Death penalty for unintentional HIV transmission via same-sex sex struck down by Uganda’s Constitutional Court

The recent (April 3rd) ruling by Uganda’s Constitutional Court declaring that the Anti Homosexuality Act of 2023 complies with the Constitution of Uganda – except in only four aspects – was quite rightly roundly condemned by Amnesty International, the Global Fund, Human Rights Watch, International AIDS Society, and UNAIDS, as well as the US Department of State, amongst many others.

Rather than strike down every section of this heinous, draconian anti-gay law, the Court was unanimous in ruling that most of its dangerous, overly broad, and problematic provisions remain in place. 

However, in its 200+ page ruling, the Court did find that Sections 3(2)(c), 9, 11(2d) and 14 did not “pass constitutional muster” and were struck down.

Sections 9 and 11(2d) refer to landlords allowing homosexuality to take place on their premises, and section 14 refers to a “duty to report acts of homosexuality” to the police.

But section 3(2)(c) was one of the most heinous of all of the Act’s horrendous provisions, proscribing the death penalty for someone living with HIV who engaged in same-sex sex and where HIV is allegedly passed on.

  1. Aggravated homosexuality (1) A person who commits the offence of homosexuality in any of the circumstances specified in subsection (2) commits the offence of aggravated homosexuality and is liable, on conviction, to suffer death. (2) (c) the person against whom the offence is committed contracts a terminal illness as a result of the sexual act.

Read the full text of the law here

Both the Court, several petitioners, and UNAIDS – who provided an amicus brief to the Court – correctly interpreted this section as criminalising unintentional HIV transmission when two people of the same sex had sex.

In paragraphs 510-512, the Court referred to several key documents – including the 2011 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and UNAIDS 2013 Guidance Note, Ending overly broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations – and were persuaded that the section did not provide for “the element of criminal intent or mens rea, which is a vital component of the concept of crime.”

The Constitutional Court ruling went on to say:

“This indeed is the approach that was adopted in section 43 of the HIV and AIDS Prevention and Control Act, 2015, which criminalizes the intentional transmission of HIV as follows: ‘a person who wilfully and intentionally transmits HIV to another person commits an offence.’

“Finding no justification for the criminalization of the unintentional transmission of HIV under section 3(2)(c) of the Anti-Homosexuality Act we take the view that it compounds the susceptibility of persons that are HIV+ to mental health issues and thus impedes their right to enjoy the highest attainable standard of mental health, with potential ramifications to their physical health as well. This is a violation of the right to health as envisaged under Article 12(1) of the ICESCR and is inconsistent with Articles 45 and 287 of the Uganda Constitution.”

 

However, people living with HIV are already over-criminalised in Uganda by various sections of the HIV and AIDS Prevention and Control Act, as summarised in our Global HIV Criminalisation Database.

What is termed as “wilful and intentional” transmission of HIV is punishable by a fine and/or up to ten years’ imprisonment. Section 43 provides a defence if the accused’s partner was aware of, and accepted, the risk of transmission, or transmission occurred during sexual intercourse and protective measures were used. Attempted transmission is punishable by a fine and/or up to five years’ imprisonment. The scope of section 41 is undefined, but cases demonstrate that the law criminalises perceived HIV ‘exposure’ broadly.

Both Section 41 and 43 are known to have been used in a broad range of circumstances, including prosecution of a man for ‘defilement’ (2013), prosecution of a teacher for alleged transmission to his student (2013), the alleged injection of a toddler/needle stick injury (2014), alleged transmission by a woman to a number of young men (2014), alleged breastfeeding of an employer’s child (2018), the arrest, conviction and acquittal of a nurse wrongfully convicted of injecting a baby with HIV-infected blood (2018), and the alleged defilement of a boy by a woman (2019). An earlier prosecution from 2008 involved a man charged with alleged transmission. In the most recent case in 2023, a woman living with HIV pled guilty to charges under section 43 after injecting her 5-year-old son with her blood and was sentenced to seven years’ imprisonment. Cases have generally not used scientific evidence to prove allegations, with convictions at lower-level courts relying only on testimony.

Nevertheless, the recognition of key legal and rights-based arguments against punishing unintentional HIV transmission with the death penalty(!) as part of an otherwise anti-rights, morality-based ruling should be seen as a small but welcome victory. Although this might be seen as similar to the 2022 Lesotho High Court decision on the unconstitutionality of the death penalty in the context of HIV transmission following rape, the difference of course is that that rape is an act of violence that should be criminalised regardless of any other circumstances, whereas consensual sex between two men or two women should never, ever be a crime.

US: New report published on the enforcement of HIV criminalisation in Ohio

‘Antiquated’ and unscientific laws enforced against Ohioans living with HIV: Report

Across the country, a growing coalition of advocates is pushing to repeal or update state laws that criminalize people living with HIV or AIDS.

In Ohio, six laws on the books either criminalize certain acts – including sex – for people living with HIV or substantially increase sentences for them compared to people who do not have the virus.

Most of the laws were passed decades ago, fueled by fear, absent scientific understanding about how HIV is transmitted and before advancements in HIV-related treatment were widely introduced. Laws still remain in place in 34 states.

There are no national reporting requirements that track arrests or prosecutions under the laws. Until now, it was unclear how frequently Ohio prosecutors have charged people under the laws, which also apply to people living with hepatitis or tuberculosis.

A report released today by Equality Ohio and the Ohio Health Modernization Movement (OHMM), two groups pushing for legal reform, reveals that more than half of the prosecutions over a six-year period were for acts – such as spitting or throwing bodily fluids – that were unlikely to transmit HIV. It also found a disproportionate number of people charged were Black compared to Ohio’s overall population of Black residents.

“Ohio is unique in that these antiquated laws are actually being utilized and enforced against everyday Ohioans who are living with HIV,” Kate Mozynski, an attorney with Equality Ohio and one of the co-authors of the report told the Buckeye Flame.

In 2022, about 25,000 people in Ohio had an HIV diagnosis. The rate of Black residents diagnosed with HIV was more than six times the rate of white residents.

The groups spent three years gathering information from prosecutors and courts in all 88 Ohio counties and identified 214 cases charged under the six laws. Often, the records lacked or had conflicting information on race or ethnicity, and the gender captured in law enforcement records didn’t always reflect a person’s gender identity.

That prevents researchers from fully understanding the impact that these laws are having on some of the most vulnerable populations in Ohio, including LQBTQ+ people, people experiencing incarceration and people of color, according to the report. The federal Centers for Disease Control and Prevention has warned that laws criminalizing HIV exposure are outdated and may discourage testing, increase stigma and exacerbate disparities in Black and Latino communities.

Cuyahoga County had the highest number of charges

 The report found that:

  • Prosecutions are concentrated in Ohio’s more populous counties, including Cuyahoga, Hamilton, Franklin and Lucas counties.
  • Cuyahoga County charged four times the number of people under the six laws than Franklin County, which has a higher population and more people living with HIV and AIDS. Cuyahoga County accounted for 26% of the cases identified.
  • The largest share of prosecutions involved Black men, based on recorded race and gender included in records.

A separate Marshall Project review of prosecutions under the six laws in Cuyahoga County from 2016 through 2022 examined 36 charges involving 35 defendants. That doesn’t didn’t include charges for solicitation, prostitution or loitering, which are generally misdemeanor crimes.

The cases involved 18 law enforcement agencies, including three hospital police departments and public transit police.

The Cuyahoga County Prosecutor’s office, which decides whether to prosecute felony cases under Ohio’s laws, said these charges are determined on a “case-by-case basis” after considering input from victims, according to Lexi Bauer, communications manager. Bauer noted that the majority of the “harassment by bodily fluid” charges in recent years were related to hepatitis and not HIV.

Ohio penalties among the harshest

Ohio’s laws remain among the harshest when it comes to HIV criminalization, not just based on the conduct that is criminalized but also the penalties, said Jada Hicks, staff attorney for The Center for HIV Law and Policy.

In Ohio, people living with HIV (or viral hepatitis or tuberculosis) can be charged whether or not they:

  • Engaged in sex practices or other acts that could transmit the virus.
  • Transmitted HIV.
  • Used protection, such as condoms and/or dental dams.
  • Had an undetectable level of virus in their blood and were unable to transmit HIV.

Most of the charges examined in the report fall under two Ohio laws.

One law makes it a crime for a person living with HIV (or hepatitis or tuberculosis) to “harass” someone with their bodily fluids. That would include spitting or throwing urine, feces or blood at another person.

Under the other law, a person can be charged with felonious assault if they have sex with another person without telling them that they are living with HIV.

The penalties for failing to disclose HIV status in Ohio are stiff regardless of whether the virus was actually transmitted or whether it was even possible for a person to transmit the virus. Possible sentences for individuals living with HIV can be anywhere from two to 29 times longer than those for Ohioans who are HIV-negative.

Ohio is also one of six states that require individuals convicted under one of these statutes to register as a sex offender.

“Ohio’s HIV laws don’t require actual transmission or even the intent to transmit,” said Nathan Cisneros, a researcher with the Williams Institute, which does legal and public policy research on sexual orientation and gender identity. “Conduct that couldn’t transmit HIV – like spitting and biting, loitering while having a conversation about sex work – can land you in prison.”

The Williams Institute also published a report today that looked at arrests under Ohio’s six laws over two decades and felony prosecutions in Cuyahoga County from 2009 to 2022. Researchers identified at least 530 separate allegations under the six laws since 2000. Having consensual sex without disclosing an HIV-positive status made up nearly half of the total cases. Incidents related to sex work and bodily fluid exposure each accounted for nearly one-fifth of the total.

Changing legal landscape

Thirteen states have either repealed or modernized their HIV laws, according to the Center for HIV Law and Policy, including Illinois in 2021 and New Jersey in 2022.

Ohio advocates have been at the forefront of efforts to challenge the laws as discriminatory. In 2022, the Center for HIV Law and Policy filed a complaint with the Department of Justice on behalf of people living with HIV in Ohio and Tennessee.

In December, the DOJ notified Tennessee it was violating the Americans with Disabilities Act (ADA) by enforcing the state law that increases penalties for people convicted of prostitution if they also have HIV. On Feb. 15, the Justice Department filed charges against the state in federal court..

Combing state records for HIV-related charges

OHMM researchers gathered information from county-level online court records and local county clerk and prosecutors’ offices in Ohio’s 88 counties for a six-year period ending in 2020. The project identified 214 cases prosecuted under the six laws.

Behind each one of the cases, there is a “real, everyday Ohioan who happens to have a medical condition,” Mozynski said.

Where in Ohio are people being charged?

The highest concentration of charges are in the state’s larger metropolitan areas.

  • 26% in Cuyahoga County (Cleveland)
  • 12% in Hamilton County (Cincinnati)
  • 7% in Lucas County (Toledo)
  • 7% in Franklin County (Columbus)
  • Montgomery (Dayton) and Warren (Lebanon) counties, about 5% each.

What charges are most common?

More than half of the cases identified were for the charge of “harassment with a bodily substance,” which carries with it a penalty of up to 5 years in prison and a $10,000 fine. Cases with this charge are often related to acts against law enforcement or corrections officers or healthcare workers.

Charges don’t distinguish between bodily fluids that can transmit HIV, such as blood, and those that do not, such as saliva, urine or feces. People can also be charged if they are living with hepatitis, regardless of whether it is transmitted.

Prosecutors also don’t have to prove whether a person is capable of transmitting the virus or determine whether it is scientifically impossible to transmit the virusdue to prescription-drug treatments that have reduced the presence of the virus in a person’s blood – called a viral load – to undetectable levels.

A third of the cases were for “felonious assault,” which carries the most severe penalty of any HIV-related charge – up to eight years of incarceration and a $15,000 fine. Each sexual act can be charged separately. It also doesn’t require that the virus be transmitted.

OHMM found no cases where people were charged with “selling or donating contaminated blood.” The Williams Institute found six arrests over a 20 year period related to blood donation.

Read the OHMM (“Enforcement of HIV Criminalization in Ohio: Analysis of Court Cases from 2014 to 2020”) report here.

Read the Williams report (“Enforcement of HIV Criminalization in Ohio HIV-related criminal incidents from 2000 to 2022”) here.

US: Report by the Williams Institute examines the enforcement of HIV criminalisation laws in Mississippi

HIV criminal laws lopsided impact on Black men in Mississippi

A new report by the Williams Institute at UCLA School of Law finds that at least 43 people in Mississippi were arrested for HIV-related crimes between 2004 and 2021. Half of all arrests in the state happened between 2017 and 2021.

The HIV epidemic and Mississippi’s HIV-related criminal laws disproportionately impact men, and Black men in particular. Men make up 49% of Mississippi’s population, 71% of people living with HIV (PLWH), and 72% of HIV-related arrests. Black men comprise 18% of the state’s population and 50% of PLWH. However, they make up 47% of HIV-related arrests.

Researchers analyzed data obtained from the Mississippi Department of Public Safety. Findings show that the enforcement of HIV criminal laws is concentrated around the state’s capital and most populous city, Jackson, and near the Gulf Coast. Almost 20% of arrests occurred in three counties: Harrison (15%), Hinds (13%), and Lamar (11%).

HIV criminalization is a term used to describe laws that either criminalize otherwise legal conduct or increase the penalties for illegal conduct based on a person’s HIV-positive status. Nearly two-thirds of U.S. states and territories currently have laws that criminalize people living with HIV.

Mississippi has two HIV criminal laws. The knowing exposure law makes it a felony to knowingly expose another person to HIV, hepatitis B, or hepatitis C and is punishable by up to 10 years in prison and/or a $10,000 fine. Mississippi’s endangerment by bodily substance law makes it a misdemeanor to attempt to expose or expose anyone at a correctional facility to bodily fluids. However, if someone knows their HIV or hepatitis status, the crime is upgraded to a felony punishable by 3 to 10 years in prison and/or a $10,000 fine.

“Mississippi’s criminal laws do not require the actual transmission of HIV, the intent to transmit, or even conduct that can lead to the transmission of HIV,” said lead study author Nathan Cisneros, HIV Criminalization Project Director at the Williams Institute. “We now have medical treatments that wholly eliminate the risk of transmitting HIV through sex, yet these advances are not reflected in Mississippi’s laws.”

Mississippi’s 2021 Ending the HIV Epidemic Plan called for reform of the state’s HIV criminal laws to align with modern HIV medicine.

“HIV criminal laws perpetuate stigma and can discourage testing and treatment,” said co-author Brad Sears, Founding Executive Director at the Williams Institute. “That’s why many national and state organizations, including the American Medical Association, have called for a repeal of these laws.”

This report is part of a series of reports examining the ongoing impact of state HIV criminalization laws on people living with HIV.

Read the report

Tajikistan: The discrimination and legal difficulties of women living with HIV

Infecting your wife and then accusing her: The Tajik HIV-positive women confronting social exclusion

Translated from via Deepl.com. For the article in French and the Original article in Russian, please scroll down.

In Tajikistan, women living with HIV are denied help by their families. Many of them live in very precarious conditions, have no medical support and cannot find work.

HIV-positive women are one of the most discriminated against groups in Tajikistan. They are shunned by society as a whole, including their immediate families. Excluded, they can no longer work or have access to appropriate medical assistance. And yet, most of the time, these women pose no risk to the health of those around them.

To mark the “16 Days of Activism against Gender Violence” event and the International Day against HIV (Human Immunodeficiency Virus), Asia-Plus takes a look at the discrimination faced by these women.

A number of laws and documents exist in Tajikistan to directly or indirectly prevent discrimination against people living with HIV, as set out in an article by the NGO Foreign Policy Centre. In 2023, this list was supplemented by a new law on equality and the elimination of all forms of discrimination. According to human rights activists, it introduces the concept of “indirect discrimination”, which vulnerable groups often face. However, HIV-positive women are not entirely reassured by this new legal reference, as they already face direct discrimination on a daily basis.

Discrimination extending from the family to the medical community

“Despite the fact that HIV is not transmitted in everyday life and that antiretroviral (ARV) treatment (a treatment that slows down the development of the virus and the disease, editor’s note) reduces the viral load to a minimum, HIV-positive women are discriminated against at every street corner. And above all within their families”, explains Tahmina Khaïdarova, Tajikistan spokesperson for the Eurasian Women’s AIDS Network.

“As soon as her diagnosis is known, her family restricts contact with her and avoids her. This attitude then follows her wherever her situation becomes known.

Also read about Novastan: HIV positive and unemployed

Strange as it may seem, HIV-positive women often report discrimination from healthcare workers. These include dentists, surgeons, midwives and gynaecologists. Some doctors refuse to help women with HIV, and they have to find friendlier doctors through acquaintances.

“Yet modern medicine has eliminated all risk. Today, HIV is a chronic disease like diabetes. With the right ARV treatment and medical follow-up, HIV-positive women can become mothers of healthy children, but even some health workers don’t have this information,” explains Tahmina Khaïdarova.

Discrimination trivialised in the media
Local journalists also discriminate against women with HIV. The content devoted to this subject often takes a pejorative angle. The media confirm stereotypes, stigmatisation and prejudice, without explaining to the public what HIV is today.

“Even today, local journalists still use phrases like ‘AIDS: the plague of the 21st century’, ‘the terror of HIV‘ and other statements that have nothing to do with reality”, says Tahmina Khaïdarova.

Journalists often use intimidating language to talk about criminal cases (article 125 of the Tajik penal code, editor’s note) brought against women with HIV who are accused of knowingly infecting their husbands.

Discrimination, a source of violence against women

The Convention on the Elimination of All Forms of Discrimination against Women, to which Tajikistan has been a signatory for 30 years, states that gender inequality and discrimination are the primary reasons for violence against women.

In fact, any serodiscordant couple (where one partner is HIV-positive and the other is not, editor’s note) can fall foul of the first part of article 125 of the Tajik criminal code. This states: “knowingly placing another person at risk of HIV contamination”. It therefore refers not to factual contamination, but to the risk of infection. And all HIV-positive people who have a sexual partner are de facto exposing them to the risk of infection.

“But in reality, things don’t work like that. If a person is on ARV treatment, their viral load is reduced and even if they have unprotected sex, their partner will not catch HIV”, explains Tahmina Khaïdarova.

Women with HIV more discriminated against than men

The spokeswoman tells us that at the twelfth International Conference on HIV Research, held in Brisbane from 23 to 26 July, the World Health Organisation presented new scientific and methodological recommendations relating to HIV. Among them is the indication of the viral load thresholds required for HIV infection.

This means that HIV-positive people who achieve a viral load level below this threshold by adhering to ARV treatment will not transmit HIV to their sexual partners. They have only a low risk of transmitting the virus vertically to their children.

“Many of the criminal cases that have resounded in Tajikistan have been launched on the basis of the first part of Article 125. But in reality, none of the ‘victims’ have been infected with HIV”, reveals Tahmina Khaïdarova. According to her, although men with HIV are also discriminated against, women are discriminated against to a greater extent.

Legal difficulties

The fact is that society still considers that a woman with HIV has had many sexual partners. However, according to statistics, sex workers represent only 1.7% of HIV-positive women in Tajikistan in 2022. All the others are women leading ordinary lives, sometimes housewives, who contracted the virus from their husbands.

“Not long ago, we were contacted by an HIV-positive woman. She was married, had a child, and her husband beat her. He even beat her during her pregnancy, so that she lost her second child”, says Tahmina Khaïdarova. “Although it was her husband who gave her HIV, her family blamed her.

“She left with her child, rented a room and found a job. But her ex-husband has got the child back and is threatening to deprive her of her rights over him because she is HIV-positive, uneducated and on a modest salary on which she can’t look after her child.”

The courts also discriminate against women, even those without HIV. That’s why there’s no guarantee that if her husband does try to deprive her of her child, the judge will see the absurdity and injustice of the situation.

Translated from the Russian by Paulinon Vanackère and edited by Coraline Grondin

Contaminer son épouse puis l’accuser : ces femmes tadjikes séropositives face aux discriminations sociales

Au Tadjikistan, les femmes atteintes du VIH se voient refuser l’aide de leur famille. En grande précarité, beaucoup ne bénéficient pas d’accompagnement médical et ne trouvent pas de travail.
Tadjikistan

Les femmes séropositives sont un des groupes les plus discriminés au Tadjikistan. La société entière se détourne d’elles, y compris leur famille proche. Exclues, elles ne peuvent plus travailler ni avoir accès à une aide médicale adaptée. Pourtant, la plupart du temps, ces femmes ne représentent aucun risque pour la santé de leur entourage.

A l’occasion de l’événement « 16 jours d’action contre les violences de genre » et de la journée internationale de lutte contre le VIH (virus de l’immunodéficience humaine), Asia-Plus se penche sur les discriminations que ces femmes rencontrent.

Diverses lois et documents existent au Tadjikistan pour empêcher directement ou indirectement la discrimination des personnes atteintes du VIH, rassemblées dans un article de l’ONG Foreign Policy Centre. En 2023, cette liste a été complétée d’une nouvelle loi sur l’égalité et l’élimination de toutes les formes de discrimination. Selon les défenseurs des droits humains, elle fait apparaître le concept de « discriminations indirectes » auxquelles les groupes vulnérables sont souvent confrontés. Cependant, les femmes séropositives ne sont pas pleinement rassurées par cette nouvelle mention légale car elles font déjà face à des discriminations directes au quotidien.

Des discriminations s’étendant de la famille à la communauté médicale

« Malgré le fait que le VIH ne se transmet pas dans la vie quotidienne et que le traitement antirétroviral (ARV) (un traitement qui ralentit le développement du virus et la maladie, ndlr) atténue au minimum la charge virale, les femmes séropositives sont discriminées à chaque coin de rue. Et avant tout dans leur famille », explique Tahmina Khaïdarova, porte-parole pour le Tadjikistan du Réseau des femmes eurasiennes sur le SIDA.

« A peine son diagnostic est-il connu que sa famille restreint ses contacts avec elle et l’évite. Puis, cette attitude la suivra partout où sa situation est connue. »

Aussi étrange que cela puisse paraître, les femmes séropositives rapportent souvent des discriminations de la part des travailleurs de la santé. Parmi eux, dentistes, chirurgiens, sages-femmes ou gynécologues. Des médecins refusent de porter assistance aux femmes atteintes du VIH et elles doivent trouver des docteurs plus amicaux en passant par des connaissances.

« Pourtant, la médecine moderne a fait disparaître tout risque. Aujourd’hui, le VIH est une maladie chronique comme le diabète. Avec un traitement ARV adéquat et un suivi médical, les femmes séropositives deviennent mères d’enfants en bonne santé, mais même certains travailleurs de la santé n’ont pas ces informations », explique Tahmina Khaïdarova.

Les discriminations banalisées dans les médias

Les journalistes locaux discriminent également les femmes atteintes du VIH. Les contenus consacrés à ce thème prennent souvent un angle péjoratif. Les médias confirment des stéréotypes, des stigmatisations et des préjugés, sans expliquer au public ce que représente aujourd’hui le VIH.

« Encore aujourd’hui, on rencontre chez les journalistes locaux des formulations comme « le sida : la peste du XXIème siècle », « la terreur du VIH » et autres affirmations qui n’ont rien à voir avec la réalité », raconte Tahmina Khaïdarova.

Souvent, les journalistes utilisent des formules intimidantes pour parler de cas d’affaires pénales (article 125 du code pénal tadjik, ndlr) ouvertes contres des femmes atteintes du VIH et accusées d’avoir consciemment contaminé leur mari.

Les discriminations, sources de violences faites aux femmes

La Convention sur l’élimination de toutes les formes de discrimination à l’égard des femmes, dont le Tadjikistan est signataire depuis 30 ans, affirme que l’inégalité et la discrimination de genre sont les raisons premières des violences faites aux femmes.

En fait, tout couple sérodiscordant (dont un des partenaires est séropositif et l’autre non, ndlr) peut tomber sous le coup de la première partie de l’article 125 du code pénal tadjik. Celle-ci indique : « placer consciemment une autre personne en position de risque de contamination au VIH. » Ainsi, elle fait référence non pas à la contamination factuelle, mais au risque d’infection. Et tous les séropositifs qui ont un partenaire sexuel le placent de fait face au risque d’être contaminé.

« Mais en réalité, les choses ne fonctionnent pas ainsi. Si une personne est sous traitement ARV, la charge virale est diminuée et même en cas de relation sexuelle non protégée, son partenaire n’attrapera pas le VIH », explique Tahmina Khaïdarova.

Les femmes atteintes de VIH plus discriminées que les hommes

La porte-parole raconte qu’à la douzième conférence internationale pour la recherche contre le VIH, qui a eu lieu du 23 au 26 juillet dernier à Brisbane, l’Organisation mondiale de la santé a présenté de nouvelles recommandations scientifiques et méthodiques en relation avec le VIH. Parmi elles, l’indication des seuils de charge virale nécessaires à la contamination par le VIH.

Ainsi, les personnes séropositives qui atteignent un niveau de charge virale inférieur à ce seuil grâce à l’observance du traitement ARV ne transmettent pas le VIH à leurs partenaires sexuels. Elles n’ont qu’un risque faible de transmettre verticalement le virus à leurs enfants.

De nombreuses affaires pénales qui ont résonné au Tadjikistan ont été lancées en s’appuyant sur la première partie de l’article 125. Mais en réalité, aucune des « victimes » n’a été contaminée par le VIH », révèle Tahmina Khaïdarova. Selon elle, bien que les hommes atteints de VIH soient aussi soumis à la discrimination, les femmes le sont davantage.

Des difficultés face à la justice

Le fait est que la société considère toujours qu’une femme atteinte du VIH a eu beaucoup de partenaires sexuels. Cependant, selon les statistiques, les travailleuses du sexe représentent seulement 1,7 % des femmes séropositives au Tadjikistan en 2022. Toutes les autres sont des femmes menant une vie ordinaire, parfois femmes au foyer, qui ont contracté le virus par leur mari.

« Il y a peu, nous avons été contactées par une femme séropositive. Elle était mariée, a eu un enfant, et son mari la battait. Il l’a battue même pendant sa grossesse, si bien qu’elle a perdu son deuxième enfant », raconte Tahmina Khaïdarova. « Bien que ce soit son mari qui lui a donné le VIH, sa famille l’a accusée, elle. »

« Elle est partie avec son enfant, loue une chambre et a trouvé un travail. Mais son ex-mari a récupéré l’enfant et la menace de la priver de ses droits sur lui parce qu’elle est séropositive, sans éducation et avec un salaire modeste avec lequel elle ne peut pas s’occuper de son enfant. »

Les tribunaux aussi discriminent les femmes, mêmes non atteintes du VIH. C’est pourquoi rien ne garantit que si son mari tente effectivement de la priver de son enfant, le juge s’aperçoive de l’absurdité et de l’injustice de la situation.

La rédaction d’Asia-Plus
Traduit du russe par Paulinon Vanackère

Сам заразил, но жену обвинил. Женщины с ВИЧ подвергаются в Таджикистане дискриминации

Женщинам с диагнозом ВИЧ в Таджикистане отказывают в поддержке не только родственники, но помощь могут не оказать даже врачи.

Женщины с ВИЧ – одна из самых дискриминируемых групп в Таджикистане. От них отворачивается всё общество, включая самых близких родственников; они не могут найти работу или получить медицинское обслуживание. При этом чаще всего никаких рисков здоровью окружающих эти женщины не несут.

В честь международной акции «16 дней активных действий против гендерного насилия» и Всемирного дня борьбы против СПИДа «Азия-Плюс» рассказывает о дискриминации, с которой они сталкиваются.

В Таджикистане существует целый список самых разных законов и документов, которые прямо или косвенно защищают людей, живущих с ВИЧ от дискриминации.

В прошлом году этот список пополнился еще одним законом «О равенстве и ликвидации всех форм дискриминации». В нем, к удовлетворению правозащитников, появилось понятие «косвенной дискриминации», с которой чаще всего сталкиваются уязвимые группы в Таджикистане. Однако женщин, живущих с ВИЧ, это важное описание в законе, не успокаивает, потому что именно эта группа населения каждый день сталкивается с прямой дискриминацией.

«Несмотря на то, что ВИЧ не передается бытовым путем, а современная АВР-терапия (терапия, которая замедляет развитие вируса и заболевание, – ред.) до минимума снижает вирусную нагрузку, дискриминации женщина с ВИЧ подвергается на каждом шагу, – говорит Тахмина Хайдарова, руководительница Сети женщин, живущих с ВИЧ. – Прежде всего, внутри семьи.

Как только выясняется, что у нее положительный статус, родственники сокращают с ней контакты, избегают ее. Со временем такое отношение будет сопровождать ее везде, где узнают о ее статусе».

Как это ни странно, отмечает Тахмина, женщины, живущие с ВИЧ, часто жалуются на проявление дискриминации со стороны медицинских работников: стоматологов, хирургов, акушеров, гинекологов. Доктора отказываются оказывать помощь женщинам с ВИЧ и им приходится искать дружественных специалистов через знакомых.

«При этом современная медицина сняла все риски: ВИЧ сегодня это такое же хроническое заболевание, как сахарный диабет. При адекватной АВР-терапии и врачебном уходе, женщины с ВИЧ становятся матерями здоровых детей, но даже у медицинских работников нет актуальной информации на этот счет, – поясняет Тахмина Хайдарова.

Дискриминируют женщин с ВИЧ и местные журналисты. В контенте, посвященном женщинам с ВИЧ, часто присутствуют уничижительные обороты, медиа транслируют стереотипы, стигму и предрассудки, и не объясняют аудитории о том, что собой сегодня представляет ВИЧ.

«До сих пор в материалах местных журналистов встречаются такие обороты, как “ВИЧ/СПИД – чума 21 века”, “ВИЧ-террор” и прочие утверждения, не имеющие ничего общего с реальностью», – говорит Хайдарова.

Часто журналисты используют устрашающие обороты при освещении случаев возбуждения уголовных статей (125 ст. УК РТ, – ред.) в отношении женщин с ВИЧ, которые якобы осознанно заражают мужчин.

В Конвенции о ликвидации всех форм дискриминации в отношении женщин (КЛДЖ), подписанной Таджикистаном 30 лет тому назад, говорится, что гендерное неравенство и дискриминация являются первопричинами насилия в отношении женщин.

«По сути, под первую часть 125 статьи УК Таджикистана могут попасть и все дискордантные пары (в которых один партнер с положительным статусом ВИЧ, другой – с отрицательным, – ред.). В этой части прописано: “Заведомое поставление другого лица в опасность заражения ВИЧ‐инфекцией”, то есть это не фактическое заражение, а риск заражения. И все люди с положительным ВИЧ-статусом, у которых есть половой партнер, фактически, ставят его под угрозу риска заражения.

Но по факту это не так: если человек принимает АРВ-терапию, его вирусная нагрузка снижена, и даже в случае незащищенного секса, его партнер не заразится ВИЧ», – говорит руководительница Сети женщин, живущих с ВИЧ.

Женщинам с ВИЧ достается больше

Она рассказывает, что на двенадцатой международной конференции по научным исследованиям ВИЧ, которая проходила 23–26 июля в австралийском городе Брисбен, Всемирная организация здравоохранения представила новые научные и методические рекомендации в отношении ВИЧ.

В них были приведены ключевые пороговые значения вирусной нагрузки при ВИЧ.

Так, ВИЧ-положительные лица, у которых благодаря соблюдению режима антиретровирусной терапии достигнут неопределяемый уровень вирусной нагрузки, не передают ВИЧ своим сексуальным партнерам и подвергаются низкому риску «вертикальной» передачи вируса своим детям.

«Многие громкие уголовные дела в Таджикистане были возбуждены именно по первой части статьи 125 УК. Но на деле никто из “пострадавших” не заразился ВИЧ», – объясняет Тахмина Хайдарова.

По ее словам, несмотря на то, что мужчины с положительным статусом ВИЧ также подвергаются дискриминации, женщинам достается больше.

Дело в том, что до сих пор общество считает, что женщина с ВИЧ – это женщина, у которой было много сексуальных партнеров. Тогда как по статистике секс-работниц среди женщин с ВИЧ в Таджикистане на конец 2022 года всего 1,7 %. Все остальные – это, как правило, обычные женщины-домохозяйки, которые заразились от своих мужей.

«К нам недавно обратилась женщина, живущая с ВИЧ: она была замужем, родила ребенка, муж ее ужасно избивал. Избивал даже во время беременности так, что она потеряла второго ребенка, – рассказывает Тахмина. – Несмотря на то, что именно муж заразил ее ВИЧ, его семья во всем обвиняла саму женщину.

Она ушла от него с ребенком, сняла комнату, устроилась на работу. Но бывший муж забрал ребенка и теперь угрожает лишить ее родительских прав, потому что у нее положительный статус ВИЧ, нет образования и маленькая зарплата, на которую она не может содержать ребенка».

Учитывая тот факт, что таджикские женщины даже без ВИЧ подвергаются дискриминации в судебных органах, нет никакой гарантии, что в случае, если мужчина, о котором рассказывает Тахмина, действительно попытается лишить свою бывшую жену родительских прав, в суде увидят всю абсурдность и несправедливость ситуации.

Подробнее: https://asiaplustj.info/ru/news/tajikistan/society/20231201/sam-zarazil-no-zhenu-obvinil-zhentshini-s-vich-podvergayutsya-v-tadzhikistane-diskriminatsii

The unseen consequences of HIV criminalisation and its impact on marginalized communities

How civil commitment can ensnare people prosecuted under HIV criminalization

By
Robert Suttle

TheBody recently published, “We Keep Ignoring HIV Criminalization,” an article that addressed the lack of attention given to HIV criminalization laws.

These laws criminalize people living with HIV for a range of actions―such as having sex without first disclosing their serostatus―often, even when they are virally suppressed and therefore incapable of transmitting the virus. As is always the case, ignorance of the law is no defense against it.

In some states, HIV criminalization laws punish people living with HIV for biting or spitting even though, once again, these acts cannot transmit the virus. But losing one’s freedom under these laws doesn’t stop at simple prosecution. In some states, people prosecuted under these laws are required to register on state sex-offender registries, even when no sexual assault has taken place.

It should be noted that prosecuting and equating people living with HIV with rapists and other violent sexual assailants does nothing to decrease HIV transmissions. Rather, as “We Keep Ignoring HIV Criminalization” notes, these harsh measures promulgate stigma, possibly discourage people from getting tested, and place targets on the foreheads of anyone living with the virus.

Beyond this, part of what makes HIV criminalization laws so insidious is that they have additional components to them that can destroy a person’s life in ways that few people are aware of—until they’ve been prosecuted and deemed a “sexually dangerous person” by the state. This is called civil commitment and can keep a person imprisoned indefinitely without the basis of a new offense.

To help shed light on this shadowy form of incarceration and what can happen to people who have been prosecuted for HIV criminalization, TheBody spoke with two members of the Center for HIV Law and Policy: staff attorney Kae Greenberg (pronouns he/him), and policy and advocacy manager Amir Sadeghi (pronouns he/him).

Robert Suttle: The Prison Policy Initiative recently published, “What Is Civil Commitment?” Can you speak about how it can be applied to HIV criminalization, especially when sex offense has been included in the prosecution?

Amir Sadeghi: I’m so glad we’re talking about this. People across the country have been wrestling with this because 20 states have these laws in place. Civil commitment is a system of civil laws that detain people convicted of certain sex offenses long after serving their criminal sentences. This kind of state custody and detention happens on top of somebody’s criminal sentence.

Suttle: So basically an added punishment after one has “repaid their debt to society.” Some people might look at this and celebrate. How do you talk about this with people who are opposed to eliminating these laws?

Sadeghi: I think about questions that people usually ask prison abolitionists: What are you going to do about sexual violence? What are you going to do about these really hard cases?

I think the most important thing I want to foreground in discussions about sex offense civil commitment is that I don’t downplay the harm of sexual violence. It’s a deeply personal and real thing that happens in our society.

However, it is unclear that detaining people with very little due process has any measurable or meaningful impact on reducing gender-based violence and sexual violence. And actually, there’s been a huge mobilization of survivor-led movements and organizations who have begun to condemn harsh responses that happen in their name. For instance: sex-offense civil commitment, sex-offense registries, detention, and state violence.

I think that the history of laws that punish people long after their criminal sentence via sex-offense civil commitment [comes from] highly publicized cases about sexual violence [and has] motivated politicians and the public to react very strongly against these cases. It has created a very draconian system of facilities that many advocates and people who’ve been in sex-offense civil commitment themselves call shadow prisons.

Kae Greenberg: I want to clarify something about people serving or being punished long after their crimes. People are incarcerated because they have been convicted or have pleaded guilty to a crime. But they are in civil commitment because they have been deemed a potential [risk] of reoffending in some way or incapable of controlling themselves. It’s essentially some dystopian RoboCop or Judge Dredd situation where they’re trying to predict whether or not you will potentially commit a future serious crime and, therefore, lock you away from society just in case.

When we talk about the minimal protections in the criminal justice system, like the standard of proof or reasonable doubt, we know that’s a very high standard, hypothetically. Something that would stop you or cause you to make an important life decision. Civil commitment is a much lower standard of proof; it’s just beyond 50%. We only know a little about what happens in these hearings because they are not open to the public.

What’s used is the speculation of mental health practitioners, and I’m not trying to disparage the mental health community. I’m a big proponent of mental health practitioners, but we’re talking about having someone confined indefinitely for something they “might do.” There is potentially no end to this. It’s until [the state] decides that you’re done.

Suttle: Let’s address the elephant in the room: Nushawn Williams. Where do things stand with his ongoing detainment related to the civil commitment in New York?

Sadeghi: Many people know that the Center for HIV Law and Policy (CHLP) has filed amicus briefs supporting Nushawn Williams in the past. We are a proud member of the Free Nushawn Coalition, which was founded by Brian C. Jones and Davina Connor, who I think a lot of HIV activists know warmly and lovingly.

The New York State Department of Health cooperated with prosecutors in the case to criminalize Nushawn Williams. Why did they do this? Because his HIV status and race were weaponized against him. Newspapers called Nushawn an AIDS monster, an AIDS predator. Then-Mayor [of New York City] Rudy Giuliani said he wanted Nushawn Williams tried for, quote, “attempted murder or worse.” There was a horrific stigmatizing frenzy to lock him up and throw away the key.

Nushawn pled guilty in 1999 to statutory rape and reckless endangerment and served his maximum criminal sentence relating to that plea agreement. But in 2010, his release from Wende Correctional Facility in upstate New York was blocked by then–Attorney General Andrew Cuomo, who filed an Article 10 Mental Hygiene Law petition to have Nushawn civilly committed. I think the frenzy and racist spectacle that was made to paint Nushawn as a monster makes it clear that his HIV status and race are major factors in what the state decided to do.

Editor’s note: An example of this spectacle is that two corrections officers reported that Williams “stated that he intended to continue that behavior [sex without sharing his HIV status] upon his release, specifically referencing underage girls”―an absurd and unlikely contention when one considers that such a statement would expose him to undue scrutiny as well as the very punitive treatment he is currently experiencing. In its explanation for why Williams is still detained, the state lists his prior substance use, sexual offenses, prison record prior to 2006, and his “failure to complete sex offender treatment,” without detailing what completion entails. Taken as a whole, it is clear that the state unfairly views Williams as the person he was when he entered prison 24 years ago.

I would just like to let folks know that Nushawn is still in state custody today, well over a decade beyond his maximum criminal sentence. And there is no end in sight to his civil commitment. Many people, especially people living with HIV, were rightfully dismayed and disturbed by the prosecution and the decision to civilly commit him. That has brought, I think, a lot of energy and activism to addressing the systemic issue of sex-offense civil commitment. For instance, Black men in New York are nearly two times more likely to be civilly committed than white men.

Suttle: When you talk about detainment, this is in a civil commitment facility. How do they look? Are they different from prisons?

Sadeghi: They have iron-clanging doors. They are surrounded by barbed wire. You are heavily surveilled and subjected to constant searches. They look like prisons because they are prisons. And people are not being successfully or meaningfully treated. People are being detained and punished, often as political prisoners.

So, you don’t have a lot of the protections afforded by the safeguards of the criminal legal system because you are not in criminal custody anymore. You are a “patient” being “treated” in a “secured treatment facility.”

Suttle: The idea that this is being done against a person’s will is obviously troubling. But how do you respond to people who diminish treatment for a sexual offense as being “not so bad?”

Greenberg: The idea of sex-offender “treatment” is very complicated. If one meaningfully engages in some treatment and talks about anything that could potentially (A) allude to their being a risk to others or (B) shows they engaged in some other potentially criminal activity, they could find themself facing new charges or extended civil commitment―just because they were trying to engage in this treatment honestly.

Being engaged in this kind of sex-offender rehabilitation and treatment is kind of a sword of Damocles. One needs to engage in it enough socially. But, potentially, if one engages with full force, they might be putting themself at further risk of consequence. I join with Amir in saying I’m not trying to minimize sexual violence or what the victims of sexual violence have gone through. But it also scares me to live in a society where we lock up people for something they haven’t done.

If we want to talk about how this is tied to other systems―they’re trying to roll out all kinds of sentencing algorithms to determine what someone’s bail should be. What’s scary is it’s all about whether there’s a scientific way to decide who will recidivate and essentially plan to punish people for future crimes [they might not commit]. Ruha Benjamin has done a lot of writing about this, showing how racist and awful these algorithms and sentencing are. Civil commitment is tied to other larger systems throughout the criminal legal system.

Suttle: Would you say that’s why marginalized groups or people should be concerned about this?

Sadeghi: Yes. It’s a really important issue at the intersection of criminalizing sex identity, class, race, and beyond. Research by the Williams Institute on sex-offense civil commitment has shown that Black men are two times more likely than their white peers to be civilly committed after they’ve already served their criminal sentences.

If you think about sexual violence and you find yourself overwhelmed with a sense that people are irredeemable and need to be warehoused in a cage indefinitely, I’d like you to reflect on how that same mentality and rhetoric has often been used to justify HIV criminalization. HIV criminalization laws are often defended and justified by arguments that they prevent intimate partner violence and sexual violence.

But, in reality, we know that women living with HIV have higher rates of experiencing sexual violence. And that women living with HIV are overwhelmingly overrepresented in arrests and prosecutions of people targeted because of their health status as people living with HIV. So I think when we recognize the truth about HIV, health, and criminalization, we can start to understand the rationale that has gone into justifying detaining people. And then we can think about how the state has used these instruments to target and punish “undesirable people,” who are often also suffering in the middle of an axis of different kinds of marginalization.

Again, I think it’s important to note that networks of survivors of sexual violence think it’s ridiculous to confront unconsensual acts of violence with unconsensual treatment and state violence. And we have to take that seriously.

Suttle: Going back to Nushawn, is there anything that people can do to support him or get involved in the coalition to end civil commitment in New York?

Sadeghi: There is a burgeoning campaign of sexual survivor–led movements, people living with HIV, and racial justice advocates. If you’re feeling animated and ready to challenge these draconian systems that target and criminalize and incarcerate people, please reach out to us at CHLP. We’d love to work with you to challenge and end sex-offense civil commitment and other harsh policies that target, criminalize, and incarcerate folks who have been historically marginalized.

Suttle: What is your hope for the future of health and human rights for communities most affected by these issues?

Greenberg: To a certain extent, my hope combines two parts of the question. Health is seen as a human role and not limited by access. As awful as things are―following the Dobbs decision―we’ve also been presented with an opportunity to reframe some of these issues. So instead of dealing with individual access, individual rights to privacy, individual concerns, we can reframe them as public health concerns and about a right to health. We’ve been stripped down to the bare bones, but I’m holding on to that right now. In terms of hope, we can build up in a way that will reach and impact people who haven’t previously had access to meaningful health care and health.

Sadeghi: Over the years, I’ve observed that in the face of this kind of injustice and stigma, it is so important to build power from the bottom up and by cross-movement organizing. I think we, as HIV advocates and people working in the HIV anti-criminalization space, really need to deepen our relationships, partnerships, and accountability to sex worker–led groups, advocacy groups, sex work decriminalization groups, racial justice groups, and prison industrial complex (PIC) abolitionists.

To do that, we need to partner with and build power with these very communities and people who are most likely to be criminalized because of their health status. I’m excited about that new direction. I think I feel it in our movement that we are going there. And I’m looking forward to seeing what happens over the next few years.

Robert Suttle:  Robert Suttle is a New York City-based advocacy consultant and movement leader in the global HIV community with expertise in decriminalization, human rights, and the intersection between equity and social justice.

New report from Williams Institute finds that HIV criminalisation in Arkansas disproportionately impacts Black men

Enforcement of HIV Criminalization in Arkansas

Overview

The Williams Institute analyzed data from the state of Arkansas about individuals who came into contact with the state’s criminal system through allegations of HIV-related crimes. We analyzed both law enforcement arrest data and data from the state’s Department of Corrections and sex offender registries to understand the beginning and end stages of the criminalization cycle. In total, we estimate that at least 108 people have had contact with Arkansas’ criminal system because of allegations of HIV crimes.

Findings

  • There have been at least 119 charges at arrest for allegations of HIV-related crimes since 1990, including four charges for failure to disclose one’s HIV status to a medical professional.
  • Arrests continue to the present day, with the latest arrest in 2022—the latest year for which data were available.
  • Enforcement is highly concentrated by geography:
    • 18% of all arrests originated with Little Rock Police Department, followed by Fort Collins Police Department (10%).
    • Likewise, Pulaski County originated one-third of all HIV-related arrests, followed by Sebastian County with 12% of arrests, and Miller County with 5% of arrests. In contrast, most counties had one or no arrests.
  • The racial composition of people arrested for allegations of HIV-related crimes skews Black: Black people were 48% of all HIV-related arrests, but only 15% of the state’s population, and 43% of people living with HIV in the state:
      • Black men in particular were overrepresented—7% of the state’s population, 31% of people living with HIV, and 44% of HIV-related arrests.
  • Four in five arrests (80%) that proceeded to the prosecution phase resulted in a guilty outcome. Only one case resulted in a not guilty outcome, and the remaining cases had charges dropped or prosecutors declined to pursue the case.
  • The youngest person with an HIV-related conviction was 18 years old.
  • Fourteen people were currently on the sex offender registry for an HIV-related conviction in 2023.
    • Half of these people were Black men, although Black men made up only 22% of the overall sex offender registry.
  • Twenty-one people across two snapshots of people in Arkansas Department of Corrections (DOC) custody (in 2007 and 2023) had HIV-related convictions mandating a sentence:
    • The average sentence per count for the HIV-related conviction was 24 years.
    • Four people only had HIV-related convictions; they had no other current or prior convictions.
    • Black men were 57% of all people with an HIV-related DOC sentence, compared to 38% of all people in DOC custody.

Download the full report

Mexico: Greater collaboration needed between civil society, health authorities and legislators

HIV stigma: A social struggle that needs political reinforcement

Translated with Deepl.com. For article in Spanish, please scroll down.

For sociologist Axel Bautista, the fight against HIV-related stigma encompasses social awareness and a cry for help for legislators.

HIV stigma: A social struggle that needs legislative reinforcement, awareness and mass information in today’s Mexico. This is the opinion of Axel Bautista, one of the activists of this cause, who through an analysis of the origin, development and fight against this form of discrimination, finds a proposal to combat it that brings together the key social actors in the fight.
“Greater collaboration is needed between civil society, health authorities and, above all, communication between the health sector and legislators with an interest in the issue.

HIV stigma

Axel Bautista became the only Mexican and Latin American to represent the fight against HIV-related stigma at the HIV In View forum in London.

He observed a sexual health system with openness, access to vaccines, treatment and sensitivity on the part of doctors, health personnel and civil society, something that for the content creator can be replicated in Mexico with the help of constant and coordinated work between all social actors.

“More and better social communication campaigns are needed because they help to break down prejudices and myths on HIV issues (…) Mexico used to lead Latin America in terms of implementing public policies and treatment, and still does, but I feel that it has lost some leadership on how to do social communication on prevention issues, it has stagnated,” he said.

Fighting stigmas with legislation

For Axel, clear, unbiased and open information triggers an opening of social awareness that stops stigmas. But he stresses that the most important actor in this move is the politician.

“For example, in the CDMX there has been a rapprochement with Congressman Temístocles Villanueva, from Morena, to address issues of decriminalisation of the danger of contagion”.

The initiative seeks a reform in the penal code of the CDMX to repeal a law that is outdated by current medicine and that “serves to stigmatise people living with HIV,” he said. “It is more related to moral and good practices than to a public health approach,” he said.

However, this initiative has not caused an echo in Morena at the CDMX or Federal level. Deputies such as Salma Luévano and María Clemente García have dealt with it, but not in depth in their proposals.

The panorama for fighting HIV stigmas in Mexico is advancing in the medical and social field with content creators who demystify life with HIV. But the political reinforcements that serve as a push on a national scale are still dormant in this urgent social struggle.
“A person diagnosed with HIV is not alone, you can go on and your sentimental, sexual and working life will not stop. It’s okay to feel sad, but it’s not the end,” stresses Axel Bautiza.

Estigmas por VIH: Una lucha social que necesita refuerzos políticos

Para el sociólogo, Axel Bautista, la lucha contra los estigmas relacionados al VIH engloba la conciencia social y un grito de ayuda para legisladores

Estigmas por VIH: Una lucha social que necesita refuerzos legislativos, de conciencia e información masiva en el México actual. Así lo considera Axel Bautista, uno de los activistas de esta causa, quien a través de un análisis sobre el origen, desarrollo y combate a esta forma de discriminación; encuentra una propuesta de combate que reúne a los actores sociales clave en la lucha.
“Se necesita mayor colaboración entre sociedad civil, autoridades sanitarias y, principalmente, comunicación entre sector salud y legisladores con interés en el tema“.

Estigmas por VIH

Axel Bautista se convirtió en el único mexicano y latinoamericano en representar la lucha contra los estigmas relacionados al VIH en el foro HIV In View realizado en Londrés.

Observó un sistema de salud sexual con apertura, acceso a vacunas, tratamientos y sensibilidad por parte de médicos, personal de salud y sociedad civil, algo que para el creador de contenido es replicable en México con ayuda de trabajo constante y coordinado entre todos los actores sociales.

“Hacen falta más y mejores campañas de comunicación social porque ayudan a romper prejuicios y mitos en temas de VIH (…) México lideraba América latina en temas de implementación de políticas públicas, tratamiento; y todavía lo hace pero, siento que ha perdido cierto liderazgo sobre cómo hacer comunicación social en temas de prevención, se quedó estancado“, opinó.

Combatir estigmas con legislaciones

Para Axel, la información clara, sin prejuicios y abierta desencadena una apertura de conciencia social que frena estigmas. Pero destaca que el actor más importante en esta jugada es el político.

“Por ejemplo, en la CDMX ha habido un acercamiento con el diputado Temístocles Villanueva, de Morena, para abordar temas de despenalización del peligro de contagio.”

La iniciativa busca una reforma en el código penal de la CDMX para derogar una ley rebasada por la medicina actual y que “sirve para estigmatizar a las personas que vivimos con VIH“, comentó “Se relaciona más con practicas de buenas costumbres y moral que con enfoque de salud pública“, puntualizó.

Sin embargo, dicha iniciativa no ha causado eco entre Morena a nivel CDMX o a nivel Federal. Pues diputadas como Salma Luévano o María Clemente García han tratado pero no a profundidad en sus propuestas.

El panorama para combatir los estigmas de VIH en México avanza en terreno médico y social con creadores de contenidos que desmitifican la vida con VIH. Pero los refuerzos políticos que sirven de empuje a escala nacional aún siguen dormidos en esta urgente lucha social.
“Una persona con diagnóstico de VIH no esta sola, puede continuar y tu vida sentimental, sexual, laboral, no se va a detener. Se vale sentirse tristes, pero no es el fin“, destaca Axel Bautiza.

Austria: Care organisations refuse to provide home care for 81-year-old man living with HIV

Just like in the 80s: No 24-hour care for HIV-positive people.

Translated via Deepl.com. For original article in German, please scroll down.

A large care organisation terminated without notice a contract concluded shortly before, because of HIV infection. All others also refused because of HIV.

In this guest blog, lawyer Helmut Graupner describes how an HIV infection can still lead to discrimination in Austria, despite the fact that educational work has been going on for decades and effective HIV therapy is available that prevents the disease, leads to a normal life expectancy and even means that HIV-infected people cannot infect anyone.

In the spring of 2023, an 81-year-old gentleman, let’s call him RS, found that outpatient home care was no longer sufficient and 24-hour nursing care was becoming necessary. RS has been HIV positive for many years. Due to successful treatment, the infection has never caused him to become ill. The Red Cross had provided the previous outpatient home care in an exemplary manner, with commitment and without any reservations regarding the HIV infection.

In mid-April, a contract was concluded with one of the large Austrian nursing organisations for the placement of nursing staff. For this purpose, the regional manager of this organisation was on site at the flat. He had an insight into the care book and the care records that had previously been kept by the Red Cross. In the documentation folder of the Red Cross, the HIV infection was noted on the very first page. The regional officer also spoke for a long time on the phone with the head of the previous care provided by the Red Cross and discussed how to proceed. The HIV infection could also be seen in the findings and diagnoses that were consulted.

The nursing organisation found a nurse who immediately started her first rotation. A week later, the area manager visited the home. One of the things discussed was that RS has to be taken to hospital every three months for HIV status check. This lady also did not express any concerns about HIV infection.

Carers not asked at all

The surprise was all the greater when, four days after this meeting, a (different) representative of the care organisation called to say that the written termination of the contract was already in the mail. She explicitly mentioned the HIV infection as the reason. Pointing out that his status was below the detection limit, i.e. RS was not contagious at all, was of no use. This did not change the fact that no nursing staff would be willing to take over the care. The matter had been discussed internally and the nursing staff could not be told. They would not understand because they all came from Romania and Slovakia and all had this negative attitude. There was no mention of caregivers themselves refusing care.

So the care organisation did not even try to discuss the matter with a single one of the caregivers (who were allegedly so prejudiced) and win them over to care for RS. Even the nurse who was already placed and working at the time only knew that she would not be replaced by the originally intended colleague. She did not know any reason and assumed that she would return in four weeks. In any case, she (coming from Romania) had no problem with the HIV status.

One day after the phone call, the letter from the care organisation arrived. The placement contract was terminated without notice (without observing the period of notice!) at the end of the current caregiver’s rotation. The reason given was succinct: “The care cannot be transferred to the care workers for professional reasons. It is not possible to find new caregivers.

Austrian organisations all refused

Upon lawyer intervention, the care organisation insisted in a written statement on the termination without notice. Even the fact that the Romanian carer who had already been placed was willing to continue the care did not change anything. The care organisation could only guarantee quality assurance if it could cover each rotation with a carer who had a contractual relationship with it. If the Romanian carer who had already been placed wanted to stay and continue caring for RS, the organisation could “gladly accept that”. However, she would then have to leave the contractual relationship with the care organisation (“We do not keep the carer”).

Although the Aidshilfe Wien and the legal committee Lambda stood up for RS, the care organisation remained firm. That was not enough. RS and his relatives then tried to get 24-hour care from the other Austrian care organisations available in the region. All of them explained that this was not possible because the care workers came from countries where people had just such attitudes.

Slovakian agency had no problem

RS considered a complaint of discrimination, but died a few weeks later, now 82 years old. He died knowing that he was discriminated against because of his HIV infection and that nobody could do anything about it. And the discriminators got away with it just fine.

At least he was cared for at home in his last weeks, despite the closed refusal in Austria. An agency from Slovakia had no problem with the HIV status, just like the caregivers they placed. A disgrace for Austria in 2023

Wie in den 80ern: Keine 24-Stunden-Pflege für HIV-Positive

Eine große Pflegeorganisation kündigt den kurz zuvor geschlossenen Vertrag fristlos wegen einer HIV-Infektion. Auch alle anderen lehnen wegen HIV ab

Im Gastblog schildert Rechtsanwalt Helmut Graupner, wie eine HIV-Infektion in Österreich noch immer zu Diskriminierung führen kann, obwohl seit Jahrzehnten Aufklärungsarbeit betrieben wird und eine wirksame HIV-Therapie vorhanden ist, die die Erkrankung verhindert, zu einer üblichen Lebenserwartung führt und sogar bewirkt, dass HIV-Infizierte niemanden anstecken können.

Im Frühjahr 2023 ergibt sich bei einem 81-jährigen Herrn, nennen wir ihn RS, dass die ambulante Hauskrankenpflege nicht mehr ausreicht und eine 24-Stunden-Pflege notwendig wird. RS ist seit vielen Jahren HIV-positiv. Durch die erfolgreiche Behandlung hat die Infektion bei ihm nie eine Erkrankung hervorgerufen. Das Rote Kreuz hatte die bisherige ambulante Hauskrankenpflege vorbildlich, engagiert und ohne jegliche Vorbehalte hinsichtlich der HIV-Infektion erbracht.

Mitte April wurde mit einer der großen österreichischen Pflegeorganisationen ein Vertrag über die Vermittlung von Pflegekräften abgeschlossen. Dazu war der Regionsverantwortliche dieser Organisation vor Ort in der Wohnung. Er hatte Einblick in das Betreuungsbuch und in die Pflegeunterlagen, die bisher vom Roten Kreuz geführt wurden. In der Dokumentationsmappe des Roten Kreuzes war gleich auf der ersten Seite die HIV-Infektion vermerkt. Der Regionsverantwortliche hat überdies lange Zeit mit der Einsatzleiterin der bisherigen Pflege durch das Rote Kreuz telefoniert und dabei die weitere Vorgangsweise abgesprochen. Auch den eingesehenen Befunden und Diagnosen war die HIV-Infektion zu entnehmen.

Die Pflegeorganisation vermittelte eine Pflegerin, die ihren ersten Turnus sogleich angetreten hat. Eine Woche später suchte die Bereichsleiterin die Wohnung auf. Dabei wurde unter anderem besprochen, dass RS alle drei Monate zur Überprüfung des HIV-Status in ein Krankenhaus gebracht werden muss. Auch diese Dame äußerte keine Bedenken bezüglich der HIV-Infektion.

Pflegepersonen gar nicht gefragt

Umso größer war die Verwunderung als vier Tage nach dieser Besprechung eine (andere) Vertreterin der Pflegeorganisation anrief und mitteilte, dass die schriftliche Auflösung des Vertrages bereits mit der Post unterwegs sei. Als Begründung hat sie ausdrücklich die HIV-Infektion genannt. Der Hinweis darauf, dass sein Status unter der Nachweisgrenze liegt, RS also gar nicht ansteckend ist, nutzte nichts. Das ändere nichts daran, dass kein Pflegepersonal bereit wäre, die Pflege zu übernehmen. Die Sache sei intern beraten worden, und man könne das den Pflegekräften gar nicht sagen. Diese würden das nicht verstehen, denn sie kämen alle aus Rumänien und der Slowakei und hätten halt alle diese negative Einstellung. Es war nicht die Rede davon, dass Betreuerinnen oder Betreuer selbst die Pflege abgelehnt hätten.

Die Pflegeorganisation hat also mit keiner einzigen der (angeblich derart vorurteilsbehafteten) Pflegepersonen auch nur versucht, die Sache zu besprechen und sie für eine Pflege von RS zu gewinnen. Auch die damals bereits vermittelte und tätige Pflegerin wusste nur, dass sie nicht von der ursprünglich vorgesehenen Kollegin abgelöst wird. Grund wusste sie keinen und ging davon aus, dass sie in vier Wochen wiederkommt. Sie (aus Rumänien kommend) hatte jedenfalls kein Problem mit dem HIV-Status.

Einen Tag nach dem Telefonat langte das Schreiben der Pflegeorganisation ein. Der Vermittlungsvertrag wurde mit Ende des laufenden Turnus der aktuellen Pflegerin fristlos (ohne Einhaltung der Kündigungsfrist!) aufgelöst. Zur Begründung hieß es lapidar: “Die Betreuung kann aus fachlichen Gründen den Betreuungskräften nicht übertragen werden. Eine Vermittlung von neuen Personenbetreuer*innen ist nicht möglich.”

Österreichische Organisationen lehnten alle ab

Auf anwaltliche Intervention beharrte die Pflegeorganisation in einer schriftlichen Stellungnahme auf der fristlosen Auflösung. Auch der Umstand, dass die bereits vermittelte rumänische Pflegerin zur Fortführung der Pflege bereit war, änderte daran nichts. Die Pflegeorganisation könne die Qualitätssicherung nur gewährleisten, wenn sie jeden Turnus mit einer Pflegekraft abdecken könne, die mit ihr in einem Vertragsverhältnis steht. Wenn die bereits vermittelte rumänische Pflegerin bleiben und die Pflege von RS fortsetzen wolle, könne die Organisation “das gerne akzeptieren”. Sie müsse dann aber aus dem Vertragsverhältnis mit der Pflegeorganisation ausscheiden (“Wir halten die Betreuerin nicht fest”).

Obwohl sich die Aidshilfe Wien und das Rechtskomitee Lambda für RS einsetzten, blieb die Pflegeorganisation hart. Damit nicht genug. RS und seine Angehörigen versuchten dann bei den anderen in der Region verfügbaren österreichischen Pflegeorganisationen eine 24-Stunden-Pflege zu erhalten. Alle erklärten, dass dies nicht möglich sei, weil die Pflegekräfte aus Ländern kämen, in denen die Menschen eben solche Einstellungen hätten.

Slowakische Agentur hatte kein Problem

RS überlegte eine Klage wegen Diskriminierung, ist aber einige Wochen danach, mit mittlerweile 82 Jahren, verstorben. Er starb im Wissen, dass er wegen seiner HIV-Infektion diskriminiert wurde und niemand etwas dagegen tun konnte. Und die Diskriminierenden damit gut durchgekommen sind.

Zumindest wurde er in seinen letzten Wochen dann, trotz der geschlossenen Weigerung in Österreich, doch noch zu Hause gepflegt. Eine Agentur aus der Slowakei hatte, ebenso wie die von ihr vermittelten Pflegekräfte, kein Problem mit dem HIV-Status. Eine Schande für Österreich im Jahr 2023.

IAS 2023: Five-year impact of Expert Consensus Statement – poster published today

Today, 24th July, at the 12th IAS Conference on HIV Science on Brisbane, we presented our research findings on the five-year impact of the ‘Expert Consensus Statement on the Science of HIV in the Context of Criminal Law’.

Click on the image above to download the pdf of the poster

Tomorrow, 25th July, we will publish the full research report and discuss the findings on our live webshow, HIV Justice Live!

Hosted by HJN’s Executive Director, Edwin J Bernard, the show will include a discussion with the report’s lead author, HJN’s Senior Policy Analyst Alison Symington, as well as interviews with Malawian judge Zione Ntaba, Taiwan activist Fletcher Chui, and SALC lawyer Tambudzai Gonese-Manjonjo on the Statement’s impact.

We’ll also hear from some of the Expert Consensus Statement’s authors, including Françoise Barré-Sinoussi, Salim S Abdool Karim, Linda-Gail Bekker, Chris Beyrer, Adeeba Kamarulzaman, Benjamin Young, and Peter Godfrey-Faussett.

Ugandan lawyer and HJN Supervisory Board member Immaculate Owomugisha will also be joining us live from the IAS 2023 conference where she is serving as a rapporteur, to discuss the Statement’s relevance today.

HIV Justice Live! Episode 5: Bringing Science to Justice will be live on Facebook and YouTube on Tuesday 25th July at 3pm CEST (click here for your local time).