France: National Aids Council President, Patrick Yeni, on why HIV criminalisation remains a problem for France

A year ago, in April 2015, the French National AIDS and Viral Hepatitis Council (Conseil national du sida et des hépatites virales, known simply as ‘CNS’) following extensive research into the law, nature of complaints and prosecutions, and their impact, issued a report, opinion and recommendations.

An English language version of the report, opinion and subsequent recommendations is still being prepared.

Earlier this year, Professor Patrick Yeni (pictured), chair of the CNS, was interviewed by Jean-François Laforgerie on the French language HIV website, seronet.info. His interview is eye-opening and powerful.

It highlights that although they had only found 23 convictions up to the end of 2014, surveys of people living with HIV suggest that up to 2000 complaints may have been made since the start of the epidemic.

The survey shows that slightly more than one person living with HIV in ten claims to have been tempted to complain against the person that they believed to be the source of infection. According to the same source, 1.4% of people living with HIV surveyed reported having actually complained. Based on these figures, we estimate an order of magnitude from 1 500 to 2 000 complaints that could be filed in total since the beginning of the epidemic.

He also notes that the law currently only recognises condom use as a way to show lack of a guilty mind, and he and his colleagues are concerned that up-to-date science is not reflected in the law. He also highlights that in France disclosure of known HIV-positive status – and subsequent consent to ‘risky’ sex – is not actually a defence, although in practice only cases where no disclosure took place and where no condoms were used have reached the court.

It seems unthinkable that what is obvious in terms of public health today on the promotion of biomedical preventions is lagging behind legally.

Given the importance of this body of work, we have decided to publish the interview and a summary of the main CNS recommendations beneath it, despite no official English translation.

It is interesting that the people who complain and go to trial are not part of the so-called risk groups where prevalence is high. For example, there is virtually no migrants among the complainants. Moreover, today there is a much greater legalisation of intimacy, including sexual facts than existed in the past. Perhaps this plays on the fact that people complain more now than twenty years ago.

Below is the English translation of the seronet.info interview, further improved from Google translate’s version by Sylvie Beaumont. Version anglaise via Google translate. Le texte français est après la traduction.

Q: In 2006, the National AIDS and viral hepatitis Council (CNS) published their review of the criminalisation of HIV transmission. What led you to work again on this issue and publish, in 2015, a second opinion?

Patrick Yeni [PY]: The media coverage of some trials in France and, secondly, the situation internationally. In other countries, there was an active debate on the criminalisation of HIV transmission, while in France this reflection seemed stalled. These are the two reasons that led us to revisit this issue, trying to understand and think about how things had changed since our first review.

Q: In your 2015 recommendations, you noted that the attention paid to legal, ethical and health issues relating to criminalisation of HIV transmission was low, both on the part of public authorities and civil society actors. How do you explain that?

PY: We have no clear answer to that. This is also why we wanted to restart the debate. If one takes the point of view of government and we take stock of court cases – 23 convictions for HIV transmission since the beginning of the epidemic throughout France – one can imagine that for the state this is not a national major problem at the criminal level, at least quantitatively. I guess the debate on criminal justice focuses primarily on other issues. For HIV organisations, it is probably more complicated because legal proceedings – as we attempt to analyse them in the recommendations – somewhat undermined the historical foundations on which the fight against HIV is based. By that I mean solidarity between people living with HIV and the refusal to distinguish between “patients as victims” allegedly infected and others who simply became infected. I imagine that this problem could have induced some inertia in advancing the debate. One recommendation from the CNS is to urge organisations to resume this discussion today, because it is a lever to act on issues of stigma, discrimination … and HIV prevention in general.

Q: What is prosecuted today? And what is a crime under the law?

PY: Primarily the fact that a person who knows s/he is HIV-positive, transmits HIV to a partner while s/he has not taken preventive measures to prevent this, i.e used a condom. In almost all trials in France, this is what has been prosecuted. We have had discussions on other issues as lawyers who supported us explained that the scope of what could be prosecuted or what could be an offence is probably wider than what is actually applied today.

Q: What are you referring to?

PY: One must think on several levels. The first criterion is that they are people who know they are HIV-positive. But it’s more complicated. Thus, from a legal point of view, we cannot know that a person, while not knowing officially that they are HIV-positive would consider themselves to be negative while they are engaged in repeated risky sexual behaviour. Justice may consider that even if they did not know their status officially, their sexual behaviour should have pushed them to consider themselves as potentially HIV-positive, and therefore to do a test and take preventive measures. In this case, the absence of screening does not guarantee the absence of criminal risk. The second criterion is that there must be proof that the person has transmitted HIV. Our analysis of judgments shows that exposing someone to HIV transmission, even without actual transmission can also be penalised. There have been convictions in France for exposure to the risk of transmission. This has occurred in the case of additional convictions to convictions for actual transmission, but it exists.

Q: So you think we could one day have a conviction on the sole ground of the risk of exposure to HIV transmission?

PY: Yes. The legal elements are there. That is, according to our analysis, another possibility of expanding the criminal field. The third criterion is that the ‘victim’ is not aware of the HIV status of their partner. In criminal law, whether or not the victim is informed does not exempt the defendant from liability. One cannot argue that the partner was informed and has agreed not to protect themselves and therefore would not be responsible. The information is not enough.

Fourth criterion. In all cases today, sexual prevention is understood as the use of condoms. It is the condom which is retained as the manifestation of concerns relating to the risk of transmission. We do not know what will happen when there will be proceedings for transmission or exposure by people who do not use condoms, but are treated effectively. Some lawyers have told us that if there was transmission despite condom use, it would be a case of force majeure which is exculpatory of responsibility. We can not guarantee the same thing about treatment. In other words, even with a good track treatment, a viral load of less than 20 copies, one cannot guarantee that there is not occasionally a little HIV in semen … and therefore transmission is possible even if  treatment is adhered to, and viral load is undetectable … other lawyers tell us that we are, in this case, in a random situation, which does not exempt the person with HIV from responsibility. We must think about this. It seems unthinkable that what is obvious in terms of public health today on the promotion of biomedical preventions is lagging behind legally. This is a warning that we mention in the recommendation. But unfortunately we fear that this debate will only take place when a case of transmission from someone on effective treatment will come to court.

Q: How do you explain that the role of treatment as prevention is recognised in Switzerland with all the legal consequences that this entails, and yet the same argument does not hold legally with us?

PY: We wanted to alert on this point precisely so the conclusions of judges, when they have to decide, are identical to the public health conclusions we know today. We must not get to this contradiction where a person who is effectively treated is found guilty because s/he would not use a condom. With these examples, we can see the narrow scope of what is actually prosecuted and that it is imperative to have a debate on the possible expansion of what is a crime.

Q: The argument is often made that further criminalisation would deter people from testing?

PY: The review analysed the consequences of the criminalisation of HIV transmission on testing. All the studies to which we had access, mainly foreign, do not indicate that criminal risk linked to knowing one’s status would lead to decreased use of testing.

Q: You note the paradox that legal proceedings have developed in a context of “normalisation” of the disease. In other words, cases flourished in the 2000s, after the most acute phase of the epidemic. How do you explain it?

PY: We had discussions about it. Some of us were reluctant to say that there was an increase in the number of cases. One thing is certain, we are on a low figure: 23 convictions. Especially if we compare the data of the ANRS-Vespa 2 survey. The survey shows that slightly more than one person living with HIV in ten claims to have been tempted to complain against the person that they believed to be the source of infection. According to the same source, 1.4% of people living with HIV surveyed reported having actually complained. Based on these figures, we estimate an order of magnitude from 1,500 to 2,000 complaints that could be filed in total since the beginning of the epidemic. We do not know why some complaints were accepted and others not, why some were eventually classified and others have prospered. We have, unfortunately, no way to evaluate it. We just know that few cases reach a conviction.

To respond more specifically, one must take into account the fact that there is a significant delay, sometimes ten years from the time a complaint is filed to the time when an appeal judgment is pronounced. It might be possible to say that today there is an increase in the number of procedures, but it is not certain. We must be careful about this point. If this is true, how can we explain it? One hypothesis is that in the early days of the epidemic, when many people died of AIDS, a complaint against a person who was likely to die did not make much sense. Today the situation is different. For people, this may appear more “logical” to do so. We advance this hypothesis, but we don’t have the figures to confirm it. One can also look at who is complaining. It is interesting that the people who complain and go to trial are not part of the so-called risk groups where prevalence is high. For example, there is virtually no migrants among the complainants. Moreover, today there is a much greater legalisation of intimacy, including sexual facts than existed in the past. Perhaps this plays on the fact that people complain more now than twenty years ago.

Q: What goals did you set by publishing this new advice?

PY: Firstly: to inform people living with HIV about the conditions under which their criminal responsibility may be engaged. Our thinking has focused on being able to contribute to a fair justice. How? By raising awareness of the investigators in this matter through the National Schools of Police and Gendarmerie. By working with judges and lawyers. It is not possible for judges to have the technical knowledge about different diseases, we admit. Similarly, we can not consider today that under the pretext that people no longer die of AIDS, HIV is commonplace. This is not possible even today because there is a context of social representations that make it a special disease. However, the situation is not the same today, in particular medical progress has taken place. It is very important that judges and lawyers are aware of this. We propose that the National School of Magistrates opens this debate in its initial training as well as in continuing education. We asked the school director to include a discussion on HIV in its knowledge training. A problem that does not concern judges, is that of upgrading one’s knowledge to contribute to a fair trial. One of our wishes is also to allow a reflection on the position of criminal justice. Prison sentences predominate in cases of HIV transmission and issues of rehabilitation and prevention of relapses are not taken into account, even though the court must ensure both aspects in its approach.

Q: Specifically what do you recommend?

PY: For the Department of Justice to develop a form of observatory monitoring  of judgments, to document the characteristics of procedures. The tool does not exist and we had to carry out considerable work to realise our new advice and to find all cases that resulted in convictions. We must create an interdepartmental committee to work on the development and provision of information tools tailored to professional (police, lawyers, judges) and other persons concerned, so that the procedures take account of available scientific and medical data, and for doctors to be better informed about the criminal risk of HIV transmission. It’s lobbying work which we pursue, including with HIV organisations. They must reclaim this question on which they were at a standby. We must recognise that the right to resort to justice is a right for all citizens, that our struggle is not against criminal law, but rather to ensure a fair process and prevent risks of criminalisation.

Summary of the CNS’s 2015 recommendations on HIV criminalisation

No. Objectives Recommendations Competent authorities

and/or recommendation targets
1 Contribute to better information of judges Promote initial and continuing education of magistrates and future magistrates on HIV related issues French National School for the Judiciary (école nationale de la magistrature)
2 Bolster the quality of police investigations Promote training actions of police officers and future officers on HIV related issues Ministry of the Interior
3 Prevent reoffending, enable the integration and reintegration of convicted people and improve their support Apply alternatives to custodial sentences Ministry of Justice
4 Promote the prevention of the prosecution risk Contribute to a better understanding of legal issues by the people and communities concerned HIV/AIDS associations
Support actions aiming to provide information on the legal rights and responsibilities of people living with HIV. Ministry of HealthFrench National Institute for Health Prevention and Education (INPES)
Promote actions to fight PLHIV stigmatisation and discrimination and prevention actions towards the general population Ministry of Health, Regional Health Agencies (ARS), French National Institute for Health Prevention and Education (INPES)Other competent ministriesHIV/AIDS associations
5 Provide access to up-to-date and high-quality legal and scientific information Implement a reporting tool to follow-up the rulings issued in France and to document the characteristics of the related proceedings Ministry of Justice
Initiate the creation of a working group in charge of designing and provisioning of information tools suitable for professionals and people involved Health/Justice Interministerial Committee

 

 

Article original

PÉNALISATION DE LA TRANSMISSION DU VIH : GARANTIR UNE PROCÉDURE ÉQUITABLE

Où en est-on aujourd’hui en France sur la pénalisation de la transmission de VIH ? Le professeur Patrick Yéni, président du Conseil national du sida (CNS) fait le point. Interview.

In 2006, le Conseil national du sida et des hépatites virales (CNS) avait publié un premier avis sur la pénalisation de la transmission du VIH. Qu’est-ce qui vous a conduit à travailler de nouveau sur ce sujet et à publier, en 2015, un second avis ?

Patrick Yeni : Il y a la médiatisation de certains procès en France et, d’autre part, le constat sur le plan international, dans d’autres pays concernés, qu’il y avait une réflexion active sur la pénalisation de la transmission de l’infection par le VIH alors qu’en France cette réflexion semblait marquer le pas. Ce sont ces deux raisons qui nous ont conduits à retravailler sur cette question, en essayant de comprendre et de réfléchir à la façon dont les choses avaient évolué, depuis notre premier avis.

Dans l’avis de 2015, vous jugez que l’attention apportée aux enjeux juridiques, éthiques et sanitaires de la pénalisation de la transmission est faible, tant de la part des pouvoirs publics que des acteurs associatifs. Comment l’expliquez-vous ?

Nous n’avons pas de réponse claire à cela. C’est aussi pour cela que nous avons voulu reprendre cette réflexion. Si l’on se place du point de vue des pouvoirs publics et que l’on fait le bilan des affaires judiciaires — soit 23 condamnations pour transmission du VIH depuis le début de l’épidémie pour toute la France —,  on peut imaginer que pour l’Etat il ne s’agit pas là d’un problème majeur national au niveau pénal, du moins sur le plan quantitatif. J’imagine que la réflexion sur la justice pénale porte prioritairement sur d’autres questions. Pour les associations de lutte contre le sida, c’est probablement plus compliqué parce que les procédures judiciaires — comme nous essayons de l’analyser dans l’avis — mettent quelque peu à mal les fondements historiques de la lutte contre le VIH. Je citerai la solidarité entre les personnes atteintes et le refus de distinguer entre des “malades victimes” qui auraient été contaminés et d’autres qui se seraient infectés. J’imagine que cette difficulté a pu introduire de l’inertie dans la progression de la réflexion. C’est justement une recommandation du CNS que d’exhorter les associations à reprendre aujourd’hui cette réflexion, parce qu’elle constitue un bras de levier pour agir sur les stigmatisations, les discriminations… et la prévention en général.

Qu’est-ce qui est condamné aujourd’hui ? Et qu’est-ce qui est condamnable sur le plan pénal ?

C’est avant tout le fait pour une personne qui se sait séropositive d’avoir transmis le VIH à un ou une partenaire alors qu’elle n’avait pas pris de mesure de prévention pour prévenir cette transmission, en l’occurrence l’utilisation de préservatif. Dans la quasi-totalité des procès en France, c’est cela qui est condamné. Nous avons eu des réflexions sur d’autres points car les juristes qui nous ont accompagnés ont expliqué que le champ de ce qui est condamnable, de ce qui pourrait représenter un délit, est sans doute plus large que celui qui est effectivement appliqué aujourd’hui.

A quoi faites-vous référence ?

Il faut raisonner sur plusieurs niveaux. Le premier critère retenu est que ce sont des personnes qui se savent séropositives. Mais c’est plus compliqué. Ainsi, d’un point de vue juridique, on ne peut assurer qu’une personne bien que ne se sachant pas formellement séropositive puisse se considérer comme séronégative alors qu’elle est engagée dans des comportements sexuels à risques, répétés. La justice peut considérer que même si elle ne sait pas de façon formelle quel est son statut, son comportement sexuel aurait du l’inciter à se considérer comme potentiellement séropositive, donc à se tester et à mettre en œuvre des moyens de prévention. Dans ce cas, l’absence de dépistage ne garantit pas l’absence de risque pénal. Le deuxième critère est qu’il faut la preuve que la personne ait transmis le VIH. Notre analyse des jugements montre que le fait d’exposer à la transmission du VIH, même sans transmission effective, peut également être pénalisé. Il y a eu des condamnations en France pour exposition au risque de transmission. Cela s’est produit dans des cas de condamnations additionnelles à des condamnations pour transmission effective, mais cela existe.

Vous estimez donc qu’on pourrait se trouver un jour avec une condamnation au seul motif du risque d’exposition à la transmission du VIH ?

Oui. Les éléments juridiques sont là. C’est, selon notre analyse, une autre possibilité d’élargissement du champ pénal. Le troisième critère est le fait que la victime ne soit pas informée de la séropositivité du ou de la partenaire. En droit pénal, le fait que la victime soit informée ou pas n’exonère pas le prévenu de sa responsabilité. On ne peut pas arguer que le partenaire était informé et qu’il a accepté de ne pas se protéger et donc qu’on ne serait pas responsable. L’information ne suffit pas.

Quatrième critère. Dans toutes les affaires aujourd’hui, la prévention des rapports sexuels est comprise comme l’usage du préservatif. C’est le préservatif qui est retenu comme la manifestation de la préoccupation face au risque de transmission. Nous ne savons pas ce qui se passera lorsqu’il y aura des procédures engagées pour transmission ou exposition concernant des personnes qui n’utilisent pas de préservatifs, mais qui sont traitées efficacement. Certains juristes nous ont expliqué que s’il y avait transmission malgré l’usage du préservatif, il s’agirait d’un cas de force majeure qui est exonératoire de la responsabilité. On ne peut pas garantir la même chose concernant le traitement. Autrement dit, avec un traitement bien suivi, une charge virale dans le sang inférieure à 20 copies, on ne peut pas garantir qu’il n’y ait pas de temps en temps un peu de VIH dans le sperme… et donc qu’une transmission soit possible même si le traitement est bien suivi, la charge virale indétectable… D’autres juristes nous disent que nous sommes, dans ce cas-là, dans une situation d’aléa, qui, elle, n’est pas exonératoire de la responsabilité. Nous devons réfléchir à cela. Il paraîtrait impensable que ce qui est une évidence en termes de santé publique aujourd’hui sur la promotion des préventions biomédicales, soit en décalage sur le plan juridique. C’est un motif d’alerte que nous mentionnons dans l’avis. Mais il est à craindre malheureusement que cette réflexion n’ait lieu que le jour où un cas de transmission concernant une personne sous traitement efficace vienne au tribunal.

Comment expliquer que le rôle du Tasp dans la protection du rapport soit reconnu en Suisse avec toutes les conséquences juridiques que cela implique et que ce même argument ne tienne pas juridiquement chez nous ?

Nous avons souhaité alerter sur ce point afin que justement les conclusions de la justice, lorsqu’elle aura à se prononcer, soient identiques aux conclusions de santé publique que nous connaissons aujourd’hui. Nous ne devons pas arriver à cette contradiction qu’une personne qui se traiterait efficacement soit condamnée parce qu’elle n’utiliserait pas le préservatif. Avec ces exemples, on voit bien l’espace assez restreint de ce qui est effectivement condamné aujourd’hui et le fait qu’il faut absolument avoir une réflexion sur le possible élargissement de ce qui est condamnable.

L’argument est souvent avancé qu’un engagement plus avant dans la pénalisation dissuaderait les personnes de faire le dépistage ?

L’avis a analysé les conséquences de la pénalisation de la transmission en matière de recours au dépistage. Toutes les études auxquelles nous avons eu accès, essentiellement étrangères, n’indiquent pas que le risque pénal lié à la connaissance de son statut sérologique conduirait à une diminution du recours au dépistage.

Vous notez le paradoxe que les recours en justice se sont développés dans un contexte de “normalisation” de la maladie. Autrement dit, les affaires ont prospéré dans les années 2000, postérieurement à la phase la plus aigüe de l’épidémie. Comment l’expliquez-vous ?

Nous avons eu des discussions à ce sujet. Certains d’entre nous étaient réticents à affirmer qu’il y avait une augmentation du nombre de cas. Une chose est sûre, nous sommes sur un chiffre bas : 23 condamnations. D’autant plus si on le rapporte aux données de l’enquête ANRS-Vespa 2. L’enquête montre qu’un peu plus d’une personne vivant avec le VIH sur dix déclare avoir été tentée de porter plainte contre la personne qu’elle estimait être à l’origine de sa contamination. Selon la même source, 1,4 % des personnes vivant avec le VIH interrogées déclaraient avoir effectivement porté plainte. Sur la base de ces chiffres, nous avons estimé un ordre de grandeur de 1 500 à 2 000 plaintes qui auraient pu être déposées au total depuis le début de l’épidémie. Nous ne savons pas pourquoi certaines plaintes ont été acceptées et d’autres pas, pourquoi certaines ont finalement été classées et d’autres ont prospéré. Nous n’avons, hélas, aucun moyen d’évaluer cela. Nous savons juste que peu d’affaires arrivent à une condamnation.

Pour répondre plus précisément, il faut prendre en compte le fait qu’il y a un délai important, parfois dix ans, entre le moment où une plainte est déposée et celui où un jugement en appel est prononcé. Dire qu’aujourd’hui nous sommes sur une augmentation du nombre de procédures, c’est possible, mais pas certain. Nous devons être prudents sur ce point. Si c’est vrai, comment l’expliquer ? Une des hypothèses, c’est qu’aux premiers temps de l’épidémie, lorsque beaucoup de monde décédait du sida, porter plainte contre une personne qui allait sans doute mourir n’avait pas grand sens. Aujourd’hui, la situation est différente. Pour des personnes, cela peut apparaître plus “logique” de le faire. Nous avançons cette hypothèse, mais aucun chiffre ne permet de la confirmer. On peut aussi regarder quels sont ceux qui portent plainte. C’est intéressant de voir que les personnes qui portent plainte et arrivent au procès ne font pas partie des groupes dits à risques où la prévalence est très forte. Par exemple, il n’y a quasiment pas de personnes migrantes parmi les plaignants. Par ailleurs, il existe aujourd’hui une judiciarisation bien plus importante de l’intime, notamment des faits sexuels, qu’elle n’existait dans le passé. Peut-être cela joue-t-il dans le fait de porter plainte plus aujourd’hui qu’il y a vingt ans.

Quels objectifs vous êtes-vous fixés en publiant ce nouvel avis ?

Tout d’abord : informer les personnes vivant avec le VIH sur les conditions dans lesquelles leur responsabilité pénale peut être engagée. Notre réflexion a surtout porté sur le fait de pouvoir contribuer à une justice équitable. Par quels moyens ? Par une sensibilisation des enquêteurs à cette question par les écoles nationales de police et de gendarmerie. Par un travail auprès des magistrats et des avocats. Il n’est pas possible que les juges aient des connaissances techniques sur les différentes maladies, nous l’admettons. De la même façon, on ne peut pas considérer aujourd’hui, au prétexte qu’on ne meure plus du sida, que l’infection par le VIH est banale. Ce n’est pas possible parce qu’il existe un contexte de représentations sociales qui en font une maladie particulière. Pour autant, la situation n’est plus la même aujourd’hui, des progrès notamment médicaux ont eu lieu. C’est très important que les magistrats et les avocats aient connaissance de cela. Nous proposons que l’Ecole nationale de la magistrature ouvre cette réflexion dans sa formation initiale, comme dans sa formation continue. Nous avons sollicité le directeur de cette école pour lui demander d’inclure une réflexion autour du VIH dans la formation des connaissances. Un problème, qui ne concerne pas que les juges, est celui de la mise à niveau des connaissances pour contribuer à une justice équitable. Un de nos souhaits est aussi de permettre de réfléchir à la position de la justice pénale. Les peines de prison ferme prédominent dans les affaires de transmission du VIH et les questions de réinsertion et de prévention de la récidive ne sont pas du tout prises en compte, alors même que la justice doit veiller à ces deux aspects dans sa démarche.

Concrètement que préconisez-vous ?

Pour le ministère de la Justice, de se doter d’une forme d’observatoire de suivi des jugements rendus, de documenter les caractéristiques des procédures. L’outil n’existe pas et nous avons dû effectuer un travail considérable pour réaliser notre nouvel avis et retrouver tous les cas ayant abouti à des condamnations. Il faut créer un comité interministériel pour qu’il travaille à la création et la mise à disposition d’outils d’information adaptés aux professionnels (policiers, avocats, magistrats) et aux personnes concernées, pour que les procédures tiennent compte des données scientifiques et médicales disponibles, pour que les médecins soient mieux informés sur le risque pénal de la transmission du VIH. C’est du travail de lobbying que nous menons, y compris auprès des associations de lutte contre le sida. Elles doivent se réapproprier cette question, sur laquelle elles étaient un peu en situation de veille. Nous devons admettre que le droit au recours à la justice est un droit des citoyens, que notre combat n’est pas contre la justice pénale, mais plutôt pour garantir une procédure équitable et prévenir le risque pénal.

Propos recueillis par Jean-François Laforgerie.

Australia: Analysis of the limitations of scientific evidence to prove timing and direction of alleged HIV transmission in three criminal trials

This article by Paul Kidd in the March 2016 issue of HIV Australia examines the use of HIV phylogenetic analysis in three Australian criminal trials. It argues that courts in Australia appear to accept forensic evidence uncritically. As the forensic methodology used in phylogenetic analysis is inherently limited, it argues there is risk of miscarriage of justice where this type of evidence forms a substantial part of the prosecution case.

Read the full article at: https://www.afao.org.au/library/hiv-australia/volume-14/vol-14-no-1/phylogenetic-analysis-as-expert-evidence-in-hiv-transmission-prosecutions

Canada: Canada's HIV disclosure laws are dangerous for women says B.C. Civil Liberties Association

HIV disclosure laws endanger women says B.C. Civil Liberties Association

Fear of legal repercussions keeps HIV-positive women from reporting sexual abuse, says Michael Vonn

Canada’s HIV disclosure laws are dangerous for women, especially those in abusive relationships or who have been sexually assaulted, says a lawyer with the B.C. Civil Liberties Association.

Michael Vonn, the civil rights group’s policy director, says a lack of awareness of the law can lead people — mostly women, but not exclusively — to disclose their HIV positive status in situations where that information can be used against them.

“Women who are HIV positive, if they are in abusive relationships, are often essentially ‘disciplined’ with the threat of [revealing their status],” Vonn told Early Edition host Rick Cluff.

“If you don’t do what I say, or you try to leave me, I’m going to go to the police and I’m going to say you didn’t disclose,” she said. “It’s emotional blackmail.”

Vonn said similar logic can often discourage HIV-positive women from reporting incidents of sexual assault.

“[They are often] too afraid to go to the police to report that crime because of concerns it will somehow boomerang back on them,” she said.

This fear of criminal liability for failure to disclose is compounded, Vonn said, by the fact that Canada is one of the most aggressive prosecutors of HIV nondisclosure in the world on a per capita basis.

Law not well known

In 1998, a landmark Supreme Court of Canada decision made it a crime to not disclose a positive HIV diagnosis to a sexual partner. Someone with such a diagnosis can be charged with aggravated assault for failing to disclose it, even if the virus is not transmitted.

A 2012 ruling clarified that disclosure is not required if the “realistic possibility of transmission of HIV is negated” — specifically, if the HIV-carrying partner has a low viral load and a condom is used during sexual intercourse.

Vonn says that ruling can compel an HIV-positive partner to disclose even when an abusive partner could use that information against them.

It can also strengthen an abusive partner’s blackmail efforts by allowing them to lie and say one of those conditions was not being met.

“Treatment options [can] make you virtually unable to infect somebody, because your virus will be so successfully suppressed,” Vonn said. “Who exactly tells you that that good news story medically is not the good news story legally?”

Medical professionals often don’t feel comfortable giving legal advice to their newly low-viral-count patients, said Vonn, which makes them less aware of their obligations.

Change not likely in short term

Vonn said she does not have any particular hope that the law will change any time soon, especially since the relevant Supreme Court rulings are so recent. In lieu of legal change, Vonn emphasizes education and prosecutorial discretion.

“[We want the Crown to] really think about the public interest in terms of making such prosecutions,” she said.

As for the education component, Vonn urged HIV-positive Canadians to familiarize themselves with disclosure law as it pertains to them. To that end, SFU is holding a free information session on Wednesday, March 30, at which Vonn will be a panelist.

“Understand the law,” Vonn said. “If this is news to you, there are resources that are available.”

Originally published in CBC News

US: Can the American Psychological Association's stand against HIV criminalization laws convince state policymakers that [potentially exposing someone to] the virus should not be a crime?

Criminalizing HIV Transmission Does More Harm Than Good

Can the American Psychological Association’s stand against HIV criminalization laws convince state policymakers that transmitting the virus should not be a crime?
Originally published in Pacific Standard by Elena Gooray on

Last week, the American Psychological Association published a resolution against HIV criminalization laws—measures that punish people with the virus for not telling their sexual partners about their HIV status. These measures grew out of panic over AIDS in the 1980s, driven partly by a lack of knowledge about how HIV is transmitted, and partly by prejudice against the population in which the virus was spreading fastest—men having sex with men. But the APA argues that, rather than reducing the spread of the virus, these laws can actually fuel the epidemic.

These HIV-specific laws can discourage people from getting tested by making ignorance of their HIV status a form of protection against sex-related criminal charges, according to David Martin, senior director of the APA’s office on AIDS. “If you don’t know whether you have [the virus], you can’t be prosecuted for having sex with someone and not telling them you have HIV,” he says. “But if you do know and don’t inform your partner, even if you use a condom and everything you did was safe with regards to the possibility of transmission, you can be incarcerated.” After being locked up, Martin explains, people become much more likely to transmit HIV, due to the prevalence of high-risk sexual behavior and drug use in prison—as well as a lack of condoms.

A wave of research has already argued against HIV-specific laws.

And yet, HIV criminalization measures remain popular. Thirty-three states have HIV-specific laws on the books. The justification for these laws is that having sex while infected with HIV means running a substantive risk of passing on the virus, and partners have the right to know exactly what risks they’re taking. But people with HIV can take effective steps to prevent transmission. As early as the late 1990s, researchers had found that consistent condom use is at least 90 percent effective in preventing HIV transmissions. And the base risk of contracting the virus itself is small: The most likely route of transmission is from unprotected anal sex, and in that case epidemiologists have estimated the risk to be below two percent.

A wave of research has already argued against HIV-specific laws, noting that those rare cases in which people do intentionally spread HIV can be prosecuted under broader criminal law and so do not require targeted legislation. The White House chimed in against HIV criminalization in 2010, followed by a 2014 Department of Justice guide for updating the laws to reflect the latest research. But states have yet to respond.

Though the APA has long voiced support for reversing HIV-specific laws, their recent resolution gives them greater clout for advocacy with government officials, according to Martin. Now, when the APA sends representatives to lobby on Capitol Hill, “They can say, ‘This is the APA’s official policy,’ rather than just, ‘We think this is a good idea,'” Martin says.

Decisive resolutions from the APA are noteworthy. The organization frequently weighs in on issues to which psychological research can be applied—including best practices in delivering health care, sexual assault in the military, and affirmative action policies—by distributing press releases of relevant research findings or contributing briefs to individual court cases. But the APA takes a unified, official position on social issues far less often.

Still, Martin says, staying silent on political issues relevant to public-health research runs counter to the APA’s mission. He points to the APA’s past resolutions against sexual orientation-based discrimination, and, in 2014, the organization called for greater gun control measures and warned against treating gun violence as chiefly a problem of mental illness. “People think of the APA as mostly a professional guild agency,” Martin says. “But its stated mission is to advance the creation, communication, and application of knowledge from psychology to improve lives. Passing this resolution is perfectly within that scope.”

Psychological research can be applied to everything from policing to education disparities, and the APA has an important role in determining whether the field’s findings are being applied constructively or harmfully. But the organization’s public image as an advocacy organization took a hit last summer, when it broke that APA psychologists had cooperated with the Central Intelligence Agency and Pentagon to develop torture techniques after the 9/11 attacks, as documented in a report by a former federal prosecutor. The APA promptly responded to the report by banning psychologist participation in national security interrogations.

Still, the scandal undoubtedly damaged the APA’s credibility as an organization committed to bettering society. But Martin and his colleagues are hopeful that the organization’s latest resolution will help the APA have a positive social impact, by bringing researchers’ and federal policymakers’ consensus on HIV criminalization to the state level.

Zimbabwe: The persecution and prosecution of Harare model highlights reasons why HIV should not be criminalised

For the past few weeks, social and conventional media have been awash with the most heinous of headlines — “Harare model injects lover’s son with HIV.”

BY BELLINDA CHINOWAWA & ELIZABETH MANGENJE

An outraged public bayed for her blood, denouncing the model and calling for her immediate incarceration. After an invasive HIV test, it emerged that the allegations against the model were false, and that she is just another victim of the poorly crafted section 79 of the Criminal Law (Codification and Reform) Act, which in part reads as follows;

“ Any person who

(a) Knowing that he or she is infected with HIV; or

(b) Realising that there is a real risk or possibility that he or she is infected with HIV

Intentionally does anything or permits the doing of anything which he or she knows will infect, or does anything which he or she realises involves a real risk or possibility of infecting another person with HIV, be guilty of deliberate transmission of HIV, whether or not he or she is married to that other person, and shall be liable to imprisonment for a period not exceeding twenty years.”

The wording of this provision is objectionable because:

It criminalises sexual intercourse

Under this section, any person who has had sexual intercourse can be arrested and prosecuted, as with every sexual encounter, there is a risk or possibility of infection with HIV. Scientific research shows that no one method is 100% effective in protecting against the risk of infections. Having safe sexual intercourse is, strictly speaking, irrelevant for the purposes of this provision. A dangerously wide offence has been created.

It creates conditions for false incrimination

It is currently not possible in this country to tell who was infected first. Thus, the story which carries the day is that of the person who reports to the police first. This disadvantages women, who by reason of their reproductive health needs invariably get to know their status first as antenatal care services make HIV-testing compulsory for women. The only option for women to avoid prosecution under section 79 is to avoid antenatal care services or to opt out of HIV-testing, notwithstanding the danger that these decisions present for their own health, the health of their unborn babies and the community at large.

It does not reduce the spread of HIV

There is no evidence that applying criminal law to HIV risk behaviour incapacitates, rehabilitates, or deters offenders.

It promotes fear and stigma

Prosecution under section 79 is typically accompanied by inflammatory and ill-informed media coverage and this only serves to reinforce stigma against people living with HIV.

It penalises a conjectural likelihood

In terms of section 79, one does not actually have to have infected someone with HIV for a court to find that there has been “deliberate transmission of HIV”. Where a person facing charges under this section is tested and found positive, then a court must convict them, whether or not any transmission took place!

It disproportionately affects the already marginalised

Due to the persistence of deep-rooted prejudice against groups such as commercial sex workers, there is a real possibility that criminal prosecution will disproportionately affect them, as they are easy targets for such a witch hunt.

Data and evidence collected in 15 years (1986-2001) on prosecution for HIV transmission or exposure in the United States as well as several studies conducted around Europe revealed that most of the individuals convicted for HIV transmission or exposure were in vulnerable social and economic positions, including, commercial sex workers and prisoners.

Thus, it is arguable that section 79 of the Criminal Law (Codification and Reform) violates section 56 of the Constitution which guarantees non-discrimination and equal protection of the law. A law that puts people at risk of prosecution and 20 years imprisonment for a crime whose elements are not sufficiently clear for them to regulate their conduct cannot be said to be in line with the protection guarantee under the Constitution. As Edwin Cameron, a Judge of the Supreme Court of Appeal of South Africa, has noted, “prosecutions for HIV transmission and exposure, and the chilling content of the enactments themselves, reinforce the idea of HIV as a shameful, disgraceful, unworthy condition.”

The persecution and prosecution of the Harare model is proof of all the reasons why HIV should not be criminalised. The general criminal law is sufficient to deal with instances where a person maliciously and deliberately infects others with HIV, and in other jurisdictions, such persons are charged with assault, or attempted murder. There is no proof that criminalising HIV transmission will achieve either criminal justice or prevents HIV transmission.

The sentiment behind section 79 is understandable — it is grounded in the belief that, given the deleterious nature of HIV, any person living with it, has a moral duty to avoid infecting others. In this instance, however, the criminal law is a blunt instrument, imprecise and heavy-handed, leaving a trail of destruction in its wake. The criminalisation of HIV transmission threatens a human rights response to HIV that empowers people to avoid infection or live successfully with HIV. As UNAIDS has noted, instead of applying criminal law to HIV transmission, governments should expand programmes which have been proven to reduce HIV transmission and strengthen and enforce laws against rape and other forms of sexual violence against women and children.

The events of the past few weeks have shown that Section 79 of the Criminal Law (Codification and Reform) Act is overly-broad, and open to abuse. It only serves to entrench stigma and discrimination, and has no place in a society ostensibly founded on recognition of the inherent dignity and worth of each human being.

l Bellinda Chinowawa and Elizabeth Mangenje are project lawyers with Zimbabwe Lawyers for Human Rights

 Originally published in The Standard

 

US: Indiana Law Review critically examines how the state's HIV non-disclosure law is overly broad and problematic

Criminalization of HIV: Spread of the Viral Underclass

by Tyler J. Smith

J.D., 2015, Indiana University Robert H. McKinney School of Law

H-I-V. Arguably, no three letters in American society have generated more fear of a “viral underclass” [1] than those associated with the Human Immunodeficiency Virus (“HIV”). In many states, including Indiana, simply having HIV is a crime with potentially severe consequences. The criminalization of HIV is founded on a fear of something many people do not fully understand and the stigma of “HIV’s association with an ‘outlaw’ sexuality, anal intercourse, gay men, people of color, and people who use drugs.” [2] Indeed, convictions under these statutes rarely have anything to do with actual HIV transmission or risk of transmission. [3] Over thirty states currently have HIV specific criminal statutes “based on perceived exposure to HIV, rather than actual transmission of HIV to another.” [4]

The Infectious Diseases Society of America (IDSA) and HIV Medical Association (HIVMA) assert that “[c]riminalization is not an effective strategy for reducing transmission of infectious disease and in fact may paradoxically increase infectious disease transmission.” [5] Studies further indicate that “these laws discourage individuals from being screened and treated for conditions when early diagnosis and treatment of infected individuals is one of the most effective methods to control the disease.” [6] More people have been convicted under these laws in the United States and Canada than all other countries in the world combined. [7]

Numerous examples illustrate the unfounded fear and stigma that fuel egregious convictions and unjust sentences of HIV positive people. An HIV positive man in Michigan was charged under the state’s anti-terrorism statute with possession of a “biological weapon” after he allegedly bit his neighbor. [8] Another HIV positive man in Texas is currently serving thirty-five years for spitting at a police officer. [9] A man in Iowa with an undetectable viral load received a twenty-five year sentence after a one-time sexual encounter in which he wore a condom. [10] His sentence was suspended, but he was placed on probation for five years and had to register as a sex-offender for ten years. [11]

Many states rightfully criminalize reckless, knowing, or intentional behaviors that actually put others at significant risk. However, some states have other criminal statutes that are overbroad, or criminalize simply having HIV and engaging in conduct that scientifically poses no risk of transmission. Such statutes clearly exhibit a complete lack of scientific understanding of how HIV is transmitted and because of their overbroad nature, give prosecutors “significant discretion in determining whether and how to prosecute individuals arrested or reported for HIV exposure.” [12] The actual risk of transmission depends on the amount of the virus in a person’s blood. [13] The risk-per-exposure for various sex acts, without factoring in how condoms or medical treatment reduce the risk even further, ranges from zero to eighty-two in 100,000. [14] Intravenous drug use risk-per-exposure ranges from sixty-three to 240 in 100,000. [15] Despite the relatively low risk, “courts rarely look at what a person did to further reduce the risk of transmission.” [16] Simply having HIV is a considered a crime.

With overwhelming bi-partisan support, criminalization of HIV became federal in 1990 with the Ryan White Comprehensive AIDS Resources Emergency Act. [17] The Act’s namesake, Ryan White, a thirteen-year old boy from Russiaville, Indiana, contracted the disease in 1984 following a blood transfusion. [18] This act created The Ryan White HIV/AIDS Program; the “most comprehensive Federal program that provides services exclusively to people living with HIV.” [19] It serves more than 500,000 people that do not have adequate health care coverage to manage their treatment. [20]

Congress exercised its power to control funding by requiring states to “protect against intentional transmission” to receive federal funding for the new program. [21] Section 2647 of the Act provided in part that “[t]he Secretary may not grant . . . to a State unless the chief executive officer determines that the criminal laws of the State are adequate to prosecute any HIV infected individual” who intended to transmit HIV through donation of bodily fluid, engaging in sexual activity intending to transmit HIV, or shared needles intending to transmit HIV. [22] This provision was repealed in 2000; however, the seeds for states to go above and beyond were already sown. Some states went further than what the federal law required by defining intentional transmission as non-disclosure of their positive status to a sexual partner. [23]

Although thirty-plus states criminalize HIV under HIV-specific criminal statutes or STD criminal statutes that specifically encompass HIV, [24] zero states have criminalized the transmission or the failure to disclose the positive status of other sexually transmitted diseases, such as the Human Papillomavirus (“HPV”). [25] According to the Centers for Disease Control and Prevention (“CDC”), 33,000 new cases of cancer are reported each year with about 26,900 of these cancers caused by HPV. [26] Nearly all cases of cervical cancer are caused by HPV [27] and 4074 women died of cervical cancer in 2012. [28] In 2013, an estimated 9278 women received a new diagnosis of HIV. [29] In 2012, among women who previously received a diagnosis of AIDS, an estimated 3561 women died. [30] Thus, more women were diagnosed with cancer caused by HPV than women who were diagnosed with HIV and more women died of cancer caused by HPV than women who died of AIDS. [31] Yet HPV has not been criminalized in any state. [32]

Portions of Indiana’s criminal code do make sense. Someone who recklessly, knowingly, or intentionally donates or sells semen or blood that contains HIV could rightfully face felony charges. [33] However, other statutory provisions in the criminal code are overbroad and punish scientifically unfounded conduct. For example, a person without HIV can be charged with a Class C Misdemeanor for “battery” by placing bodily fluid or waste on another person in a rude, insolent, or angry manner. [34] A person without HIV can be charged with “malicious mischief,” a Class B Misdemeanor, for placing bodily fluid or fecal waste with the intent that another person will involuntarily touch it. [35] If a person is HIV positive, both of these offenses become Level 6 Felonies for exposing to others any bodily fluid, including those scientifically proven to not transmit HIV. [36] Battery is a Level 5 Felony if the bodily fluid or waste is placed on a public safety officer, but only if the accused is HIV positive. [37] If the accused is not HIV positive, then committing battery on a public safety officer remains a Level 6 Felony. [38] Therefore, simply having HIV statutorily increases the penalty for these offenses.

Despite laws to the contrary, the CDC clearly states that “[c]ontact with saliva, tears, or sweat has never been shown to result in transmission of HIV.” [39] Very low quantities of HIV have been found in the saliva and tears of some AIDS patients. [40] However, “finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid.” [41] HIV has not been found in the sweat of HIV-infected patients. [42] Indiana prosecutors have discretion to prosecute HIV positive persons criminally for a variety of offenses related to their HIV positive status regardless of intent to transmit or actual transmission and regardless of whether transmission is even scientifically possible.

Indiana law also criminalizes simply having what it defines a “dangerous communicable disease.” [43] Carriers of HIV, AIDS, and Hepatitis B have a duty to “warn or cause to be warned by a third party a person at risk” of the carrier’s disease status and the need to seek healthcare. [44] HIV positive persons must disclose their status to past, present, and future sexual or needle-sharing partners or face criminal penalty. [45] The burden of proof shifts to the accused to show he or she in fact disclosed his or her positive status to those past, present, or potential partners. [46] A person who “recklessly” violates the statutory provision commits a Class B Misdemeanor. [47] A person who “knowingly or intentionally” fails to comply with the statutory provision commits a Level 6 Felony. [48] Each day a violation of the duty statute continues is considered a separate offense. [49] In Indiana, a Class B Misdemeanor carries a penalty of imprisonment for a fixed term of not more than 180 days and a fine of not more than $1000, [50] and a Level 6 Felony carries a penalty of imprisonment for a fixed term between six months and three years, and a fine of not more than $10,000. [51] Neither the intent to transmit nor the actual transmission of HIV is required to be prosecuted under this statute. [52]

The “duty to warn” statutes make sense on their face, but no evidence exists to suggest these statutes fulfill their intent. Criminal consequences for a failure to disclose are intended by lawmakers to increase testing, encourage those who are positive to disclose, and thus decrease the number HIV infected persons. However, evidence and logic suggest the opposite is true. [53] People at risk are afraid to know their status in fear of being prosecuted.

Because public health is a significant state interest, one would think that state legislators would pass laws based on science and logic, not on fear of what or whom they do not understand. HIV is not easily transmitted, yet nearly seventy percent of states criminally target conduct unlikely to result in harm and increase criminal penalties for simply having HIV. [54] The first step in solving a problem is acknowledging there is one. States, including Indiana, must look beyond their own fear to see the “viral underclass” they have statutorily created. Having HIV or any disease should not be a crime.

[1] Sean Strub, Prosecuting HIV: Take the Test – And Risk Arrest?, Positively Aware (May/June 2012), http://www.positivelyaware.com/archives/2012/12_03/prosecutingHIV.shtml [https://perma.cc/3ZK7-RTYF].

[2] Sean Strub, Body Counts: A Memoir of Activism, Sex, and Survival 393 (2014).

[3] Id.

[4] H.R. Res. 1586, 114th Cong. (2015) (Introduced in Congress on March 24, 2015, this bill seeks to modernize laws and eliminate discrimination with respect to people living with HIV/AIDS).

[5] Infectious Diseases Society of America (IDSA) and HIV Medicine Association Position on the Criminalization of HIV, Sexually Transmitted Infections and Other Communicable Diseases, HIV Med. Ass’n (Mar. 2015), http://www.hivma.org/uploadedFiles/HIVMA/Policy_and_Advocacy/HIVMA-IDSA-Communicable%20Disease%20Criminalization%20Statement%20Final.pdf [https://perma.cc/G7AQ-WAN4].

[6] Id.

[7] Glob. Network of People Living With HIV, The Global Criminalisation Scan Report 2010 12 (2010), available at http://www.gnpplus.net/assets/wbb_file_updown/2045/Global%20Criminalisation%20Scan%20Report.pdf [https://perma.cc/X4CM-A44R] (reporting more than 300 people have been convicted under these laws in the United States and more than sixty in Canada).

[8] The Ctr. for HIV Law & Policy, Ending and Defending Against HIV Criminalization: State and Federal Laws and Prosecutions (May 2015), available at http://hivlawandpolicy.org/resources/ending-and-defending-against-hiv-criminalization-state-and-federal-laws-and-prosecutions [https://perma.cc/3E24-YVGZ].

[9] Id.; see also German Lopez, An HIV-Positive Man in Texas is Serving 35 Years in Prison for Spitting on a Cop, Vox (Feb. 19, 2015, 4:10 PM), http://www.vox.com/2015/2/19/8071687/hiv-criminalization [https://perma.cc/PP5Q-HLY5].

[10] The Ctr. for HIV Law & Policy, supra note 8; see also Diana Anderson-Minshall, Amazing HIV+ Gay Men: Nick Rhoades, Plus (Sep. 11, 2014 4:00 AM), http://www.hivplusmag.com/people/2014/09/11/amazing-hiv-gay-men-nick-rhoades [https://perma.cc/8NJX-L7EX].

[11] Id.

[12] The Ctr. for HIV Law & Policy, Ending & Defending Against HIV Criminalization: A Manual for Advocates 9 (2015), available at http://hivlawandpolicy.org/sites/www.hivlawandpolicy.org/files/HIV%20Crim%20Manual%20%28updated%205.4.15%29.pdf [https://perma.cc/S5D2-RHNU].

[13] See generally The Ctr. for HIV Law & Policy, Why Are We Putting People in Jail for Having HIV? (Nov. 2015), http://www.hivlawandpolicy.org/resources/why-are-we-putting-people-jail-having-hiv-a-grassroots-guide-hiv-criminalization-facts [https://perma.cc/DTF8-V7J9].

[14] Id.

[15] Id.

[16] Id.

[17] Pub. L. No. 101-381, 104 Stat. 576 (1990) (Congress reauthorized this act in 1996, 2000, 2006, 2009, and 2013).

[18] Who Was Ryan White?, Dep’t. Health & Hum. Servs., http://hab.hrsa.gov/abouthab/ryanwhite.html [https://perma.cc/7P2W-VKE5] (last visited Mar. 4, 2016).

[19] Ryan White CARE Act Celebrates 25th Anniversary, Dep’t. Health & Hum. Servs. (Aug. 18, 2015), http://www.hhs.gov/about/news/2015/08/18/ryan-white-care-act-celebrates-25th-anniversary.html [https://perma.cc/HQD4-4EQD].

[20] Id.

[21] Ryan White Comprehensive AIDS Resources Emergency Act of 1990 § 2647.

[22] Id.

[23] See Mich. Comp. Laws 333.5210 (2015).

[24] The Ctr. for HIV Law & Policy, supra note 12, at 292.

[25] Strub, supra note 2, at 393.

[26] HPV and Cancer, Ctrs. for Disease Control & Prevention, http://www.cdc.gov/cancer/hpv/statistics/cases.htm [https://perma.cc/TQY8-YQRM] (last updated June 23, 2014).

[27] Which Cancers Are Caused by HPV, Nat’l Cancer Inst., http://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet#q2 [https://perma.cc/M7K8-N7PT] (last reviewed Feb. 19, 2015).

[28] Cervical Cancer Statistics, Ctrs. for Disease Control & Prevention, http://www.cdc.gov/cancer/cervical/statistics/#2 [https://perma.cc/HV3Y-DNMZ] (last visited Dec. 9, 2015).

[29] HIV Among Women, Ctrs. for Disease Control & Prevention, http://www.cdc.gov/hiv/group/gender/women/ [https://perma.cc/9ED7-5ZJ6] (last reviewed Nov. 9, 2015).

[30] Id.

[31] Strub, supra note 2, at 393.

[32] Id.

[33] Ind. Code § 16-41-14-17 (2015).

[34] Id. § 35-42-2-1(b), (e), (g).

[35] Id. § 35-45-16-2(a)-(f).

[36] Id. § 35-42-2-1(b), (e), (g); id. 35-45-16-2(a)-(f).

[37] Ind. Code § 35-42-2-1(g).

[38] Id. § 35-42-2-1(d)(2).

[39] HIV and Its Transmission, Ctrs. for Disease Control & Prevention (July 1999), http://hivlawandpolicy.org/sites/www.hivlawandpolicy.org/files/CDC%2C%20HIV%20and%20its%20transmission.pdf [https://perma.cc/T2PQ-LPXC].

[40] Id.

[41] Id.

[42] Id.

[43] Ind. Code § 16-41-7-1.

[44] Id.

[45] Id.

[46] Id.

[47] Id. § 16-41-7-5.

[48] Id. § 35-45-21-3.

[49] Id.

[50] Id. § 35-50-3-3.

[51] Id. § 35-50-2-7(b).

[52] Id. § 16-41-7-1.

[53] HIV Medical Ass’n, supra note 5.

[54] The CTR. for HIV Law & Policy, supra note 12, at 292.

US: New York Public radio produces empathatic audio feature story on HIV criminalisation

Last summer, in a Missouri courtroom, a college wrestler named Michael Johnson was sentenced to 30 years in prison for “recklessly infecting a partner with HIV.”

Johnson, who also goes by “Tiger Mandingo”, was accused of knowingly infecting his partners with HIV, although at least one of them said Johnson called to tell him the diagnosis when Johnson tested positive for the virus.

The case shed light on the stigmas surrounding sexually transmitted infections, or STIs, and especially HIV/AIDS. In more than 30 states there is a legal requirement for HIV positive individuals to disclose their status to whomever they’re having sex with. And while most people agree that honest conversation is a good practice, the laws allow people with HIV to be imprisoned for even spitting, biting or oral sex.

“Every person with HIV in the country who knows they have HIV is one accusation away from finding themselves in a courtroom,” said Sean Strub, director of The Sero Project.

Strub was diagnosed with HIV in the 1980s. Since then, treatments for STIs like HIV/AIDS has made significant progress across the globe. But Strub argues that an HIV diagnosis has continued to carry a stigma, perhaps even worse than before. And Strub said forcing people to disclose their status can backfire, and alienate a population that needs support.

While Strub is working to change the policy, New York University sex researcher and educator, Zhana Vrangalova, is focused on challenging society’s perception of risky sex.

“People really fear that STIs are more prevalent than they are…and that once you catch it you may always keep it,” she said.

Vrangalova is on a mission to de-stigmatize safe sexual behavior. Her website, for example, is about casual sex and provides a forum for people to talk about the flings and one-night stands that are usually dismissed in traditional sex education. Students in her class learn how to balance health and protection with redefining normal sexual behavior.

Jake Hernandez, a 23-year-old nursing student taking her class, has had personal experience with the same situation that got Michael Johnson behind bars. His ex-boyfriend called him to tell him he was HIV positive after they had oral sex, and luckily, Hernandez tested negative.

While he felt betrayed by his boyfriend, Hernandez still believes society needs to challenge the stereotypes surrounded STIs and the people who have them, especially gay men. While visiting a sex shop for his class with Vrangalova, he said the assumption is, “that we just walk around having sex all the time.”

“I mean I would probably say I’ve had casual sex once in my life. If I was dating a girl would you be saying all these things?”

Listen here

Originally published at WNYC.com

US: Hillary Clinton: "We should call on states to reform outdated and stigmatizing HIV criminalization laws."

Yesterday, at Nancy Reagan’s funeral, I said something inaccurate when speaking about the Reagans’ record on HIV and AIDS. Since then, I’ve heard from countless people who were devastated by the loss of friends and loved ones, and hurt and disappointed by what I said. As someone who has also lost friends and loved ones to AIDS, I understand why. I made a mistake, plain and simple.

I want to use this opportunity to talk not only about where we’ve come from, but where we must go in the fight against HIV and AIDS.

To be clear, the Reagans did not start a national conversation about HIV and AIDS. That distinction belongs to generations of brave lesbian, gay, bisexual, and transgender people, along with straight allies, who started not just a conversation but a movement that continues to this day.

The AIDS crisis in America began as a quiet, deadly epidemic. Because of discrimination and disregard, it remained that way for far too long. When many in positions of power turned a blind eye, it was groups like ACT UP, Gay Men’s Health Crisis and others that came forward to shatter the silence — because as they reminded us again and again, Silence = Death. They organized and marched, held die-ins on the steps of city halls and vigils in the streets. They fought alongside a few courageous voices in Washington, like U.S. Representative Henry Waxman, who spoke out from the floor of Congress.

Then there were all the people whose names we don’t often hear today — the unsung heroes who fought on the front lines of the crisis, from hospital wards and bedsides, some with their last breath. Slowly, too slowly, ignorance was crowded out by information. People who had once closed their eyes opened their hearts.

If not for those advocates, activists, and ordinary, heroic people, we would not be where we are in preventing and treating HIV and AIDS. Their courage — and their refusal to accept silence as the status quo — saved lives.

We’ve come a long way. But we still have work to do to eradicate this disease for good and to erase the stigma that is an echo of a shameful and painful period in our country’s history.

This issue matters to me deeply. And I’ve always tried to do my part in the fight against this disease, and the stigma and pain that accompanies it. At the 1992 Democratic National Convention, when my husband accepted the nomination for president, we marked a break with the past by having two HIV-positive speakers — the first time that ever happened at a national convention. As First Lady, I brought together world leaders to strategize and coordinate efforts to take on HIV and AIDS around the world. In the Senate, I put forward legislation to expand global AIDS research and assistance and to increase prevention and education, and I proudly voted for the creation of PEPFAR and to defend and protect the Ryan White Act. And as secretary of state, I launched a campaign to usher in an AIDS-free generation through prevention and treatment, targeting the populations at greatest risk of contracting HIV.

The AIDS crisis looks very different today. There are more options for treatment and prevention than ever before. More people with HIV are leading full and happy lives. But HIV and AIDS are still with us. They continue to disproportionately impact communities of color, transgender people, young people and gay and bisexual men. There are still 1.2 million people living with HIV in the United States today, with about 50,000 people newly diagnosed each year. In Sub-Saharan Africa, almost 60 percent of people with HIV are women and girls. Even though the tools exist to end this epidemic once and for all, there are still far too many people dying today.

That is absolutely inexcusable.

I believe there’s even more we can — and must — do together. For starters, let’s continue to increase HIV and AIDS research and invest in the promising innovations that research is producing. Medications like PrEP are proving effective in preventing HIV infection; we should expand access to that drug for everyone, including at-risk populations. We should call on Republican governors to put people’s health and well-being ahead of politics and extend Medicaid, which would provide health care to those with HIV and AIDS.

We should call on states to reform outdated and stigmatizing HIV criminalization laws. We should increase global funding for HIV and AIDS prevention and treatment. And we should cap out-of-pocket expenses and drug costs—and hold companies like Turing and Valeant accountable when they attempt to gouge patients by jacking up the price of lifesaving medications.

We’re still surrounded by memories of loved ones lost and lives cut short. But we’re also surrounded by survivors who are fighting harder than ever. We owe it to them and to future generations to continue that fight together. For the first time, an AIDS-free generation is in sight. As president, I promise you that I will not let up until we reach that goal. We will not leave anyone behind.

Canada: Latest unjust HIV non-disclosure conviction highlights everything that’s wrong with Canada’s approach

Analysis: Canada’s newest sex offenders

On March 1, a 29-year-old indigenous woman in Manitoba was sentenced to prison for the crime of aggravated sexual assault. More than four years ago, Marjorie Schenkels had sex without a condom with a friend on three occasions. Schenkels did not disclose the fact that she is HIV-positive. Schenkels, a survivor of sexual violence in both her family and relationships, is now registered as a sex offender and will spend the next two years in jail.

This is where the Supreme Court of Canada, and prosecutors, have brought us with their overly broad use of criminal law when it comes to HIV. Because of a series of much-criticized decisions that equate HIV non-disclosure before sex with sexual assault, indigenous women living with HIV are now a new face of sexual offender in this country.

Schenkels’ case is a window into this miscarriage of justice. As in many other cases of HIV non-disclosure, the sentencing judge found that there was no lie, manipulation or exploitation by Schenkels. Rather, her silence was the result of fear and denial. Nor was there any evidence that she actually transmitted the virus to the complainant who has since tested positive for HIV. But because the Supreme Court ruled that HIV non-disclosure before sex can amount to fraud invalidating consent to sex, people living with HIV can be convicted of aggravated sexual assault — an offence usually reserved for the most violent cases of sexual assault — even if the sex was neither forced nor coerced, there was no intention to harm and HIV was not transmitted.

Criminalizing HIV non-disclosure is often perceived as a means of protecting women. This perception is reinforced by the fact that the charge used to prosecute people for not disclosing the fact they have HIV is sexual assault. But criminalizing HIV non-disclosure does not protect women from HIV, nor from gender-based violence nor the inequality in which it is rooted. What it does do is put women living with HIV — especially those in abusive relationships — at increased risk of violence, abuse and prosecution. For many indigenous women, particularly those surviving a legacy of colonization and the intergenerational effects of residential schools, the overly broad criminalization of HIV non-disclosure has only institutionalized another form of violence against them.

As of today, at least 17 women living with HIV have been prosecuted for HIV non-disclosure in Canada. Most of them were already living on the margins, already facing a greater risk of acquiring HIV and making it even more challenging to disclose their status. Some of those women, like Schenkels, are indigenous; also like her, some are survivors of sexual or other violence. Many were and are living in poverty or with little income security. Some had precarious immigration status. Add to this marginalization the dilemma of revealing a heavily stigmatized status such as being HIV-positive or facing criminal charges for one of the most serious offences in the Criminal Code. This bind does not help or protect women.

When a person does not disclose they have HIV, it is usually not about asserting force over another person in order to gain sexual gratification, but rather the result of fear of violence or other harm, rejection or denial. By associating HIV non-disclosure with sexual assault, we are both harming people living with HIV and seriously undermining the law of sexual assault. These concerns are not limited to the HIV community. Feminist scholars and advocates are also questioning the value of such use of the law, as captured in a new documentary film, Consent: HIV non-disclosure and the law of sexual assault. (see below; the image above is a still from the film).

As one of the film’s experts asks, “What does it do to our understanding of sexual assault law as a vehicle to promote women’s equality if the new faces of sex offenders are young, racialized, aboriginal or street-involved women?” It is a bitter irony that Consent was publicly screened in Winnipeg the day of Schenkels’ sentencing hearing.

Schenkels’ case brings Canadians, once again, face to face with the cruelty of a justice system that not only fails to protect women from sexual violence, but also ensnares the most vulnerable, despite their efforts to overcome their struggles. Schenkels is taking responsibility for her life and her former actions. She is married and a caregiver to her partner’s child, and she is accessing HIV care. Even the sentencing judge acknowledged she was considered “a viable candidate for community supervision” rather than imprisonment. Nevertheless, she will spend the next two years in an institution notorious for its limited resources for addressing the health needs of its population, especially those living with HIV. It’s a tragic illustration of how equating HIV non-disclosure with sexual assault makes women less safe and simply multiplies the forms of systemic violence that women living with HIV suffer.

Cécile Kazatchkine is a senior policy analyst and Vajdon Sohaili is director of communications for the Canadian HIV/AIDS Legal Network. Laverne Gervais is the project co-ordinator of Sisters of Fire at Ka Ni Kanichihk.

This piece was originally published in the Winnipeg Free Press.

Consent: HIV non-disclosure and sexual assault law from AIDSLAW on Vimeo.