Canada: Review of HIV non-disclosure laws still in place in Canada

Everything you need to know about Canada’s HIV non-disclosure laws

How LGBTQ2 communities are affected, what laws remain in place and what’s being done to end unjust criminalization

In early February, a man identified only by the initials N.G. had his appeal heard at Ontario’s Superior Court in what advocacy groups hoped could establish a new precedent for Canada’s HIV disclosure laws. N.G. was convicted of aggravated sexual assault in 2017 after three complainants said he did not disclose his HIV diagnosis before their sexual encounters. He used a condom and did not transmit the virus to any of his partners. Still, N.G. was sentenced to 42 months in prison—short of the life sentence an aggravated sexual assault conviction could carry.

According to a CBC report, the Crown attorney for the case, Grace Choi, said “low risk or lack of intent to transmit the virus are not sufficient, even if a person uses a condom.” She also reportedly questioned whether condom use “prevents the reasonable possibility of transmission.” Failing to disclose a person’s HIV status “deprives the sexual partner of meaningful choice,” she told the court.

But “continuing to criminalize people living with HIV who use condoms is discriminatory and an overly broad application of the criminal law that is harmful and bad for public health,” wrote Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network (CHLN), in a statement in response to the appeal hearing.

The case highlights the patchwork of laws that direct Canada’s HIV non-disclosure laws, and just how complex they can be. Here’s everything you need to know about HIV non-disclosure laws in the country.

What is HIV non-disclosure criminalization?

In Canada, there is no criminal statute that requires people to disclose their HIV-positive status before sex. But courts have taken matters into their own hands when it comes to defining when disclosure should happen.

The Supreme Court of Canada weighed in on the matter in 2012, with two rulings that gave more clarity on the issue. Judges ruled that people living with HIV have an obligation to disclose their positive status before sex that “poses a serious risk of bodily harm.” That means disclosure is not required when using a condom for vaginal sex or when the HIV-positive person has a low viral load. What the ruling does not account for are other forms of sex, such as anal and oral.

But provincial and municipal courts dealing with HIV non-disclosure cases often prosecute outside of this Supreme Court ruling. According to the CHLN, many people living with HIV have been charged and convicted despite there having been little to no risk of transmission during their sexual encounters.

“The theory is, because you can die from HIV, then that’s an endangerment to your life,” Elliott says.

Being convicted of aggravated sexual assault can have dramatic consequences: Those convicted are automatically registered as sex offenders for life. People who are not Canadian citizens—including visitors and permanent residents—can be deported. And for many, the charge can lead to further stigma beyond their HIV status, including isolation and difficulty finding housing, employment and even healthcare support.

What’s the science behind HIV non-disclosure laws?

Since the HIV/AIDS epidemic of the 1980s, healthcare researchers and providers have made strides in managing the virus. With proper treatment, many living with HIV can have what is considered an “undetectable” viral load. That means the virus becomes so suppressed that HIV-positive people cannot transmit it, even in the absence of other forms of protection such as condoms, or medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The science has given rise to the phrase U=U, or “undetectable equals untransmittable.”

According to CATIE, Canada’s resource for HIV/AIDS and hepatitis C information, studies define “undetectable” as less than 200 copies of the virus per millilitre of blood. It’s higher than what most clinical tests aim for, which is 40 to 50 copies per millilitre. Canada’s Supreme Court uses the 200 copies-per-millilitre value—meaning, if someone has less than 200 copies/ml of the virus in their blood, there is a negligible reasonable risk of transmission and therefore no obligation to disclose.

What is the federal government doing about HIV non-disclosure criminalization in Canada?

In 2018, the federal government released a directive to the Public Prosecution Service of Canada that narrowed the scope of Canada’s HIV non-disclosure prosecution. It follows a 2017 report from the Standing Committee on Justice and Human Rights regarding Canada’s laws surrounding HIV non-disclosure.

The 2017 report notes that, because the current law treats all cases involving a “realistic possibility of transmission” as aggravated sexual assaults, there’s been an over-criminalization of those living with HIV: They’ve been charged with the most serious sexual offence on Canada’s books.

The 2018 directive says:

The criminal law will continue to apply to persons living with HIV if they do not disclose, or misrepresent, their HIV status before sexual activity that poses a realistic possibility of HIV transmission… This should not apply in cases where the person has not maintained a suppressed viral load but used condoms or engaged only in oral sex or was taking treatment as prescribed, unless other risk factors are present.

It also says that police should instead charge individuals with—and prosecutors should pursue cases where—criminal offences that are non-sexual in nature, such as in the cases of assault, criminal negligence or nuisance. This model follows in the U.K.’s footsteps, creating more flexibility for prosecutors and ensuring that those charged would not automatically be registered as sex offenders. If a person living with HIV has sought or received services from public health authorities, it should be taken into account when determining whether it’s in the public interest to pursue criminal charges against them.

The catch, however, is that the directive only immediately applies to the territories—the Yukon, Nunavut and the Northwest Territories—because the Public Prosecution Service of Canada is the prosecutor there; the provinces have their own prosecutors. Despite the directive, it’s still up to individual provinces to make their own choices in relation to non-disclosure prosecutions. That said, Ontario, British Columbia and Quebec have similar directives in place.

The 2017 Justice Committee report also recommended Parliament convene to establish a federal-provincial working group to develop a common prosecutorial directive for non-disclosure laws across Canada. In a media response to Xtra, the Justice Department was unable to confirm if that working group has been established.

In June 2019, Minister of Justice and Attorney General of Canada David Lametti acknowledged that the directive should go further, and, if re-elected, the Liberals would tackle the issue. In a follow-up from Xtra, the Department of Justice was unable to elaborate on what concrete measures will be taken.

Who is most affected by HIV non-disclosure laws in Canada?

Alexander McClelland, a researcher and Banting Postdoctoral Fellow at the University of Ottawa, has found that found HIV non-disclosure criminalization affects a number of communities in different ways—including a significant number of straight men who have sex with women. But when looking into other, more marginalized communities, McClelland discovered that those who engage in sex work and LGBTQ2 communities experience unique challenges with non-disclosure criminalization.

Of cases involving LGBTQ2 folks, McClelland says those involving gay men are most sensationalized by the media. “Gay men still represent a majority of the HIV cases in Canada, and I think the way in which gay men have [different] kinds of sex freaks out authorities,” he says. “It’s very polarizing when it comes out. A lot of people think when someone has been promiscuous and hasn’t disclosed their HIV status that they should be prosecuted or criminalized. Usually someone’s name and picture ends up in the media through the police—and that can create a sense of hysteria for those who slept with that person.”

McClelland says these media depictions, contribute to an ongoing stigmatization of people living with HIV. “The only time you see a representation of people living with HIV is when it’s a police photo in the media about them being a violent perpetrator spreading HIV,” he says. “In my research, when I actually spoke to people, they understood they were trying to do something to protect their partners by taking medication, using condoms or overtly telling people.”

Another barrier that increases the risk of prosecution, McClelland adds, is a lack of access to viral suppression medication. In line with the 2018 federal directive, Ontario, Quebec and B.C.  no longer prosecute people who can achieve undetectable viral loads. This caveat affects a wide number of socially marginalized communities, including people who are street involved, have recently been released from prison or those working on the street as sex workers, for example.

“This means those people will be further marginalized socially and thought of as more deviant, more diseased and more infectious—and more in need of criminalization,” McClelland says.

What still needs to be done to address these issues in Canadian law?

While reform in criminal justice has yet to happen, it could be on the horizon. Last June, the Justice Committee issued another report on HIV criminalization. This time, it called for two major changes: Removing HIV non-disclosure from the reach of sexual assault law, and limiting the criminalization of HIV to cases with actual transmission only.

In regards to the latter, CHLN wants the law to go further, limiting prosecution to intentional transmission of HIV. “There is an increasing amount of people that see using sexual assault laws for this as problematic,” Elliott says. “We don’t have an HIV-specific provision, or even an STI-specific provision in the Criminal Code. But the way the law has evolved we do effectively have prosecutions that target HIV-positive people with sexual assault.”

HIV Justice Network reaches key milestone with the publication of our first annual report

Today, the HIV Justice Network (HJN) reaches an important milestone with the publication of our first annual report, covering January – December 2019.

2019 was a landmark year for HJN, not only in terms of organisational growth, but also in terms of the scale-up of key resources – most published in four languages – and the provision of technical and financial support to organisations and networks in many regions of the world, all of which led to some remarkable advocacy successes.

HJWW2020 HJN board and teamThe HJN Team and Supervisory Board (SB) dine together following a successful Strategy Meeting in Amsterdam, January 2020 (L-R): Paul Kidd (Secretary, SB) , Sally Cameron (Senior Policy Analyst), Rebekah Webb (Senior Associate), Sylvie Beaumont (Outreach / Research Co-ordinator), Lisa Power (Chair, SB), Dymfke van Lanen (Finance Manager), Edwin Bernard (Executive Director), Julian Hows (GAP Co-ordinator) and Raoul Fransen (Treasurer, SB).

 

“Our 2019 Annual Report illustrates the importance of joined-up activism towards a common goal. We can all play a part in resisting HIV criminalisation at home and across the globe. HJN, under the passionate leadership of Edwin Bernard, gives us the tools, the structures and the inspiration to do the job.” Lisa Power, Chair, Supervisory Board

 

Members of HJN’s team also participated in a number of global and regional meetings, presenting on various aspects of our work, such as monitoring, supporting strategic litigation, and working with the media.

As a result, we forged stronger relationships with many organisations undertaking human rights work around the world, including establishing new contacts for possible collaborative projects in the future.

As well as HJN’s own workplan, much of the team’s time is spent co-ordinating a wide range of activities on behalf of HIV JUSTICE WORLDWIDE (HJWW), as well as managing the Robert Carr Fund grant to the HIV Justice Global Consortium.

“This report highlights the achievements of our small team and our global partners in the last year, and demonstrates that we are delivering on our mission of challenging HIV criminalisation around the globe. We strive to defend the human rights of marginalised people with HIV in the face of unjustified and unscientific punitive laws – something that is now in even sharper focus with the coronavirus pandemic.” Paul Kidd, Secretary, Supervisory Board

 

There are exciting plans ahead for HJN in 2020, including a new version of HJN’s website that will incorporate – and update – data previously collected in GNP+’s Global Criminalisation Scan, and the debut of HJN’s live streamed web show, HIV Justice Live!

The PJP Update – April 2020

The April 2020 edition of the Positive Justice Project newsletter is available here.

Proudly announcing HIV Justice Network’s Global Advisory Panel

Today, the HIV Justice Network is proud to announce our Global Advisory Panel (GAP), an international expert reference group of activists, lawyers and academics – more than half of whom are openly living with HIV – from all regions of the world who are working on ending  HIV and intersectional criminalisations.

Sarai Chisala-Tempelhoff, a Malawian human rights lawyer, says: “As an African woman and feminist who has been researching and exploring the interactions between law, HIV and women’s lives for almost two decades, being a member of the GAP feels like a fitting culmination of my life’s passions and goals: to keep bridging that gap between marginalised women’s lived realities and the laws that they live under.”

 

Members have been selected on the basis that they have specific skills, interests, and knowledge of the issues that we work on, and how this intersects with other social justice issues and movements.

Elie Balan, who works on LGBT rights in the Middle East / North Africa region says: “As a person living with HIV I have seen HIV criminalisation happen around me and to people I know, and to me it is a personal issue more than anything. I am excited to be part of the GAP to ensure such practices are ceased within my country and region.”

 

The GAP, co-ordinated by HJN team member, Julian Hows, has been convened to assist HJN deliver on its mission by:

  • Providing feedback on our current work, activities and outputs.
  • Being both a ‘critical friend’ as well as an ambassador for the ways that we are delivering on our mission, strategically and operationally.
  • Assisting us with building strategic alliances towards the common goal of ending HIV-related criminalisation around the world.

Alexander McClelland, a Canadian activist and social scientist living with HIV, says: “Being part of the GAP is vital to ensure we share globally what is happening in our respective countries, so we can learn strategies of resistance, and build a forceful collective response to help end practices of criminalisation.”

 

All members have indicated a willingness to serve for an initial period of two years (i.e. 1 January 2020 until 31 December 2021).  In fact, the GAP has met twice – virtually – since initally coming together in January 2020, including earlier this week where information was exchanged regarding the impact of the COVID-19 pandemic on HJN’s work, and in the countries, regions and constituents served by GAP members. 

Jeffry Acaba, who fights for the rights of people living with HIV in the Asia Pacific region: “HIV criminalisation continues to take place in many parts of the world and the platform that the GAP provides is vital to our collective effort to finally end this unjust and unfair policy practice. I’m honored to be contributing towards that change through the GAP.”

 

We very much welcome all of the GAP members, and look forward to working together to achieve HIV justice.

The current members of the Global Advisory Panel are:

  • Jeffry Acaba (ASIA PACIFIC)
  • Elie Ballan (MENA)
  • Edwin Cameron (AFRICA) 
  • Sarai Chisala-Tempelhoff (AFRICA)
  • Cecilia Chung (NORTH AMERICA)
  • Michaela Clayton (AFRICA)
  • Ann Fordham (EUROPE)
  • David Haerry (EUROPE)
  • Jules Kim (ASIA PACIFIC)
  • Ron MacInnis (NORTH AMERICA)
  • Allan Maleche (AFRICA)
  • Alexander McClelland (NORTH AMERICA)
  • Gennady Roschupkin (EECA)
  • Robert Suttle (NORTH AMERICA)

To read more about the individual members of the GAP – and their many achievements – please visit HJN’s dedicated GAP page.

HIV criminalisation still an issue during COVID-19 pandemic

On 21 February, just prior to the start of the COVID-19 pandemic, we celebrated a week where – for the first time in years – we saw no reported cases of HIV criminalisation anywhere in the world.

Soon after we began to notice fewer reports of HIV criminalisation cases and fewer articles related to our collective advocacy.  We wondered at the time whether this may be due, in part, to our previous advocacy successes, athough we thought it was more likely a reflection of the media and the criminal justice system changing their focus to COVID-19.

Certainly, police have been unbelievably busy dealing with ensuring lockdowns and quarantines are followed – some more zealously than others – and courts, as well as parliaments are either closed or dealing only with the most urgent of cases. This is having a concerning impact upon the processing of HIV criminalisation cases, including appeals, leaving those unjustly accused or convicted in limbo and at greater risk of acquiring COVID-19 whilst on remand or in prison.

Now, after several weeks of seeing no HIV-related criminal cases, this past week we have, unfortunately, documented two further HIV-related arrests – a woman in the Rostov region of Russia is accused of passing on HIV to her husband and faces five years in prison; and a man in Louisiana in the United States was arrested after allegedly spitting on an officer and then charged with “intentional exposure to the AIDS virus” after he informed medical staff of his HIV-positive status.

The US news report notes – without obvious irony – the Kafkaesque nature of the law in Louisiana by concluding:

While saliva alone cannot transmit HIV or AIDS, Louisiana law holds that knowingly infected people who spit at first responders can face up to 11 years in prison and/or pay a $6,000 fine.

 

This week, we also saw a remarkably comprehensive article about HIV criminalisation in Tajikistan, which explored how and why the country’s criminal code potentially considers every HIV-positive citizen to be a criminal, what this means for people living with HIV in the country, and how to avoid prosecution as well as ways to organise.

Finally, some good news relating to HIV criminalisation as well as to COVID-19 criminalisation.

In Spain, the Supreme Court upheld the acquittal of a man accused of criminal HIV transmission noting that evidence pointed to the complainant being aware of his status prior to agreeing to condomless sex, meaning there was consent. 

And in Malta, where it was proposed earlier in the week to add COVID-19 to the list of communicable diseases covered by the law used to criminalise the wilful or negligent spread of HIV and hepatitis, this proposal has since been put on hold, due to very real concerns that this may do more harm than good for public health, as well as create difficulties around proof in court.

The Times of Malta reports:

The law could also strain the already stretched law enforcement resources if they suddenly had to deal with a flood of reports over possible criminal spreading of the virus.

“In essence, this seems like a good idea at first glance but it presents a number of problems,” one government minister privy to the discussions said.

The possibility of such a reform had not even been brought before Cabinet yet, he said, adding he understood it “has been put on the back burner for now”. 

“We have bigger fish to fry, right now.”

 

If only other punitive-minded governments – and overly-zealous law enforcement officers – around the world thought this way about COVID-19 and other communicable diseases right now, including, of course, HIV.

Tajikistan: The Criminal Code potentially considers every HIV-positive citizen to be a criminal

How can we save 14,000 Tajiks from the threat of prison and the country from an epidemic?

The Criminal Code potentially considers every HIV-positive citizen to be a criminal, not a person in need of state support.

Why do criminal measures against Tajiks living with HIV contribute to the rapid growth of the HIV/AIDS epidemic in the country? What is the practice in neighbouring countries? And, most importantly, how citizens can protect their rights, the correspondent of “Asia-Plus” understood.

The approach to the fight against HIV in Tajikistan, when law enforcement agencies, not doctors, take over, can have the opposite effect. This is the view of Tajik and international human rights activists, as well as the UN Committee on the Elimination of Discrimination against Women.

According to the Ministry of Health, more than 14 thousand people with human immunodeficiency virus (HIV) live in the country, almost half of whom do not even know about their HIV-positive status, and their number keeps growing.

On November 9, 2018, the UN Committee on the Elimination of Discrimination against Women (CEDOW) issued recommendations to Tajikistan, noting that there are a number of barriers in access to health care, which lead to the rapid spread of HIV.

Thus, paragraph 40 contains a recommendation to decriminalize HIV – complete abolition of Article 125 of the Criminal Code of Tajikistan. In the same year, in 2018, 33 criminal cases were initiated against 26 HIV-positive people, and in 2019 this number was increased by at least 6 more cases. These data were voiced by the prosecutor of Khujand Habibullo Vohidov at the coordination council of law enforcement agencies, on 2 May last year.

Since the beginning of 2020, human rights activists of the Centre for Human Rights and ReACT have already registered two such cases.

Article 125 is no longer in effect.
According to the Global Network of PLHIV (GNP+) Stigma and Discrimination Program Manager Alexandra Volgina, Article 125 of the Criminal Code of Tajikistan is taken from the Soviet legislation and reflects the reality of those years when there were no drugs for the disease. HIV rapidly progressed into AIDS, which was in fact a death sentence.

The first part of the 125th article of the Criminal Code of the Republic of Tajikistan speaks about infecting another person with venereal disease by a person who knew that he had this disease. This is despite the fact that antiretroviral therapy (ARV – ed.) completely eliminates the risk of transmission of the immunodeficiency virus and makes a person with HIV completely safe in terms of virus transmission.

It is important to note that antiretroviral therapy works only against HIV and does not protect against other sexually transmitted infections. Therefore, it is important not to forget about condom use as well.
“Criminalisation in itself is a stigma that society perpetuates in law or practice against people living with HIV. They are treated as criminals by default,” says Mikhail Golichenko, a lawyer and international human rights analyst for the Canadian Legal Network.

By placing all responsibility for preventing the transmission of immunodeficiency virus to people living with HIV, the article on criminalization of HIV, in fact, gives society false hope, misleads society when people think that “if HIV is criminalized, I will be warned in any case,” said the lawyer.

In Tajikistan, the diagnosis of HIV is perceived as a threat. This is a big problem, which under the current global scientific base is simply pointless.

The principle of ‘Undefined=Untransferable’ (if a person with HIV receives treatment, the virus in his blood is reduced to a minimum and then he cannot transmit HIV to his sexual partner) is a long-proven scientific fact and a turning point in the history of the fight against HIV/AIDS.

Thus, today HIV-positive women, while receiving treatment, give birth to healthy children, people with HIV live as long as without it. Families where partners with different HIV statuses, without transmitting the disease to each other, live happily, and this happens not somewhere far away, but in neighboring countries: Russia, Kyrgyzstan, Kazakhstan and Uzbekistan.

Women in a trap
Under article 125 of the Criminal Code, women are mainly recruited in Tajikistan. Human rights expert in the aspect of access to HIV prevention and treatment NGO “Center for Human Rights” Larisa Aleksandrova, says about the stereotype inherent in Tajik society – that HIV infection is mainly caused by sex workers.

In fact, according to the National Programme on Combating HIV Epidemic in 2017-2020, HIV prevalence among sex workers is 3.5%.

Heterosexual sex is the main route of HIV transmission in Tajikistan. In some regions, the proportion of such cases reaches 70%.
Larisa Alexandrova shared real examples of violations of women’s rights from the practice of lawyers of the NGO “Center for Human Rights” Zebo Kasymova and Dilafruz Samadova.

In order to protect personal data, no names are given.

Punishment without a crime
“A 41-year-old resident of Khatlon province was previously convicted under part 2 of article 125 of the Criminal Code and was sentenced to one year in prison in 2018. By court order, she was released early in 9 months due to poor health.

But already in 2019 the woman was repeatedly detained. A criminal case was initiated against her in the same episodes as in 2018. None of the sexual partners in the case were found to be HIV-positive, neither in 2018 nor in 2019. However, the court found the woman guilty again, only under Part 1 of Article 125 of the Criminal Code she was sentenced to 1 year in prison. Under article 71 of the Criminal Code, the court did not impose a suspended sentence, but gave her a probationary period for correction, but under control of her behavior.

Expert opinion: Analysis of this case, according to the lawyer, revealed a low level of professionalism of law enforcement officials, both in terms of knowledge of HIV and in legal proceedings. The reopening of a case on the same episode, on the same facts of a criminal case against a person is a direct violation of the Constitution of Tajikistan and the International Covenant on Civil and Political Rights, the expert assures.

– The woman served 9 months for the first time, and under Part 2 of Article 125 of the Criminal Code. Initially, the wrong norm was applied, as Part 2 says about HIV infection. But none of the sexual partners was found to have HIV. Accordingly, there should have been part 1, – sums up Larisa Alexandrova.

A trial without a victim.
“A resident of Khujand, who injected drugs, volunteered for an NGO. A criminal case was initiated on 11 October 2018 under part 1 of article 125 of the Criminal Code. The victims of this case were male. During the trial the man stated that he did not agree with the fact that he was recognized as a victim.

After the initiation of the criminal case on the basis of the commission expert opinion, it was found that the man did not have HIV. At the trial, the lawyer asked questions: “Did the defendant offer to use a condom during sexual intercourse?”, to which the man answered:

“Yes, but I refused. I know that she has this disease, but nevertheless, I love her, I will live with her, I have no complaints or demands to her”.
The legislation of the Republic of Tajikistan refers Article 125 part 1 to the cases of private and public prosecution, which means that these cases are initiated at the request of the victim of the crime, but in case of reconciliation with the accused, the proceedings are not terminated. Despite this, the defendant was sentenced to one year and two months’ deprivation of liberty under article 125, part 1, of the Criminal Code.

Expert opinion: In this case, the person was put in jail despite the fact that she had good medical data. In addition, her sexual partner knew that she had HIV. He did not even submit any application. In that case, the case should have been initiated at least by the prosecutor, not the internal affairs system. And we don’t know who reported this case, either. In this case, the procedure for instituting criminal proceedings and the defendant’s procedural rights were also violated.

The investigator did not even let the attorney or the person under investigation see the indictment. The indictment was presented to the lawyer who defended the woman for the first time at the request of the police. Later the defendant refused to defend him, and she was represented by a lawyer from the NGO “Center for Human Rights”. The lawyer filed a complaint against the investigator with the prosecutor’s office, but the prosecutor’s office found no violations.

The judge did not pay attention to all these violations and passed a sentence, comments the expert Aleksandrova. The case was appealed both to the cassation and supervisory authorities, but the judges considered that there were no violations.

International expert Mikhail Golichenko explained what “knowingly” means from the legal point of view.

Part 1 of Article 125 of the Criminal Code of Tajikistan provides for liability for knowingly putting another person in danger of contracting the human immunodeficiency virus. This article does not provide for such a sign as “infection”. In other words, putting another person in danger of infection is sufficient.

The word “knowingly”, interpreted by lawyer Mikhail Golichenko, means that a person knew in advance about the presence of HIV. Being put in danger, without infection itself, means that the crime is a formal one.

For comparison, the Criminal Code of the Republic of Tajikistan also has actions with the material composition, where the obligatory sign is the public dangerous consequences. For example, murder is a material composition, as for the completed composition it is necessary to have such socially dangerous consequences as the death of a person.

For crimes with formal composition, the only form of guilt can only be direct intent. If a person was aware of public danger of his or her action (inaction) and wanted to commit exactly these actions. If there are signs in the case that, for example, the sexual intercourse without a condom was due to fear of violence by the partner, at the request of the partner. Or for other reasons, which give grounds to conclude that there is no desire to put in danger the infection, it is impossible to prosecute under paragraph 1 of Art. 125 of the Criminal Code. There is no necessary element of the crime – guilt in the form of direct intent.

“No treatment, no punishment”: expert recommendations for Tajikistan
Lawyer Mikhail Golichenko and international human rights expert Aleksandra Volgina are sure that Article 125 is not needed, because intentional HIV transmission is the most likely. In addition, this article is covered by another article of the Criminal Code of Tajikistan – “On causing harm to health”. They are convinced that all parts 1, 2, 3 of Article 125 of the Criminal Code of Tajikistan have long lost their relevance.

In itself, the existence of special responsibility for HIV infection is the stigma attached to people living with HIV as enshrined in the criminal law. And in this sense, Article 125 of the Criminal Code of RT plays a negative role in HIV prevention. In this regard, the best option would be to abolish this norm completely. For rare cases of intentional HIV infection it is possible to apply Article 111 of the Criminal Code of Tajikistan on the liability for intentional harm to health of average gravity.

According to Tatiana Deshko, director of international programs in the Public Health Alliance, in Tajikistan it is necessary to bring medical issues under the control of physicians.

– Let’s look at the results of the “work” of this criminal code article. In Tajikistan, more than one million HIV tests were conducted in 2019, and just over 1,000 new HIV cases were identified – that’s very little. People who have a real risk and HIV infection are simply afraid to be tested. That is not surprising, and it happens everywhere.

“Imagine that you would be isolated for the coronovirus not at home or in a hospital, but in an isolation ward and prison. “Then why would you be tested? Still, medical issues should be dealt with by doctors, not the police – then everything would be in its place and we would become healthier,” says Tatiana Deshko.
Thus, Larisa Aleksandrova said that the telephone hotline of the NGO “Center for Human Rights” also began to be contacted by forensic medical experts on gender reassignment and documents of title for transgender people. Such cooperation began to take shape after trainings for some judges: they begin to refer people living with HIV, who are accused under Article 125 of the Criminal Code, for legal assistance. This suggests that the information and scientifically proven arguments are obvious, as well as the fact that the authorities, receiving more information, are ready to contribute in every way to the reasonable support of human rights.

“The Global Fund confirms its readiness to continue supporting Tajikistan’s efforts in the fight against AIDS in implementing an effective response to HIV based on scientific evidence,” said Alexandrina Iovita, Human Rights Adviser, Global Fund to Fight AIDS, Tuberculosis and Malaria to Asia Plus.
– The focus of these activities is to prevent new cases, increase ARV coverage and reduce barriers to human rights violations faced by key populations in accessing services. Evidence and recommendations from technical partners such as UNAIDS and UNDP indicate that overly broad criminalization of HIV prevents people from getting tested and starting ARVs and jeopardizes adherence.

We welcome the increasing focus on public health rather than on punitive approaches. It is public health that is based on effective and humane interventions that are essential when comparing resources spent and results obtained.

Where to go for help for people living with HIV?
The Republic has organizations that provide support and advice to people living with HIV in difficult circumstances. These are SPIN-plus and the Network of Women Living with HIV in Tajikistan.

As for legal assistance, in Tajikistan there is a hotline of NGO “Center for Human Rights”, +992933557755.

“In just 4 months (October 2019-January 2020), 60 people (21 men, 36 women and 3 transgender people) contacted the hotline,” said Larisa Alexandrova.
Any person in a difficult situation due to HIV can contact the hotline and receive free legal advice and / or support for representation in courts, state agencies.

Lawyers who have not previously dealt with such cases, recommended international human rights activist Mikhail Golichenko, should consult with experienced lawyers in advance. Special organizations, such as the Center for Human Rights in Tajikistan, can be contacted to explain what to do in different situations.

You can’t try to do something on your own, better involve allies and organize protection. Lawyers must be clear about what evidence they need to gather in order to do so.

UNAIDS states unequivocally that there is no evidence to support the effectiveness of criminal law enforcement for HIV transmission in preventing HIV transmission. Rather, it undermines public health goals and the protection of human rights. UNAIDS commends country initiatives to review such legislation and repeal it.

Как спасти 14 тысяч таджиков от угрозы тюрьмы, а страну – от эпидемии?

УГОЛОВНЫЙ КОДЕКС РТ КАЖДОГО ВИЧ-ПОЗИТИВНОГО ГРАЖДАНИНА ПОТЕНЦИАЛЬНО РАССМАТРИВАЕТ КАК ПРЕСТУПНИКА, А НЕ ЧЕЛОВЕКА, НУЖДАЮЩЕГОСЯ В ПОДДЕРЖКЕ ГОСУДАРСТВА

Почему уголовные меры против таджиков, живущих с ВИЧ, способствуют стремительному росту эпидемии ВИЧ/СПИДа в стране? Какая практика у соседних стран? И, главное, как гражданам защищать свои права, разбирался корреспондент «Азия-Плюс».

Подход в борьбе с ВИЧ в Таджикистане, когда за дело берутся правоохранители, а не врачи, может дать обратный эффект. Так считают таджикские и международные правозащитники, а также комитет ООН по ликвидации дискриминации в отношении женщин.

По информации Минздрава РТ в стране проживает более 14 тыс. людей с вирусом иммунодефицита человека (ВИЧ), почти половина которых, даже не подозревает о своём ВИЧ-положительном статусе, и их число продолжает расти.

9 ноября 2018 года, комитет ООН по ликвидации дискриминации в отношении женщин (CEDOW) опубликовал рекомендации в адрес Таджикистана, отметив наличие ряда барьеров в доступе к здравоохранению, которые приводят к стремительному распространению ВИЧ.

Так, в пункте 40 содержится рекомендация по декриминализации ВИЧ – полной отмене статьи 125 Уголовного кодекса РТ. В том же 2018 году было возбуждено 33 уголовных дела в отношении 26 ВИЧ-позитивных людей, а в 2019 году к этому числу прибавилось еще, как минимум, 6 дел. Эти данные озвучил прокурор Худжанда Хабибулло Вохидов на координационном совете правоохранительных органов, 2 мая прошлого года.

С начала 2020 года правозащитники ОО «Центра по правам человека» и ReACT зарегистрировали уже 2 таких кейса.

125-я статья уже не работает

По словам менеджера программ по стигме и дискриминации Глобальной Сети ЛЖВ (GNP+) Александры Волгиной, 125 статья в Уголовном кодексе Таджикистана взята из советского законодательства и отражает реальность тех лет, когда еще не было лекарств от этого заболевания. ВИЧ быстро прогрессировал в состояние СПИДа, что являлось фактически смертельным приговором.

Первая часть 125-й статьи УК РТ говорит о заражении другого лица венерической болезнью лицом, знавшим о наличии у него этой болезни. Это притом, что антиретровирусная терапия (АРВ, – ред.) полностью устраняет риск передачи вируса иммунодефицита и делает человека с ВИЧ совершенно безопасным в плане передачи вируса.

Важно отметить, что эта АРВ терапия работает только против ВИЧ и не защищает от других инфекций, передающихся половым путем. Поэтому важно не забывать и об использовании презерватива.

«Сама по себе криминализация — клеймо, которое общество закрепляет в законе или в практике против людей, живущих с ВИЧ. Они рассматриваются как преступники, по умолчанию», – говорит Михаил Голиченко, адвокат, международный аналитик по правам человека Канадской правовой сети.

Возлагая всю ответственность за профилактику передачивируса иммунодефицита на людей, живущих с ВИЧ, статья о криминализации ВИЧ, по сути, дает обществу ложную надежду, вводит общество в заблуждение, когда люди думают, что «если ВИЧ криминализовано, то меня в любом случае предупредят», – отмечает адвокат.

В Таджикистане диагноз «ВИЧ» воспринимается как угроза. Это большая проблема, которая при существующей мировой научной базе просто бессмысленна.

Принцип “Неопределяемый=Непередаваемый” (если человек с ВИЧ получает лечение, у него в крови вирус снижается до минимума и тогда он не может передать ВИЧ половому партнеру) – давно доказанный научный факт и переломный момент в истории борьбы с ВИЧ/СПИДом.

Так, сегодня ВИЧ-положительные женщины, принимая лечение, рожают здоровых детей, люди с ВИЧ живут так же долго, как и без него. Семьи, где партнеры с разными ВИЧ статусами, не передавая болезнь друг другу, живут счастливо, и это происходит не где-то далеко, а в соседних странах: России, Кыргызстане, Казахстане и Узбекистане.

Женщины в западне

В Таджикистане по 125-й статье Уголовного кодекса РТ в основном привлекаются женщины. Эксперт по правам человека в аспекте доступа к профилактике и лечению ВИЧ ОО «Центра по правам человека» Лариса Александрова, говорит о стереотипе, присущем таджикскому обществу – о том, что заражают ВИЧ-инфекцией в основном секс-работницы.

На самом деле, по данным Национальной программы по противодействию эпидемии ВИЧ на 2017-2020 гг. распространенность ВИЧ среди секс-работниц – 3,5%.

Гетеросексуальные половые контакты – основной путь передачи ВИЧ в Таджикистане. В ряде регионов доля таких случаев достигает 70%.

Лариса Александрова поделилась реальными примерами нарушения прав женщин из практики адвокатов ОО «Центра по правам человека» Зебо Касымовой и Дилафруз Самадовой.

В целях защиты персональных данных, имена не указываются.

Наказание без преступления

«41-летняя жительница Хатлонской области ранее была судима по ч.2 статьи 125 УК РТ и приговором суда в 2018 году была осуждена на год лишения свободы. Постановлением суда через 9 месяцев освобождена досрочно в связи с плохим состоянием здоровья.

Но уже 2019 году женщина была повторно задержана. В отношении неё было возбуждено уголовное делопо тем же эпизодам, что и в 2018 году. Ни у одного из проходящих по делу половых партнёров не было выявлено ВИЧ, ни в 2018, ни в 2019году. Однако суд повторно признал женщину виновной, только уже по ч.1 статьи 125 УК РТ ей назначали 1 год лишения свободы. Суд на основании статьи 71 УК РТ условно не применил наказание, а дал ей испытательный срок для исправления, но в условиях контроля за её поведением».

Мнение экспертов: Анализ данного кейса, по словам адвоката, выявил низкий уровень профессионализма сотрудников правоохранительных органов, как по знанию особенностей ВИЧ, так и по судопроизводству. Повторное возбуждение делапо одному и тому же эпизоду, по тем же фактам уголовного дела против человека – прямое нарушение Конституции РТ и Международного пакта о гражданских и политических правах, уверяет эксперт.

–  Женщина первый раз отсидела 9 месяцев, причём по части 2 ст.125 УК РТ. Изначально была применена неправильная норма, так как часть 2 говорит о заражении ВИЧ. Но ни у одного из половых партнеров не был обнаружен ВИЧ. Соответственно должна была быть часть 1, — резюмирует Лариса Александрова.

Суд без потерпевшего

«Жительница г. Худжанд, употреблявшая инъекционные наркотики, работала волонтёром в НПО. Уголовное дело было возбуждено 11 октября 2018 года по ч.1. статьи 125 УК РТ. Потерпевшим по этому делу проходил мужчина. В ходе судебного процесса мужчина заявил, что он не согласен с тем, что его признали потерпевшим.

После возбуждения уголовного дела на основании заключения комиссионной экспертизы, было выявлено, что у мужчины отсутствует ВИЧ. На суде были заданы вопросы со стороны адвоката: «Предлагала ли подзащитная использовать презерватив при половом контакте?», на что мужчина ответил:

«Да, но я отказался. Я знаю, что у неё есть это заболевание, но, тем не менее, я люблю её, буду с ней жить, не имею к ней претензии и требований».

Законодательство Республики Таджикистан относит статью 125 часть 1 к делам частно-публичного обвинения, это означает, что эти дела возбуждаются по заявлению лица, пострадавшего от преступления, но в случае примирения его с обвиняемым производство по ним не подлежит прекращению. Несмотря на это, в отношении подсудимой был вынесен приговор – 1 год 2 месяца лишения свободы по ч.1 статьи 125 УК РТ».

Мнение экспертов: В этом случае, человека посадили, несмотря на то, что у неё были хорошие медицинские данные. К тому же о наличии у неё ВИЧ половой партнёр знал. Он даже не подавал никакого заявления. В таком случае дело должно было быть возбуждено, как минимум прокурором, а не системой внутренних дел. И кто сообщил об этом кейсе тоже неизвестно. В данном кейсе был нарушен и порядок возбуждения уголовного, дела и процессуальные права подсудимой женщины.

Следователь даже не дал ознакомиться с обвинительным заключением ни адвокату, ни самой подследственной. Обвинительное заключение было представлено адвокату, которая защищала женщину впервые дни по запросу органов милиции. В впоследствии подсудимаяот его защиты отказалась, и ей был представлен адвокат от ОО «Центр по правам человека». Адвокатом была подана жалоба на следователя в прокуратуру, но прокуратура не нашла никаких нарушений.

Судья не обратил внимания на все эти нарушения и вынес приговор, комментирует эксперт Александрова. Дело было обжаловано и в кассационную, и надзорную инстанции, но и там судьи посчитали, что нарушений нет.

Что значит «заведомо» – с юридической точки зрения объяснил международный эксперт Михаил Голиченко.

Часть 1 ст. 125 УК Таджикистана предусматривает ответственность за заведомоепоставление другого лица в опасность заражения вирусом иммунодефицита человека. В этой статье не предусмотрен такой признак как «заражение». То есть самой постановки в опасность заражения достаточно.

Слово «заведомо», толкует юрист Михаил Голиченко, означает, что человек заранее знал о наличии у него ВИЧ. Поставление в опасность, без наступления самого заражения, означает, что состав преступления формальный.

Для сравнения, в УК РТ также есть действия с материальным составом, где обязательным признаком выступают общественно-опасные последствия. Например, убийство – материальный состав, так как для оконченного состава необходимо наступление такого общественно-опасного последствия, как смерть человека.

Для преступлений с формальным составом единственной формой вины может быть только прямой умысел. Если человек осознавал общественную опасность своего действия (бездействия) и желал совершить именно эти действия. Если в деле есть признаки того, что, например, половой акт без презерватива был по причине страха насилия со стороны партнёра, по просьбе самого партнёра. Либо по другим причинам, которые дают основания для вывода об отсутствии желания поставить в опасность заражения, то привлечь к ответственности по части 1 ст. 125 УК РТ нельзя. Отсутствует необходимый элемент состава преступления – вина в форме прямого умысла.

«Лечить, нельзя наказывать»: рекомендации экспертов для Таджикистана

Адвокат Михаил Голиченко и международный эксперт по правам человека Александра Волгина уверены, что статья 125 не нужна, потому что умышленная передача ВИЧ –редчайшая вероятность. К тому же эта статьяохваченадругой статьей УК Таджикистана – «О причинении вреда здоровью». Они убеждены, все части 1,2,3 ст. 125 УК РТ давно утратили свою актуальность.

Само по себе наличие специальной ответственности за заражение ВИЧ является закрепленной в уголовном законе стигмой по отношению к людям, живущим с ВИЧ. И в этом смысле ст. 125 УК РТ играет негативную роль в вопросах профилактики ВИЧ-инфекции. В этой связи лучшим вариантом была бы отмена данной нормы полностью. Для редких случаев умышленного заражения ВИЧ возможно применении ст. 111 УК РТ об ответственности за умышленное причинение вреда здоровью средней тяжести.

По мнению Татьяны Дешко, директора международных программ в Альянсе общественного здоровья, в Таджикистане необходимо дать медицинские вопросы под контроль медиков.

– Давайте посмотрим на результаты «работы» этой статьи уголовного кодекса. В Таджикистане в 2019 году проведено более миллиона тестов на ВИЧ-инфекцию, а выявлено чуть больше 1 тыс новых случаев ВИЧ – это очень мало. Люди, которые имеют реальный риск и ВИЧ-инфекцию, просто боятся тестироваться. Неудивительно и так происходит везде.

“Представьте, что за короновирус вас бы изолировали не дома или в больнице, а в изоляторе и тюрьме. Пошли бы вы тогда тестироваться? Все-таки медицинскими вопросами должны заниматься врачи, а не полиция, – тогда все станет на свои места и станем здоровее”, – говорит Татьяна Дешко.

Так, Лариса Александрова рассказала, что на телефон горячей линии ОО «Центр по правам человека» начали обращаться также и сотрудники судебно-медицинской экспертизы по поводу изменения пола и правоустанавливающих документов по трансгендерным людям. Такое сотрудничество начало складываться после проведения тренингов для некоторых судей: они начинают перенаправлять людей, живущих с ВИЧ, которые обвиняются по ст.125 УК РТ, за правовой помощью. Это говорит о том, что информирование и научно доказанные аргументы очевидны, а также о том, что представители власти, получая больше информации готовы всячески способствовать разумному сопровождению прав человека. 

«Глобальный фонд подтверждает свою готовность продолжать поддержку деятельности Таджикистана в борьбе со СПИДом в применении эффективных мер ответа на ВИЧ, основанных на научно-доказанных данных, – сказала «Азия-Плюс» Александрина Иовита, советник по правам человека, Глобального фонда для борьбы со СПИДом, туберкулёзом и малярией. 

– Фокус этой деятельности направлен на предотвращение новых случаев, расширение охвата АРВ и снижение барьеров, связанных с нарушением прав человека, с которыми сталкиваются представители ключевых групп в контексте получения доступа к услугам. Фактические данные и рекомендации от технических партнеров, таких, как ЮНЭЙДС и ПРООН, указывают на то, что чрезмерно широкая криминализация ВИЧ не позволяет людям проходить тестирование и начинать АРВ, а также ставит под угрозу приверженность.

Мы приветствуем все больший фокус на общественном здравоохранении, а не на карательных подходах. Именно общественное здравоохранение основано на эффективных и гуманных мерах, представляющих большую значимость при сравнении затраченных ресурсов и полученных результатов».

Куда обратиться за помощью людям, живущим с ВИЧ?

В республике работают организации, которые оказывают поддержку и консультирование людям, живущим с ВИЧ, оказавшимся в сложных жизненных обстоятельствах. Это СПИН-плюс и Сеть женщин, живущих с ВИЧ в Таджикистане.

Что касается правовой помощи, в Таджикистане работает горячая линия ОО «Центра по правам человека», +992933557755

«Только за 4 месяца (октябрь 2019-январь 2020) на горячую линию обратились 60 человек (21 мужчина, 36 женщин и 3 трансгендерных человека)», – говорит Лариса Александрова.

Любой человек, оказавшись в сложной ситуации, в связи с ВИЧ, может обратиться на горячую линию и получить бесплатно правовую консультацию и/или поддержку по представительству в судах, государственных органах.

Адвокаты, которые ранее не занимались подобными делами, рекомендует международный правозащитник Михаил Голиченко, должны заранее проконсультироваться с опытными юристами. Можно обратиться в специальные организации – такие как ОО «Центр по правам человека в Таджикистане», чтобы им могли разъяснить, как быть в разных ситуациях.

Нельзя пытаться что-то делать своими силами, лучше привлечь союзников и организовать защиту. Адвокат должен четко знать, какие доказательства для этого необходимо собрать.

ЮНЭЙДС однозначно заявляет, что нет никаких данных, подтверждающих эффективность применения уголовного законодательства в отношении передачи ВИЧ – для предотвращения передачи ВИЧ. Наоборот, такое применение подрывает цели общественного здравоохранения и защиту прав человека. ЮНЭЙДС высоко оценивает инициативы стран по пересмотру такого законодательства и его отмене.

UNAIDS “extremely concerned” by new COVID-19 laws that target people living with or vulnerable to HIV

This week, echoing the concerns of the HIV JUSTICE WORLDWIDE Steering Committee, amongst others, UNAIDS issued a strongly worded press release condemning governments for abusing the current state of emergency over the COVID-19 pandemic for overreaching their powers and enacting laws that target people who are living with, or vulnerable, to HIV.

“In times of crisis, emergency powers and agility are crucial; however, they cannot come at the cost of the rights of the most vulnerable,” said Winnie Byanyima, Executive Director of UNAIDS. “Checks and balances that are the cornerstone of the rule of law must be exercised in order to prevent misuse of such powers. If not, we may see a reversal of much of the progress made in human rights, the right to health and the AIDS response.”

Notably, UNAIDS singles out EU member states, Hungary and Poland.

In Hungary, a new bill has been introduced to remove the right of people to change their gender and name on official documents in order to ensure conformity with their gender identity, in clear breach of international human rights to legal recognition of gender identity.

In Poland, a fast-tracked amendment to the criminal law that increases the penalties for HIV exposure, non-disclosure and transmission to at least six months in prison and up to eight years in prison has been passed—a clear contravention of international human rights obligations to remove HIV-specific criminal laws.

In addition, UNAIDS condemns overly zealous policing that is especially targeting key populations already stigmatised, marginalised, and criminalised.

UNAIDS is also concerned by reports from a number of countries of police brutality in enforcing measures, using physical violence and harassment and targeting marginalized groups, including sex workers, people who use drugs and people who are homeless. The use of criminal law and violence to enforce movement restrictions is disproportionate and not evidence-informed. Such tactics have been known to be implemented in a discriminatory manner and have a disproportionate effect on the most vulnerable: people who for whatever reason cannot stay at home, do not have a home or need to work for reasons of survival.

They single out Uganda where “23 people connected with a shelter for providing services for the LGBTI community have been arrested—19 have been charged with a negligent act likely to spread infection or disease. Those 19 are being held in prison without access to a court, legal representation or medication.”

They also highlight Kenya as a model of cjvil society rapid response to human rights concerns following the release of an advisory note “calling for a focus on community engagement and what works for prevention and treatment rather than disproportionate and coercive approaches.”

The statement concludes:

While some rights may be limited during an emergency in order to protect public health and safety, such restrictions must be for a legitimate aim—in this case, to contain the COVID-19 pandemic. They must be proportionate to that aim, necessary, non-arbitrary, evidence-informed and lawful. Each order/law or action by law enforcement must also be reviewable by a court of law. Law enforcement powers must likewise be narrowly defined, proportionate and necessary.

UNAIDS urges all countries to ensure that any emergency laws and powers are limited to a reasonable period of time and renewable only through appropriate parliamentary and participatory processes. Strict limits on the use of police powers must be provided, along with independent oversight of police action and remedies through an accountability mechanism. Restrictions on rights relating to non-discrimination on the basis of HIV status, sexual and reproductive health, freedom of speech and gender identity detailed above do not assist with the COVID-19 response and are therefore not for a legitimate purpose. UNAIDS calls on countries to repeal any laws put in place that cannot be said to be for the legitimate aim of responding to or controlling the COVID-19 pandemic.

UNAIDS recently produced a new guidance document that draws on key lessons from the response to the HIV epidemic: Rights in the time of COVID-19: lessons from HIV for an effective, community-led response.   

Criminalisation laws are harmful for the vulnerable communities affected and for overall public health

Decriminalizing Sex Work, HIV and Substance Use Is the HIV Prevention Strategy We Need

Though maybe not nationally recognized yet, the push to decriminalize sex work, substance use, and HIV has been one of the strongest and fiercest movements of our time. Activists globally are working with legislators to introduce bills that protect communities from harmful laws that keep innocent people behind bars.

You may have heard of activists’ efforts to legalize things that are currently illegal, like marijuana. Legalization, though it sounds progressive, often means including federal and state government. Due to the controlled and contained nature of legalization, it generally introduces added police and militarized involvement, which further harms communities already affected by the abusive behavior of police presence and force. This is why advocates often aim for decriminalization rather than legalization.

As the HIV epidemic progressed, we saw scientific advances in HIV prevention and treatment, including the knowledge of treatment as prevention, or “TasP,” the reality that effective treatment prevents the spread of HIV. This came alongside rapid testing and pre-exposure prophylaxis (PrEP), which are all steps people can take to prevent HIV transmission, depending on access to these avenues of preventative care. And while all of these are interpersonal ways that people can reduce HIV transmission, there is a structural tool that can use existing movements to prevent HIV—decriminalization. It’s what I call DasP, or decriminalization as prevention.

Feeling a little lost? Don’t worry. I’ll unpack everything step by step.

Decriminalizing Sex Work as Prevention

Sex workers continue to be some of the least protected people in our society, despite the long history of sex work as a profession. Sex work criminalization can include one of many things: criminalizing people for having condoms, jailing people for solicitation or for simply even walking while appearing to be engaging in sex work (locally known as “Walking While Trans” bills). The most recent and well-known example of criminalizing sex work is most likely FOSTA-SESTA, the federal law that penalizes sites like Craigslist and Backpage simply for hosting ads advertising sex work, even though those sites allowed sex workers to screen clients and stay safe.

With sex-work criminalization comes escalated intimidation from law enforcement, fear of seeking services from health care providers, and unsanitary working environments. Due to the covert and stigmatized culture of sex work (even at times as a direct result of criminalization), workers are forced to perform in isolated areas and are typically rushed while having sex, therefore not being able to use condoms. Many sex workers have also witnessed police destroying, confiscating, and using condoms as physical evidence to incarcerate. All of this instilled fear results in a decrease in sexual empowerment and a spike in HIV transmission rates for sex workers who do not feel permitted to access and adapt preventative care (such as PrEP and TasP). If we make a considerable effort to decriminalize sex work, studies show that we have the ability to drastically reduce HIV transmissions by 33% to 46% worldwide.

But why stop at decriminalizing sex work, when we can legalize it? The legalization of sex work, though sounding seemingly “progressive,” results in heavier regulations by government agencies, which in turn still criminalize sex workers who do not comply with existing law. Legalizing would also disproportionately affect communities that continually get harassed by discriminatory policing (including but not limited to undocumented people, drug users, and people living with HIV).

Decriminalizing Substance Use as Prevention

Although there is no federal ban on needle-exchange programs, prior to 2016, there was a funding ban for the government to use any money to support such programs. Still, there are currently 15 states in the U.S. that ban needle-exchange programs. For instance, when HIV advocates saw that Mike Pence was slated to lead efforts to confront coronavirus nationally, they referenced his response to an HIV outbreak in Scott County, Indiana. As governor, Pence actively delayed implementing needle-exchange programs across the state up until the federal Centers for Disease Control and Prevention intervened.

We know that as with sex work, drug decriminalization combined with needle exchange, harm reduction, and safe consumption sites have proven to drastically decrease HIV transmissions. Currently, drug-related offenders comprise 191,000 of the 1.3 million people in state prisons, 157,000 of the 631,000 in local jails, and 100,000 of the 226,000 people in federal prisons, according to the Prison Policy Initiative.

Portugal decriminalized drug use in 2001. Data showed that, along with overdoses and drug-related crimes, the number of HIV transmissions descended from a high of 104.2 new transmissions per million in 2000 to 4.2 new transmissions per million in 2015. Although these numbers were specific to harm reduction, one can argue that harm reduction combined with decriminalization was a recipe for a radical and forceful decrease.

In addition to Portugal, the Czech Republic, the Netherlands, and Switzerland also have passed sweeping drug decriminalization bills. A 2019 UNAIDS report showed that once these bills were passed, the four countries invested in public programs that used harm reduction as a tool for substance users. The rates of HIV transmission among injection drug users in these countries are currently visibly low.

The report also proved that people who live in communities that have access to harm reduction services are more likely to get tested and therefore adhere to treatment if they test positive. Having empowering and affirming programs gives users support and not the fear and stigma that fuel new HIV transmissions.

Decriminalizing HIV as Prevention

Most HIV criminalization laws were introduced and passed during the early years of the epidemic, before there was effective medication. Fear of the virus created hysteria among legislators, and many wanted people (and communities) to blame for the rate of transmissions.

Many activists have historically argued that HIV criminalization laws were based on homophobic and racist bias. The Ryan White CARE Act, which continues to be a driving force getting Americans lifesaving treatment and prevention, required states to show that they made efforts to criminalize individuals who exposed people to HIV. Currently there are 34 states and two U.S. territories that criminalize people transmitting HIV. Although laws differ from state to state, as the American Academy of HIV Medicine states, “Many of these laws are applicable whether or not actual harm has been demonstrated or caused.”

Just this past January, New York City’s Port Authority Police Department arrested an HIV-positive man at LaGuardia Airport for spitting into an officer’s mouth. The police report and the CBS News article alerting the public that followed spread false information, stating that the officer was in danger of contracting HIV. As we know, HIV cannot be spread via saliva, yet the report included that the HIV-positive man had a “lethal weapon” on him. Since the report was not detailed, many advocates implied that the “lethal weapon” was the individual’s status. This is one of many examples of recent criminalization across the U.S.

Through the scientific advancements of treatment, testing, and prevention, we know that there is zero percent of transmission sexually from a person who is on successful HIV treatment (undetectable equals untransmittable, or U=U), we know that individuals will be less likely to transmit HIV if they know their status, and we know that PrEP is 99% effective to stop the transmission of HIV. We also know that through active criminalization laws, individuals are less likely to get tested out of fear of having HIV. A majority of criminalization laws only incarcerate if the individual knows their status. A study in Toronto between 2010 and 2012 showed that 7% of men who had sex with men were less likely to get an HIV test for fear of future prosecution. The same study also explained that the fear of knowing their status could lead to an 18.5% increase in HIV transmission. Additionally, people living with HIV who are in criminalization states fear seeking treatment, which is not only a detriment to their own health, but also to public health, because, as a result, HIV continues to spread.

We also know in 2020 that HIV is no longer a death sentence. People living with HIV live long and healthy lives, and are actually more in tune with their own physical health. If anything, active HIV criminalization laws enable and breed stigma and discrimination against people living with HIV and the communities disproportionately affected by it.

There has been a recent movement in HIV criminalization reform, as recently as weeks ago in Washington State, where legislators moved to reduce penalties for people transmitting HIV. This similar modernizing of HIV criminalization laws has also passed in states like California, where Rep. Barbara Lee has led the national charge with these repeals. She introduced the REPEAL HIV Discrimination Act back in 2011 in the House of Representatives, then reintroduced the bill in 2017.

In her own words:

“HIV criminalization laws are based on bias, not science. Instead of making our communities healthier, these laws breed fear, discrimination, distrust, and hatred. Punishments under these laws or statutes include decades-long sentences and sex offender registration, even for behaviors and situations that pose no HIV transmission risk. These dangerous and stigmatizing laws undermine public health and can contribute to worsening the HIV epidemic—and are one of the top 4 reasons why people living with HIV do not seek medical care. Our laws should not perpetuate prejudice against anyone, particularly against those living with diseases like HIV. By introducing this legislation, we are sending a signal that discrimination and stigma have no place in our laws. We must all keep fighting to ensure everyone can live with dignity and respect, and to one day achieve an AIDS-free generation.”

To end the epidemic, we—as Rep. Lee states—need to trust science, not bias.

Decriminalizing COVID-19

With a continuing pandemic at our feet, we are already seeing how the government can prey on the marginalized during a public health crisis. As ProPublica reports, an alarming rate of Black and Brown Americans are contracting and dying of coronavirus. We also know that the hardest hit by new HIV transmissions are Black and Brown people, mostly in Southern states. They are also the most frequent victims of criminalization laws.

We are already seeing the beginnings of COVID-19 criminalization. As recently as March 25, officers in a Chicago Police Department station arrested a man who entered the precinct and coughed on them. He was arraigned for “reckless conduct.” The Department of Justice is planning to charge people as “terrorists” if purposefully exposing coronavirus to others. Additionally, Mayor de Blasio of New York announced on March 29 that the New York Police Department will begin fining people between $250 and $500 if they do not practice social distancing. Gov. Cuomo also voiced support for enforcing social distancing in New York State.

Many advocates say that these examples are a pathway to criminalization. As a response to these and similar offenses in countries such as Bulgaria, Canada, Peru, and South Africa, the HIV Justice Network (a global advocacy hub fighting HIV criminalization) released a statement, voicing, “Communicable diseases are public health issues, not criminal issues.”

As we see New York City jails become the epicenter of the pandemic in the world, we must reiterate that jails are not beneficial to public health. With overcrowded and unsanitary prisons come exponential numbers of transmission rates of both HIV and COVID-19. It is imperative that we mobilize and introduce sweeping decriminalization bills to radically reduce HIV and COVID-19 transmissions. These laws are not only harmful for the vulnerable communities affected, but for overall public health.

To learn more, the author implores readers to follow Decrim NY, DECRIMNOW, SWOP Brooklyn, and Red Canary for movement work on sex work decriminalization, Harm Reduction Coalition and VOCAL NY for movement work on drug decriminalization and harm reduction, and The Sero Project, ACT UP NY, HIV Is Not a Crime, and HIV Justice Network for movement work on HIV decriminalization.

HIV JUSTICE WORLDWIDE Steering Committee
Statement on COVID-19 Criminalisation

Communicable diseases are public health issues, not criminal issues: what we have learnt from the HIV response

Measures that are respectful of human rights and the empowering of communities are more effective than punishment and imprisonment.

As the world struggles with a new global pandemic, law- and policymakers are taking drastic measures in an attempt to minimise the spread of SARS-CoV-2, the virus that causes COVID-19. The situation continues to evolve rapidly and, as it does so, our liberties are being limited in unprecedented ways.

We remind law- and policymakers that each and every limitation of rights should satisfy the five criteria of the Siracusa Principles, as well as be of a limited duration and subject to review and appeal. These principles are:

  • The restriction is provided for and carried out in accordance with the law;
  • The restriction is in the interest of a legitimate objective of general interest;
  • The restriction is strictly necessary in a democratic society to achieve the objective;
  • There are no less intrusive and restrictive means available to reach the same objective;
  • The restriction is based on scientific evidence and not drafted or imposed arbitrarily, that is in an unreasonable or otherwise discriminatory manner.

We also warn law- and policymakers against the temptation to use the criminal law or other unjustified and disproportionate repressive measures in relation to COVID-19. These measures can be expected to have a devastating impact on the most vulnerable in society, including those who are homeless and/or living in poverty, as well as individuals from marginalised and already stigmatised or criminalised communities – especially where no economic and social support is provided to allow people to protect themselves and others, including through self-isolation.

As a global coalition campaigning to abolish criminal and similar laws, policies and practices that regulate, control and punish people living with HIV based on their HIV-positive status, we know the deleterious consequences of the criminalisation of diseases on both human rights and public health.

Criminalisation disproportionately impacts the most marginalised, stigmatised and the already criminalised people and communities in society.

 

Criminalisation is not an evidence-based response to public health issues. In fact, the use of the criminal law most often undermines public health by creating barriers to prevention, testing, care, and treatment – for example, people may not disclose their status or access treatment for fear of being criminalised.  It can also lead to ill-informed ‘trial’ by social and news media, and to a myriad of human rights violations, from arbitrary arrests and detentions to unfair trials (or no trials at all under new emergency measures) and harsh prison sentences. This can also lead to the spread of infections and communicable diseases in prisons and is of particular relevance in the context of COVID-19, which reveals, once again, the need to address overcrowding and other poor healthcare and sanitation conditions that are all too common in prisons and other closed settings.

Our experience has taught us that hastily drafted laws, as well as law enforcement, driven by fear and panic, are unlikely to be guided by the best available scientific and medical evidence – especially where such science is unclear, complex and evolving. Given the context of a virus that can easily be transmitted by casual contact and where proof of actual exposure or transmission is not possible, we believe that the criminal justice system is unlikely to uphold principles of legal and judicial fairness, including the key criminal law principles of legality, foreseeability, intent, causality, proportionality and proof.

The human rights of those involved in criminal cases related to COVID-19 are at risk of being ignored or violated.

 

We therefore urge law- and policymakers, the media, and communities at large, to keep human rights front and centre as we collectively respond to a new public health crisis in a climate of fear and uncertainty. It is more critical than ever to commit to, and respect, human rights principles; ground public health measures in scientific evidence; and establish partnerships, trust, and co-operation between law- and policymakers and communities.

The HIV JUSTICE WORLDWIDE Steering Committee, comprising: AIDS Action Europe; AIDS and Rights Alliance for Southern Africa (ARASA); Canadian HIV/AIDS Legal Network; Global Network of People Living with HIV (GNP+); HIV Justice Network;  International Community of Women Living with HIV (ICW); Positive Women’s Network – USA; Sero Project; and Southern Africa Litigation Centre.

 

Additional references

Last week, a group of human rights experts at the United Nations warned governments against the abuse of emergency measures to suppress human rights:

“While we recognize the severity of the current health crisis and acknowledge that the use of emergency powers is allowed by international law in response to significant threats, we urgently remind States that any emergency responses to the coronavirus must be proportionate, necessary and non-discriminatory,” the experts said. “Restrictions should be narrowly tailored and should be the least intrusive means to protect public health.” Also, authorities must seek to return life to normal and must avoid excessive use of emergency powers to indefinitely regulate day-to-day life.”

UNAIDS also issued guidance last week that included a number of recommendations, including recommending that States “avoid the use of criminal laws when encouraging behaviours to slow the spread of the epidemic”, noting that empowering and enabling people and communities to protect themselves and others will have a greater overall effect.

And, as described in a recent open letter by more than 800 public health and legal experts in the United States providing recommendations to government officials: “Voluntary self-isolation measures [combined with education, widespread screening, and universal access to treatment] are more likely to induce cooperation and protect public trust than coercive measures and are more likely to prevent attempts to avoid contact with the healthcare system.”

US: Lawmakers fail to pass HIV modernisation bill in Florida

Ending the Epidemic in Florida Must Include Ending HIV Criminalization

“Lawmakers Finally Pass HIV Modernization Bill in Florida to End HIV Epidemic by 2030.”

This should have been the headline at the end of the Florida legislative session in Tallahassee, which concluded on March 12. Instead, Florida lawmakers missed the opportunity to pass common-sense legislation for an easy bipartisan win that could benefit all Floridians. The HIV modernization bills sponsored by state Rep. Nick Duran and Sen. Jason Pizzo would have modernized Florida’s outdated HIV-specific laws written in the early ’80s, which do not reflect the scientific and social reality of HIV today. Florida is both the epicenter of the HIV epidemic in the United States and one of the states that continually sends people to prison for nondisclosure of HIV status. If we’re ever going to end the HIV epidemic in the U.S., we will have to end it in Florida. And we have to end HV criminalization in the state to achieve the goal of ending the epidemic.

The HIV prevention bills in the Florida House and Senate introduced this year were designed to align Florida’s outdated HIV laws with the current science of prevention and treatment. The new law would have required actual HIV transmission in order to convict—but it allows for exceptions “if he or she in good faith complies with a treatment regimen prescribed by his or her health care provider or with the behavioral recommendations of his or her health care provider or public health officials to limit the risk of transmission, or if he or she offers to comply with such behavioral recommendations, but such offer is rejected by the other person with whom he or she is engaging in sexual conduct.” It would also reduce harsh penalties (from a felony to a misdemeanor) for nondisclosure. Lastly, the bill would allow for organ donation between people of shared HIV status, which has been legal at the federal level since 2013.

While the bill did not advance this session, lawmakers did demonstrate resounding support for updating Florida’s law that makes it a felony for someone living with HIV to donate organs, tissue, blood, or plasma to someone else living with HIV. A provision to remove the felony and allow for such donations was added into a bill that unanimously passed the House and a bill that unanimously passed the Senate. Unfortunately, neither bill ultimately made it to the governor’s desk to be signed into law. According to a report by the Williams Institute, an average of 35 people are arrested in Florida every year for HIV-related offenses all across the state, but mainly in Central and North Florida.

The provision doesn’t just benefit people living with HIV by expanding their potential donor pool; when anyone receives an organ, everyone on the organ-donor waiting list benefits by being bumped up a spot. Last year, the national story of Nina Martinez and the first successful transplant of a kidney between two people of shared HIV status gave hope to those people who could benefit from the practice.

“Allowing patients with HIV to donate organs to people living with HIV who need them is just common sense,” said Howard Grossman, M.D., an HIV physician and researcher based in South Florida. “Organ donation already involves extensive screening, testing, and informed-consent protocols. What reason could rational people have to deny lifesaving therapy when it is readily available? Many states have already approved such procedures, with excellent results.”

But the states, including Florida, have more work to do. The Trump administration announced Ending the HIV Epidemic: A Plan for America in February, 2019. The end of HIV was mentioned again in the latest State of the Union address. The plan aims to reduce HIV transmissions by 90% by 2030. It allocates funding to the most impacted areas identified by the Centers for Disease Control and Prevention, including seven states, two cities, and 48 counties where at least 50% of people living with HIV in the U.S. currently reside, areas that have some of the highest diagnosis rates in the country. Most of those jurisdictions are in the southern states, and seven Florida counties have been identified as focus areas in the initiative (Broward, Duval, Hillsborough, Miami-Dade, Orange, Palm Beach, and Pinellas counties).

Fixing outdated criminalization laws must be part of the calculus when policymakers consider the range of social determinants of HIV. Without reforming laws that unjustly criminalize people based on their HIV status, we cannot end the epidemic. The American Medical Association has opposed HIV criminalization since 2014, when the organization published a statement calling for the modernization of laws as part of a public health response to the epidemic. Current Florida law criminalizes people living with HIV, working against public health policy by keeping people from seeking testing and treatment.

Florida saw broad, bipartisan support for HIV modernization last session, when House and Senate committees passed the HIV modernization bills, even though they ultimately did not pass the full chambers. We hope for broader HIV criminalization reform from the Florida Legislature. Last year, the Florida Infectious Disease Elimination Act (IDEA) was passed, expanding needle-exchange programs throughout the state. This law built on the success of a pilot project implemented by the University of Miami to help reduce HIV and hepatitis C transmissions, spearheaded by HIV advocate and professor Hansel Tookes, M.D., M.P.H.

The Florida HIV Justice Coalition represents just part of the worldwide HIV criminal reform movement, which has the support of major organizations and professional groups like the World Health Organization, American Medical Association, UNAIDS, and the Presidential Advisory Council on HIV/AIDS (PACHA).

There is no hyperbole in the claim that the current HIV modernization legislation will affect the lives of all Floridians. This session’s progress toward modernizing organ donation was an important step in the road to fully modernizing the HIV-specific laws of the state. Modernizing organ donation is long overdue, and its potential to save lives cannot be underestimated. The inclusion of people living with HIV as organ donors can also eliminate some of the undue stigma still prevalent in our state. That stigma underlies all of Florida’s outdated HIV laws.

The time to fully modernize Florida’s outdated HIV laws is now.