Russia: The deportation of people living with HIV is outdated, bad for public health and economically ineffective

“He sees his children only by video link.” How the law to deport migrants with HIV turns foreigners into illegal immigrants and destroys families

Automatic Google translation, for original article in Russian, please scroll down.

Author: Ekaterina Ivaschenko

Russia is one of 19 countries in the world where HIV is the basis for deportation. In practice, when migrants find out about their positive status, they do not leave, but turn into illegal immigrants and are afraid to seek treatment. Those who report themselves can be expelled even if they have a family in Russia – although this has been banned since 2015.

We will tell you why the law on deportation harms not only the migrants themselves, but also the economy of Russia, as well as the health of all its inhabitants, regardless of citizenship.

Sardor is 24 years old. He came to work in Russia from Kyrgyzstan nine years ago, at the age of 15. His mother was the first to leave for Russia – after her husband and her three children were abandoned. Sardor did not get along with his father and stepmother, so after the eighth grade he came to his mother. The teenager was sent by bus through Kazakhstan, leaving the driver with a power of attorney.

“I dreamed of getting a good education, becoming a doctor, but in the end, when I came to Russia, I did not speak a word of Russian,” Sardor says. Until the age of 16, he worked at a brick factory in a village near Novosibirsk, then returned to his homeland, received a passport and returned to Russia.

Three years ago, Sardor moved to Moscow, where he worked in various fields, from a janitor to a cook. He found out about his HIV status last year when he got seriously ill in winter and was tested. A specialised NGO (nongovernmental organisation) helps him to receive antiretroviral therapy. The young man does not want to return to his homeland: he says that there is discrimination against HIV-infected people. He also does not tell his relatives about his status.

How deportation law turns migrants into illegal immigrants

For years, specialised NGOs and human rights activists have been fighting for the right of people like Sardor to live in Russia without the threat of deportation. But Russia remains one of 19 countries in the world from which HIV-positive foreigners are expelled . These restrictions are spelled out in the law “On Preventing the Spread of Disease Caused by the Human Immunodeficiency Virus in the Russian Federation”, adopted back in 1995 .

If a person takes an HIV test officially: for example, to obtain a patent or apply for citizenship, his data goes to Rospotrebnadzor, which makes a decision on the undesirability of a foreigner’s stay in Russia and sends the document to the Ministry of Internal Affairs. Since in such cases people have to leave the country on their own, they often remain in Russia illegally. Those who know about this norm in advance take the test anonymously. In case of a positive result, they can cross the border to receive treatment at home, but do not draw up documents.

The coordinator for academic relations of the Regional Expert Group on the Health of Migrants Daniil Kashnitsky explains that in practice the rule on the deportation of HIV-infected foreigners does not work, because deportation itself is expensive even for Russia, the richest state in the region: “After Rospotrebnadzor decides on Deportation of a person is sent to the Ministry of Internal Affairs for execution, but it is impossible to find a person, because he often does not live at the place of registration, plus the deportation itself costs money, to which is added the cost of keeping people in TsVSIGs . And people with HIV-positive status, realising that, for example, they cannot get a patent for work and it is better not to leave the country, because they will never be able to return, they go into illegality. ”

The hidden HIV epidemic: statistics and causes

In 2021, the Financial Research Institute of the Ministry of Finance of Russia published a socio-economic study of state policy on HIV , which also mentions migrants.

The document says that “one of the components of the problem of high levels of HIV incidence among the population of Russia may be the growing scale of the latent epidemic, formed mostly by migrants from Moldova, Tajikistan, Uzbekistan, Ukraine. status”.

“As of 2018, foreign citizens accounted for only 2.1% of new cases of HIV infection, but the Ministry of Internal Affairs data on the number of illegal migrants does not allow us to say that official statistics reflect the true picture of the incidence and prevalence of HIV infection among foreign citizens, “the study says.

The authors of the document say directly that the underlying epidemic is based on the current legal status of HIV-infected migrants: “Under the conditions of Russian legislation, which imposes restrictions on entry and stay on the territory of the country for HIV-infected people, foreign citizens are forced to hide their status, which is a significant threat for the development of a latent epidemic “.

“I read this report, and I was confused by this quote,” says Daniil Kashnitsky, explaining that he means the authors of the report assertion that “one of the components of the problem of high levels of HIV incidence among the Russian population may be the growing scale of a hidden epidemic formed mostly by migrants from Moldova, Tajikistan, Uzbekistan, Ukraine “.

“It is wrong to say that migrants are contributing to the epidemic. If migration is well organised, then this is an extremely positive process from all sides. Not migration is a risk factor, but the circumstances in which migrants find themselves and the laws that are in force in the receiving country, in our case, in Russia, “emphasises Kashnitsky.

The available figures for migrants are really low, especially in comparison with the general data for Russia, where 1.2% of the adult population is infected with HIV . According to Rospotrebnadzor, 2.5 million foreigners were tested for HIV in Russia in 2017. Among the citizens of the neighbouring countries, 32,885 HIV cases were detected, 70% of the detected infected were from Ukraine, Uzbekistan and Tajikistan. “In 2014-2015, 4000-4500 new cases of HIV infection were detected among foreign citizens, mainly from Ukraine, who traveled to Russia en masse. Now about 3500 cases are detected a year. But there are more migrants with HIV, because some of them are tested anonymously, and some avoid testing, knowing that they are infected, “the representative of Rospotrebnadzor said at the time.

An interesting situation is with Turkmenistan, which officially reported two cases of HIV infection in the country. At the same time, on the territory of Russia in 2017, Rospotrebnadzor recorded 136 cases of HIV infection among citizens of this country, although the flow of migrants from there is small.

A separate situation for the citizens of Kyrgyzstan. The fact is that the country is a member of the EAEU, therefore, unlike Uzbeks and Tajiks, its citizens do not receive a patent for which they need to take an HIV test.

Helping people with HIV is cheaper than treating AIDS. Who does it

The fact that foreigners with HIV remain in Russia is evidenced, for example, by the data of the Patient Control movement : “In 2020, thanks to the donations provided and the joint efforts of HIV activists, 449 people from 19 countries received ARVs on the territory of Russia, of them: Tajikistan – 88, Kyrgyzstan – 67, Uzbekistan – 33, Kazakhstan – 20 and Turkmenistan – 2 “.

Kirill Barskiy, program coordinator of the Steps Foundation, one of the few Russian nongovernmental organisations that helps HIV-positive migrants, says that foreigners have been turning to them for help since the foundation was founded in 2004. In 2020 alone, more than 2,000 people. People who contacted the fund wanted to anonymously take a test for HIV, hepatitis and even coronavirus, get advice on their health, and also sought help in finding therapy.

36-year-old Kemal is one of those who “Steps” literally helped to get back on their feet. Kemal ended up in Russia 10 years ago. I came from Turkmenistan to earn money under the pretext of studying – otherwise it was impossible to get here because of the visa regime between the countries. The young man really studied at the university, and at night he worked as a loader, cook, waiter to pay for his studies.

Kemal learned about his HIV status in 2014, when he updated his medical book and passed an HIV test. “I didn’t immediately understand what it was: they didn’t give me a medical book, well, okay. 2,000 rubles in cash, “says Kemal.

The man got worse every month. He dropped out of school but continued to work. At some point, it became very bad, and he went to the hospital. “As I later found out, HIV had already spilled over into AIDS and I had Kaposi’s sarcoma,” says Kemal. Thanks to the work of the foundation’s staff, he was able to recover and start taking antiretroviral drugs.

“Now I work in those jobs where a medical book and a contract are not needed. Every day I take therapy. It costs 10 thousand rubles a month – a significant amount for an illegal migrant. But I have HIV, with which I can live in Moscow, but in Turkmenistan is not, because they deny the presence of HIV-infected, “- explains the man.

The abolition of the deportation rule is beneficial even economically, says Daniil Kashnitsky: it will enable migrants to take therapy on time, and HIV will not turn into AIDS, which develops serious and costly diseases.

“When life is threatened, a person is subject to emergency treatment, which is provided to everyone in Russia free of charge. According to our data, inpatient treatment of a person with HIV-associated diseases will cost Russia three times more than if he buys the therapy himself or receives it for AIDS. -the center of his state, – explains the expert. – The principle itself is important here: a person takes therapy – and in three months his viral load drops to zero. He will not transmit HIV through unprotected sex, he can give birth to healthy children, work and pay taxes. not being treated, he develops one of the concomitant diseases – and the cost of treatment, already from the Russian budget, will be at least three times more expensive than a year’s course of therapy. ”

Kirill Barskiy, the coordinator of the Steps Foundation, emphasises that the authorities’ attempt to control does not work with any disease: “People will still hide. Do not forget that HIV infection has a window period of six months when the virus is not detected. that the authorities have to wait six months for a second test, at the same time prohibiting the migrant from any contacts. But this is impossible. Therefore, mechanisms are needed to control the process of treatment of foreigners. In fact, no one knows the real statistics of HIV-positive migrants in Russia. Accordingly, we do not know how many are taking treatment and controlling the disease, and how many are not. If a person is not expelled, he will not hide, and this will make it possible to build a system for monitoring his disease and preventing its spread. ”

Deportation of relatives with HIV: banned since 2015, but ongoing

NGOs and the community have long been fighting for the complete abolition of the deportation rule, says Daniil Kashnitsky. The first letter with such an initiative was sent to the government in May 2018, then they turned to relevant government agencies.

“We have received replies to all our letters, but these are polite enumerations of the norms of Russian legislation concerning foreigners with HIV. The letters invariably mention the norm that foreigners with HIV, whose relatives are Russian citizens, may remain in Russia. In practice, only a few have managed to achieve this. , therefore, the norm must be abolished entirely, because it is bad for migrants, for Russia and its budget. There is not a single plus in maintaining this norm, “Kashnitsky is sure.

The ruling of the Constitutional Court that if an HIV-positive foreigner has a spouse, children or parents who are Russian citizens, then he cannot be expelled from the country, was adopted in 2015. However, in reality, lawyers have been fighting for years for the rights of HIV-infected foreigners to live with their families in Russia.

Alisher, originally from Andijan, came to Russia in 2013 after his parents. His father already has Russian citizenship. At first, the man lived with his parents in one of the regions, and then moved to Moscow, where he met a Russian woman.

In 2015, they had a daughter with Alisher, and in 2016, a son. The marriage was not registered, but Alisher is listed as a father in the birth certificates of the children. In 2017, the man decided to apply for a temporary residence permit in Russia (RVP) for marriage. To do this, it was required to pass an HIV test, which turned out to be positive.

The man did not know that the entrance to the country was closed for HIV-positive migrants, and after another flight to his homeland, he was not allowed to enter Russia. It was in the spring of 2018. The wife appealed against the decision of Rospotrebnadzor in the district court of Khabarovsk, at the place of permanent registration of Alisher. But in December 2019, the judge left the decision of the migration authorities unchanged.

“I have been in charge of this case for several years,” says Olga Belousova, a lawyer who assists migrants in similar situations. “Now his wife has hired a lawyer who represents Alisher’s interests in Russian courts. …

Such cases last at least a year, notes Olga Belousova. And there are times when the deportation rule leads to sad consequences. The lawyer tells how she handled the case of an HIV-infected girl from Ukraine, who in Russia received a residence permit on her father’s side. At the stage of taking the tests, the girl was diagnosed with HIV, issued a document obliging her to leave Russia, and put a lifelong entry ban. In 2019 she returned to Ukraine.

“The girl had the right to be in Russia. She contacted us, we completed all the documents on time, but at the trial we were told that we were late and did not cancel the decision of Rospotrebnadzor. Against the background of this news, her father had a heart attack, and in August He died in 2019. My applicant was unable to bury him or visit her relatives, “Olga Belousova said.

But there are stories with happy endings. Now a lawyer is working on the case of a woman from Kazakhstan who, together with her husband and two children, applied for citizenship under the resettlement program.

“They were refused because the woman was diagnosed with HIV. She decided to divorce in order to give her husband and children an opportunity to obtain citizenship. She lived in Kazakhstan for a year and did not see her children, did not take part in their upbringing. After the husband and children received citizenship, the family decided to recover. We submitted a request to Rospotrebnadzor to find out about the woman’s position, and we received an answer that she was not on the lists of those who were denied entry to Russia, since during the pandemic the adoption of such decisions was suspended. She has Russian relatives, and the family will finally be reunited. ”

Why the deportation norm is not only outdated, but also economically unprofitable for Russia

The coordinator of the Regional Expert Group on the Health of Migrants Daniil Kashnitsky emphasises that the law on HIV adopted in 1995 was long out of date: “Then the deportation rule was prescribed, because there was no effective treatment for either foreigners or Russians, and people with HIV were quickly dying. Thanks to modern drugs, which, moreover, become cheaper every year, treating people is much more profitable than driving them out of the country. ”

Kirill Barsky from the Steps Foundation says that during negotiations with the community, the authorities operate with the fact that “foreigners are spreading the infection”, although no one can verify and prove this.

“However, the main counterargument comes not from the deputies, but from the economic departments, which believe that they will have to pay for the treatment of foreigners from the state budget,” says Barsky. for a start, it was possible to carry out surveillance of a real disease. And for this it is necessary to remove protective measures so that people are not afraid to go to hospitals. ”

“It is impossible to talk about building a system of assistance to HIV-positive foreigners at the expense of the countries of origin of migrants or the Global Fund, as long as there is a rule on deportation,” continues Kirill Barsky. “People are afraid to seek help. In principle, they do not want to talk to doctors, fearing, that at any moment they will be put in the CVDIG and sent home.Migrants are in a situation where they understand that they need help, and often they can pay for therapy themselves, but cannot tell about it, because they understand what the consequences could be. Often, even the citizens of the EAEU countries, who do not need to take an HIV test to obtain a patent, live well here and receive therapy from their homeland, but they are still afraid to get to the clinic, because they are at risk of being deported. ”

Daniil Kashnitsky, who works with representatives of AIDS centers in the countries of origin of migrants, notes that Russia should not be afraid that if the deportation rule is canceled, the costs of treating foreigners will fall on its budget: “Employees of AIDS centers in Central Asian countries are not only ready to share therapy, they They are already doing this. They send therapy to their migrants, regardless of their status of residence in Russia. For example, during the closed borders, Kyrgyzstan gave therapy to his hands for up to a year. so he knows what’s going on with his patient. ”

Kirill Barskiy confirms that the countries of origin (NGOs contacted the Ministry of Health of Uzbekistan, Kyrgyzstan, Moldova and other states) answered that they were ready to treat their citizens. Kyrgyzstan gave a detailed answer that it is ready to discuss these initiatives between the countries and, if necessary, to adopt appropriate changes to the legislation.

“In order for Russian officials to change their minds about HIV among foreigners, our experts are preparing an economic argument that the benefits of removing barriers are much higher than their existence. All civilised countries have removed barriers, and the countries of North America and Europe are even treating at their own expense foreigners, because they understand how it is economically beneficial for them. We are not opposing the state, but we are promoting a scientific justification for the need to revise the deportation rule, “Kirill Barsky concludes.

Екатерина Иващенко

“Видит своих детей только по видеосвязи”. Как закон о депортации мигрантов с ВИЧ превращает иностранцев в нелегалов и разрушает семьи

Россия – одна из 19 стран в мире, где ВИЧ – основание для депортации. На практике мигранты, узнавая о своем положительном статусе, не уезжают, а превращаются в нелегалов и боятся обращаться за лечением. Те, кто сообщает о себе, могут быть высланы, даже если в России у них есть семья, – хотя с 2015 года это запрещено.

Рассказываем, почему закон о депортации вредит не только самим мигрантам, но и экономике России, а также здоровью всех ее жителей, независимо от гражданства.

Сардору 24 года. Он приехал на заработки в Россию из Кыргызстана девять лет назад, 15-летним. Первой в Россию уехала его мать – после того как ее и троих детей бросил супруг. Сардор не ужился с отцом и мачехой, поэтому после восьмого класса приехал к матери. Подростка отправили автобусом через Казахстан, оставив водителю доверенность.

“Я мечтал получить хорошее образование, стать врачом, а в итоге, когда приехал в Россию, ни слова не говорил по-русски”, – говорит Сардор. До 16 лет он работал на кирпичном заводе в деревне под Новосибирском, потом вернулся на родину, получил паспорт и снова приехал в Россию.

Три года назад Сардор перебрался в Москву, где работал в самых разных сферах, начиная от дворника и заканчивая поваром. Про свой ВИЧ-статус он узнал в прошлом году, когда серьезно заболел зимой и сдавал анализы. Получать антиретровирусную терапию ему помогает профильная НПО (неправительственная организация). Возвращаться на родину молодой человек не хочет: говорит, что там по отношению к ВИЧ-инфицированным существует дискриминация. Родственникам о своем статусе он тоже не говорит.

Как закон о депортации превращает мигрантов в нелегалов

Профильные НПО и правозащитники годами бьются за право таких, как Сардор, жить в России без угрозы депортации. Но Россия остается одной из 19 стран мира, откуда выдворяют ВИЧ-положительных иностранцев. Эти ограничения прописаны в принятом еще в 1995 году законе “О предупреждении распространения в Российской Федерации заболевания, вызываемого вирусом иммунодефицита человека”.

Если человек сдает тест на ВИЧ официально: например, для получения патента или оформления документов на гражданство, – его данные попадают в Роспотребнадзор, который выносит решение о нежелательности пребывания иностранца на территории России и отправляет документ в МВД. Так как в таких случаях люди должны самостоятельно покинуть страну, они чаще всего остаются в России нелегально. Те, кто знает об этой норме заранее, сдают тест анонимно. В случае положительного результата они могут пересекать границу, чтобы получать лечение на родине, но не оформляют документы.

Координатор по академическим связям Региональной экспертной группы по здоровью мигрантов Даниил Кашницкий объясняет, что на практике норма о депортации ВИЧ-инфицированных иностранцев не работает, потому что сама депортация дорога даже для России – самого богатого государства в регионе: “После того как Роспотребнадзор принимает решение о выдворении человека, оно отправляется на выполнение в МВД. Но человека невозможно найти, потому что он чаще всего проживает не по месту регистрации, плюс сама депортация стоит денег, к которой добавляется стоимость содержания людей в ЦВСИГах. То есть из России их насильно не выдворяют. А люди с ВИЧ-положительным статусом, понимая, что им, например, не получить патент для работы и лучше не покидать страну, потому что они никогда не смогут вернуться, уходят в нелегальность”.

Скрытая эпидемия ВИЧ: статистика и причины

В 2021 году Научно-исследовательский финансовый институт Минфина России обнародовал социально-экономическое исследование государственной политики борьбы с ВИЧ, в котором в том числе упоминаются мигранты.

В документе сказано, что “одной из составляющих проблемы высоких уровней заболеваемости населения России ВИЧ-инфекцией могут являться растущие масштабы скрытой эпидемии, формируемой по большей части мигрантами из Молдовы, Таджикистана, Узбекистана, Украины. В условиях действующего законодательства представители подобной группы населения вынуждены скрывать свой статус”.

“По данным на 2018 год, на долю иностранных граждан приходилось только 2,1% новых случаев выявления ВИЧ-инфекции, но данные МВД по количеству нелегальных мигрантов не позволяют говорить о том, что официальная статистика отражает истинную картину заболеваемости и распространенности ВИЧ-инфекции среди иностранных граждан”, – говорится в исследовании.

Авторы документа прямо говорят, что в основе скрытой эпидемии лежит текущее правовое положение ВИЧ-инфицированных мигрантов: “В условиях российского законодательства, предполагающего ограничение на въезд и пребывание на территории страны для инфицированных ВИЧ, иностранные граждане вынуждены скрывать свой статус, что представляет собой существенную угрозу для развития скрытой эпидемии”.

“Я читал этот доклад, и меня смутила эта цитата”, – говорит Даниил Кашницкий, объясняя, что имеет в виду утверждение авторов доклада о том, что “одной из составляющих проблемы высоких уровней заболеваемости населения России ВИЧ-инфекцией могут являться растущие масштабы скрытой эпидемии, формируемой по большей части мигрантами из Молдовы, Таджикистана, Узбекистана, Украины”.

“Говорить, что мигранты вносят вклад в эпидемию, неправильно. Если миграция хорошо организована, то это со всех сторон исключительно положительный процесс. Не миграция фактор риска, а те обстоятельства, в которые попадают мигранты, и те законы, которые действуют в стране приема, в нашем случае в России”, – подчеркивает Кашницкий.

Имеющиеся цифры по мигрантам действительно невысокие, особенно в сравнении с общими данными по России, 1,2% взрослого населения которой инфицировано ВИЧ. По информации Роспотребнадзора, в 2017 году в России на ВИЧ было протестировано 2,5 миллиона иностранцев. Среди граждан стран ближнего зарубежья выявлено 32 885 случаев ВИЧ, 70% выявленных инфицированных – из Украины, Узбекистана и Таджикистана. “В 2014-2015 годы выявлялось по 4000-4500 новых случае ВИЧ-инфекции среди иностранных граждан, преимущественно Украины, которые массово ехали в Россию. Сейчас выявляется порядка 3500 случаев в год. Но мигрантов с ВИЧ больше, потому что часть из них сдает анализы анонимно, а часть избегает тестирования, зная, что они инфицированы”, – говорил тогда представитель Роспотребнадзора.

Интересна ситуация с Туркменистаном, который официально докладывал о двух случаях ВИЧ-инфекции на территории страны. При этом на территории России в 2017 году Роспотребнадзор зафиксировал 136 случаев ВИЧ-инфекции среди граждан этой страны, хотя поток мигрантов оттуда небольшой.

Отдельное положение у граждан Кыргызстана. Дело в том, что страна входит в ЕАЭС, поэтому, в отличие от узбекистанцев и таджикистанцев, ее граждане не получают патент, для которого нужно сдавать тест на ВИЧ.

Помогать людям с ВИЧ дешевле, чем лечить от СПИДа. Кто это делает

О том, что иностранцы с ВИЧ остаются в России, свидетельствуют, например, данные движения “Пациентский контроль”: “В 2020 году благодаря предоставленным пожертвованиям и объединенному усилию ВИЧ-активистов помощь на территории России с АРВ-препаратами получили 449 человек из 19 стран, из них: Таджикистана – 88, Кыргызстана – 67, Узбекистана – 33, Казахстана – 20 и Туркменистана – 2”.

Кирилл Барский, координатор программ фонда “Шаги” – одной из немногих российских неправительственных организаций, которые помогают ВИЧ-положительным мигрантам, – рассказывает, что иностранцы обращаются к ним за помощью с момента основания фонда в 2004 году. Только в 2020 году – более 2000 человек. Обратившиеся в фонд люди хотели анонимно сдать тест на ВИЧ, гепатит и даже коронавирус, получить консультацию на тему своего здоровья, а также искали помощи в поиске терапии.

36-летний Кемаль – один из тех, кому “Шаги” буквально помогли встать на ноги. Кемаль оказался в России 10 лет назад. Приехал из Туркменистана на заработки под предлогом учебы – по-другому сюда было не попасть из-за визового режима между странами. Молодой человек действительно учился в вузе, а по ночам работал грузчиком, поваром, официантом, чтобы оплачивать обучение.

Про свой ВИЧ-статус Кемаль узнал в 2014 году, когда обновлял медкнижку и сдал тест на ВИЧ. “Я не сразу понял, что это такое: не дали медкнижку, ну и ладно. Но без нее с работы уволили, еще и последнюю зарплату не выплатили. Я устроился работать уборщиком в ночной клуб. Работал без договора, зато каждый день получал 1500-2000 рублей наличными”, – рассказывает Кемаль.

С каждым месяцем мужчине становилось хуже. Он бросил учебу, но продолжал работать. В какой-то момент стало совсем плохо, и он обратился в больницу. “Как я потом узнал, ВИЧ уже перетекал в СПИД и у меня началась саркома Капоши”, – говорит Кемаль. Благодаря работе сотрудников фонда ему удалось вылечиться и начать принимать антиретровирусные препараты.

“Сейчас я работаю на тех работах, где не нужна медкнижка и договор. Каждый день принимаю терапию. На нее уходит 10 тысяч рублей в месяц – существенная сумма для нелегального мигранта. Но у меня ВИЧ, с которым в Москве я могу жить, а в Туркменистане нет, потому что там отрицают наличие ВИЧ-инфицированных”, – объясняет мужчина.

Отмена нормы о депортации выгодна даже экономически, считает Даниил Кашницкий: она даст возможность мигрантам вовремя принимать терапию, и ВИЧ не перейдет в СПИД, при котором развиваются тяжелые и дорогостоящие заболевания.

“При угрозе жизни человек подпадает под лечение по экстренной помощи, которая в России оказывается всем бесплатно. Согласно нашим данным, России обойдется в три раза дороже стационарное лечение человека с ВИЧ-ассоциированными заболеваниями, чем если он будет сам покупать терапию или получать ее от СПИД-центра своего государства, – объясняет эксперт. – Тут важен сам принцип: человек принимает терапию – и за три месяца его вирусная нагрузка снижается до нуля. Он не передаст ВИЧ при незащищенном сексе, может рожать здоровых детей, работать и платить налоги. Либо человек не лечится, у него развивается одно из сопутствующих заболеваний – и расходы на лечение, уже из российского бюджета, будут как минимум в три раза дороже годового курса терапии”.

Координатор фонда “Шаги” Кирилл Барский подчеркивает, что попытка контроля со стороны властей не работает ни с каким заболеванием: “Люди все равно будут прятаться. Не стоит забывать, что у ВИЧ-инфекции есть период окна в полгода, когда вирус не выявляется. Получается, что власти должны ждать полгода повторного теста, параллельно запрещая мигранту любые контакты. Но это невозможно. Поэтому нужны механизмы, которые будут контролировать процесс лечения иностранцев. На самом деле никто не знает реальную статистику ВИЧ-позитивных мигрантов в России. Соответственно, мы не знаем, сколько принимает лечение и контролирует заболевание, а сколько – нет. Если человека не будут выдворять, то он не будет прятаться, и это даст возможность выстроить систему наблюдения за его заболеванием и предотвращением ее распространения”.

Депортация родственников с ВИЧ: запрещена с 2015-го, но продолжается

НПО и сообщество давно борются за полную отмену нормы о депортации, рассказывает Даниил Кашницкий. Первое письмо с такой инициативой отправили в правительство в мае 2018 года, затем обратились и в профильные госорганы.

“На все свои письма мы получили ответы, но это вежливые перечисления норм российского законодательства, касающиеся иностранцев с ВИЧ. Неизменно в письмах упоминают норму, что в России могут остаться иностранцы с ВИЧ, родственники которых – граждане России. На практике лишь единицам удалось этого добиться, поэтому норму надо отменять целиком, потому что это плохо для мигрантов, для России и ее бюджета. В сохранении этой нормы нет ни одного плюса”, – уверен Кашницкий.

Постановление Конституционного суда о том, что если у ВИЧ-положительного иностранца есть супруг, дети или родители – граждане России, то его нельзя выдворять из страны, принято в 2015 году. Однако в реальности юристы годами борются за права ВИЧ-инфицированных иностранцев жить со своей семьей в России.

Алишер родом из Андижана, в Россию приехал в 2013 году вслед за своими родителями. У его отца уже есть гражданство России. Первое время мужчина жил с родителями в одном из регионов, а потом переехал в Москву, где познакомился с россиянкой.

В 2015 году у них с Алишером родилась дочь, а в 2016-м – сын. Брак не был зарегистрирован, но в свидетельствах о рождении детей Алишер указан как отец. В 2017 году мужчина решил подать документы на получение разрешения на временное проживание в России (РВП) по браку. Для этого требовалось сдать анализ на ВИЧ, который оказался положительным.

Мужчина не знал, что для ВИЧ-положительных мигрантов закрывают въезд в страну, и после очередного полета на родину в Россию его не впустили. Это было весной 2018 года. Супруга обжаловала решение Роспотребнадзора в районном суде Хабаровска, по месту постоянной регистрации Алишера. Но в декабре 2019 года судья оставила решение миграционных властей без изменений.

“Я курирую это дело уже несколько лет, – говорит юрист Ольга Белоусова, которая оказывает помощь мигрантам, попавшим в подобные ситуации. – Сейчас его жена наняла адвоката, который представляет интересы Алишера в российских судах. А пока он видит своих детей только по видеосвязи”.

Такие дела длятся минимум год, отмечает Ольга Белоусова. И бывают случаи, когда норма о депортации приводит к печальным последствиям. Юрист рассказывает, как вела дело ВИЧ-инфицированной девушки из Украины, которая в России получала вид на жительство по отцу. На этапе сдачи анализов у девушки обнаружили ВИЧ, выдали документ, обязывающий покинуть Россию, и поставили пожизненный запрет на въезд. В 2019 году она вернулась в Украину.

“Девушка имела право находиться в России. Она связалась с нами, все документы мы оформили в срок, но на суде нам сказали, что мы опоздали, и не отменили решение Роспотребнадзора. На фоне этих новостей у ее отца случился сердечный приступ, и в августе 2019 года он скончался. Моя заявительница не смогла ни похоронить его, ни приехать к родственникам”, – рассказала Ольга Белоусова.

Но есть истории и со счастливым концом. Сейчас юрист ведет дело женщины из Казахстана, которая вместе с мужем и двумя детьми подавала на гражданство по программе переселения.

“Им отказали, так как у женщины обнаружили ВИЧ. Она решила развестись, чтобы дать возможность мужу и детям получить гражданство. Год жила в Казахстане и не видела своих детей, не принимала участие в их воспитании. После получения гражданства мужем и детьми семья решила восстановиться. Мы подали запрос в Роспотребнадзор, чтобы узнать о положении женщины, и нам пришел ответ, что ее нет в списках тех, кому закрыт въезд в Россию, так как на время пандемии принятие таких решений было приостановлено. Теперь мы срочно готовим документы, что у нее есть родственники-россияне, и семья наконец-то воссоединится”.

Почему норма депортации не только устарела, но и экономически невыгодна России

Координатор Региональной экспертной группы по здоровью мигрантов Даниил Кашницкий подчеркивает, что принятый в 1995 году закон о ВИЧ давно устарел: “Тогда норма о депортации была прописана, потому что не было эффективного лечения ни для иностранцев, ни для россиян и люди с ВИЧ быстро умирали. Благодаря современным препаратам, которые к тому же с каждым годом становятся дешевле, лечить людей намного выгоднее, чем выгонять из страны”.

Кирилл Барский из фонда “Шаги” рассказывает, что во время переговоров с сообществом власти оперируют тем, что “иностранцы распространяют инфекцию”, хотя никто не может это проверить и доказать.

“Однако основная контраргументация идет со стороны не депутатов, а экономических ведомств, которые считают, что платить за лечение иностранцев придется из средств госбюджета, – говорит Барский. – Никто из этих ведомств не рассматривает возможность дать этим людям обнаружиться и быть в законном поле, чтобы для начала можно было осуществить надзор за реальным заболеванием. А для этого надо снять заградительные меры, чтобы люди не боялись обращаться в больницы”.

“Невозможно говорить о выстраивании оказания системы помощи ВИЧ-положительным иностранцам за счет стран исхода мигрантов или Глобального фонда, пока существует норма о депортации, – продолжает Кирилл Барский. – Люди боятся обращаться за помощью. Они в принципе не хотят разговаривать с врачами, боясь, что в любую секунду их посадят в ЦВСИГ и отправят на родину. Мигранты находятся в такой ситуации, когда понимают, что им нужна помощь, и зачастую сами могут оплачивать терапию, но не могут про это рассказать, потому что понимают, какие могут быть последствия. Нередко даже граждане стран ЕАЭС, которым не надо сдавать тест на ВИЧ для получения патента, прекрасно здесь живут и получают терапию с родины, но все равно боятся попасть в поликлинику, потому что подвержены риску быть депортированными”.

Сотрудничающий с представителями СПИД-центров стран исхода мигрантов Даниил Кашницкий отмечает, что Россия не должна бояться, что в случае отмены нормы о депортации расходы на лечение иностранцев лягут на ее бюджет: “Сотрудники СПИД-центров стран Центральной Азии не только готовы делиться терапией, они уже это делают. Они своим мигрантам, независимо от их статуса проживания в России, отправляют терапию через родственников. Например, во время закрытых границ Кыргызстан выдавал терапию на руки до года. Единственно, раз полгода человек должен отправлять лечащему врачу результаты своих тестов на ВИЧ, чтобы он знал, что происходит с его пациентом”.

Кирилл Барский подтверждает, что страны исхода (НКО обращались в Минздрав Узбекистана, Кыргызстана, Молдовы и других государств) ответили, что готовы лечить своих граждан. Кыргызстан дал развернутый ответ, что готов обсуждать эти инициативы между странами и, если потребуется, принять соответствующие изменения в законодательство.

“Чтобы российские чиновники могли изменить мнение о ВИЧ среди иностранцев, наши эксперты готовят экономическую аргументацию того, что выгода от снятия заградительных мер гораздо выше, чем их существование. Все цивилизованные страны сняли заградительные меры, а страны Северной Америки и Европы даже за свой счет лечат иностранцев, потому что понимают, как это экономически выгодно им. Мы не противостоим государству, а продвигаем научное обоснование необходимости пересмотра нормы о депортации”, – заключает Кирилл Барский.

HIV Justice Network’s Supervisory Board gains new members and a new Chair

The HIV Justice Network (HJN) is delighted to announce a number of significant changes to its Supervisory Board.

Following a joint meeting of the Supervisory and Management Boards earlier this month, Kevin Moody was appointed as the new Chair of the Supervisory Board, taking over from Lisa Power who stepped down after almost four years as the “start-up” Chair.

“Like all organisations that want to survive it’s vital that HJN grows and changes to meet an ever-changing world, the changing faces of HIV and the stigma that leads to criminalisation,” said Ms Power. “I’m very confident in handing over to Kevin Moody (as Chair) that this will continue. I think the greatest challenge in the next decade is to engage and enthuse the newer generations of people with HIV and allies to continue the fight; to challenge inappropriate, unfair and often intersecting laws and those who enforce them without heed to human rights, science and common sense.”

Mr Moody, who was appointed to the Supervisory Board in September 2020, is an independent consultant working on evidence-based research, policy and programming to support the development of person-centred initiatives to improve the health and quality of life of people living with and affected by HIV. A former CEO of the Global Network of People Living with HIV (GNP+), he has previously worked with the World Health Organization and Médecins sans Frontières.

Mr Moody said he was excited to Chair the Supervisory Board as “it is an opportunity to work with incredibly talented people at HJN. I hope to support the continued development and success of HJN as it works globally to eliminate the unjust regulation, control and punishment of people living with HIV.”

In addition HJN welcomed three new members to the Supervisory Board this month, including former founding Director of the AIDS and Rights Alliance for Southern Africa (ARASA), Michaela Clayton who was elected Treasurer; George Ayala, Deputy Director of the Alameda County Public Health Department and the former Executive Director of MPact Global Action for Gay Men’s Health and Rights; and Sarai Chisala-Tempelhoff, a Malawian human rights lawyer and a legal researcher with over 15 years of experience in women’s access to justice. Australian lawyer and activist, Paul Kidd, will continue in his role as Secretary.

Ms Chisala-Tempelhoff said she ‘felt at home’ with her new role. “I am celebrating my new role serving HJN on the Supervisory Board! HIV decriminalisation has been my passion and research focus since I wrote my undergrad dissertation on this two decades ago! This role and this organisation feel like home.”

Lisa Power, as outgoing Chair, will remain on the Supervisory Board as a member without portfolio. Reflecting on her term as Chair, Ms Power said, “The great public achievement of HJN in the past few years has been the Expert Consensus Statement, but I think the most notable feature of HJN – and this is down to [Executive Director, and sole Management Board member] Edwin J Bernard’s leadership – is the universal regard for the organisation and its work in a very difficult and often fraught field, which has been a constant. All I did was give Edwin the space to create while being a sounding board for his concerns as he steered HJN from being one man with a very bright idea to a solid organisation.”

You can read more about the Supervisory Board here.

US: Ending Criminalization of HIV is among Equality Virgina’s legislative priorities for 2021

Equality Virginia outlines 2021 legislative agenda

Equality Virginia Executive Director Vee Lamneck on Monday announced HIV decriminalization is among their organization’s legislative priorities during the 2021 legislative session that begins this week.

“Virginia is one of 37 states with outdated laws targeting and punishing people based on their HIV positive status,” they said during a Zoom call.

According to the Centers for Disease Control and Prevention, these states with laws criminalizing HIV exposure were implemented during the early years of the epidemic to discourage risky behavior leading to transmission, promote safer sex practices and in some instances receive funds to support HIV prevention. The CDC, however, states many of these laws “are now outdated and do not reflect our current understanding of HIV.”

Cedric Pulliam and Deidre Johnson, co-founders of Ending Criminalization of HIV and Over-incarceration in Virginia, support Equality Virginia’s efforts to decriminalize HIV transmission in the state.

“These laws disincentivize testing, deepen community distrust of public health institutions and put people living with HIV at heightened risk of intimate partner violence,” Pulliam told call participants. “Someone can be bit or spit on and they can go to court on that and we know that’s not how transmission occurs.”

Senate Bill 1138, the proposed HIV decriminalization law, is one of eight bills for which Equality Virginia and state legislative sponsors are encouraging public support once the General Assembly convenes on Wednesday. They include an LGBTQ panic defense ban, second-parent adoption protections and an effort to amend the state constitution to affirm marriage equality.

Virginia voters in 2006 approved an amendment to the state constitution to ban same-sex marriages and unions, though the U.S. Supreme Court’s 2015 Obergefell decision rendered the change unconstitutional.

State Sen. Adam Ebbin (D-Alexandria) and state Del. Mark Sickles (D-Alexandria), like others, are concerned with U.S. Supreme Court Justices Clarence Thomas and Samuel Alito’s comments last October that challenged the Obergefell ruling and support amending the state constitution again to affirm marriage equality.

Sickles told attendees on Monday’s call he supported the bill to repeal the marriage amendment, and the two-year amendment process it would initiate because of the conservative makeup of the U.S. Supreme Court and “we don’t know where they are going to go right now.”

However, he felt confident the legislation would pass the 2021 session and make its way to Virginia voters in 2022 when they will vote to affirm marriage equality in the state’s constitution.

“The way Americans think about this fundamental right,” Sickles said. “We should get an overwhelming majority in 2022.”

Lamneck said it was important to remove the ban on marriage equality from Virginia’s legal code and from the state constitution “which is a reflection of Virginia’s values.”

Equality Virginia and state Del. Mark Levine (D-Alexandria), who is running to be the state’s first openly LGBTQ lieutenant governor, also support repealing a “conscience clause” enabling religious-based adoption agencies to discriminate against qualified LGBTQ families.

Ted Lewis, the executive director of Side-by-Side, a Virginia organization supporting homeless LGBTQ youth, said they were excited to support Equality Virginia’s full legislative advocacy agenda. Lewis specifically looks forward to mobilizing around second-parent adoption, more LGBTQ-inclusive family life curriculum, and the repeal of the “conscience clause” exemption.

Many of the other advocates and supporters on the call used a virtual poll to signal their support for a ban on the so-called panic defense.

Sponsored by state Del. Danica Roem (D-Manassas), this legislation would prevent a defendant from blaming violence or murder on the victim’s sexual orientation or gender identity. 

“For Black or brown trans women, we know this is more likely to happen in court that the perpetrators would say the violence was okay because they were LGBTQ,” Equality Virginia Program Director Thalia Hernandez told participants. “It is unacceptable that this is still happening in Virginia and we need to make sure that it is not happening any more.”

Hernandez was pleased to see many of the measures promoted by Equality Virginia were being supported by attendees via the poll, including protections for LGBTQ seniors and Gov. Ralph Northam’s proposed expansion of Medicaid coverage to include transgender health care services.

UK: The criminal law around HIV transmission has failed to keep pace with social and scientific change

Laws around HIV transmissions need urgent update

The criminal law in relation to HIV transmission has not kept up with the science, according to a team of researchers based at Oxford Brookes, Northumbria and Kingston universities.

Alex Powell, Teaching Fellow in Law at Oxford Brookes University said: “The criminal law has continued to frame HIV in terms of personal responsibility and bodily autonomy within the dominant narratives of danger, disease, and out-dated science. Doctrinal law has failed to keep pace with social and scientific change.”

HIV and the Criminal Law

At present, there is no specific law or Act of Parliament in England and Wales that explicitly addresses the subject of HIV transmission. Nonetheless, the criminalisation of HIV has become the subject of growing academic and policy debate. Falling under the scope of the Offences Against the Person Act 1861, the criminal law has established that HIV transmission can constitute an offence of Grievous Bodily Harm (GBH).

In the article, the researchers considered the changing social and scientific landscape associated with condomless sex, to re-evaluate the development of law in this area, concluding that:

  • The criminal law in relation to HIV transmission has not kept up with the science.
  • If the purpose of HIV transmission is to prevent or regulate ‘serious harm’ (GBH), this definition should be supported by current research rather than outdated fear. The law may be contradictory on these terms by further contributing to medical and social harms such as stigma.

Chris Ashford, Professor of Law and Society at Northumbria University also commented: “The experiences of people living with HIV have been transformed over recent years. Advances in medical science have made the virus a manageable chronic condition, while eliminating the risk of onward transmission for those with access to treatment, something referred to as TasP (treatment as prevention) or U=U (undetectable equals untransmissible).”

Max Morris, Lecturer in Criminology at Kingston University added: “Through the reframing of HIV transmission as an act of harm, criminalisation also implicates the positive partner as a ‘vector of disease’. In doing so, we argue that the language of law diminishes the humanity of HIV positive people by re-constituting them as a ‘danger’ or ‘threat’ to (‘innocent’) HIV negative people.”

The study is published in the Journal of Criminal Law, titled ‘Bareback Sex in the Age of Preventative Medication: Rethinking the “Harms” of HIV Transmission’.

Belarus: Process to abolish HIV criminalisation statutes in Belarus criminal code has been launched

On improvement of the Criminal Code of the Republic of Belarus and the exclusion of Article 157 “HIV infection”

Translation via Deepl.com – For article in Russian, please scroll down.

People PLUS in action

The legal environment for HIV-positive people will be further improved. The process has been launched. On the eve of December 1 a letter from the Deputy Chairman of the Permanent Commission on National Security of the House of Representatives of the National Assembly of the Republic of Belarus A.V. Dubov was received by the Public Association “PLUS People”.

“I would like to inform you that the proposals to make amendments to the Criminal Code of the Republic of Belarus in the part of abolishment of articles 157 and 158 that were received from the Ministry of Health of the Republic of Belarus in my address have been considered together with interested state bodies. Proposals to repeal Articles 157 and 158 have been sent for consideration and taken into account in the course of finalizing the draft laws.

Proposals to amend the Criminal Code were formed at the Round Table “Maintenance of the status of elimination of HIV transmission from mother to child. Amendments to the Criminal Code of the Republic of Belarus in the part of abolition of articles 157 and 158”, which was held on September 28, 2020 with the participation of Deputies of the House of Representatives of the National Assembly of the Republic of Belarus, the Deputy Minister and heads of departments of the Ministry of Health of the Republic of Belarus, country offices of UNAIDS and WHO, the Republican associations of the Belarusian Red Cross Society and Public Association “PLUS People”.

In their presentation, “PLUS People” RSO told the participants of the Round Table about the benefits that the improvement of legislation will bring to society.

“The qualification of crimes related to HIV infection, not according to a special article, but according to the articles for harm to health and how the cases of private and public prosecution will develop in the society a culture of caring about each person’s own health and measures to prevent HIV infection and other diseases”.

People will no longer be afraid to know their HIV status and will be bravely tested for HIV.

People living with HIV:

After learning the diagnosis, they will not avoid being registered at the dispensary.
be able to exercise their right to establish a family and have children without fear
will not be victims of blackmail, extortion and intimidation
We express our gratitude to the brave people who dared to tell the audience of the Round Table their life stories about how they faced stigma and discrimination, thereby confirming and strengthening the arguments for the exclusion of Article 157 from the Criminal Code of RB, cited by ROO “PLUS People”.

О совершенствовании Уголовного кодекса РБ и исключении ст. 157 «Заражение ВИЧ»

Люди ПЛЮС в действии Просмотров: 84

Правовая среда в отношении ВИЧ-положительных людей будет дальше совершенствоваться. Процесс запущен. Накануне 1 декабря в адрес РОО “Люди ПЛЮС” пришло письмо от Заместителя председателя Постоянной комиссии по национальной безопасности  Палаты представителей Национального собрания Республики Беларусь А.В. Дубова.

«Информирую о том, что поступившие из Министерства здравоохранения Республики Беларусь в мой адрес предложения о внесении изменений в Уголовный кодекс Республики Беларусь в части отмены статей 157 и 158 рассмотрены совместно с заинтересованными государственными органами.Принимая во внимание, что в Министерстве юстиции Республики Беларусь создана межведомственная рабочая группа по подготовке проектов кодексов об уголовной ответственности, в рамках деятельности которой предполагается изучение основных направлений совершенствования Уголовного, Уголовно-процессуального и Уголовно-исполнительных кодексов. Предложения в части отмены статей 157 и 158 направлены для рассмотрения и учета их в ходе доработки законопроектов».

Предложения о внесении изменений в Уголовный кодекс были сформированы на Круглом столе «Поддержание статуса элиминации передачи ВИЧ от матери ребёнку. Внесение изменений в УК РБ в части отмены статей 157 и 158», прошедшем 28 сентября 2020 г. с участием Депутатов Палаты представителей Национального собрания Республики Беларусь , Заместителя Министра и руководителей управлений Министерства здравоохранения РБ, страновых офисов ЮНЭЙДС и ВОЗ, Республиканских объединений «Белорусского Общества Красного Креста» и РОО «Люди ПЛЮС».

РОО «Люди ПЛЮС» в своей презентации рассказывали участникам Круглого стола о том, какую пользу совершенствование законодательства принесёт обществу.

«Квалификация преступлений в связи с заражением ВИЧ , не по специально выделенной статье, а по статьям за причинение вреда здоровью и, как дела частного и частно-публичного обвинения будут развивать в обществе культуру заботы каждого человека о собственном здоровье и мерах профилактики заражения как ВИЧ-инфекции, так и других заболеваний».

Люди перестанут боятся узнать свой ВИЧ-статус и будут смело тестироваться на ВИЧ. 

Люди, живущие с ВИЧ:

  • узнав диагноз, не станут избегать постановки на диспансерный учёт
  • без страха смогут реализовывать право на создание семьи и рождение детей 
  • не станут жертвами шантажа, вымогательства и запугиваний

Выражаем благодарность смелым людям, которые решились рассказать аудитории Круглого стола свои жизненные истории, о том как они столкнулись со стигмой и дискриминацией, тем самым подтверждая и усиливая аргументы за исключение ст. 157 из УК РБ, приведённые РОО “Люди ПЛЮС”.

 

Canada: Ontario’s sex offender registry needs further amendments

How should Ontario’s sex offender registry work?

Ontario’s sex offender registry has some soul searching to do. Does it exist to punish offenders, or protect communities? And how can the framework for who goes on the list, which the Supreme Court has ruled discriminatory, support this core objective?

The government has one year to amend Christopher’s Law, named for 11-year-old Christopher Stephenson, who in 1988 was tragically abducted, assaulted and murdered by a known pedophile. A coroner’s jury recommended creating an electronic registry of sex offenders to help police target their neighbourhood searches during the critical hours after a child goes missing.

The legislation received all-party support when tabled by the Harris government in 1999. Members touted the wide net cast by the proposed registry — the first of its kind in Canada — avowing: “Even those offenders who have received absolute or conditional discharges would have to register, with no exceptions.”

That tough talk eventually gave way to reasonable “exit ramps,” providing avenues to stay off the registry if an absolute discharge is given, or to be removed if a record suspension or pardon is granted. That makes sense if the registry’s goal is protection. If it’s not in the public interest for an individual to have a criminal record, how would their presence on a registry help investigators solve any crimes?

When an offender is deemed not criminally responsible (NCR) as a result of a mental disorder, those same considerations may exist. Yet, even with an absolute discharge, these individuals have no way to get off the registry. The discrepancy amounts to discrimination, the Supreme Court ruled last week, upholding a 2019 ruling by the Ontario Court of Appeal.

The charges originated when a man experienced a single manic episode after the 9/11 terrorist attacks. He was found NCR, and received an absolute discharge, yet was placed on the sex offender registry for life. In the years since, he has managed his mental health disorder and committed no further crimes. The victim, his ex-wife, supported his bid to be removed from the registry.

The ruling doesn’t mean every NCR offender should be left off the registry; there’s no evidence suggesting that would serve public safety. But there’s equally no evidence they automatically belong on the registry, perhaps for life, with no consideration of their actual risk of reoffending.

As legislators take another pass at these “exit ramps,” they should think about another group whose presence on the sex offender registry is of questionable value to community safety.

In Canada, people can still be prosecuted for having sex without disclosing they are HIV positive, even when condoms are used diligently and there is no realistic chance of transmission. Failure to disclose invalidates consent, turning otherwise consensual encounters into sexual assault.

The law is a holdover from the days when HIV was considered a death sentence. Canadian courts are slowly recognizing a suppressed viral load makes the virus untransmissible. But they’ve been slower to accept broad scientific consensus that correct condom use also negates any realistic possibility of transmission. Federal prosecutors in the territories are no longer pursuing such cases. But the Ontario Court of Appeal upheld a conviction just this summer.

Men and women who are reluctant to disclose they have HIV, but take diligent measures to prevent transmission, are not aggressors or a threat to public safety. Placing them on a sex offender registry for life does nothing to protect communities from predatory behaviour, nor does it help police knock on the right doors when children go missing.

If the sex offender registry exists to protect, not punish, that’s how it should really work.

AFRAVIH symposium devoted to stigma and discriminatory measures in times of Covid-19 and relevant lessons from the HIV Response

No contradiction between human rights and public health

Google translated extracts from an article published in Seronet on November 11, 2020.  The full article in French can be accessed here: https://seronet.info/article/pas-de-contradiction-entre-droits-humains-et-sante-publique-88959. 

From November 8 to 11, 2020, Dakar hosted the tenth AFRAVIH conference. The 2020 edition, held virtually, was as rich and dense as in previous years. To return on the strengths of the second day: UNAIDS symposium devoted to discrimination, Covid-19 as a possible “chronic disease” and social sciences, societies and behaviours.

In addition to plenary sessions and numerous thematic sessions, the program for each edition of Afravih is supplemented by symposia organised by major international and non-governmental institutions. November 9 thus proposed, at the end of the day, a symposium of UNAIDS, the wing of the United Nations responsible for the fight against AIDS. This year, the UN agency has chosen to work on “stigma and discriminatory measures in times of Covid-19: the relevant lessons learned from the response to HIV”. In this case, it was not only a question of discussing the subject, but also of including recommendations and proposing “an action plan against stigma” at the end of the conference. 

Roots of stigma and discrimination

“Stigma is unfair treatment, based on negative representations based on identities and in particular the fear of death. It conveys devaluation ”, suggests the definition of Erving Goffmann, theorised in the 1960s. As Auguste Didier Blibolo (human sciences researcher) reminded us, AIDS has been presented as a disease of death and of “unsavoury” people with “socially condemned behaviour”. Initially, the vision was that of a disease of people who had deviant sexual behaviour. And this was associated with the ignorance of the modes of transmission. For the researcher, there are comparable situations between the two pandemics, but to a lesser extent with Covid-19 which is a few months old compared to the HIV pandemic which has lasted for 40 years. One of the possible levers to change this is to raise awareness through the communication of people living with HIV. That is, the public and voluntary affirmation of one’s serological status. Another is to favour the Positive Health Dignity Protection (SPDP) strategy. Its aim is to improve the dignity, quality and longevity of people living with HIV. If this principle is realised, it should have a far-reaching and beneficial impact on communities of people living with HIV, their partners and families. As it has been thought, especially by activists, “Positive Health, Dignity and Prevention” recognises and covers all issues of health and social justice for people living with HIV. It espouses the “fundamental principles that responsibility for HIV prevention should be shared and policies and programs for people living with HIV should be designed and implemented with the meaningful participation of people living with HIV”.

Measuring stigma against vulnerable people

“The fight against stigma and discrimination is a process”, immediately recalled Dr. Ramatoulie Jallow (Yaounde, Cameroon). “We must therefore recognise that social change takes time. The HIV epidemic has taught us that the responses given by communities are the most effective, in particular to fight against discrimination and the stigma experienced by populations and that these responses lack funding, ”she explained. “Today, the crisis due to Covid-19 reminds us of these phenomena of discrimination and stigmatisation of patients. As with HIV, patients with Covid-19, or those who are suspected of being ill, are kept at a distance. The difference with HIV is in the level of information. At the start of the AIDS epidemic, there was no such international dimension, this dimension of community and especially not this feeling that everywhere in the world we are affected by the same pandemic at the same time ”.

The stigmatisation of people living with HIV and people with Covid-19 (and the discrimination to which they are victims) is therefore comparable, but to a lesser extent concerning the latter. For example, the self-discrimination of people living with HIV appears to be stronger. It is true that it is still little studied for people with Covid-19. And Ramatoulie Jallow concluded that in 40 years of the HIV pandemic, it is the community response that has proven to be “the most effective”; All that remains today is to put the necessary funding to make it even more effective and not only for HIV.

It is in the field of “human rights in times of pandemic” and especially on the question of “containment, rights and lessons learned from HIV in the response to Covid-19”, that Mianko Ramaroson intervened (UNAIDS). The expert reported people stopping taking ARVs due to confinement conditions, instances of rights violation, an increase in acts of violence against women and children (+40 to 60 % depending on the situation and country). She also mentioned the loss of income for sex workers, not compensated for by government assistance. The poor consideration of people consuming psychoactive products, or even the absence thereof, in the context of the first confinements. She also mentioned police violence (depending on the country) against the general population; violence often accentuated for the most vulnerable people. She recalled this obvious fact, but which does not seem to apply to everyone: “There is no contradiction between human rights and public health”.

One of the points in common between the HIV and Covid-19 epidemics, in terms of discrimination, remains the cumulative vulnerabilities of the most exposed and vulnerable populations. A UNAIDS report shows that HIV / AIDS and Covid-19 have the particularity of weighing on health systems, especially in the South, poorly funded and ill-prepared to respond to these pandemics. They also have the particularity of revealing and exacerbating existing social inequalities. We learned with the HIV epidemic, punitive measures tend to keep vulnerable people away from care, however, the measures taken during the first confinement seem to have learned no lesson from that time with restrictive measures which harshly penalised populations already highly precarious and stigmatised (sex workers, drug users, etc.) . It is necessary to take this “intersectionality” into account to adapt responses to the health crisis but also to allow everyone access to information… and to their rights.

Recommendations for tomorrow!

At the end of the symposium, five major recommendations emerged from the discussions:

1 – Link the results on the stigma index to the Global Program to Combat All Forms of Discrimination, and make resources available to networks of people living with HIV as part of their advocacy efforts. (Dr Ramatoulie Jallow, GNP +);
2 – Strengthen the awareness of people living with HIV to help them assume their serological status, treat themselves and protect others by being part of the “Positive health, dignity prevention” program. (Auguste Didier Blibolo);
3 – Base health responses on human rights and put communities at the center of these responses. (Mianko Ramaroson, Onusida);
4 – Insist on general information to the population to guarantee the right to be informed and develop partnerships with state departments for new legal provisions. (Maria Amar, CNDH);
5 – Promote mediation approaches and set up contractual systems associating community workers and legal aid in cases of discrimination. (Patrice Sanon, lawyer and activist in the fight against AIDS).

 

 

Global networks and organisations call on the Global Fund to safeguard and support community systems strengthening

Open letter to the Global Fund to Fight AIDS, TB, and Malaria

10 November 2020

Dear Board Leadership, Board Members and Peter Sands,

Community-led and community-based health systems are essential for Resilient and Sustainable Systems for Health that are person-centred, equitable, evidence-based and inclusive

We are a group of global networks and organisations working to advance global health. We have come together to call on decision makers, civil society, technical experts, relevant private sector and other stakeholders from across the global health response to explore how vertical disease-oriented health programmes can integrate, evolve and transform in order to respond and meet the health needs of all people everywhere, and ultimately achieve the highest attainable standard of health through universal health coverage (UHC).

The COVID-19 pandemic (exacerbated by the collision of communicable and noncommunicable disease) has brought the importance of resilient and sustainable systems for health into sharp focus as the first line of defence against the outbreak of disease. 

However, not all COVID-19 responses have recognised the importance of scaling up the work on human rights, the removal of legal and other barriers that hinder access to health, and the importance of community-led and community-based health infrastructure and systems. 

The vital role of communities and civil society has been amply demonstrated in responses to COVID-19 all over the world. Communities have been at the forefront of the pandemic response, delivering life-saving and essential medication despite lockdowns and supply chain disruptions, ensuring food supplies, offering psycho-social support and housing and developing public-information campaigns. Community-led health systems are dynamic, have demonstrated ability to deliver integrated programs across disease areas, and can reach the most marginalised and vulnerable. 

A global survey by UHC2030 and the Civil Society Engagement Mechanism (CSEM) has found that many governments are making decisions without the meaningful engagement of community, people with lived experiences and civil society representatives. Without due consultation of this health expertise, including social and behavioural research and qualitative health data, national response plans will be incomplete and will inadequately reflect the pandemic’s disproportionate impacts on marginalised and at-risk populations. Moreover, the shrinking of civil society space, the persistence of laws that criminalise exposure and transmission of communicable disease, and the disproportionate use of criminal laws and regulations against key and vulnerable populations during COVID-19, all seriously threaten the attainment of the global health goals. 

We know from decades of experience that excluding civil society and community engagement from health approaches results in failure. To be effective, universal health coverage and epidemic preparedness strategies must be based on diverse and multi-sectoral systems for health that integrate and resource community responses as an essential component, rather than an ‘optional extra’. These strategies need to be person-centred and decentralised, addressing all the health needs of the community, especially when targeting communities underserved by current health systems. 

We warmly welcome the Global Fund’s commitment to reinforce systems for health by supporting urgent enhancements to community-led response systems, as part of the four-pronged response to the COVID-19 pandemic. In the 2017-2019 allocation cycle, the Global Fund invested more than US$100 million in community systems strengthening. We urge you to safeguard and build further on this strategic investment that has built resilience and sustainability, making a huge difference in the ability of communities to respond to COVID-19.

We therefore call on the Global Fund to:

  • Prioritise and proactively support community-led and person-centred health initiatives as a crucial component of Resilient and Sustainable Systems for Health
  • Ensure the active and meaningful engagement of civil society, communities and people with lived experiences at every stage of the design and implementation of universal health coverage and COVID-19 response
  • Invest in strong, locally community-driven UHC monitoring and accountability mechanisms at district and national level
  • Invest in robust public health data mechanisms that monitor accurately the response and can provide information about which communities need greater attention and enhanced access to services so that they are not left behind
  • Increase dialogue and initiatives supporting governments to ensure all UHC legislation is rights-based and inclusive, and where necessary reform and repeal laws that criminalise communicable disease

Sincerely,

Georgina Caswell, Head of Programmes, Global Network of People Living with HIV (GNP+)

Victoria Grandsoult, Executive Director a.i., UNITE Global Network of Parliamentarians to End Infectious Diseases

Cary James, Chief Executive Officer, World Hepatitis Alliance

Nina Renshaw, Policy and Advocacy Director, NCD Alliance 

Lucy Stackpool-Moore, Director, HIV Programmes and Advocacy, International AIDS Society (IAS)

Contact: Georgina Caswell, email – gcaswell@gnpplus.net

US: Council of State and Territorial Epidemiologists recommends the elimination of HIV-specific statutes criminalising HIV and the end to prosecutions

CSTE recommendations for modernization of laws to prevent HIV criminalization

I. Statement of the Problem:

The Ending the HIV Epidemic (EHE): A Plan for America initiative aims to reduce new HIV infections in the United States by 90% by 2030 through leveraging critical advances in HIV prevention, diagnosis, treatment and outbreak response. People with living with HIV (PLWH) and stakeholders continue to raise concerns about HIV criminalization as a potential barrier to achieving HIV prevention and care goals . These laws may prevent public health agencies from responding effectively to the HIV epidemic by perpetuating stigma, racism, xenophobia, social and economic injustice, and reducing willingness for people to participate in HIV prevention, testing, and care.

HIV criminalization is defined as laws and policies that are used to criminalize the transmission of or exposure to HIV, or to enhance sentencing because a person has HIV. These laws and policies put PLWH potentially at risk for prosecution in all states, with the majority of states having HIV-specific laws in place. However, state laws, and the application of these laws, vary widely. Most laws do not account for the actual scientificallybased level of risk engaged in or risk reduction measures undertaken by PLWH or persons exposed to HIV. In some states, public health officials are required by law to share protected health information with law enforcement officials.

HIV criminalization has not been shown to be an effective public health intervention. There is no association between HIV infection diagnosis rates and the presence of state laws criminalizing HIV exposure. Studies have suggested these laws are associated with decreased HIV testing and increased HIV prevalence. Surveys among PLWH have not demonstrated that these laws have an effect on sexual practices and therefore, these laws do not serve as a deterrent for potential HIV exposure. Given the punitive but ineffectual outcomes of these laws on PLWH, existing HIV-related laws must be eliminated.

II. Statement of the desired action(s) to be taken:

HIV criminalization laws and policies do not reflect the current science of HIV, but instead criminalize behaviors posing low or negligible risk for HIV transmission, stigmatize and discriminate against PLWH, and undermine national and local HIV prevention efforts. CSTE joins numerous other organizations across the globe in strongly opposing any criminalization of HIV exposure or transmission and recommends that all states, U.S. territories, and local jurisdictions:

1) Eliminate HIV-specific statutes that criminalize HIV, including HIV-specific penalties under general statutes.

2) Eliminate prosecution of HIV under general statutes (non-HIV specific criminalization).

3) Change relevant state and local statutes to specifically prohibit the use of HIV-related, public health data for uses outside of public health purposes, including law enforcement, family law, immigration, civil suits, or other legal purposes.

Public health agencies are the central authorities of the nation’s public health system and must actively inform public policy to ensure laws, regulations, and policies are data driven and scientifically sound. Local, state, and territorial public health officials can do this by engaging in the following activities.

1. Investigate their city, county, and/or state’s laws, regulations, and policies on HIV criminalization and data protection.

2. Assess the disproportionate impact of HIV criminalization laws (in their city, county, and state) on racial, ethnic, immigrant, LGBTQ and other priority populations (now referred to collectively as priority populations). Council of State and Territorial Epidemiologists Interim-20-ID-05 2

3. Engage with and educate public health legal counsel to assure they are up to date on surveillance technology and science of HIV transmission.

4. Review internal legal counsel and health department policies and practices with regard to public health data release for law enforcement purposes and prohibit or significantly limit data release or strengthen data protections when data must be released.

5. Provide unequivocal public health leadership, education, support and information to elected state and local officials, prosecutors, and law enforcement on the relative risks of transmission and the dangers of a punitive response to HIV exposure on our ability to respond to the epidemic.

6. Provide information at legislative or governmental hearings emphasizing data-driven and scientifically sound public health arguments against HIV criminalization.

7. Engage community stakeholders most affected by the epidemic on the impact of HIV criminalization on their lives. Invite them to partner with their relevant public health department to eliminate these laws.

8. Ensure states and local jurisdictions assess the impact of HIV criminalization and address action steps for HIV decriminalization in their EHE initiative implementation plans and the disproportionate impact on priority populations.

9. Identify and share best practices with elected state and local officials, law enforcement and community stakeholders related to successes in changing laws and policies to prevent HIV criminalization.

10. Provide information to the media on advances in HIV treatment and prevention and the detrimental impact of HIV criminalization and prosecution on public health efforts.

III. Public Health Impact:

Preventing HIV criminalization will diminish the burden that has been placed on priority populations and strengthen public health interventions. HIV decriminalization has the potential to engage more individuals in HIV testing and care, leading to earlier antiretroviral treatment (ART) initiation, increased viral suppression, and decreased transmission. Furthermore, prevention activities can be strengthened as more individuals become aware of their HIV status and potential risks for acquiring HIV.

1. Increase HIV testing. Studies suggest that HIV criminalization laws deter participation in HIV testing. Deterrence to HIV testing propagates HIV transmission and results in missed opportunities for HIV care and early ART initiation specifically in priority populations. Thirty-eight percent of new HIV transmissions are attributed to PLWH who are unaware of their status; therefore, HIV testing is essential to increasing awareness among PLWH.

2. Decrease stigma and discrimination related to HIV. Given the heightened community concerns regarding law enforcement actions in minority communities, it is critical that public health activities are decoupled from law enforcement. HIV criminalization perpetuates stigma and discrimination, which are significant barriers to EHE, thereby fueling the epidemic. Eliminating HIV criminalization laws will reduce stigma and may help meet EHE targets.

3. Remove a disincentive to participation in public health efforts (i.e., EHE Pillars: Prevent, Diagnose, Treat, and Respond) Trust is the cornerstone of public health, yet communities of color have a long history of systemic and institutional racism that has eroded trust in public health. Public health officials and community members have raised concerns that routinely-collected public health data can be misused for HIV criminalization and contribute to community opposition to partner services and cluster response. Removing HIV criminalization laws and securing HIV data protections will help to rebuild trust in public health and engage communities of color in critical public health services.

The full statement is available here: https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-05_HIV_Final.pdf

Uzbekistan: While people with HIV are still criminalised, there is hope for change with the the country’s entry into the UN Human Rights Council

Punishment for illness: why HIV is still a crime in Uzbekistan

Google translation. For article in Russian, please go to: https://uz.sputniknews.ru/analytics/20201028/15275804/Nakazanie-za-bolezn-pochemu-VICh-v-Uzbekistane-do-sikh-por-prestuplenie.html

Unfortunately, people living with HIV in Uzbekistan are victims of a discriminatory legal system. But there is hope that with the country’s entry into the UN Human Rights Council, the situation with obsolete norms will begin to change.

 

TASHKENT, October 28 – Sputnik, Anna Zhelikhovskaya. Shortly before the introduction of quarantine in Tashkent, an investigation began on the case of 52-year-old Natalya (name has been changed. – Editor’s note), a single mother who works as a hairdresser and colourist. The woman is a professional master all-rounder with over 20 years of experience in this field. She was charged under article 113, part 4 of the Criminal Code of the Republic of Uzbekistan “The spread of a venereal disease or HIV infection / AIDS” – knowingly endangering or getting infected with HIV / AIDS.  

Positive result

In 2014, the List of professional activities prohibited for persons infected with the human immunodeficiency virus was updated. It included, in particular, the profession of a hairdresser associated with cutting and shaving. Natalya’s story began in 2017, when the director of the beauty salon where she worked sent employees to undergo, as it turned out, mandatory HIV testing.   

“My test turned out to be positive. I realised that it was impossible, and retaken the analysis. I don’t know how I got through these days of waiting … The answer was again yes. The first thing I experienced was shock. Before that, I did not know anything about this disease I never came across him. Of course, the doctors talked to me, I registered at the Tashkent City AIDS Center, leaving all my data there, “the woman recalls.

She immediately started taking antiretroviral therapy (ART). This specific treatment helps patients block the virus, which means they do not put others at risk, live a full life, have a family and healthy children. For the next two years, she continued to work in the service industry, realising every day that management should know about her illness. Natalya explained the lack of a certificate to the director by the fact that she could not pay for the test at the moment.

“With the best of intentions, of course, he called the SES and asked if I could still not take the test, since I’m not a beautician, I don’t do tattoos and make-up, neither do manicure. I work with paints and cut my hair, mainly with a machine. replied that in this case, the test can not be taken, “- says the woman.

According to her, she did not report the test results to the director because she was afraid of losing her job. Raising a teenage child alone, a woman treasured her only source of income. In addition, Natalia had already learned enough about her illness and understood that with an undetectable viral load (the amount of virus in the blood), she was safe for others.

“Of course, I do not justify myself in any way. I had to report everything to the management and leave the profession. But I was scared, I was lost and did not understand what to do next, how to live now …”

In March 2020, a few days before quarantine, police officers came to the beauty salon with a purposeful check. According to the woman, one of them took her into a separate room and said that with such a diagnosis she was not allowed to work as a hairdresser. It was explained to Natalia’s colleagues and her management that the problem was in the medical book. At the same time, according to her, one of them reassured her, assuring her that there would be no trial, and she would limit herself only to a fine. However, an investigation soon began and the first court hearing was scheduled. Before the trial began, none of her colleagues and the director knew about the real reason for the audit.

“In a conversation with an operative, a doctor in the AIDS center, in the makhalla committee indirectly, not directly, but it was felt that I was suspected of indecent behaviour. To say that I was mentally and psychologically crushed is to say nothing. I am a believer, I walk to the church. For the trial, even my positive characteristics were provided from there, “recalls Natalya.

Today in the minds of people there is still a deep conviction that this is a disease of the marginalised. And if a woman has it revealed, then she will certainly receive the stigma of the fallen. Antiquated HIV legislation also hinders the fight against this stigma.

A new look at old laws

Uzbekistan’s Criminal Code was approved in 1994, and article 113 has its roots in the 1980s. Then the diagnosis was really a sentence, there was no treatment or diagnosis, and criminal prosecution was considered almost the only type of prevention. Several years ago, the World Health Organization officially recognised HIV as a chronic, not fatal, disease. People who regularly take therapy live long and healthy lives. Therefore, the list of permitted professions and the justice system for positive ones should be revised.

“To date, not only has the status of the disease changed, but there is also a lot of data that make it possible to unequivocally assert that criminal prosecution does not prevent the spread of the virus in any way. The existence of criminal liability for endangering and transmitting HIV, on the contrary, leads to the fact that people who practice risky behaviour, avoid testing. After all, while they do not know about their status, they are not subject to responsibility, “says lawyer Timur Abdullaev.

Natalia’s public defender at the trial was Evgenia Korotkova, coordinator of the Positive Women program “Ishonch va hayot”. She says that they monitored the list of prohibited professions for people with HIV in the CIS countries, and nowhere is the profession of a hairdresser.

“At the very first court session, we petitioned for the appointment of a forensic medical examination with the involvement of an experienced infectious disease expert working with HIV. The investigation established that the accused had zero viral load. danger. The indictment states that in order to prevent infection of third parties, she did not work with cutting tools, but used a typewriter. That is, by her actions, she tried to protect clients from HIV transmission, “says Evgenia.

In world medicine, the thesis “Undetectable = Untransmittable” (the principle “U = U”) has been finally proved. Experts and legislators of Uzbekistan have more than 10 years of their own observations and statistics, confirming international data. This already allows us to revise the list of prohibited professions for people with HIV, the relevant law and decriminalise Article 113.

You can already start by looking at the list of prohibited occupations that people with HIV can do.

“Amendments to this list can be achieved if the convict in question does not stop and continues to defend her rights up to the Constitutional Court and the UN Human Rights Committee,” the lawyer said.

According to him, the UN Special Rapporteur on the Right to Health and representatives of other structures of the organisation spoke about the harm of HIV criminalisation, as well as the fact that it violates a number of rights enshrined in international pacts ratified by Uzbekistan. However, so far no action has been taken in this direction.

According to human rights activists, there is a serious flaw in Article 113, which is found in almost all the criminal codes of the Central Asian countries: it contains the word “knowingly”.

“What is” knowingly “and how it relates to intent, the Code itself does not explain. As a result, such a” trifle “becomes a secondary circumstance. Whether intent or not can affect only the severity of punishment, but responsibility does not cancel out. depending on whether a person wanted to infect someone with HIV or not, the article “shines” in any case, “Timur Abdullaev explained.

Usually such inaccuracies in the legislation are eliminated either by bylaws or by Resolutions of the Plenum. But with regard to Art. 113 there is neither one nor the other. There are only Criminal and Criminal Procedure Codes, and everything else is at the discretion of the court. If the judge does not understand what HIV is and how it is transmitted, then the defendant will have a difficult time.

Moreover, even among scientists there is no consensus on whether the presence of intent is mandatory for the onset of responsibility. If so, what should this intent be? After all, it can be direct – “malicious” or indirect.

We need to talk about it

Evgenia also talks about the low level of awareness of representatives of law enforcement agencies and the judiciary about HIV transmission and treatment. She is convinced that to a greater extent this is what influences the sentencing. In her opinion, the application of modern scientific evidence in criminal cases can limit unfair prosecutions and acts of justice.

“When making a diagnosis, doctors do not tell patients about the ‘N = N’ strategy, but take a receipt of criminal responsibility for infecting others with them. Also, activists have difficulty access to the accused, and most lawyers have a prejudiced attitude towards such clients,” the human rights activist adds …

According to the law of Uzbekistan “On the protection of the health of citizens”, the patient has the right not only to keep confidential information about the diagnosis, but also to choose the persons to whom information about the patient’s health can be transferred in the interests of the patient.

Natalia and HIV activists ask themselves: where did the law enforcement agencies get the information about her diagnosis and why did they come to work, inflicting severe moral and psychological damage on the woman? Thus exposing her to the risk of disclosing the diagnosis. At the request of the editorial office, this question was answered at the Republican AIDS Center. We publish the text in full.

The Republican Council for the Coordination of Citizens’ Self-Government, the Committee on Religious Affairs and the Youth Union of Uzbekistan, the Tashkent AIDS Center provided information to the Criminal Investigation Department of the Ministry of Internal Affairs on February 10, 2020 at the request of citizens who are diagnosed with HIV and who work in salons of personal services. At the same time, the center’s specialists ensure the confidentiality of information about people living with HIV and medical secrets in accordance with Article 45 of the Law “On the Protection of Citizens’ Health” dated August 29, 1996, “the letter says. It was not possible to drop the charges against Natalia. But she escaped real imprisonment and received a two-year suspended sentence.

“A large role in our case was played by the competence and interest in the details of the case, as well as in the topic of HIV and the ways of its transmission on the part of the judge and the prosecutor. But this is more a special case than a rule. The judge gave recommendations to lobby for a revision of the list of prohibited professions for HIV – positive, to exclude the position of a hairdresser from it, “says Evgenia Korotkova.

The media should also participate in the formation of a competent public opinion about HIV, but today this topic is almost never raised in the press, and specialised structures do not interact well with journalists. 

Now Natalia has no official job. Several times the makhalla provided her with material assistance, both in connection with the pandemic and with her current situation. But there is no regular, even minimal, earnings.

On October 15, 2020, Uzbekistan adopted a law “On the Rights of Persons with Disabilities.” It lists the basic principles that ensure their rights and protection against discrimination on health grounds. People living with HIV should have similar guarantees. Uzbekistan recently joined the UN Human Rights Council. Perhaps this status will speed up the revision of Article 113 of the Criminal Code. Lawyers are convinced that the punishment should follow exclusively for willful malicious infection or its attempt. Reforms in this area will significantly strengthen the position of the republic in the field of human rights protection.