Jordan: Health professionals mandated to report individual’s HIV status to the government

Foreigners Living with HIV in Jordan Face an Impossible Choice

Government Mandates Reporting HIV Status, Deports People Living with HIV

In Jordan, medical professionals and health facilities are mandated to report an individual’s HIV status to the government. Foreign nationals found to be HIV-positive are summarily deported regardless of the consequences to their health and safety and banned for life from returning.

Earlier this year, an Iraqi gay man living with HIV fled to Jordan to escape persecution he faced at home for being gay, yet he could not access HIV treatment without being immediately deported. When his health rapidly deteriorated, he could not seek medical attention for fear of being deported. Whatever decision he made would threaten his life.

Jordan also obliges nationals to undergo HIV testing when seeking employment in the public sector and for non-nationals obtaining work permits, and denies them jobs if they are HIV-positive. It also requires testing for non-nationals renewing residency permits. For LGBT people living with HIV, the stigma and discrimination by medical professionals and employers often bars them from accessing basic rights, without any legal recourse.

Abdallah Hanatleh, executive director of “Sawaed,” an Amman-based organization that facilitates access to HIV treatment, told Human Rights Watch that his organization documents dozens of deportations based on HIV status annually.

Jordan is not alone in this abusive practice. Gulf states including Saudi Arabia and the United Arab Emirates also deport people found to be HIV-positive without any provision for continuity of care. Worse yet, in Jordan, as in Saudi Arabia and the UAE, HIV-positive foreign nationals in the criminal justice system are denied adequate access to treatment in prison. “They are placed in solitary confinement, further isolating and stigmatizing them,” Hanatleh said.

International law prohibits deportations based solely on HIV status. Jordan should explicitly ban discrimination based on HIV status and stop deporting HIV-positive individuals under the principle of non-refoulement. This principle applies to asylum seekers and refugees, and for people with HIV, it means that governments are prohibited from returning them — depending on how advanced the disease — to places where they do not have adequate access to medical care and social support, or where they risk being subjected to persecution or degrading treatment on account of their HIV status.

Jordan should not mandate reporting of HIV status and employers should not be requiring HIV testing in the first place. People living with HIV should never be forced to forego lifesaving treatment in order to avoid deportation to danger.

US: To end the HIV epidemic in Nevada, laws must be based on science, not stigma and fear

Nevada’s criminalization of HIV must stop now

By Andre C Wade

According to the Center for HIV Law & Policy, 32 states have laws that criminalize behavior of people living with HIV. Nevada is one of those states. In 1993, the U.S. was grappling with HIV — how to treat it and people living with it, how to protect those not living with it — and sought to criminalize behavior of those living with it as a way to remove them from society, in a misguided attempt to decrease transmission of the virus.

During this time of heightened fear and homophobia, when we knew little about HIV, there was a concern about the knowing and intentional transmission and exposure of HIV from one person to the another. This was a concern brought up during the 1993 Nevada Legislature when discussing Senate Bill 514, which prohibits certain conduct through which human immunodeficiency virus may be transmitted after testing positive for disease. One of the villains during the session was Dr. Paul Cameron, who at the time was the Director of the Family Research Institute. The Institute’s mission was to denounce homosexuality and pathologize gay people.

Through his testimony, he likened gay people to serial killers, helping to secure passage of the bill, which stigmatized and criminalized people living with HIV for decades to come. The bill set in motion the penalty of imprisonment for up to 20 years, a fine up to $10,000, or both, for intentionally, knowingly, or willfully engaging in conduct in a manner that is likely to transmit AIDS (which should be HIV as AIDS is not transmittable). It should be noted that in the early 1980s, the American Psychological Association discontinued Cameron’s membership for his unethical practices as did many psychological and sociological associations at the time.

Currently, in Nevada — thanks in part to Cameron’s homophobic misinformation — it is a Class B felony for a person living with HIV and who knows their status, to intentionally engage in behavior that could transmit the virus to someone else. Public health experts agree that criminalizing a health condition is not a smart strategy for preventing its transmission, but the most egregious part of Nevada’s law is that to be legally liable, the prosecutors don’t actually have to show that there was any risk of transmission or any intent to transmit the virus.

Rather, anyone living with HIV who engages in certain behaviors — regardless of whether they are detectable and transmittable, regardless of preventative measures like condom use or their HIV-negative partner taking PrEP, regardless of the outcome — can be convicted of intentionally transmitting the virus, according to Nevada’s outdated
and harmful law.

Nevada law further complicates the situation by failing to fully define any and all behaviors that could likely transmit HIV — including behaviors such as spitting and biting that public health experts now agree pose no risk of transmission. Back in the 1980s and 1990s, these behaviors were thought to “likely transmit” HIV, which in 2020 we know is medically and scientifically impossible. Yet, these behaviors are still included in Nevada’s law and could still lead to a conviction. It’s a felony conviction if someone is charged with transmitting the virus to someone else (even if transmission doesn’t occur and even if there wasn’t intent). With other communicable diseases, the charge is a misdemeanor. So, sadly and inappropriately, an incident involving HIV would add a sentence enhancement to a felony.

As it stands, our HIV criminal laws in Nevada are based on stigma and fear, rather than modern science. They don’t take into account the fact that a person living with HIV, today, can take medication to reduce their viral load — the amount of virus present in their body — to an undetectable level, in which case there is no risk of transmission. Our laws are even more out of step given medical advancements via medications taken by HIV-negative people to prevent transmission known as PrEP (Pre-exposure prophylaxis) and PEP (Post-exposure prophylaxis).

It’s time to modernize our HIV laws in Nevada. Sen. David Parks, and the Nevada HIV Modernization Coalition, the Human Rights Campaign and Silver State Equality, amongst others agree. At the national level, the Department of Justice and the Center for Disease Control, the Center for HIV Law and Policy and The Elizabeth Taylor Foundation, to name a few, have called for the repeal or modernization of laws that criminalize HIV.

In 2019, Sen. Parks passed Senate Bill 284 that created a governor-appointed Advisory Task Force on HIV Exposure Criminalization for the state. The task force is charged with, in part, submitting a report that reviews and evaluates current statutes that criminalize exposure to HIV; identifies disparities in arrests, prosecutions and convictions under the statutes; evaluates current medical and scientific research regarding HIV transmission; and looks at what’s happening in other states regarding the modernization of HIV laws.

The Williams Institute is conducting research in Nevada as it has done in California, Florida, Georgia and Missouri to look at disparities in arrests, prosecutions and convictions.

Their current findings in other states are that these laws disproportionately impact Black and Latinx people, LGBTQ+ people, women, sex workers and young people, including minors. These are individuals who are interacting with the criminal justice system, often for the first time and when they otherwise would not have. In Missouri, the Williams Institute has found, that HIV criminalization has cost the state nearly $18 million.

Sadly, the criminalization of HIV undermines the work of public health officials charged with ending the epidemic.

When states and local jurisdictions create and implement plans for ending HIV, often they engage those living with HIV to develop a plausible plan of action.

But our laws are criminalizing those who are supposed to be engaged in plans to end HIV, thereby decreasing the likelihood that they will be able and willing to participate in a meaningful way.

Additionally, the criminalization of HIV further stigmatizes people living with HIV, which can affect overall mental health and well-being, cause someone to not disclose their status to a health care provider or to their partner, or discourage them from accessing health care altogether. Stigmatizing HIV causes people to not want to get tested in the first place, thereby decreasing the chances they will know their status.

HIV is not a crime. Here in Nevada, we need to repeal harmful statutes, reduce sentence enhancements and move some statutes from criminal codes to public health codes. Modernizing our laws based on science and what we know about our laws’ harmful impacts will help Nevada end the epidemic in the state.

André C. Wade is the state director, for Silver State Equality. He is also the chairman for the Advisory Task Force on HIV Modernization for the state of Nevada.

The Importance of Human Kindness and
Connection: Sero’s Holiday Card Project

In an era where the term ‘lockdown’ is used to limit our movements, spare a thought for the many prisoners living with HIV (some of whom have been unjustly convicted under HIV criminalisation laws) who are experiencing real lockdowns and severe isolation.

With community support interventions becoming increasingly formalised, and NGOs pushed to operate in terms of strategic plans, deliverables, outputs and outcomes, Sero’s Holiday Card Project stands as a rare example of an organisation recognising the worth of a project focused solely on gestures of basic human kindness.

Last year, the project delivered Holiday cards to around 900 incarcerated people, most of whom are living with HIV. For some, it was the only mail they received all year.

So how did the Holiday Card Project come to be, has it made a difference, and how can you help this year?

Back in the 1980s and ’90s, Cindy Stine lost a lot of friends to HIV. In 1996, just before effective treatments became available, she lost a close friend who was like a son. She made a promise to him that she would continue to be involved in the AIDS response. That’s a promise she’s kept.

In 2011, Cindy was serving on the board of a local LGBT centre when she invited two speakers from the fledgling Sero Project to speak at an event. The speakers were Sean Strub, Sero’s Executive Director, and Robert Suttle. Sean introduced the audience to the concept of HIV criminalisation, a new issue for most, including Cindy. Robert talked about what it means to live as an HIV criminalisation survivor, explaining that as the result of an HIV non-disclosure charge, he served six months in the Louisiana state prison and would be registered as a sex offender for 15 years. Robert showed an image of his driver’s license, with ‘sex offender’ stamped in bold red lettering: ID he has to show often and in many different circumstances.

Cindy approached Sean and Robert to let them know that she wanted to help. A few days later, Sean rang Cindy and invited her to his office where he showed her a stack of letters that Sero had received from people in prison. Sean asked Cindy if she’d volunteer to take on the task of answering the letters. She agreed.

Things could have ended there, with Cindy answering people’s individual letters, but as Cindy read those letters week after week, each letter more heart-breaking than the last, she began to really appreciate the isolation, loneliness and desperate need for connection experienced by many of those inside. She talked it over with her Sero colleagues, and they decided their efforts to build a movement against HIV criminalisation needed to expand to be more inclusive of those who were incarcerated; those directly impacted by HIV criminalisation. They decided to explore how they could support development of a prisoners’ network, starting by compiling a database of contact details of those who’d written.

As Sero grew, Cindy was employed to take on community education and other projects but her work answering prisoners’ letters continued. Cindy says of those letters, “sometimes the people writing didn’t even have access to paper, so they’d write on any scrap of paper they could find – recycled envelopes or bits of paper torn off something else. Many of those sending letters weren’t really literate but they wanted to communicate.”

As the 2015 Holiday season approached, Cindy found the letters got harder to read. “A lot of people wrote about loneliness and about their families disowning them after finding out they had HIV, or were gay, or were transgender. People felt they’d been thrown away and forgotten.” Then she had a simple thought, “Wouldn’t it be nice for them to know that they’re not alone.” Then another, “We should send Holiday cards”. She took the idea to Sean, who agreed.

By then, Cindy’s database was so large that she realised Sero would need to prioritise who got cards, focusing on those who were incarcerated as a result of HIV, or they had HIV or another debilitating illness. Cindy also wanted to ensure each person got at least three or four cards but … how to go about it? Cindy put out a call to the 900 or so people on the Sero list-serve asking if anyone was interested in writing some Holiday cards. The response was overwhelming. Many offered to help, with some asking to do 20 cards, some asking to do 200.

The Holiday Card Project has continued each year since then. People express an interest, Cindy sends them a list of first names; they write message on the cards, put them in blank envelopes and return them to Sero; Cindy sorts them, addresses them, and mails them off.

Those who write cards come from all different parts of the community, including some working in other HIV advocacy organisations, some parents of prisoners, and some people living with HIV. People are asked not to ask personal questions but to write messages of support: things like ‘hope you’re doing well’, ‘we’re thinking of you’, and ‘you’re not forgotten’. Some write about themselves, their experience living with HIV, their thoughts and prayers. Some write, ‘we’re thinking of you when we fight HIV criminalisation’.

One group gets together and spends a day each year writing Holiday cards. People come from all over, saying it feels really good coming into a non-judgemental space and writing messages from the heart. Sometimes Sero will set up a table at a conference and invite people to write cards. Others write cards at home. People feel involved. Each step in the process has meaning: the choice of card, the choice of words, with many people sending their cards with stamps to send them on, to further support the project.

Last Holiday season, about 900 people received cards in facilities across the US, including people on death row. The responses from those who received cards is humbling. Some said, it was the only card they’d received all year, but those cards meant that they knew they were not forgotten. They couldn’t describe the feeling of hearing someone from the mailroom say, ‘You’ve got mail’. They knew that somebody out there had thought enough of them to send a card. Recently Cindy received a letter from a man who’s recently been released. He said that for the last three years he’d so looked forward to those cards as it was the only mail he got. It meant a lot that people had taken the time to write.

The project is not without its challenges. Cindy spends considerable time keeping track of people, as prisoners are often moved. There are also major issues regarding mail screening. Although Cindy has worked to build a rapport with those managing mail distribution at many of the prisons, that hasn’t guaranteed mail is always received. Mail screening rules differ from state to state, institution to institution, and the rules keep changing. Some prisons have now banned cards altogether, some won’t allow glue or glitter or coloured paper, etc. If mail is considered contraband it may be thrown out or returned to Sero. That process has at times driven Cindy to photocopy returned cards, sending the copies in the hope the person will still receive the good wishes.

The Holiday Card Project may have modest goals – to show compassion and care to those who feel abandoned, but it has delivered far more. It has made a difference to the lives of many, letting them know that there are people outside of prison ready to provide support. It has raised awareness about HIV criminalisation and provided a mechanism for people to show they care. It has also helped build trust between prisoners and Sero, a facor that has proven critical to the development of a stronger prisoners’ network and greater engagement with Sero. A stronger prisoners’ network has meant more support for those inside, and it has also resulted in other great projects, like Turn It Up, the health magazine that includes information about HIV for those in prison, largely written by people who are, or have been, incarcerated.

While Sero is best known for its HIV criminalisation reform programmes, its efforts to support network building and empowerment have proven equally important. Sero operates from the belief that those most directly impacted should be at the centre of this work, which is why facilitating the creation and strengthening of networks of People Living with HIV and allies, particularly those representing key populations, remains critical and a priority.

Every year the Holiday Card Project has grown, with prisoners writing to Cindy to let her know if they’ve been moved to another facility. Others write saying, “a friend of mine got cards. Can I be put on the list?” Parents get in touch too, asking for their children to be added to the list, and also writing letters of thanks for cards received.

Still, Cindy thinks there is room for the project to grow; sending cards for holidays celebrated by other religions at other times of the year, and also considering whether cards could be sent for some non-religious events, such as Halloween or Thanksgiving. That way the project can become more inclusive and people won’t have to wait an entire year for mail. Of course, that will mean attracting more people to write cards so that more people can receive them.

If you’re interested in supporting the work of the Holiday Card Project, please contact Cindy at cindy.stine@seroproject.com, Subject – Holiday Card Project.

Uganda: HIV activists ask government to review the HIV/AIDS law and remove clauses that criminalise HIV

Activists, chief justice call for review of HIV/AIDS law

By Betty Amamukirori, John Masaba

The majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status.

HIV/AIDS activists have asked the Government to review the HIV and AIDS Prevention and Control Act 2014, saying it is fuelling stigma and discrimination.

The activists, while speaking at the Philly Bongole Lutaaya memorial lecture, said the law has clauses in it that if left unchanged could undo the country’s gains in the fight against the disease.

Dora Musinguzi, the executive director of Uganda Network on Law and Ethics (UGANET), said clauses that criminalise HIV, especially intentional transmission are causing more harm because it’s scaring people away from testing, disclosing their status to the spouses or seeking treatment.

She pointed out clauses such as sections 41 and 43 which spell out punishments for attempted transmission of HIV and intentional transmission, respectively.

“We need to do everything it takes to repeal this law, especially the punishment for exposure to HIV/AIDS. We need to remove the criminalisation under the law because it is causing more harm,” Musinguzi said.

The activists said the majority of the HIV-positive persons are living in fear of the law and many choose not to disclose their status to their significant others for fear of prosecution. This, they said, has fuelled self-stigma.

Justice Alfonse Owiny-Dollo, in his keynote address as the guest speaker, agreed that the law needs to be amended if Uganda is to achieve its goal of ending the AIDS epidemic by 2030. His address was read by the Judiciary’s Chief Registrar, Sarah Langa.

Owiny-Dollo called on Parliament to enact and review laws that will improve the wellbeing of the society especially the people living with HIV.

“The HIV and AIDS Prevention and Control Act 2014 may need to be reviewed,” he said.

“Ending HIV requires enabling legal and social environments that guarantee the health, dignity and security of all people living with or at risk of HIV. This is the only way to ensure that all those in need of HIV prevention, treatment, care, and support have access to these services without fear of discrimination, exclusion or bias,” Owiny-Dollo said.

He said much as there are enabling laws on non-discrimination on the basis of one’s HIV status, the HIV-positive still face limitations when seeking justice. These include lengthy proceedings and an unfriendly court environment.

The lecture was held under the theme Access to HIV services during COVID-19 pandemic. It was held at the Office of the President auditorium and was notably attended by the late Lutaaya’s children, friends, activists, musicians living with HIV. The HIV prevalence is 6.2% amongst adults aged 15-64 years; 7.6% in women and 4.7% in men.

Tezra Lutaaya, a daughter of the deceased, said although her father championed the fight against the disease, stigma and discrimination against HIV-positive persons is still rife.

“I strongly believe that an end to HIV is in sight if we continue to fight stigma, make sure seamless information and access to all interventions are available and that we continue to have dialogue with the young people both infected and affected by HIV,” she said.

Esther Mbayo, the Minister for the Presidency, said if AIDS is to be ended by 2030, there is need to exhibit the spirit of Philly Lutaaya.

“We need to get out of our comfort zones, especially now that we are dealing with two pandemics — HIV and COVID-19. On an individual level, we need to test for HIV with our partners and together irrespective of the results, decide to prevent HIV,” she noted.

She called for deliberate efforts to reach those at most risk of getting infected with HIV in order to reduce the high HIV prevalence and towards ending stigma and discrimination.

Owiny-Dollo urged the Government to prioritise creating awareness, promoting advocacy that reaches the young people and all generations with messages on HIV and AIDS.

Canada: HIV Legal Network publishes new guide to assist journalists in reporting responsibly about HIV criminalisation cases

Media Reporting: HIV and the Criminal Law

This guide is an evidence-based resource to assist journalists in Canada in reporting responsibly and accurately about alleged HIV non-disclosure and resulting criminal cases.

People living with HIV in Canada can be prosecuted for “aggravated sexual assault” (one of the most serious charges in the Criminal Code) if they don’t tell their sexual partners, in advance of intimate contact, that they have HIV. The criminalization of “HIV non-disclosure” is severe and rooted in stigma: people face charges even in cases where there is little or no risk of transmitting HIV. The maximum penalty is life imprisonment, and a conviction carries with it a mandatory designation as a sex offender. This approach has been criticized, both domestically and internationally, as being contrary to human rights and principles of public health, including by United Nations experts. Instead of reducing HIV transmission, HIV criminalization is now recognized by many experts as a driver of the epidemic.

There have been dramatic advances in treating and preventing HIV, which have resulted in a gradual change in public discourse and understanding. But there’s still a lot of misinformation. Media can play a vital role by modernizing the discussions we’re having about HIV and by reporting about HIV non-disclosure in an evidence-based and responsible way that doesn’t perpetuate stigma.

The guide is available in English and in French

UK: National AIDS Trust responds to misinformation presented in the case of woman accused of using bloodied clothes as a weapon

National AIDS Trust reacts to Newtown HIV threat court case

THE National AIDS Trust has moved to quell fears that anyone could contract HIV via bloodied clothing after a woman was fined for threatening to infect a police officer in Newtown last week.

This week C. pleaded guilty to assaulting an emergency worker when she appeared at Welshpool Magistrates Court.

The 35-year-old was brought in to custody at Newtown Police Station on August 26 covered in blood – which she claimed belonged to someone else – and became abusive, eventually stripping and throwing the bloodied clothes at custody sergeant Grace Coburn, telling her the clothes had hepatitis and HIV on them.

Sgt Coburn was told by C. that she probably also “had Covid as well”.

But the trust – the UK charity dedicated to transforming society’s response to HIV – has responded to the “misinformation” presented by the case, moving to reassure people that HIV cannot be transmitted in this way.

Danny Beales, head of policy and campaigns at the National AIDS Trust, said: “It’s disappointing to read that HIV is still being used as a threat in 2020.

“The stigma and misinformation that surrounds HIV mean that cases like this are far too common. We would reassure readers that there is no risk from HIV on bloodied clothing as the virus is very fragile and does not last long outside the body.

“Also, the majority of people living with HIV in the UK are on effective treatment which means they cannot pass on the virus in any way.”

C. was given a £200 fine and will pay compensation of £50 to the officer. She will also pay £85 costs.

We Are People, Not Clusters! Why public health surveillance using blood taken for HIV resistance testing risks doing more harm than good

by Edwin J Bernard, HJN’s Executive Director

A series of articles and editorials in the October 2020 issue of the American Journal of Bioethics published last Friday examine a growing concern amongst community leaders of people living with HIV and our scholarly allies: the use of blood taken from people living with HIV during routine testing prior to starting or changing antiretroviral therapy in surveillance databases, without our permisssion, for public health purposes.

This is already taking place across the United States and in some Canadian provinces, and is currently being considered elsewhere in the world.

The rollout of so-called ‘molecular HIV surveillance’ to identify ‘clusters’ of transmissions to attempt to further improve public health responses to HIV is a growing source of anxiety and concern for people living with HIV in the US and Canada, especially for people who are already marginalised and criminalised in other ways, because they can’t be certain that this data won’t be shared with law enforcement or immigration authorities, which can lead to prosecution and/or deportation.

Coming to Facebook Live on 30th September – HIV Justice Live! Whose Blood is it, Anyway? Like or follow us on Facebook to watch and participate in the first of our new interactive webshows, which will focus on molecular HIV surveillance.

In our lead guest editorial, entitled ‘We Are People, Not Clusters!’ which I co-authored with Alexander McClelland, Barb Cardell, Cecilia Chung, Marco Castro-Bojorquez, Martin French, Devin Hursey, Naina Khanna, Brian Minalga, Andrew Spieldenner, and Sean Strub, we support the concept of “HIV data justice” put forth in the lead target article, by Stephen Molldrem and Anthony Smith, Reassessing the Ethics of Molecular HIV Surveillance in the Era of Cluster Detection and Response: Toward HIV Data Justice.

“HIV data justice draws on the collective resources of the HIV/AIDS movement to build new alliances aimed at providing affected individuals and communities with greater control over how their data are utilized in the healthcare system, with the paired aim of providing them with greater access to better services on terms of their own choosing.”

Molldrem and Smith

In the editorial, we welcome Molldrem and Smith’s critique of the controversial rollout of molecular HIV surveillance (MHS) in the United States, which explores three intersecting concerns:

(1) the non-consensual re-purposing of personal health information and biomaterial for public health surveillance;

(2) the use of molecular HIV surveillance data in larger databases to find ‘clusters’ of infections and to make determinations about transmission directionality, and the criminalising implications that follow such determinations; and

(3) the way MHS amplifies the targeting and stigmatisation of already oppressed and marginalized communities.

The editorial questions the rationale behind the use of MHS as one of four pillars of the US Centres for Disease Control (CDC) End The Epidemic (ETE) Plan and calls for the abolition of molecular HIV surveillance in the United States as it is currently being rolled out by the CDC because it blurs the boundaries between consent and criminalisation.

Instead, we envision a future of new participatory and intersectional racial and viral justice possibilities, one which ensures the lives, voices, self-determination, and autonomy of people living with HIV are central to HIV research and public health practice.

Further reading

Bryn Nelson. Questioning the Benefits of Molecular Surveillance. POZ Magazine, July-August 2020.

South Africa: Libyan embassy allegedly pressuring SA workers to test for HIV

The Department of International Relations and Cooperation (DIRCO) is investigating allegations that South Africans working at the Libyan embassy in Pretoria were pressured to test and reveal their HIV status after asking to be tested for COVID-19.

Several of the affected employees who spoke to Spotlight on the condition of remaining anonymous, have worked for the embassy for over a decade. They say that someone who visited the embassy had tested positive for COVID-19 and that at least one of the embassy’s workers had been exposed to the person who tested positive.

The workers say they asked the embassy to arrange and pay for COVID-19 tests, since the possible exposure happened in the workplace and they could not pay the costs themselves. They say this was at first refused because their employee contracts do not cover such medical expenses. Later the workers were given the option to be tested, if they agree to also test for other conditions, particularly HIV and hepatitis.

One worker says that while he knew that this wasn’t right and tried to push back, he eventually gave in to the idea because he was afraid of getting sick. He says he has a known comorbidity that added to his concern. “Because I was so scared of COVID-19 I said sir, please, let me go test, everything is fine.”

Questions were sent to the Libyan embassy and Spotlight was telephonically informed that the matter would be raised with embassy leadership, but despite being given multiple opportunities over a period of more than a week, the embassy did not respond to our questions by the time of publication. Spotlight has however seen letters and e-mails that appear to confirm at least some of the allegations made by the workers.

DIRCO stated that it could not comment on the situation until their investigations were finalised.

Previous DIRCO involvement

This follows a similar incident in December 2018, when all local employees at the embassy were allegedly instructed to test for HIV, tuberculosis, and hepatitis A, B, and C. At the time DIRCO met with representatives of the embassy to discuss the situation. A subsequent letter from DIRCO (seen by Spotlight) explains that mandatory medical testing is against South African law and the Vienna Convention on Diplomatic Relations of 1961, and urged the embassy to reconsider its position.

One worker describes the reaction by embassy leadership to their request for COVID-19 tests as “if you want to test this, remember you refused to test HIV”. “We’ll include HIV on the list and if you go test, the embassy will pay for you.”

The workers eventually did go for COVID-19 tests, over two weeks after the possible exposure. On the day, some again refused to test for the other conditions, but say they eventually did so after more pressure from the embassy, including alleged threats to fire them.

They also allege that the embassy instructed the testing laboratory to send all the results to the embassy.

Phila Malaza from the Union for the Local Employees in Missions Accredited to South Africa (ULEMASA), says that in addition to DIRCO, the incident has also been reported to the South African Human Rights Commission. A case of unfair labour practices has also been opened at the Commission for Conciliation Mediation and Arbitration (CCMA) and the union has sent a letter to the Chairperson of Parliament’s Portfolio Committee on International Relations and Cooperation to request an intervention on the matter.

What the law says

There are a variety of local laws and guidelines that protect the confidentiality of certain medical results. The National Health Act says that information relating to one’s health status may not be disclosed unless consented to in writing, ordered by a court or law, or if “non-disclosure of the information represents a serious threat to public health”. Section 7 of the Employment Equity Act restricts medical testing of an employee and prohibits HIV testing unless “determined to be justifiable by the Labour Court”.

Retired Constitutional Court Justice Edwin Cameron, who is a long-time activist for HIV issues, says it is important for individuals to have control over the privacy of results because of stigma. He says that while HIV is entirely medically manageable, there is still a long way to go in changing attitudes. “That is why HIV is still a disease of silence across the African continent – shame, rooted in sexual transmission, and stigma about it.”

Cameron says that HIV results remain private. “Employers have no reason at all to want to know them, unless for beneficent reasons, like a genuine offer to assist employees with HIV to locate counselling and ARV treatment, and to accommodate this in their work duties.”

He explains, however, that some legislation, such as the Employment Equity Act, was in place before the widespread availability of ARV treatment. “There was little reason to test, at that time, other than to try to single out and discriminate against those testing positive.” However, consensual and private testing should now be widely encouraged.

The director of the Centre for Medical Ethics & Law at Stellenbosch University, Professor Keymanthri Moodley, says that the underlying ethical principle is a respect for autonomy, making consent and confidentiality crucial. She says, “with respect to HIV testing, privacy is important because this is personal, sensitive information and because a person’s HIV status could potentially lead to harm, including stigmatisation linked to the disease and death in some cases”.

Moodley explains that there are some medical exceptions, such as in the current pandemic. She says, “COVID-19 is a threat to public health as it is transmitted via the respiratory route”. “Disclosure is legally permitted because of the public health risk.”

Beyond South African legislation, global sentiment goes against coerced testing. Edwin Bernard, the executive director of the HIV Justice Network, says “mandatory, compulsory or coerced HIV testing of individuals on public health grounds is never acceptable”. He points to a 2017 statement by the World Health Organisation (WHO) and UNAIDS guidelines which insist on consent and confidentiality as crucial in HIV testing services.

“HIV testing, no matter how it is delivered, must always respect personal choice and adhere to ethical and human rights principles,” the statement reads. The only scenarios in which WHO and UNAIDS supports mandatory HIV testing is during medical procedures such as organ transplants and giving of blood destined for transfusions.

Emotional impact

One worker says they repeatedly explained to the diplomats it is against the law. “I don’t know why they want the results, because we’ve been working with them for a long time, even if we are positive, we contracted that disease and have been working with them.”

Another worker says they are scared and being impacted deeply by the situation. “This thing is affecting me too much emotionally, because to be honest, people like me already know their status. I’m already on ARVs, so if they would find out that I’m positive, I think the situation would change.”

Yet another employee says he feels traumatised by the situation. He asks, “if I lose this job, how am I going to support my family?” Beyond the worry of possibly losing his income, he says that he did not like that he was being pressured to take an HIV test, instead of being able to make that choice in his own time.

US: “Institutionalized discrimination gives people a reason to avoid getting tested or having open conversations around the disease”

The HIV Pandemic Is Still Raging—and Won’t Stop Until We End the Stigma

One of the hardest lines I’ve ever had to deliver was, “I’m going to die.” It was the initial response of my character Ricky after being diagnosed with HIV during the height of the epidemic in season two of the 1990s drama POSE.

Ricky, like me, is a young Black queer man. I, the actor, had to contend with how true this statement must have felt for him, because an HIV diagnosis was largely a death sentence in 1990. Today, despite all the advances in science and medicine, as a Southerner, I am more likely than the average American to contract HIV, less likely to receive treatment, and more likely to die from HIV.

Tens of thousands of people are diagnosed every year, and in some states, annual diagnoses are on the rise. This is particularly true in the South, which accounts for 51 percent of HIV diagnoses despite only making up 38 percent of the U.S. population. There is a level of complacency around HIV that troubles me. Most people don’t understand that we’re still in the midst of the HIV epidemic.

It is true that HIV is no longer a death sentence, but fear, misinformation, and shame surrounding the disease remain and make the epidemic harder to contain. Stigma makes it harder to educate people about the disease, and stops people from seeking crucial treatment that saves lives and prevents its spread.

Americans are still seriously misinformed about HIV. The GLAAD and Gilead Science’s ‘State of HIV Stigma’ Survey found that the public’s knowledge of HIV is dangerously inaccurate and that they hold significant feelings of stigma towards people living with the disease. According to their study, only 60 percent of Americans believe that “HIV is a medical condition that can be treated,” despite the fact that drugs treating HIV have been on the market for over a decade. Even more troubling, nearly 6 in 10 Americans wrongfully believe that “it is important to be careful around people living with HIV to avoid catching it.”

Scientists have proven that HIV cannot be passed through healthy, unbroken skin, and people with HIV who take HIV medicine as prescribed and keep an undetectable viral load have virtually no risk of sexually transmitting HIV to their HIV-negative partners. Yet, this is not widely understood by the public and contributes to more people unnecessarily contracting the disease. A study in Toronto, where HIV is criminalized, found that men who had sex with men were less likely to get tested because of the laws, creating an exponential 18.5 percent increase in HIV transmission.

Around the same time Ricky found out he had HIV, I was born in Florida, a state that still criminalizes HIV and uses the law to punish people and perpetuate stigma. Engaging in consensual sex or donating blood or organs without disclosing one’s HIV status is a third-degree felony in the Sunshine State. This could lead to five years in prison and a $5,000 fine. Florida isn’t alone; today 34 states have HIV-specific criminal laws or sentence enhancements that apply to people living with HIV. This kind of institutionalized discrimination gives people a reason to avoid getting tested or having open and honest conversations around the disease.

Thailand: People living with HIV could be charged with killing with intent if they donate blood

HIV sufferers who donate blood can be charged with murder, says police spokesman

The deputy police spokesman stated that those who know they are HIV positive but still donate blood or persuade vulnerable people to donate blood can be charged with the criminal offence of “intent to kill”.

On August 20, at the Royal Thai Police (Police) Pol. Lt. Colonel Kritsana Phattanacharoen, deputy spokesman for the police, spoke about the case of people who have risky behaviours or are infected with HIV and donate blood, and of people persuading others in a risk group to donate blood. Such behaviours are criminal because people who are at risk or infected with HIV can not donate blood. And if they are infecting others, it would be considered an offense as per criminal law, and they would be charged with killing with intent Since the donors know that they are infected with HIV and then donate, it means that they are aware of spreading infection. The infected person is a direct victim.

พร้อมตั้งข้อหา’เจตนาฆ่า’ ใครรู้ว่าเป็นเอดส์แล้วยังบริจาคเลือด… อ่านต่อที่

“พ.ต.อ.กฤษณะ พัฒนเจริญ” รองโฆษกตร. เผย กรณีผู้ที่รู้ว่าตัวเองติดเชื้อ HIV แต่ยังไปบริจาคเลือด หรือไปชักชวนคนกลุ่มเสี่ยงด้วยกันไปบริจาคเลือด มีความผิดทางอาญาข้อหา “เจตนาฆ่า”

มื่อวันที่ 20 ส.ค. ที่สำนักงานตำรวจแห่งชาติ (ตร.) พ.ต.อ.กฤษณะ พัฒนเจริญ รองโฆษกตร. กล่าวถึงกรณีผู้ที่มีพฤติกรรมเสี่ยง หรือติดเชื้อ HIV ไปบริจาคเลือด ว่า หากผู้ที่ไปบริจาคแล้วมาชักชวนให้คนอื่นที่อยู่ในกลุ่มเสี่ยงด้วยกันไปบริจาคเลือด พฤติกรรมดังกล่าวเข้าข่ายความผิด พ.ร.บ.คอมพิวเตอร์ ฐานนำเข้าข้อมูลอันเป็นเท็จ เนื่องจากผู้ที่อยู่ในกลุ่มเสี่ยง หรือติดเชื้อ HIV แล้ว ไม่สามารถบริจาคเลือดได้ และหากทำให้ผู้อื่นติดเชื้อ จะเข้าข่ายความผิดกฎหมายอาญาข้อหาเจตนาฆ่า เนื่องจากผู้ที่บริจาคย่อมรู้แก่ใจว่าตนเองติดเชื้อ HIV แล้วยังไปบริจาคเท่ากับว่าเป็นการเล็งเห็นผลให้เกิดการติดเชื้อเพิ่มมากขึ้น โดยผู้ที่ติดเชื้อจึงเป็นผู้เสียหายโดยตรง.