UN Secretary-General, Ban Ki-moon: criminalising HIV transmission “reinforces stigma”

United Nations Secretary-General Mr. Ban Ki-moon has spoken out for the first time against the criminalisation of HIV transmission.

Speaking at the HIV/AIDS review during the 63rd United Nations General Assembly, held in New York on June 16th, Mr. Ban spoke out about laws and policies that criminalised people with, and at risk of, HIV. He ended his speech by stating:

In recent years, a growing number of countries have taken steps to criminalize HIV transmission.

In theory, this has been done to prevent the spread of infection. In practice, it has done the opposite – reducing the effectiveness of HIV prevention efforts by reinforcing the stigma.

Such measures send the message that people living with HIV are a danger to society. We must instead encourage tolerance, compassion and inclusion.

Today, the Global Network of People living with HIV (GNP+) joined Mr Ban’s call to end HIV-related stigma and discrimination and highlighted similar calls from UNAIDS Executive Director Michel Sidibé, who said, in his address to the Meeting of the Programme Coordinating Board, held in Geneva on June 23th that

punitive laws that discriminate against men who have sex with men, sex workers, injecting drug users, migrants and people living with HIV must be removed from the statute books, country by country.

I must say that I’m honoured and proud to be working with both organisations as a consultant to aid in their work towards these goals.

New Zealand: ‘HIV predator’ is named; seventh complainant adds further charges

The man dubbed the ‘HIV predator’ had his name and face splashed all over New Zealand’s media today in what has become the biggest criminal HIV transmission case in NZ history. There are now seven complainants (six men, one woman) of whom five are alleging that the man was source of their HIV infection.

As well as his name and several photos, today’s report on GayNZ.com includes many of the details left out of their earlier reporting, including his online dating profile nicknames and the name of the street he lived on in Auckland. They also highlight that HIV testing centres are anticipating a rise in HIV testing today and over the weekend as people recognise the man. But surely this is as much a ‘fishing expedition’ as a public health warning.

Today’s story on TVNZ.com includes a quote from Bruce Kilmister, chief executive of NZ’s PLHIV organisation, Body Positive

[Kilmister] said the alleged charges significantly changed a lot of people’s lives. “Everybody who has had an association with him in the past should come forward for a test. But it’s also a timely reminder that everybody has a responsibility to keep themselves safe and follow safe sex practice. HIV positive people have an added responsibility not to transmit the virus, and the best way they can do that is to have safe sex.”

To put the case into perspective, according to data from New Zealand’s Ministry of Health (AIDS New Zealand Issue 63 – March 2009 ) only 184 people were newly diagnosed with HIV in 2008 – of whom 91 were acquired via sex between men, but only 70% of these were acquired in New Zealand, most of whom lived in Auckland – and this was the highest number ever recorded. Since there are now five gay men (aged between 17 and 31) who claim the accused man infected them, this ‘cluster’ alone would represent around 8% of new diagnoses.

Adding to the panic is the 19 year-old female complainant (who has not tested positive). Between 1999-2008 there were only 52 women diagnosed with HIV that was heterosexually acquired in New Zealand. The TVNZ article continues

The fact a woman had allegedly been affected raised concerns the virus may have spread into the heterosexual community. “The reality is that most women think of the pill as the beginning and end of safe sex. It needs to be a message that goes right across the broad spectrum,” [said Kilmister.]

If this man is the source of five (or possibly more) infections, this certainly is a public health concern, and the criminal justice system involvement is, indeed, a result of the failure of public health. The call for new and better public health laws in New Zealand are understandable, and certainly would be better than the current system which required media and CJS intervention.

However, last year the NZ Ministry of Health published a study examining HIV prevalence in New Zealand, both diagnosed and undiagnosed (AIDS New Zealand Issue 62 – November 2008) which found a prevalence of 4.4% amongst men who have sex with men attending sexual health clinics, of whom only half were diagnosed. Undiagnosed people can’t disclose – and cannot be publically (or even privately) named and shamed as a way to warn others about specifically avoiding them. Undiagnosed people may also be having as much – or more – ‘promiscuous’ sex as the so-called ‘HIV predator’.

Earlier in the week, TVNZ ran an in-depth look at the case and interviewed Michael Stevens, the man who orginally brought the allegations to GayNZ.com and Simon Harger-Forde, director of HIV prevention at New Zealand AIDS Foundation. It makes for uncomfortable viewing by making patient confidentiality appear to be something bad, and conflating two issues (non-disclosure resulting in HIV exposure or transmisison being a criminally liable act and the lack of an effective public health response) without any examination of the issue of shared responsibility for sexual health. Only at the very end does Mr Harger-Forde say that laws don’t protect anyone, and that everyone should be using condoms.

Finally, an interesting blog posting from a feminist commentator, which highlights other concerns – that this case will end up leading to further stigmatisation of gay men and people living with HIV in New Zealand, and concludes:

Safe sex is crucial, of course, but it’s also crucial that the … case doesn’t become an exercise in victim-blaming, with homophobic overtones. And it’s also important that [his] behaviour doesn’t prompt a backlash against HIV positive people, who have the same needs for affection, companionship and intimacy as the rest of us.

Canada: Prosecutions having negative impact on disclosure; Edwin Cameron speaks out

In my news story for aidsmap earlier this week, I wrote:

Over the past week, the global movement against criminalisation of HIV transmission received its biggest boost since the International AIDS Conference in Mexico last July. In rallies and meetings in Australia, Canada and Sweden leading judges, lawyers and politicians joined with HIV-positive advocates and civil society organisations to condemn the criminal justice system’s current approach to HIV non-disclosure, exposure and transmission.

I’ve already posted more detailed information about the Australian meeting, one of the two events in Canada, and highlighted the situation in Sweden. Below I’m posting highlights from newspaper coverage of South Africa Constitutional Court Justice Edwin Cameron’s speech in Toronto last Friday.

Update: The official text of Edwin Cameron’s address is now available from the Canadian HIV/AIDS Legal Network website. (Une version française est disponible ici). An audio recording, which captures both the passion of his delivery, and some off-the-cuff changes, is available in the same location. Video may also be made available at a later date.

The Toronto Star ran a major article headlined, Judge slams criminalization of HIV, which put forward, without critique, Mr Justice Cameron’s international policy arguments as to why Canada needs to think again about its nondisclosure law.

Canada’s relentless practice of invoking the criminal law against people with HIV and AIDS is only intensifying the stigma surrounding the conditions and contravenes United Nations guidelines, argues a judge of South Africa’s Constitutional Court, who is HIV-positive himself.

African countries that look to Canada as a world leader on human rights issues are getting the wrong message when it puts people with HIV/AIDS on trial for having unprotected sex, even when the virus has not been transmitted, Justice Edwin Cameron said yesterday.

“Canada’s wide approach to exposure offences is sending out a terribly retrograde message to other countries, especially on my own continent, in Africa,” said Cameron, who delivered the keynote speech last night to kick off a weekend symposium on HIV and human rights issues, hosted by the Canadian HIV/AIDS Legal Network.

With human immunodeficiency virus still steeped in so much stigma in Africa that many are afraid to be tested, Canada is not providing a good example of dealing rationally and justly with the epidemic, said Cameron, noting Canada is a “world leader” in targeting HIV-positive people for prosecution.

[…]

AIDS activists, Cameron said, must accept there may be instances in which criminal liability is justified, noting that one example might be the recent case in Hamilton of Johnson Aziga, convicted of first-degree murder for actively deceiving women about his HIV status and infecting them.

But Canada needs to rethink its sweeping use of the criminal law and question why it is singling out HIV-positive people for prosecution when the same Criminal Code powers are not being used against those who expose people to other potentially deadly conditions, he said.

“Let’s take, for example, the two recent health scares, swine flu and the highly, highly contagious forms of tuberculosis. We had a case where somebody got onto an aircraft with a highly transmissible form of tuberculosis, and no one ever suggested that person should be prosecuted.”

“Queer activist” Andrew Brett also wrote about Mr Justice Cameron’s speech on rabble.ca. It’s becoming clear that the fallout of the Johnson Aziga verdict is hitting HIV-positive Canadians really hard. The few I’ve spoken with personally are feeling under attack. Mr Justice Cameron, himself HIV-positive, feels their pain. Brett writes:

Earlier this year, a court in Hamilton, Ontario became the first in the world to convict a man of murder for failing to disclose his HIV-positive status to his sexual partners, two of whom later died of AIDS. Since then, criminal prosecutions have increased and the degree of charges being laid has been elevated.In some cases, Toronto police have even issued “public safety alerts” with names and photographs of HIV-positive people who allegedly failed to disclose their status, asking their sexual partners to come forward. Cameron likened this practice to a proposal by a Swaziland parliamentarian to brand people with HIV/AIDS on the buttocks.

An article published on Tuesday in Xtra.ca, entitled Attempted murder the new aggravated assault? eloquently highlights the impact this culture of fear is having in Toronto.

Rita Shahin, associate medical officer for Toronto Public Health, says that public health can be required by law to tell police if a particular individual has tested positive for HIV.

“When the police get a complaint in front of them then they will come to us with a search warrant and if we have a file on somebody then we have to produce it,” says Shahin.

However individuals who have been tested anonymously — through the Hassle Free Clinic’s anonymous HIV-testing program, for example — will not show up in public health’s records.

Although Shahin says public health hasn’t yet seen a decrease in the number of people getting tested as a result of the recent charges laid, “it’s definitely creating a lot of anxiety and especially for those people who are behaving responsibly it’s [a question of] how do they protect themselves? How do they prove that they’ve disclosed to someone?”

[Angel] Parks [coordinator of the AIDS Committee of Toronto’s Positive Youth Outreach programme] says she’s also hearing from people living with HIV/AIDS (PWAs) who are afraid that they’ll be charged even though they’ve disclosed.

“With any other criminal charge it’s always relied upon for having forensic-type evidence and these cases seems to only be based on he-said, she-said scenarios,” says Parks.

“Now they’re are even more afraid of what the consequences will be when they do disclose… like what if things fall out in a relationship where disclosure has happened? What can they do to protect themselves to ensure they can provide a credible defence if such an incident did occur?”

Because public health also deals with complaints against individuals for nondisclosure this is a scenario Shahin has seen play out.

“That’s why we have to really investigate the complaint to sort out, is it true? Is there a basis to the complaint or is it a relationship that’s gone sour where somebody’s being vindictive?”

Both Parks and Shahin recommend the recently published HIV Disclosure: a Legal Guide for Gay Men in Ontario, produced by the HIV and AIDS Legal Clinic (Ontario).

“It is meant to target gay, bi and men who have sex with men,” says Parks, “but the information contained in it is applicable really to any person living with HIV…. They talk about how to protect yourself against malicious lies or attacks.”

It’s going to take some time before public opinion catches up with the idea that the Canadian criminal justice system’s approach to HIV nondisclosure is at best flawed, and at worst, severly and negatively impacting on the human rights of people living with HIV, as this comment from a Toronto Star reader (agreed with by 15 others, and disagreed with by only one) suggests:

The carrier should still be charged: If a person with HIV has unprotected sex with another person who doesn’t have HIV and doesn’t inform his or her sexual partner that he or she has HIV, that person should be charged. I think the same would apply to someone who has herpes and doesn’t inform his or her partner that he has it. Just because the unsuspecting sexual partner doesn’t get HIV from the carrier doesn’t mean that the carrier shouldn’t be charged. It would be like saying that if you go into a bank to rob it and you are carrying a gun but don’t use the gun, you shouldn’t be charged with bank robbery. That doesn’t make sense.

No, actually, its the gun analogy that makes no sense. Or is it the case that people with HIV are now thought of in Canada not just vectors of transmission but actually walking deadly weapons? It seems that when it comes to HIV-positive people, attitudes in ‘conservative’ Texas and ‘liberal’ Ontario are exactly the same.

Global prosecutions league table sees Sweden on top

I’ve just done a rather quick and dirty calculation of prosecutions for HIV non-disclosure, exposure or transmission per capita, based on GNP+’s Global Criminalisation Scan data, and produced this rather interesting league table.

Despite Canada, the US and Australia being disproportionately represented on my blog, due to the sheer number of prosecutions taking place, Sweden, Norway and New Zealand have actually prosecuted the highest proportion of people with HIV in their respective countries.

Having just returned from an excellent conference organised by HIV Sweden in Stockholm (on which I reported today in this aidsmap.com news story, highlights of which are below), it really comes as no surprise that Sweden and Norway head the league of shame.

And last Tuesday, Mr Justice Cameron addressed a meeting in Stockholm organised by HIV Sweden to discuss HIV and the criminal law in Sweden and other Nordic countries.

The meeting heard that Sweden’s laws were often applied selectively and discriminatory, including the recent case of an African migrant woman who had gone to the police after being raped by two men.

However, rather than charge her assailants, the police charged the woman with HIV exposure. The case is still ongoing.

Peter Gröön, of Stockholm County Council, shared data showing that African migrants – ten of the 16 people prosecuted in the past five years – also received longer prison sentences than their Swedish counterparts. Mr Justice Cameron told the meeting that this kind of HIV exceptionalism, which is fuelled by stigma, must not be tolerated. “We want [HIV to be treated] neither better, nor worse than any other disease,” he said.

The meeting also heard that a coalition of grass roots and civil society organisations in Norway might lead to an abolition of Norway’s current HIV exposure and transmission law, Section 155, which has led to ten prosecutions the past five years.

The law, which does not allow HIV-negative people to consent to unprotected sex, and makes little distinction between HIV exposure and transmission, places the burden on HIV-positive individuals to both disclose HIV status and insist on condom use in order to be able to avoid potential prosecution.

Through a campaign that has included providing every MP in Norway with information about the inequities of the law, and a major newspaper article from Mr Justice Cameron, published in May, representatives of HIV Manifesto and HIV Norway were hopeful that the law will be repealed during the country’s revision of the its Penal Code.

The meeting also heard that a similar opportunity might also be possible in Sweden later in the year, during the pubic debate that will follow a proposal to lengthen prison sentences for assault (the law under which criminal HIV exposure and transmission is prosecuted in Sweden).

Australia: New legal practitioners guide launched in NSW (updated)

Last Thursday, Australian High Court Justice Virginia Bell helped launch a new criminal HIV transmission guide for legal practitioners produced by New South Wales’ HIV/AIDS Legal Centre (HALC).

Speaking at the launch, leading civil rights lawyer, David Buchanan, noted that there was a growing tension between the “extraordinary range and depth of the public health forces marshalled against laws that criminalise people with HIV” and public opinion.

However, he said that the movement against criminalisation is not clear-cut, since “the prosecution of people with HIV in [New South Wales] has the potential both to vindicate people’s basic rights to protection from harm, yet also the potential to disrupt one of the world’s more successful exercises in the protection of public health.”

The full text of David Buchanan’s extremely interesting and insightful address (which, at over 3000 words, plus 30 footnotes, was too long to post in its entirety here) can be downloaded (as a pdf file) here. [Update: June 22nd. The previous version was not correctly formatted and resulted in the notes being out of sync. Apologies. This has now been corrected.]

Update July 1st: HALC tells me they have a limited number of hard copies of the guide available on request.

You can now download a pdf version of the guide here.

HALC also tells me they are working on an Australian-wide version of the Guide, although this is not likely to be ready until late in the year. However, they will have two more publications regarding criminal transmission coming out in July and August which I will upload when I receive them.

Canada: MPs, activists rally against criminalisation outside Parliament; Edwin Cameron gives lecture tonight

Canadian MPs Libby Davies, Bill Siksay and Hedy Fry joined with activists, people living with HIV, and supporters on Ottawa’s Parliament Hill on Wednesday, to protest Canada’s criminalisation of people with HIV due to its discriminatory HIV disclosure laws. The rally was organised by the group Legalize AIDS.

Libby Davies (NDP), MP for Vancouver East, told the rally: “We’re here today to take a very strong position that a criminalised approach to HIV/AIDS is not going to deal with the public health issues that we need to deal with. It’s not going to deal with the issues of complex human behaviour that we need to deal with. It’s not going to deal with issues of sexuality and how we approach our individual and collective and societal responsibilities.”

Watch a 3 minute 16 second video of the rally, produced for Xtra.ca.

Tonight, Justice Edwin Cameron of South Africa’s Constitutional Court, will speak in Toronto in a public lecture against the criminalisation of HIV exposure and transmission. For details, click here. He will also speak this weekend at The Canadian HIV/AIDS Legal Network’s 1st Annual Symposium on HIV, Law and Human Rights. For details, click here.

Justice Cameron recently addressed a criminalisation meeting in Stockholm, Sweden, which I attended. A report of the meeting will appear on my blog next week.

New Zealand: Article examines implications of ‘HIV predator’ case

After all the hysterical media reporting surrounding the current ‘HIV predator’ case comes a thoughtful analysis of the situation from the New Zealand Herald. The article also usefully includes a summary of the most important criminal HIV transmission cases over the years.

I include the first few paragraphs below. Click here to read the full article.

HIV-positive: The case for disclosure
By Chris Barton
Saturday Jun 06, 2009

Many questions arise from the case of the 40-year-old HIV-positive man charged with wilfully infecting three other men with HIV and attempting to infect a fourth.

Not just why the man, now in custody with name suppression, allegedly did what he did. Or why it took so long for the police to stop him. Or why our laws are so out of date that doctors and other health professionals are uncertain about what to do when they come across such reckless behaviour. Or why HIV is not a notifiable condition.

Puzzling as all that sounds, the greater mystery here is why did the man’s sexual partners participate the way they did? Why, after decades of messages honed from the reality of the Aids epidemic 25 years on, did they not practise safe sex?

Past cases include:

1994 Kenyan musician Peter Mwai sentenced to seven years jail for having unprotected sex with five women and infecting two with HIV. Deported in June 1998 having served four years in jail here, Mwai died in Uganda in September 1998.

1999 David Purvis, a 31-year-old Pakuranga invalid beneficiary, sentenced to four months jail for committing a criminal nuisance by having unprotected sex with another man who did not contract HIV. Pleaded guilty.

2001 Former male prostitute Christopher Truscott held in “secure” care (he has escaped many times) in Christchurch after being prosecuted in 1999 for having unprotected sex with four men. Intellectually impaired, Truscott seemed unable to comprehend the implications of his HIV infection.

2004 Zimbabwean Shingirayi Nyarirangwe, 25, was sentenced to three years jail after pleading guilty in the Auckland District Court to four charges of criminal nuisance and three of assault relating to unprotected sex with several women.

2005 Justin Dalley found guilty of criminal nuisance by failing to inform a woman he was HIV positive – sentenced in Wellington to 300 hours’ community work, six months’ supervision and told him to pay $1000 reparation to the woman to cover her counselling costs and expenses. The woman did not contract HIV. Soon after, Dalley was acquitted on a second, similar charge because on that occasion he did wear a condom – possibly setting a legal precedent that by wearing a condom an HIV positive man is taking “reasonable precautions” against infection and need not disclose his HIV status.

Current A New Zealander originally from the Democratic Republic of Congo awaiting trial on charges that he had unprotected sex with a woman and infected her with the virus. It is possible he also infected other women.

US: Two POZ editors editorialise eloquently on criminalisation

Two excellent, insightful articles by POZ founder, Sean Strub, and POZ editor, Regan Hoffman, published on the same date last week, highlight the issues of personal responsibility and HIV disclosure that are crucial to the wider criminalisation debate.

I’m including the first two paragraphs of each below. Click on the headline to read the full article.

 

Should people who spread HIV go to jail?

by Regan Hoffman

The Daily Beast (blog)

May 7th 2009

A Canadian court has handed down the world’s first murder conviction for knowingly exposing and infecting someone with the AIDS virus. But as an HIV-positive woman, I know that the man who infected me only deserves half the blame.

As a woman who contracted HIV from a man who claimed to have been unaware he was HIV positive, I have never entirely blamed him. Prior to being with him, I asked him questions aimed at identifying his risk factors for having HIV. Based on my trust of him, and his answers, I took a calculated risk and had unprotected sex with him. I rolled the dice—and lost.

 

Media hysteria and HIV criminalization

by Sean Strub

POZ Web Exclusives

May 7th 2009

Germany’s media have recently been in a frenzy over the arrest of pop star Nadja Benaissa. Her offense? Failing to disclose her HIV-positive status to three partners with whom several years ago she had unprotected sex (presumably intercourse without a condom). One of her accusers claims he acquired HIV from her.

In the United States, we have had a similar phenomenon when media-created hysteria—in conjunction with ignorant or ambitious prosecutors and politicians—frightens the public and brands people with HIV solely as vectors of disease or as “AIDS monsters.” This has prompted more than half the states to pass criminalization statutes, resulting in wildly unjust prosecutions and sentencing.

US: Excellent Michigan Messenger article on abuse of ineffective HIV disclosure laws

Here’s a truly excellent, and sobering, article from the Michigan Messenger – an independently-produced political news daily featuring original and investigative reporting – that spells out in an interview with an African-Amercian man convicted under the state’s HIV exposure law – just how these laws are open to abuse, both by individuals and the criminal justice system itself.

In brief, Michael S. Holder was accused of not disclosing his status before having sex by his (white) ex-girlfriend. Five members of the jury admitted during jury selection that they were prejudiced either against inter-racial relationships or against African-American men, but were allowed to remain on the jury. The complainant retracted her original testimony on the stand, and admitted that Mr Holder had, in fact, disclosed his HIV status before they had sex.

On Dec. 3, 2001, the jury of 11 white women and one white man — including the five jurors who noted their opposition to inter-racial relationships on their questionnaires — voted to convict Holder of violating the disclosure law. He was sentenced to 10-15 years in prison, three times the recommended sentence. That sentence was reduced in 2003 to 7 1/2 to 15 years because of an appeal that the state Attorney General’s office failed to respond to. But Holder’s pleas for justice in regard to incompetent counsel were denied by the Michigan Court of Appeals and the Michigan Supreme Court. A writ of Habeas Corpus filed in federal court was denied and is currently slated for a hearing in the U.S. Court of Appeals for the Sixth Circuit in June.

The article also includes a brief history both of how Michigan’s HIV exposure laws came to be enacted, and US HIV-specific laws in general.

In 1990, the Ryan White Care Act required states receiving federal funds for the assistance of those impacted by HIV to certify the state had laws to prosecute HIV transmission. By the time the bill was sent for reauthorization in 2000, this mandate was removed, because 32 states had passed laws specific to HIV, and all 50 had certified they had criminal laws to address HIV transmission.

HIV is the only virus with a felony attached to it in Michigan. Those persons with human papillomaviruses, which have been linked to cancers, herpes, Hepatitis B and C, and other viral or bacterial infections are not required under state law to disclose their infection to potential sexual partners.

[…]

State Sen. Samuel Buzz Thomas, a Detroit Democrat, toyed with the idea of introducing legislation to expand the disclosure law to include persons infected with Hepatitis B and/or C last session. But the legislation was never introduced, his chief of staff Dennis Denno said. Thomas declined multiple requests for an interview on this topic.

It also includes interviews with Lance Gable, associate professor of law at Wayne State University; Bebe Anderson, Lambda Legal’s HIV project director; Jay Kaplan, staff attorney for the LGBT project of the American Civil Liberties Union of Michigan; and, most strikingly, a Michigan Senator.

“By criminalizing sexual activity, it hasn’t been able to protect the public,” said State Sen. Hansen Clarke, a Detroit Democrat. “We’ve [the legislature] got to look at a different policy because the current one is not effective. It could be something counterproductive, but I have to research that more.”

Click here to read Michigan’s HIV disclosure law: Overly broad and open to abuse, by Todd A. Heywood.

UK: Gonorrhoea prosecution ‘a dangerous development’

I am posting an excellent analysis by Dr Matthew Weait, Senior Lecturer in Law and Legal Studies at Birkbeck College, London (and author of Intimacy and Responsibility: The Criminalisation of HIV Transmission) of the recent successful prosecution of a male migrant for ‘recklessly’ transmitting the sexually transmitted infection, gonorrhoea, through non-sexual means.

A Dangerous Development
by Dr Matthew Weait
Senior Lecturer in Law and Legal Studies
Faculty of Lifelong Learning
Birkbeck College, London

In the recent case of R v Peace Marangwanda [2009] EWCA Crim 60, the English Court of Appeal was called upon to hear an appeal against sentence that has potentially profound implications for debates surrounding the criminalisation of HIV and other serious sexually transmissible infections. Summarised, the facts were that the applicant (PM) had been charged with two offences of sexual activity with a child, contrary to section 9(1) and (2) of the Sexual Offences Act 2003. It had been alleged that PM had met the mother of the children (E and Z), started a relationship and moved in with her in September 2005. In November 2005 PM was diagnosed with gonorrhoea, and he received treatment. A month later, in December 2005, the children, E and Z, were diagnosed as having contracted gonorrhoea. PM was charged, prosecuted and tried in 2007 after E made a complaint fo sexual abuse. The jury could not agree on a verdict after hearing PM’s defence that he was not suffering from gonorrhoea at the relevant time, and that it was rather a severe from of thrush. A retrial was scheduled to take place in June 2007. Prior to the retrial a compromise was suggested by defence counsel whereby PM would plead guilty to two counts of recklessly inflicting grievous bodily harm contrary to section 20 of the Offences Against the Person Act 1861. on the basis that he had recklessly transmitted gonorrhoea to E and Z.

The plea was entered

“ … on the basis that the Defendant, whilst possessed of the knowledge that he was suffering from gonorrhoea, recklessly passed on the said gonorrhoea to the two complainants.

2. Such transmission was carried our not in any way by means of any sexual contact, direct or indirect. Such transmission was likely to have been occasioned in circumstances where the Defendant, after having touched himself and then failing to apply the proper hygiene standards, has then gone on to touch the children in an ordinary way. The Defendant would, on occasion, be involved in the daily care of the two young Complainants. This would include assisting with washing, dressing and general supervisory activities with the same.

3. It was foreseeable that such a condition as gonorrhoea could have been passed and accordingly the Defendant failed in ensuring that he adhered to the proper sanitary and hygienic principles which would have been ordinarily implied.”

PM was sentenced to two years immediate imprisonment on each count, to be served concurrently. He was also recommended for deportation, disqualified from working with children for life and made subject of a Sexual Offences Prevention Order.

PM appealed on a number of grounds, one of which was that he had pleaded guilty to offences that were not medically possible and another that, even if it were medically possible, he had not acted recklessly. (The two other grounds are not of such immediate relevance here and are not discussed – see the case report.) The Court of Appeal agreed that the sentence passed was manifestly excessive and that a sentence of 12 months on each count should have been passed, to be served concurrently. For legal reasons this meant that the order relating to not being able to work with children was quashed, but the other orders were upheld.

Discussion

This is an important and worrying decision for a number of reasons. The plea of guilty to the charges under section 20 were entered on the understanding that the gonorrhoea had been passed through casual touching. PM, it was accepted, cared for E and Z (which included physical touching). The pre-sentence report (which is prepared to assist the judge in sentencing) stated that

“The defendant has pleaded guilty to the offence in accordance with the basis of plea, namely that he inadvertently passed on gonorrhoea to the two children due to poor personal hygiene.

Mr Marangwanda was, at the time of the offence, in a relationship with the mother of the two victims. He was periodically living at the family home and as such will have regular conduct with the children.

The defendant accepts culpability in as much as he acknowledges he passed on the sexually transmitted infection to the two girls due to poor personal hygiene.

The defendant accepts that his behaviour was reckless and that as a result, two young children contracted a sexually transmitted infection.”

It was on this basis that PM was sentenced, and the Court of Appeal accepted the reasoning. It states (at paragraph 12) that

In the judgment of this court, by his plea, the defendant accepted the medical possibility of the transmission of that disease. As he knew he had gonorrhoea, provided he knew that that disease may be transmitted by transference of mucosa by hand, that transference would have constituted a reckless act …

The Court goes on to say (at para 13) that

… by virtue of the basis of plea and the applicant’s pleas, he must have been accepting the possibility that in a domestic or familial setting the disease could have been transferred. In such circumstances it would have been his duty to take the necessary protection to ensure there was no transference. We are not persuaded that there is anything in that ground of appeal.

This is, it is suggested, deeply problematic, as are other aspects of the case. First, the Court seems to be suggesting that there is a duty to take the necessary protection against the transmission of disease. With respect, there exists no such legal duty anywhere in English law. A person is not reckless because he fails to take precautions against transmission; he is reckless if it is established that he was aware of the risk of transmission. This might seem a fine distinction , but it is an important one. If the Court is thinking particularly of the positive obligation that a carer has towards children, then it should have articulated that far more clearly. In the absence of clarification it suggests that a person living with HIV has a positive obligation – enforceable at law – to prevent onward transmission to sexual partners. (And, in the light of the recent Hep B case, that those infected with Hep B may have a positive obligation to alert others not to share their razors, for example). This goes beyond the principles established in R v Dica and R v Konzani. The CPS Guidelines on prosecuting cases involving the sexual transmission of disease indicate that the appropriate use of condoms by a person living with HIV would ordinarily preclude a finding of recklessness – they do not (because the law does not require it) state that a person living with HIV is under an obligation to use a condom (or, of course, to disclose status).

Another problematic aspect of the decision is that appears to be a bad compromise. The plea was entered and accepted in part, it seems, to prevent E (the child complainant) to have to give evidence at a retrial. It is for this reason that what would otherwise have been a case involving alleged sexual offences was transmuted into one concerning offences against the person. This was arguably artificial, and (as the discussion above about the Court of Appeal’s comments about the nature of PM’s duty shows) has resulted in – it is suggested – flawed reasoning.

Finally, although it wasn’t addressed in the Court of Appeal’s judgment, there remains the question of knowledge and scientific evidence of transmission. What follows is speculative in the instant case, but important, I think, to bear in mind.

1. PM moved in with E and Z and their mother in September 2005. He was diagnosed with gonorrhoea in November 2005 and the children in December 2005. If there is any possibility that PM may have infected E and Z prior to his diagnosis, and before he had any reason to believe that he might be suffering from gonorrhoea, there was no case to answer (see R v Dica; R v Konzani).
2. If, as the Court of Appeal accepted (albeit because of the “artificial” nature of the settlement that was reached on plea to avoid retrial) that gonorrhoea may be spread manually as the result of poor manual hygiene, then questions should have been raised as to the possibility that the source of the infection may have been elsewhere. There appears to have been no scientific evidence adduced, and the prosecution did not – it appears – seek any. The CPS Guidelines make it clear that there needs to be compelling proof that the defendant is the source of a complainant’s infection – and (critically) that a guilty pleas should not be accepted unless the prosecution believes that there is sufficient evidence to prosecute. Cases involving HIV transmission have fallen because of this.

The Marangwanda case is unfortunate because it appears to be yet another example of the ways in which the ill-thought out approach of the courts to liability for the transmission of sexually transmissible diseases can – in the absence of clear thinking and understanding – have unintended effects.

Matthew Weait
23rd April 2009