедляет развитие вируса и заболевания – прим.авт.), а она часто имеет очень негативные побочные действия вплоть до галлюцинаций, и чтобы организм адаптировался, нужна, как минимум, калорийная пища, которую не каждый себе может позволить, и люди просто бросают принимать лекарства.

Потому что они думают так: «я чувствовал себя хорошо, теперь мне плохо, значит, мне лучше не пить эти лекарства». Да, после того, как человек узнает о своём диагнозе, его ставят на учет в «Республиканском центре по профилактике и борьбе со СПИД», он подписывает расписку о том, что предупрежден об уголовной ответственности, но кто даст гарантию, что он понимает всю серьезность того, что подписывает?

Кстати, в случае если человек с положительным статусом ВИЧ предупреждает своего полового партнера о наличии инфекции, и последний соглашается вступить с ним в контакт, то уголовной ответственности не наступает. Однако, потом в суде доказать это невозможно. Потому что партнеры не дают свое согласие письменно.

– Такие случаи встречались на практике?

– Иногда партнеры в курсе, но они отказываются от того, что их предупреждали об этом во время суда. По сути, под статью 125 часть 1 УК Таджикистана могут попасть и все дискордантные пары (в которых один партнер с положительным статусом ВИЧ, другой – с отрицательным – прим.авт.). В этой части прописано: «Заведомое  подставление  другого лица в опасность заражения ВИЧ‐инфекцией», то есть это не фактическое заражение, а риск заражения. И все люди с положительным ВИЧ статусом, у которых есть половой партнер, по сути, ставят его под угрозу риска заражения. Но по факту это не так: если человек принимает АРВ-терапию, его вирусная нагрузка снижена, и даже в случае незащищенного секса, его партнер не заразится ВИЧ.

Многие громкие уголовные дела в Таджикистане за последнее время были возбуждены именно по первой части статьи 125 УК. Это очень важно понимать.

– То есть никто из пострадавших не заразился ВИЧ-инфекцией?

– Последние приговоры по этой статье были вынесены в Худжанде, двух женщин приговорили к одному году тюремного срока – это статья 125, часть 1 – наказывается ограничением свободы на срок до трех лет либо лишением свободы на срок до двух лет. Тогда как вторая часть этой статьи «Заражение другого лица ВИЧ‐инфекцией» – наказывается лишением свободы на срок от  двух до пяти лет.

– Сколько женщин с положительным статусом ВИЧ являются работницами коммерческого секса?

– По статистике только семь процентов женщин работают в сфере коммерческого секса, все остальные женщины – это обычные домохозяйки, чаще – жёны мигрантов, которые заразились от своих мужей или получили ВИЧ во время различных медицинских манипуляций. Но почему-то всем до сих пор кажется, что женщина с положительным статусом ВИЧ – это обязательно работница коммерческого секса. И это приводит к тому, что люди боятся приходить в центры СПИД за помощью.

Люди с положительным статусом ВИЧ не могут сохранить конфиденциальность

– Как вы думаете, почему именно в последнее время увеличилось количество дел по 125 статье УК?

– Когда в сентябре прошлого года глава государства посетил таджикский медуниверситет и поднял там проблемы инфекционных заболеваний, в том числе и проблемы ВИЧ-инфекции, которые являются актуальными для современного мира, мы были очень благодарны, так как верили, что теперь на них будут обращать еще большее внимание. Однако все получилось несколько по-другому. Раньше вопросами ВИЧ-инфекции занимались «Республиканский центр по профилактике и борьбе со СПИД», профильные НПО, а также другие компетентные и информированные структуры, теперь в этом вопросе принимают участие и многие другие специалисты, которые, к сожалению, не всегда понимают, что такое ВИЧ-инфекция.

Кроме того, после введения обязательного тестирования молодых пар перед заключением брака, людям с положительным статусом ВИЧ стало намного сложнее сохранить свою конфиденциальность.

Вот как это происходит: при тестировании выясняется, что у человека положительный статус ВИЧ, об этом узнает орган при поликлинике по месту жительства, который выдает разрешение на брак, затем о его статусе узнает ЗАГС, который будет регистрировать брак. В регионах страны, где функции ЗАГСа выполняют отделы при джамотах, узнают и джамоаты. Учитывая то, что в Таджикистане за молодых все решают родители, чаще всего, о положительном статусе ВИЧ узнает и вся родня жениха или невесты. Тогда как конфиденциальность человеку с положительным статусом ВИЧ гарантируется Законом,  он должен сказать о статусе только своему половому партнеру.

Закон не запрещает ВИЧ положительным людям иметь семью. Но, когда ЗАГС получает информацию о том, что у человека положительный статус ВИЧ, что он должен делать? Никто не имеет права запретить вступить в брак человеку с ВИЧ, и никто не имеет права раскрывать информацию о наличии инфекции, тогда зачем это тестирование? В общем, механизмы исполнения законов не продуманы.  

К счастью, в конце января этого года министерство здравоохранения и социальной защиты населения Таджикистана совместно с международными организациями согласно рекомендации ВОЗ приняли методические рекомендации по внедрению доконтактной профилактики ВИЧ-инфекции, в котором прописаны все механизмы действия. Надеюсь, теперь что-то изменится.  

«Уже известно о третьем случае излечения от ВИЧ»

– Как информация о делах, связанных с осознанным заражением ВИЧ, отражается на людях, у которых положительный статус?

– Это очень негативно влияет на жизнь людей, потому что они видят весь этот негатив, и могут просто отказаться от АРВ-терапии, чтобы лишний раз не ходить в центры СПИД. Или люди, которые сомневаются в своем здоровье, они просто могут не пойти сдавать тест и потеряют драгоценное время. Медицина сейчас настолько продвинулась, что человек, который правильно и во время принимает АВР-терапию, становится безопасным даже для своего полового партнера, для своего будущего ребёнка. ВИЧ-инфекция уже давно не смертельное заболевание, а хроническое, которое регулируется с помощью терапии; буквально на днях стало известно о третьем случае излечения от ВИЧ.

 

У нас в Таджикистане нет проблем с получением АРВ-терапии, все медикаменты предоставляются бесплатно, люди могут их принимать и жить точно так же, как и все остальные. Если посмотреть на мировой опыт, то благодаря развитой медицине, ограничения для людей с положительным статусом ВИЧ снимаются, а у нас их наоборот станвоитяс больше.

– В Дании семь лет назад отменили наказание для человека с ВИЧ за незащищенный секс с ВИЧ-отрицательным человеком, потому что при приеме терапии, продолжительность жизни человека с положительным статусом ВИЧ не отличается от того, у кого он отрицательный.

– В октябре 2018 года комитет СИДО (CEDAW), который курирует исполнение конвенции о ликвидации всех форм дискриминации в отношении женщин (Таджикистан является подписантом конвенции – прим.авт.) представил альтернативный отчет, в котором тема женщин с положительным статусом ВИЧ серьезно обсуждалась. В отчете была высказана рекомендация об отмене части 1 статьи 125 УК Таджикистана.

Кроме того, была высказана рекомендация отменить постановление правительства от 2004 года, в соответствии с которым люди с положительным статусом ВИЧ не могут быть опекунами и приёмными родителями ребенка. Также были высказаны замечания относительно постановления от 2018 года, в котором указано, что люди с положительным статусом ВИЧ не могут учиться в медицинских вузах. Комитет рекомендует правительству устранить эти ограничения в течение пяти лет.

 

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

Source: EWNA, published on March 11, 2019

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

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

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

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

“Thank you, Madam Chair.

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

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

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

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

We recommend:

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

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

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

We recommend:

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

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

We recommend:

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

ВПЕРВЫЕ ВИЧ+ ЖЕНЩИНЫ КАЗАХСТАНА ПРЕДСТАВИЛИ ТЕНЕВОЙ ОТЧЕТ В КЛДЖ

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

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

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

«Спасибо, госпожа Председатель.

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

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

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

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

Мы рекомендуем:

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

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

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

Мы рекомендуем:

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

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

Мы рекомендуем:

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

Mexico: Local congressman calls for the repeal of legislation criminalising people with HIV in Mexico City Federal District

Published in 20 minutos on March 12, 2019 (Google translation, for article in Spanish, please scroll down)

Local deputy calls for repeal of criminalization of HIV patients

Local Congressman Temístocles Villanueva Ramos considered that the authorities of Mexico City are obliged to provide adequate information, education and support, to guarantee access to means of prevention and treatment, as well as to eradicate the criminalization of those suffering from HIV and other sexually transmitted infections. 

Presenting an initiative that reforms Article 76 and repeals Article 159 of the Criminal Code of the Federal District, the legislator for Morena indicated that criminalizing diseases such as the Human Immunodeficiency Virus (HIV) hinders the duty of the authorities to guarantee public health while respecting human rights.

“The criminalization of HIV generates more harm than benefits in public health and human rights, so this initiative aims to repeal the article and reform the other to eliminate sentencing and the type of transmission risks” said the legislator.

He explained that currently Article 159 of the Criminal Code treats sexually transmitted infections differently from any other diseases since it specifically penalizes the health condition of the active subject, which causes a discriminatory distinction between people who live with a disease acquired by sexual infection and those who have some other disease acquired by other means,

“The penalty for exposure to infection is based on the risk of harm, not on the harm itself, which overstates the responsibilities of people with HIV, limiting their adequate access to justice,” he lamented.

Villanueva Ramos said that in Mexico, as well as in other countries around the world, people with HIV are subject to criminal law when they expose other people to the virus. However, according to UNAIDS, there is no evidence that these measures generate justice or prevent the transmission of the virus. 

 

“If penalties for people with HIV and sexually transmitted infections (STIs) are eradicated, discrimination is reduced and cultural barriers to timely detection and prevention are eliminated,” he said. 

 

Villanueva Ramos warned that the main problem with the classification of “exposure to infection”, both in the Federal Criminal Code and in local codes, is the ambiguity of the definition of incriminating behaviours, so that the jurisdictional authority is the one who decides in most cases which diseases are considered serious or which behaviours are punishable.

 

This type of measures that end up violating the human rights of people with HIV without contributing to the eradication of the epidemic can also be observed in other countries,” he said.

Pide diputado local pide derogar criminalización de enfermos de VIH

El diputado local Temístocles Villanueva Ramos consideró que las autoridades de la Ciudad de México están obligadas a suministrar información, educación y apoyo adecuados, así como garantizar el acceso a los medios de prevención y tratamientos, así como erradicar la criminalización de quienes padecen VIH y otras infecciones de transmisión sexual.

Al presentar una iniciativa que reforma el Artículo 76 y se deroga el Artículo 159 del Código Penal del Distrito Federal, el legislador por Morena indicó que criminalizar las enfermedades como el Virus de la Inmunodeficiencia Humana (VIH) obstaculiza el deber de las autoridades para garantizar la salud pública respetando los derechos humanos.

“La criminalización del VIH genera más daños que beneficios en la salud pública y los derechos humanos, por lo que la presente iniciativa tiene como objeto derogar el artículo y reformar el que le hace referencia para eliminar la pena y el tipo de Peligro de Contagio”, dijo el legislador capitalino.

Explicó que actualmente el Artículo 159 del Código Penal da un trato distinto a las infecciones de transmisión sexual respecto a cualquier otra enfermedad, ya que se penaliza específicamente la condición de salud del sujeto activo, lo que provoca una distinción discriminatoria entre las personas que viven con una enfermedad adquirida por contagio sexual y quienes tienen alguna otra enfermedad adquirida por otros medios.

“La pena por Peligro de Contagio se basa en el riesgo de daño, no en el daño mismo, lo cual sobredimensiona las responsabilidades de las personas con VIH, limitando su acceso adecuado a la justicia”, lamentó.

Villanueva Ramos manifestó que en México, así como en otros países del mundo, a las personas con VIH se les aplica el derecho penal cuando exponen a otras personas, no obstante, de acuerdo con Onusida, no hay datos que comprueben que estas medidas generen justicia o que se prevenga la transmisión del virus.

“Si se erradican las penalizaciones a las personas con VIH e infecciones de transmisión sexual (ITS) se disminuye la discriminación y se eliminan las barreras culturales para la detección oportuna y la prevención”, aseguró.

Villanueva Ramos alertó que el principal problema de la tipificación de “Peligro de Contagio”, tanto en el Código Penal Federal como en los códigos locales es la ambigüedad de la definición de las conductas incriminatorias, por lo que la autoridad jurisdiccional es quien decide en la mayoría de las ocasiones qué enfermedades se consideran graves o qué conductas son las punibles.

“Este tipo de medidas que terminan violentando los derechos humanos de las personas con VIH sin aportar a la erradicación de la epidemia también se pueden observar en otros países”, refirió.

US: Five laws categorised as “bad” laws by the Human Rights Campaign in Missouri , including HIV/AIDS criminalisation laws

Missouri ranked in lowest category for LGBTQ protections, nondiscrimination

The Human Rights Campaign recently released their fifth annual State Equality Index — a state-by-state report detailing statewide laws and policies that affect LGBTQ people, assessing how well states are doing to protect LGBTQ individuals from discrimination.

This year, Missouri received the lowest rating, “High Priority to Achieve Basic Equality.” This rating is given to states that focus on raising suport for basic LGBTQ equality laws, such as non-discrimination laws, and for states focusing on municipal protections for LGBTQ people including opposing negative legislation.

Twenty-eight states earned this rating. Seventeen states earned the highest rating, “Working Toward Innovative Equality,” while the remaining five earned “Solidifying Equality” or “Building Equality.”

Karis Agnew, field director for PROMO, Missouri’s statewide LGBTQ advocacy organization, explained that they expected this rating for Missouri.

“It does not surprise me because there are basic protections that LGBTQ people lack in Missouri and those include protection of employment, housing and public accommodations,” Agnew said.

Missouri has a total of six laws that benefit LGBTQ people — hate crime laws, a college and universities non-discrimination law, a sexual orientation non-discrimination policy for state employees, an anti-bullying law specifically for cyberbullying, transgender inclusion in sports, and name and gender updates on identification documents for drivers licenses.

Missouri has five laws that the HRC categorizes as “bad” laws including HIV/AIDS criminalization laws, a state Religious Freedom Restoration Act, and transgender exclusions in state Medicaid coverage.

Missouri lacks all parenting laws such as parental presumption for same-sex couples, second parent adoption, and foster care non-discrimination. Missouri also lacks basic non-discrimination laws for employment, housing, public accommodation, education, adoption, foster care, insurance, credit, and jury selection.

The absence of youth laws in Missouri include anti-bullying laws, protection from conversion therapy, and laws to address LGBTQ youth homelessness. In the health and safety category, Missouri lacks laws including LGBTQ nondiscrimantion protections in Affordable Care Act exchanges, transgender healthcare coverage, and name and gender updates on identification documents for birth certificates.

Alex Padilla, co-president of Spectrum, an LGBTQ group at Missouri State Univerity, explained his fear regarding how few laws Missouri has protecting LGBTQ individuals like himself.

“Whenever I first came out, I was working at a fast food job and I was worried that I could be fired for who I was,” Padilla said.

He explained that he did a quick search online and found that there were no laws protecting him from being harassed or fired because of who he was.

Agnew, who prefers using gender-neutral pronouns, explained that although this rating is low, organizations like PROMO are working hard behind the scenes to make sure Missouri’s laws are progressing.

“When it comes to passing laws that are pro-equality, the thing that we really need the most to be able to do that is make sure that we don’t have bills that are anti-LGBTQ,” Agnew said.

Agnew explained that in 2018 five anti-LGBTQ laws were filed but PROMO worked to ensure zero made it to the governor’s desk to be signed.

“When those are filed, that is our priority, so it is really hard for us to file proactive legislation and pass proactive legislation when we have legislation that is harmful to LGBTQ people that we work so hard to prevent from passing,” Agnew said.

Agnew said a big reason why Missouri is far behind other states in passing pro-LGBTQ legislation is that Missouri legislators are not aware of what it is like to live as an LGBTQ individual.

“I think a lot of our legislators in Missouri honestly don’t know what it’s like to be LGBTQ — the majority of our legislators are not LGBTQ themselves,” Agnew said. “And because of that, I think a lot of them have a lot to learn from their constituents that are.”

Agnew said this year is the 21st year that PROMO has worked to file the Missouri Nondiscrimination Act, which would add protections for sexual orientation and gender identity in places of employment, housing and public accommodations.

“When their constituents aren’t bringing it up they assume it’s not important and not needed,” Agnew said. “The number one thing people can do is engage their elected officials and talk to them about why something like the Missouri Nondiscrimination Act is so important to them.”

Padilla explained how important it is for students to get involved.

“Help us lobby for equality, Padilla said. “Advocating for these things and showing that you are an ally is really helpful to all of Missouri and all of Missouri’s LGBTQ people.”

PROMO is hosting an “Equality Day,” a day of lobbying where people in the community come up to Jefferson City and talk to legislators about the Missouri Nondiscrimination Act on April 10.

Uganda: Mapping of the legal environment shows how the current criminal justice system discriminates against people living with HIV

Published in the Daily Monitor on Febraury 22, 2019

Report shows how laws discriminate against HIV positive people

KAMPALA- Various existing laws criminalise people living with HIV/ Aids, according to a new report released in Kampala on Thursday.

The report is titled: “Draft report on the assessment and mapping of the legal environment on provisions of HIV and TB services to let populations, persons living with HIV and tuberculosis”

“The existing legal framework is not favourable for some categories of the key, vulnerable and priority populations to freely access health services in Uganda. Specifically, the lifestyles sex workers, men who have sex with men, transgender persons and makes them most affected by the existing legal framework in Uganda,” read part of the report

It adds: “The laws criminalise sex work, same sex relationships and drug use. This results into violence, harassment, disappointment of sex workers and their legal recourse to address injustice against them.” “The other law, the HIV and Aids prevention and Control Act although not specifically targeting key vulnerable and priority populations, has implications for both the general affected by HIV in Uganda.”

The report indicates that the HIV and Aids Prevention and Control Act 2014 provides for voluntary HIV testing in Sub Section 9. However, the voluntarism is not considered if a person commits a sexual offense as part of the criminal proceedings and yet Section 8 provides for identity of a person tested with HIV not to be disclosed or released to any person except in accordance with the law and medical standards.

The report was carried out by civil society organisation Center for Health, Human Rights and Development (CEHURD) in conjunction with Aids and Rights Alliance for South Africa (ARASA).

The current criminal justice system is also discriminative as it hands down more deterrent jail terms to those suspects found to be living with HIV than their counterparts that are not.

Reacting to the aforementioned finding, a law professor at Makerere University, Prof. Ben Twinomugisha, explained that sometimes it’s prudent for the prosecution to take an HIV test of a suspect accused of committing a sexual offense for purposes of securing a conviction.

However, he was also quick to say that this compulsory HIV testing will lead to violation of their human rights and that this will drive those infected away instead of going to hospital to get medication.

“But a civil society organisation and I, have since petitioned court challenging Section 43 of the HIV Prevention and Control Act about criminalization of HIV,”  Prof. Twinomugisha said

“Why is it that a person suffering from Hepatitis B, which is more deadly than HIV are not subjected to a test when they commit a crime,” he wondered.

The study was carried out in three districts of Gulu, Mbarara and Tororo.

The study was mainly about the extent to which laws and policies protect and promote the rights of persons living with HIV/ Aids, let populations like sex workers, truck drivers and fishermen can access health care and services.

The HIV prevalence in Uganda stands at 6.2%. In 2016, approximately 1.4 million people were living with HIV and 28,000 Ugandans were estimated to have died of Aids-related illness.