Livestream: HIV IS NOT A CRIME III National Training Academy: Closing Plenary (HJN, 2018)

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 6 June 2018

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Pre-show with Mark S King and guests 00:08

2) Rapporteur session 03:48

3) Issues around the AIDS 2020 conference 13:30

4) State reports 16:17

5) Breaking news 40:14

6) Thank you’s 41:37

7) Chant 48:04

8) After show 49:59

Facilitated by Naina Khanna Positive Women’s Network – USA CALIFORNIA With Susan Mull Rapporteur PENNSYLVANIA and many, many others

Side show interviews with Sean Strub SERO Project PENNSYLVANIA and Edwin J Bernard HIV Justice Network UK

Livestream: HIV IS NOT A CRIME III National Training Academy: Plenary 6 – Leave No One Behind: Intersections of HIV Criminalization with Sex Work, Drug / Syringe Use, and Immigration (HJN, 2018)

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 6 June 2018

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Unscheduled action by people with disabilities 00:08

2) Pre-show with Mark S King and guests 05:39

3) Plenary 09:35

4) After show 1:28:39

Introduced by Allison Nichol SERO Project WASHINGTON DC Facilitated by Carrie Foote HIV Modernization Movement INDIANA With Tiffany Moore Criminalization survivor TENNESSEE Cris Sardina Desiree Alliance ARKANSAS Marco Castro-Bojorquez US PLHIV Caucus and HIVenas Abiertas CALIFORNIA Chris Abert Indiana Recovery Alliance INDIANA Zaniya James L.A.T.E. Project INDIANA

Side show interviews with Arneta Rogers Positive Women’s Network – USA CALIFORNIA

Livestream: HIV IS NOT A CRIME III National Training Academy: Plenary 5 – From Mexico to Colombia: The Latin-American Fight Against Criminalization (HJN, 2018)

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 5 June 2018

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Pre-show with Mark S King and guests 00:08

2) Plenary 13:02

3) After show 1:53:48

Introduced by Naina Khanna Positive Women’s Network – USA CALIFORNIA Facilitated by Gonzalo Aburto SERO Project NEW YORK Dr Patricia Ponce Red Mexicana de Organizaciones contra la Criminalización del VIH MEXICO Ricardo Hernandez Forcada Red Mexicana de Organizaciones contra la Criminalización del VIH MEXICO Leonardo Bastidas Red Mexicana de Organizaciones contra la Criminalización del VIH MEXICO Brisa Gomez Red Mexicana de Organizaciones contra la Criminalización del VIH MEXICO Dr Alfredo Daniel Bernal Red Mexicana de Organizaciones contra la Criminalización del VIH MEXICO Paola Marcela Iregui Parra Universidad del Rosario COLOMBIA German Humberto Rincon Perfetti Lawyer COLUMBIA Interpreter: Liz Essary Cabina Event Interpreting INDIANA

Side show interviews with Diego Grajalez CNET+ Belize, Edwin J Bernard HIV Justice Network UK and Marco Castro-Bojorquez USPLHIV Caucus and HIVenas Abiertas CALIFORNIA

Livestream: HIV IS NOT A CRIME III National Training Academy: Plenary 4 – Towards Liberation: Advancing a Racially Just HIV Criminalization Reform Movement (HJN, 2018)

[FYI: We didn’t live stream Plenary 3 due to confidentality concerns

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 5 June 2018 ]

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Pre-show with Mark S King and guests 00:08

2) Plenary 11:06 3)

After show 1:30:01

Introduced by Rebecca Wang Positive Women’s network – USA CALIFORNIA Facilitated by Kenyon Farrow The Body NEW YORK With Waheedah Shabazz-El Positive Women’s Network – USA PENNSYLVANIA Robert Suttle SERO Project NEW YORK Marco Castro-Bojorquez US PLHIV Caucus and HIVenas Abiertas CALIFORNIA Maxx Boykin Black AIDS Institute CALIFORNIA Naina Khanna Positive Women’s Network – USA CALIFORNIA Toni-Michelle Williams Racial Justice Action center GEORGIA

Side show interviews with Stacy Jennings BULI participant SOUTH CAROLINA and Barb Cardell Colorado Mod Squad COLORADO

Livestream: HIV IS NOT A CRIME III National Training Academy: Plenary 2 – Meaningful Involvement of People with HIV (MIPA), Leadership and Accountability (HJN, 2018)

HIV IS NOT A CRIME III National Training Academy Live from the Indiana University-Purdue University Indianapolis, 4 June 2018

Live stream hosted by Mark S King www.myfabulousdisease.com

This live stream was brought to you by HIV Justice Network www.hivjustice.net

Directed and produced by Nicholas Feustel

Running order (click on the time cues to jump there):

1) Pre-show with Mark S. King and guests 00:07

2) Plenary 12:08

3) After show 1:33:10

Facilitated by Naina Khanna Positive Women’s Network – USA CALIFORNIA With Andrew Spieldenner US PLHIV Caucus CALIFORNIA Barb Cardell Colorado Mod Squad COLORADO Arianna Lint Arianna’s Center FLORIDA Malcom Reid THRIVE SS GEORGIA

Side show interviews with Maxx Boykin Black AIDS Institute CALIFORNIA Waheedah Shabazz-El Positive Women’s Network – USA PENNSYLVANIA Laurel Sprague Activist MICHIGAN Laela Wilding Elizabeth Taylor AIDS Foundation CALIFORNIA

Mexico: Supreme Court finds Veracruz law criminalising ‘wilful transmission’ of HIV and STIs to be unconstitutional

Following a Constitutional challenge initiated in February 2016 by the Multisectoral Group on HIV / AIDS and STIs of Veracruz and the National Commission on Human Rights, and supported by HIV JUSTICE WORLDWIDE, Mexico’s Supreme Court of Justice yesterday found by eight votes (out of 11) that the amendment to Article 158 of the Penal Code of the State of Veracruz to be invalid as it violates a number of fundamental rights: equality before the law; personal freedom; and non-discrimination.

The full ruling is not yet available, but according to a news story published yesterday in 24 Horas.

…it was pointed out that the criminal offense is “highly inaccurate” because it does not establish what or what is a serious illness, besides it is not possible to verify the fraud in the transmission [and] that although the measure pursued the legitimate aim of protecting the right to health, especially for women and girls, the measure did not exceed the analysis of need because it was not ideal and optimal for the protection of that purpose, especially as [Veracruz] already criminalised the ‘willful putting at risk of contagion of serious illnesses’…

Additionally, Letra S reports,

The Minister President of the Court, Luis María Aguilar Morales, took up the recommendations of the Joint United Nations Program on HIV / AIDS and the Oslo Declaration on HIV Criminalisation, regarding the criminalization of HIV, and argued that this article left to the will of the investigating authority to decide which diseases will be considered as serious and which will not, going against the principle of legality, which implies that the crimes cannot be indeterminate or ambiguous.

In this case, the President said, the article did not establish whether STIs are only those considered serious or any, regardless of their severity. In turn, the justices determined that the resolution has a retroactive effect, that is, that those persons tried under the offense established by this article, the resolutions are invalidated.

 

Background

On August 4, 2015, the Congress of the State of Veracruz approved an amendment to Article 158 of the Criminal Code in order to add the term Sexually Transmitted Infections, which included HIV and HPV. 

It provided for a penalty ranging from 6 months to 5 years in prison and a fine of up to 50 days of salary for anyone who “willfully” infects another person with a disease via sexual transmission.

The amendment, proposed by the deputy Mónica Robles Barajas of the Green Ecologist Party of Mexico, said the legislation was aimed at protecting women who can be infected by their husbands. “It’s hard for a woman to tell her husband to use a condom,” she said in an interview with the Spanish-language online news site Animal Político.

On February 16, 2016, the National Human Rights Commission responded to the request of the Multisectoral Group on HIV / AIDS and STIs of the state of Veracruz and other civil society organizations, and filed an action of unconstitutionality against the reform in the Supreme Court of Justice of the Nation, which it said does not fulfill its objective of preventing the transmission of sexual infections to women and girls, but rather creates discrimination of people living with HIV and other STIs.

In October 2016, following a press conference at the National Commission on Human Rights (pictured above) that generated a great deal of media coverage, including a TV report, HIV JUSTICE WORLDWIDE delivered a letter to the Mexican Supreme Court highlighting that a law such as that of Veracruz does not protect women against HIV but rather increases their risk and places women living with HIV, especially those in positions vulnerable and abusive relationships, at disproportionate risk of both proseuction and violence.

In October 2017, the first Spanish-language ‘HIV Is Not A Crime’ meeting took place in Mexico City, supported by the HIV JUSTICE WORLDWIDE coalition where a new Mexican Network against HIV Criminalisation was established.

The Network issued a Statement yesterday which concluded:

We applaud the declaration of the Supreme Court of Justice of the Nation, which gives us the reason for the unconstitutionality request, shared with the National Commission of Human Rights; For this reason, we suggest to the deputies of the Congresses of the State that before legislating, they should be trained in the subject and that they do not forget that their obligation is to defend Human Rights, not to violate them.

Finally, the Mexican Network against the Criminalization of HIV recognizes that there are still many ways to go and many battles to fight, but we can not stop celebrating this important achievement.

 

Edwin Bernard (HIV JUSTICE WORLDWIDE) and Patricia Ponce (Grupo Multisectorial Veracruz) presenting the letter to Supreme Court of the Nation, Mexico City.
Edwin Bernard (HIV JUSTICE WORLDWIDE) and Patricia Ponce (Grupo Multisectorial Veracruz) presenting the letter to Supreme Court of the Nation, Mexico City.

Read the English text of the HIV JUSTICE WORLWIDE amicus letter below.

HIV JUSTICE WORLDWIDE

This is a letter of support from HIV JUSTICE WORLDWIDE[1] to Grupo Multi VIH de Veracruz / National Commission of Human Rightswho are challenging Article 158 of Penal Code of the Free and Independent State of Veracruz that criminalises ‘intentional’ exposure to sexually transmitted infections or other serious diseases, on the grounds that this law violates a number of fundamental rights: equality before the law; personal freedom; and non-discrimination.

As a coalition of organisations working to end the overly broad use of criminal laws against people living with HIV, we respectfully share Grupo Multi VIH de Veracruz’s concerns around Article 158 which potentially stigmatises people with sexually transmitted diseases and criminalises ‘intentional’ exposure to sexually transmitted infections (potentially including HIV) or other serious diseases.

All legal and policy responses to HIV (and other STIs) should be based on the best available evidence, the objectives of HIV prevention, care, treatment and support, and respect for human rights. There is no evidence that criminalising HIV ‘exposure’ has HIV prevention benefits. However, there are serious concerns that the trend towards criminalisation is causing considerable harm.

Numerous human rights and public health concerns associated with the criminalisation of HIV non-disclosure and/or potential or perceived exposure and/or transmission have led the Joint United Nations Programme on HIV/ AIDS (UNAIDS) and the United Nations Development Programme (UNDP), [2] the UN Special Rapporteur on the right to health,[3]  the Global Commission on HIV and the Law[4]  and the the World Health Organization[5],  to urge governments to limit the use of the criminal law to extremely rare cases of intentional transmission of HIV (i.e., where a person knows his or her HIV-positive status, acts with the intention to transmit HIV, and does in fact transmit it). They have also recommended that prosecutions [for intentional transmission] “be pursued with care and require a high standard of evidence and proof.” [6]

In 2013, UNAIDS produced a comprehensive Guidance Note to assist lawmakers understand critical legal, scientific and medical issues relating to the use of the law in this way.[7] In particular, UNAIDS guidance stipulates that:

  • “[I]ntent to transmit HIV cannot be presumed or solely derived from knowledge of positive HIV status and/or non-disclosure of that status.
  • Intent to transmit HIV cannot be presumed or solely derived from engaging in unprotected sex, having a baby without taking steps to prevent mother-to-child transmission of HIV, or by sharing drug injection equipment.
  • Proof of intent to transmit HIV in the context of HIV non-disclosure, exposure or transmission should at least involve (i) knowledge of positive HIV status, (ii) deliberate action that poses a significant risk of transmission, and (iii) proof that the action is done for the purpose of infecting someone else.
  • Active deception regarding positive HIV-status can be considered an element in establishing intent to transmit HIV, but it should not be dispositive on the issue. The context and circumstances in which the alleged deception occurred—including the mental state of the person living with HIV and the reasons for the alleged deception— should be taken into consideration when determining whether intent to transmit HIV has been proven to the required criminal law standard.”

Moreover, where criminal liability is extended to cases that do not involve actual transmission of HIV (contrary to the position urged by UNAIDS and other experts), such liability should, at the very bare minimum, be limited to acts involving a “significant risk” of HIV transmission. In particular, UNAIDS guidance contains explicit recommendations against prosecutions in cases where a condom was used, where other forms of safer sex were practiced (including oral sex and non-penetrative sex), or where the person living with HIV was on effective HIV treatment or had a low viral load. Being under treatment or using other forms of protections not only show an absence of malicious intent but also dramatically reduces the risks of transmission to a level close to zero. Indeed, a person under effective antiretroviral therapy poses –  at most – a negligible risk of transmission[8] and is therefore no different from someone who is HIV-negative.

Moreover, there is growing body of evidence[9] that such laws that actually or effective criminalise HIV non-disclosure, potential or perceived exposure, or transmission, negatively impact the human rights of people living with HIV due to:

  • selective and/or arbitrary investigations/prosecutions that has a disproportionate impact on racial and sexual minorities, and on women.
  • confusion and fear over obligations under the law;
  • the use of threats of allegations triggering prosecution as a means of abuse or retaliation against a current or former partner;
  • improper and insensitive police investigations that can result in inappropriate disclosure, leading to high levels of distress and in some instances, to loss of employment and housing, social ostracism, deportation (and hence also possibly loss of access to adequate medical care in some instances) for migrants living with HIV in some cases;
  • limited access to justice, including as a result of inadequately informed and competent legal representation;
  • sentencing and penalties that are often vastly disproportionate to any potential or realised harm, including lengthy terms of imprisonment, lifetime or years-long designation as a sex offender (with all the negative consequences for employment, housing, social stigma, etc.);
  • stigmatising media reporting, including names, addresses and photographs of people with HIV, including those not yet found guilty of any crime but merely subject to allegations.

In addition, there is no evidence that criminalising HIV (or other sexually transmitted infections) help protect women and girls from infections.  

Women are often the first in a relationship to know their HIV status due to routine HIV testing during pregnancy, and are less likely to be able to safely disclose their HIV-positive status to their partner as a result of inequality in power relations, economic dependency, and high levels of gender-based violence within relationships.[10]

Such a law does nothing to protect women from the coercion or violence that effectively increases the risk of HIV transmission. On the contrary, such laws place women living with HIV, especially those in vulnerable positions and abusive relationships, at increased risks of both prosecution and violence.

Some evidence suggests that fear of prosecution may deter people, especially those from communities highly vulnerable to acquiring HIV, from getting tested and knowing their status, because many laws only apply for those who are aware of their positive HIV status. [11] HIV criminalisation can also deter access to care and treatment, undermining counselling and the relationship between people living with HIV and healthcare professionals because medical records can be used as evidence in court. [12]

Finally, there is evidence[13] of an additional negative public health impact of such laws in terms of:

  • increasing HIV-related stigma, which has an adverse effect on a person’s willingness to learn about, or discuss, HIV; and
  • undermining the importance of personal knowledge and responsibility (correlative to degree of sexual autonomy) as a key component of an HIV prevention package, when instead prevention of HIV within a consensual sexual relationship is – and should be perceived as – a shared responsibility.

We hope that the Mexico Supreme Court of Justice takes our concerns and all of this evidence into account when considering the Constitutional Challenge.

Yours faithfully,

Edwin J Bernard, Global Co-ordinator, HIV Justice Network

on behalf of all HIV JUSTICE WORLDWIDE partners: 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 (PWN-USA); and Sero Project (SERO).

[1] HIV JUSTICE WORLDWIDE is an initiative made up of global, regional, and national civil society organisations working together to end overly broad HIV criminalisation. The founding partners are: 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 (PWN-USA); and Sero Project (SERO).  The initiative is also supported by Amnesty International, the International HIV/AIDS Alliance, UNAIDS and UNDP.

[2] UNAIDS. Policy Brief: Criminalisation of HIV Transmission, August 2008; UNAIDS. Ending overly-broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations, May 2013.

[3] Anand Grover. Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, June 2010.

[4] Global Commission on HIV and the Law. HIV and the Law: Risks, Rights & Health, July 2012.

[5] WHO. Sexual health, human rights and the law. June 2015.

[6] Global Commission on HIV and the Law. HIV and the Law: Risks, Rights & Health, July 2012.

[7] UNAIDS. Ending overly-broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations, May 2013.

[8] A.J. Rodger et al., “Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy,” JAMA 316, 2 (12 July 2016): pp. 171–181.

[9]op cit. Global Commission on HIV and the Law.

[10] Athena Network. 10 Reasons Why Criminalization of HIV Exposure or Transmission Harms Women. 2009.

[11] O’Byrne P et al. HIV criminal prosecutions and public health: an examination of the empirical research. Med Humanities 2013;39:85-90 doi:10.1136/medhum-2013-010366

[12]Ibid.

[13]Op cit. Global Commission on HIV and the Law.

France: HIV criminalisation laws have a disproportionate impact on women

HIV: The share of women!

For the 8th of March, International Women’s Rights Day, Seronet takes stock of some figures on HIV related to women worldwide.

HIV in the world: women’s numbers

In 2015, globally, about 17.8 million women (aged 15 and over) were living with HIV, equivalent to 51% of the total population living with HIV. About 900,000 of the 1.9 million new HIV infections worldwide in 2015 – 47 percent – were women. It is young women and girls aged 15 to 24 who are particularly affected. Globally, about 2.3 million adolescent girls and young women were living with HIV in 2015, representing 60% of the entire population of young people (aged 15 to 24) living with HIV. 58% of new HIV infections among 15-24 year olds in 2015 were among adolescent girls and young women.

According to the same source, regional differences in new cases of HIV infection among young women and the proportion of women (aged 15 and over) living with HIV compared to men are considerable. They are even more important between young women (aged 15 to 24) and infected young men. In sub-Saharan Africa, 56% of new HIV infections occurred in women, and the rate was even higher among young women aged 15 to 24, accounting for 66% of new infections.

In the Caribbean, women accounted for 35% of newly infected adults, and 46% of new infections occurred among young women aged 15 to 24 years. In Eastern Europe and Central Asia, 31% of new cases of HIV infection have affected women; however, the rate of new infections among young women aged 15 to 24 reached 46%. In the Middle East and North Africa, women represent 38% of newly infected adults, while 48% of young women aged 15 to 24 are newly infected. In Western Europe, Central Europe and North America, 22% of new infections occurred in women, the highest rate among young women aged 15 to 24, with 29% of new infections (1).

Inequalities between women themselves

Some women are more exposed to HIV than others. This is a function of belonging to certain groups. The incidence of HIV in specific groups of women is disproportionate. According to an analysis of studies measuring the cumulative prevalence of HIV in 50 countries, it is estimated that sex workers around the world are about 14 times more likely to be infected with HIV than other women of childbearing age. (2). In addition, data from 30 countries indicate that the cumulative prevalence of HIV among women who inject drugs was 13%, compared to 9% among men who inject drugs (3).

A feminization of the HIV epidemic in France

Over the years, the HIV / AIDS epidemic has been strongly feminized in France too: the share of new diagnoses has increased in France from 13% in 1987 to 33% in 2009. Heterosexual contamination is the main vector of HIV transmission (54% of HIV-positive discoveries) and women make up the majority of these infections. Compared to men, they are infected younger.

In France, women account for about 30% of new HIV infections each year, a significant proportion of whom are born abroad and especially in sub-Saharan Africa. If we look at the 2016 data, we note that among heterosexuals, the majority of diagnostics relates to 2,300 people born abroad. 80% are born in sub-Saharan Africa and 63% are women. Late-stage discoveries are more specific to men than women.

Migrant women, in greater numbers than men in France, suffer more problems related to sexual health: complications specific to pregnancy and childbirth and sexual violence. These states are dependent on the conditions of the country of origin (sexual mutilation, forced marriages), and migration (rape, trafficking in human beings). They can be strengthened upon arrival in the host country, as the period of installation often corresponds to a period of health and social precariousness, which increases the risks of exposure to HIV and sexually transmitted infections.

What factors exacerbate the prevalence of HIV?

It’s obvious … but it’s worth remembering. Violence against women and girls increases their risk of HIV infection (4). A study in South Africa found that the link between intimate partner violence and HIV was more pronounced in the presence of domineering behaviour and high HIV prevalence.

In some settings, up to 45% of adolescent girls report that their first sexual experience was forced. Worldwide, more than 700 million women alive today were married before their eighteenth birthday. Often, they have limited access to prevention information and limited means to protect themselves from HIV infection. Worldwide, out of ten adolescent girls and young women aged 15 to 24, only three of them have complete and accurate knowledge of HIV (5). Lack of information on HIV prevention and the inability to use such information in the context of sexual relations, including in the context of marriage, undermine women’s ability to negotiate condom use and engage in safer sex, says UN Women.

Seropositivity: a double sentence for women

Other data indicate that women living with HIV are at increased risk of violence (6), including violations of their sexual and reproductive rights (reproductive health). Cases of involuntary or forced sterilization and forced abortions among women living with HIV have been reported in at least fourteen countries. In addition, legal standards directly affect the level of risk for women to contract HIV, says the UN Women. In many countries where women are most at risk, the laws that are supposed to protect them are ineffective. The lack of legal rights reinforces women’s subordinate status, particularly with regard to women’s rights to divorce, to possess and inherit property, to enter into contracts, to prosecute and to testify in court, to consent to medical treatment and open a bank account. Discriminatory laws on the criminalization of HIV transmission can also have a disproportionate impact on women, as they are more vulnerable to being tested for HIV and to find out whether or not they are infected with HIV when they access healthcare for their pregnancy. HIV-positive mothers are considered criminals under HIV-related laws in several countries in West and Central Africa, which explicitly or implicitly prohibits them from being pregnant or breastfeeding. for fear that they might transmit the virus to the fetus or to the child (7).

The response to HIV for women

Globally, between 76% and 77% of pregnant women have had access to antiretroviral drugs to prevent mother-to-child transmission of HIV, says UN Women (data for 2015). Despite this encouraging rate, more than half of the 21 priority countries of the UNAIDS Global Plan were unable to meet the need for family planning services for at least 25% of all married women. Another element is that governments are increasingly recognizing the importance of gender equality in HIV interventions at the national level. However, only 57% (out of the 104 countries that submitted data) had a specific budget. For their part, Global Fund expenditures on women and girls have increased from 42 percent of its total portfolio in 2013 to about 60 percent in 2015.

(1): UNAIDS, 2015 estimates from the AIDSinfo online database. Additional disaggregated data correspond to unpublished estimates provided by UNAIDS for 2015, derived from country-specific AIDS epidemic models.

(2) : Stefan Baral and al. (15 mars 2012), “Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis”, The Lancet Infectious Diseases, vol. 12, no 7. p. 542.

(3) : UNAIDS (2014) The Gap Report, p. 175.

(4) : R. Jewkes and al. (2006) « Factors Associated with HIV Sero-Status in Young Rural South African Women: Connections between Intimate Partner Violence and HIV », International Journal of Epidemiology, 35, p. 1461-1468 ;

(5) : UNAIDS (2015) 2015 Report on World AIDS Day “On the Fast-Track to end AIDS by 2030: Focus on Location and Population“, p. 75.

(6) : WHO and UNAIDS (2010) “Addressing violence against women and HIV/AIDS: What works?“, p. 33.

(7) : Commission mondiale sur le VIH et le droit (2012) « Risques, droit et santé », p. 23.

——————————————–

VIH : La part des femmes!

A l’occasion du 8 mars, Journée international des droits des femmes, Seronet fait le point sur quelques chiffres relatifs au VIH concernant les femmes dans le monde.

VIH dans le monde : la part des femmes

En 2015, à l’échelle mondiale, environ 17,8 millions de femmes (âgées de 15 ans et plus) vivaient avec le VIH, soit 51 % de toute la population vivant avec le VIH. Environ 900 000 des 1,9 million des nouveaux cas d’infection par le VIH constatés dans le monde en 2015 – soit 47 % – ont concerné des femmes. Ce sont les jeunes femmes et les adolescentes de 15 à 24 ans qui sont particulièrement touchées. A niveau mondial, environ 2,3 millions d’adolescentes et de jeunes femmes vivaient avec le VIH en 2015, représentant 60 % de toute la population de jeunes (de 15 à 24 ans) vivant avec le VIH. 58 % des nouveaux cas d’infection par le VIH chez les jeunes de 15 à 24 ans en 2015 touchaient des adolescentes et des jeunes femmes.

Selon la même source, les différences régionales concernant les nouveaux cas d’infection par le VIH chez les jeunes femmes et la proportion de femmes (âgées de 15 ans et plus) vivant avec le VIH par rapport aux hommes sont considérables. Elles sont encore plus importantes entre les jeunes femmes (âgées de 15 à 24 ans) et les jeunes hommes infectés. En Afrique subsaharienne, 56 % des nouveaux cas d’infection par le VIH ont touché des femmes, et ce taux a été encore plus élevé chez les jeunes femmes de 15 à 24 ans, représentant 66 % des nouveaux cas d’infection.

Dans les Caraïbes, les femmes ont représenté 35 % des adultes nouvellement infectés, et 46 % des nouveaux cas d’infections ont touché les jeunes femmes de 15 à 24 ans. En Europe de l’Est et en Asie centrale, 31 % des nouveaux cas d’infection par le VIH ont touché des femmes ; toutefois, le taux des nouveaux cas d’infection touchant les jeunes femmes de 15 à 24 ans a atteint 46 %. Au Moyen-Orient et en Afrique du Nord, les femmes représentent 38 % des adultes nouvellement infectés, alors que 48 % des jeunes femmes de 15 à 24 ans sont nouvellement infectées. En Europe occidentale, en Europe centrale et en Amérique du Nord, 22 % des nouveaux cas d’infection ont touché des femmes, ce taux étant plus élevé chez les jeunes femmes de 15 à 24 ans, avec 29 % de nouveaux cas d’infection (1).

Des inégalités entre les femmes elles-mêmes

Certaines femmes sont plus exposées au VIH que d’autres. C’est notamment fonction de l’appartenance à certaines groupes. L’incidence du VIH sur certains groupes spécifiques de femmes est disproportionnée. Selon une analyse d’études mesurant la prévalence cumulée du VIH dans 50 pays, on estime que, dans le monde, les travailleuses du sexe ont environ 14 fois plus de risques d’être infectées par le VIH que les autres femmes en âge de procréer (2). Par ailleurs, d’après des données émanant de 30 pays, la prévalence cumulée du VIH chez les femmes qui consomment des drogues injectables était de 13 %, contre 9 % chez les hommes qui consomment des drogues injectables (3).

Une féminisation de l’épidémie de VIH en France

Au fil des années, l’épidémie à VIH/sida s’est fortement féminisée en France aussi : la part de nouveaux diagnostics est passée, en France, de 13 % en 1987 à 33 % en 2009. La contamination hétérosexuelle est le principal vecteur de transmission du VIH (54 % des découvertes de séropositivité) et les femmes constituent la majorité de ces contaminations. Par rapport aux hommes, elles sont contaminées plus jeunes.

En France, les femmes représentent environ 30 % des nouvelles contaminations par le VIH chaque année, une part importante d’entre elles sont nées à l’étranger et en particulier en Afrique subsaharienne. Si on regarde les données de 2016, on note que les hétérosexuels, la majorité des découvertes de séropositivité est constituée par les 2 300 personnes nées à l’étranger. Il s’agit à 80 % de personnes nées en Afrique subsaharienne et à 63 % de femmes. Les découvertes à un stade avancé concernent plus particulièrement les hommes que les femmes.

Les femmes migrantes, en plus grand nombre que les hommes en France, subissent plus de problèmes liés à la santé sexuelle : complications propres à la grossesse et à l’accouchement, violences sexuelles. Ces états sont dépendants des conditions du pays d’origine (mutilations sexuelles, mariages forcés), et du parcours migratoire (viols, trafic d’êtres humains). Ils peuvent être renforcés à l’arrivée dans le pays d’accueil, la période d’installation correspondant souvent à une période de précarité sanitaire et sociale, qui accroît les risques d’exposition aux VIH et aux infections sexuellement transmissibles.

Quels facteurs exacerbent la prévalence du VIH ?

C’est une évidence… mais qu’il est bon de rappeler. La violence à l’égard des femmes et des filles augmente leurs risques d’infection par le VIH (4). Une étude menée en Afrique du Sud a démontré que le lien entre la violence infligée par un partenaire intime et le VIH était plus marqué en présence d’un comportement dominateur et d’une prévalence élevée du VIH.

Dans certains contextes, jusqu’à 45 % des adolescentes indiquent que leur première expérience sexuelle a été forcée. Dans le monde, plus de 700 millions de femmes en vie aujourd’hui ont été mariées avant leur dix-huitième anniversaire. Souvent, elles disposent d’un accès restreint aux informations de prévention, et de moyens limités pour se protéger contre une infection par le VIH. A l’échelle mondiale, sur dix adolescentes et jeunes femmes de 15 à 24 ans, seulement trois d’entre elles ont des connaissances complètes et exactes sur le VIH (5). Le manque d’informations sur la prévention du VIH et l’impossibilité d’utiliser de telles informations dans le cadre de relations sexuelles, y compris dans le contexte du mariage, compromettent la capacité des femmes à négocier le port d’un préservatif et à s’engager dans des pratiques sexuelles plus sûres, rappelle l’ONU Femmes.

La séropositivité : une double peine pour les femmes

D’autres données indiquent que les femmes vivant avec le VIH sont davantage exposées à des actes de violence (6), y compris des violations de leurs droits sexuels et génésiques (la santé reproductive). Des cas de stérilisation involontaire ou forcée et d’avortements forcés chez les femmes vivant avec le VIH ont été signalés dans au moins quatorze pays. De plus, les normes juridiques affectent directement le niveau de risque pour les femmes de contracter le VIH, rappelle l’Onu Femmes. Dans bon nombre de pays où les femmes y sont le plus exposées, les lois qui sont censées les protéger sont inefficaces. Le manque de droits juridiques renforce le statut de subordination des femmes, en particulier au regard des droits des femmes de divorcer, de posséder et d’hériter de biens, de conclure des contrats, de lancer des poursuites et de témoigner devant un tribunal, de consentir à un traitement médical et d’ouvrir un compte bancaire. Par ailleurs, les lois discriminatoires sur la criminalisation de la transmission du VIH peuvent avoir des répercussions disproportionnées sur les femmes, car elles sont plus exposées à être soumises à des tests de dépistage et ainsi à savoir si elles sont ou non infectées lors de soins au cours de la grossesse. Les mères séropositives sont considérées comme des criminelles en vertu de toutes les lois relatives au VIH en vigueur dans plusieurs pays en Afrique de l’Ouest et en Afrique centrale, ce qui leur interdit, explicitement ou implicitement, d’être enceintes ou d’allaiter, de crainte qu’elles transmettent le virus au fœtus ou à l’enfant (7).

La réponse face au VIH pour les femmes

A l’échelle mondiale, entre 76 et 77 % des femmes enceintes ont eu accès à des médicaments antirétroviraux pour prévenir la transmission du VIH de la mère à l’enfant, indique l’Onu Femmes (données pour 2015). Malgré ce taux encourageant, plus de la moitié des 21 pays prioritaires du Plan mondial d’Onusida ne parvenaient pas à répondre aux besoins en services de planning familial d’au moins 25 % de l’ensemble des femmes mariées. Autre élément : les gouvernements reconnaissent de plus en plus l’importance de l’égalité des sexes dans les interventions face au VIH qui sont menées à l’échelle nationale. Cependant, seulement 57 % (sur les 104 pays qui ont soumis des données) d’entre eux disposaient d’un budget spécifique. De leur côté, les dépenses du Fonds mondial de lutte contre le sida consacrées aux femmes et aux filles ont augmenté, passant de 42 % de son portefeuille total en 2013 à environ 60 % en 2015.

(1) : Onusida, estimations de 2015 provenant de la base de données en ligne AIDSinfo. Les données désagrégées supplémentaires correspondent aux estimations non publiées fournies par l’Onusida pour 2015, obtenues à partir de modèles des épidémies de sida spécifiques aux pays.

(2) : Stefan Baral et al. (15 mars 2012), “Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis”, The Lancet Infectious Diseases, vol. 12, no 7. p. 542.

(3) : Onusida (2014) The Gap Report, p. 175.

(4) : R. Jewkes et al. (2006) « Factors Associated with HIV Sero-Status in Young Rural South African Women: Connections between Intimate Partner Violence and HIV », International Journal of Epidemiology, 35, p. 1461-1468 ;

(5) : Onusida (2015) Rapport 2015 sur la Journée mondiale de lutte contre le sida “On the Fast-Track to end AIDS by 2030: Focus on Location and Population“, p. 75.

(6) : L’OMS et ONUSIDA (2010) “Addressing violence against women and HIV/AIDS: What works?“, p. 33.

(7) : Commission mondiale sur le VIH et le droit (2012) « Risques, droit et santé », p. 23.

Published in Seronet on March 7, 2018

US: In Georgia, under HIV criminalisation laws, black men far more likely to be arrested and convicted

HIV Criminalization in Georgia

 by Amira Hasenbush

January 2018

Georgia laws that criminalize people living with HIV have resulted in 571 arrests from 1988 to September 2017, according to state-level criminal history record information analyzed by the Williams Institute. Analyses show some disparities in enforcement of the laws based on race, sex, geography, and underlying related offenses, including sex work and suspected sex work.

Researchers found that HIV-positive Georgians in rural areas were more likely to be arrested for an HIV-related crime than those living in urban areas. Black men were more likely to be convicted of an HIV-related offense than white men and convictions for HIV arrests were three times as likely when there was a concurrent sex work arrest.

This report provides the first-ever overview of the use and enforcement of HIV-related laws in Georgia.

Read the report

US: Trevor Hoppe, author of Punishing Disease, talks about HIV criminalisation and homophobia

HIV Criminalization Laws Are Rooted In Homophobia — An Interview with Trevor Hoppe

Last week, the Missouri trial of Michael Johnson ended when Johnson pled guilty to HIV exposure to get 10 years in prison, rather than the maximum of 96 years he might face if his case went to trial.

For many people who are diagnosed with HIV today, it is a chronic manageable disease, and more and more health officials agree that people who are HIV-positive and undetectable don’t transmit the virus. But, in the eyes of the law in many states, an HIV-positive person’s sexuality is something to be handled by the criminal justice system.

For National Gay Men’s HIV/AIDS Awareness Day, INTO spoke with Trevor Hoppe, author of Punishing Disease: HIV and the Criminalization of Sickness, due out November 14th, about HIV criminalization laws. Hoppe enlightens us on why they’re bad, why they’re homophobic and why they should be tossed out.

One of the arguments you bring up in your book is that a lot of these HIV criminalization laws that we live with now were never really, when they were written, they were framed as fighting HIV, but they came from a place of “mortality” rather than trying to combat the spread of the virus.

Definitely. So that’s one of the points that I’ve been making in my research is that from day one, criminal justice officials and police have been lobbying for these laws on the basis that they wanted to punish people living with HIV. In particular, in the early days, police were very frustrated with prostitutes who were living with HIV who they couldn’t put behind bars for more than a couple of months because prostitution was a misdemeanor.

So they were seeking a felony penalty so they could keep these mostly women behind bars for longer periods of time. Then it transitioned from a kind of fear of sex work to a fear of gay sex and homophobia. It’s never been about public health. It’s always been about punishment and irrational fears — using punishment to police irrational fears of HIV.

When AIDS hit in the 1980s, the people that were most likely to be affected were people who Americans thought were already criminals — drug users, prostitutes, homosexuals. Highly denigrated groups of people whose behaviors were thoroughly criminalized under existing law already. It wasn’t a stretch to move from blaming these groups from spreading the disease to calling for them to be punished using the criminal law.

One of the things you mention in the book is that HIV transmission became a felony because sodomy was already a felony and they didn’t want to allow people to get away with sodomy to talk about an HIV transmission charge.

There was all this fear, particularly in Nevada, but in other places as well, that if we repealed the sodomy laws in place at the time, there would be this massive outbreak of HIV because if you made gay sex legal, it would be more permissive and people would go out and infect each other.

There was this great anxiety that this would happen. So one of the deals that got struck in many states was, OK if we decriminalize sodomy, at the same time we have to find a way to criminalize people living with HIV because we’re scared without a law criminalizing their behavior, the epidemic is going to run rampant.

One of the things I noticed in your chapter was that these HIV criminalization laws, you mention them being poorly written. They really remind me of the religious freedom acts now, where state legislatures kind of copy one another and lawmakers look at one another’s paper. It really just makes these easy McBills that are copied from state to state.

We have this idea that all state lawmakers get together and craft this individual, well thought out piece of legislation. Really, the way it works is that we have these lobbying groups like the American Legislative Exchange Council that create model statutes and then shop them out to legislatures across the United States. So we have a copy and paste situation for most states and that’s part of the reason we have so many messed up laws with HIV because most states didn’t take the time to think about the issues, they just copied what neighboring states were doing and said, “Well that’s good enough!”

I’m really interested in this parallel that you draw between HIV criminalization laws and early 20th century eugenicists and the ways these laws are about controlling a population. Can you elaborate on that?

There’s a long history of using the criminal law, but also the civil law and public health to control to populations that we think are dangerous, and often times that determination is based on prejudice. We have quarantine laws being more strictly enforced against Chinese populations in San Francisco. We have sex workers being rounded up in World Wars I and II because they were seen as vectors of syphilis and other diseases.

All these efforts frail from a public health perspective because they’re not aimed at controlling disease, they’re aimed at controlling stigmatized populations and controlling them because they’re members of that social group.

A lot of people don’t know there was a movement in the United States for a time to quarantine people living with HIV. You show in this chapter that one of the architects of the early HIV criminalization laws was also a fan of quarantining people with HIV.

These things went lock and step. You had people like William F. Buckley arguing that people diagnosed with HIV should be tattooed immediately upon diagnosis. You had public health experts publishing articles in the American Journal of Public Health arguing for what they called an “HIV parole system” which was effectively quarantine with the possibility of jail time if you didn’t shape up and act in a way they deemed appropriate.

There was a really widespread effort to try to regulate people living with HIV and it was really AIDS activists that we have to thank for the fact that many of those laws never came to fruition and that we don’t have quarantine for people with HIV.

Most of these laws, as we talked about earlier, end up punishing heterosexual people, but we know that one of the most high profile cases of HIV criminalization is Michael Johnson and HIV still disproportionately affects queer people. So these laws can end up criminalizing queer sexuality still.

Absolutely. We can’t just look at who is being punished under the law, we also have to think about those other effects of how the law creates or reinforces the symbolic stigma against people living with HIV.

I know plenty of people living with HIV who live in fear that their partners will turn on them or a one-night stand can land them in jail even though they did everything they could to protect that person and, in many cases, even if they disclose. There’s still this concern that their partner, whether a one night stand or a partner, can at one point wish revenge on them. That fear is really a dangerous thing.

It’s not productive, certainly from a public health perspective. It’s emotionally draining and interesting. Really, it’s not the way to live. I think these laws are more likely to do the opposite of what they’re supposed to do. These laws are poorly written, badly construed, bad for public health, and, most importantly, bad for social justice.

What would you say to another gay man who felt like these laws actually did protect them from people living with HIV?

I think many gay men have an idea of who is being prosecuted under these laws. They imagine it to be a kind of bogeyman intentionally trying to spread the disease to their partners. They have this scary image in their mind of who is being targeted.

When I went out to research these laws, I did not know who the average person being convicted under these laws was. What I found is that the vast majority of defendants are not this scary bogeyman. They’re someone who slipped up once and they owned up to the mistake and expressed regret about it or they’re someone who was in a relationship and was struggling with how to disclose in the beginning of that relationship. There are a lot of scenarios that are far more likely to play out instead of this bogeyman scenario that most people have in their heads.

I would ask people to take a moment and not just think about the worst case scenario but think about who is being punished under these laws. They’re people like a defendant in Tennessee who attempted suicide, woke up in a hospital distressed and bit a hospital attendant and was prosecuted under Tennessee law. If you really get down to brass tacks, those are not the people they think should be punished.

And yet that’s exactly who those laws are being used to punish. There’s a disconnect between how we think the law works and how the law actually does.

People still believe that HIV is an illness of personal responsibility. When HIV-negative people imagine these laws, they imagine an HIV-positive person who in the first place must have done something wrong to get it, and then they imagine that this person might do something wrong again because they’re already morally flawed. They don’t understand that HIV is a disease of poverty, racism, homophobia, and stigma and that they themselves can one day be on the other side of the law very easily. And in America, if you do something bad, you deserve to be behind bars!

These laws are based on the idea that telling someone you’re HIV positive will surely cause them to have a different kind of sex with you or no sex at all. And really at the end of the day we have so many prevention technologies now — PrEP, treatment as prevention — that can stop transmission in its tracks when you have sex with someone living with HIV.

The evidence really suggests that the best way to get HIV is to avoid having sex with HIV-positive people and only have sex with people who think they’re HIV negative.  If you think you’re keeping yourself safe by relying on people to disclose your status to you, you have another thing coming. The people most likely to transmit are people who don’t know they’re positive because their viral loads are high because they’re not on treatment.

It’s a false security blanket for many HIV-negative gay men and that’s what I guess at the end of the day, for our day to day lives, is the most important point. Have sex with someone who’s positive. That’s your best prevention strategy given the technologies that are available today!

Published in September 28, on Into

Africa: Moving towards revolutionising approaches to HIV criminalisation

“We have all agreed with the Sustainable Development Goal of ending HIV and Tuberculosis by 2030. We cannot get there while we are arresting the same people we are supposed to ensure are accessing treatment and living positively,” said Dr Ruth Labode, a member of Parliament from Zimbabwe opening remarks at a two-day global meeting co-hosted by the AIDS and Rights Alliance for Southern Africa (ARASA) and HIV Justice Worldwide (HJWW) on 24 and 25 April 2017 in Johannesburg, South Africa, which focused on “Revolutionising approaches to Criminalisation of HIV Non-disclosure, Exposure and Transmission”.

The meeting was attended by advocates, civil society organisations, lawyers, judges, national human rights institutions and Members of Parliament from all over Africa and with some delegates from North America. Central to these deliberations was the draconian provisions within numerous HIV-specific laws being developed as government responses to the prevention and control of the HIV epidemic. The good intentions inherent in these pieces of legislation are often marred with provisions, which criminalise people based on their HIV status. Punitive provisions relating to ‘compulsory testing’, ‘involuntary partner notification’, ‘non-disclosure’ and ‘transmission’ of HIV are often cited, fueling stigma against people living with HIV.

The common theme binding these deliberations, was the negative impact of HIV criminalisation and the stories that were shared by colleagues.  The increasing trend of imposing criminal sanctions against people living with HIV, had resulted in adverse impact on public health outcomes for certain populations, especially women. While reinforcing stigma, HIV criminalisation impedes access to sexual and reproductive health services such as condoms, HIV testing and treatment. Further, HIV criminalisation discourages HIV-positive women from accessing ante-natal care, which leads to increased maternal and child mortality. The overly broad and vague nature of most HIV specific laws, accompanied by the imposition of criminal sanctions without empirical or scientific support, further underpins the rift between public health goals and the protection of human rights.

Representing the AIDS Legal Network, one of the partners who led the development of the 10 Reasons Why Criminalisation Harms Women, Johanna Kehler mentioned the fact that, “HIV criminalisation and HIV specific laws are often set against a social milieu that is patriarchal, heteronormative and perpetuates gender inequalities and utilises punitive approaches to “correct” imbalances.” She went on to add that these laws ultimately maintain and widen the divide between public health needs and human rights obligations.

Laurel 1“Most prosecutions globally involve no or negligible risk of transmission. Among the thousands of known prosecutions, cases where it was clear, much less proven beyond reasonable doubt, that an individual planned on or wanted to infect another person with HIV, are exceedingly rare. People are being convicted of crimes contrary to the best public health advice, but also contrary to scientific and medical evidence”, said Dr Laurel Sprague of the HIV Justice Network, who has since become the Executive Director of the Global Network of People Living with HIV (GNP+).

During the meeting, various organisations shared their experiences around litigating these matters and community advocacy mounted to reform problematic laws or specific draconian provisions. Cases from Zimbabwe, Nigeria and Niger showcased that challenges were experiences in most contexts.

The Uganda Network on Law, Ethics & HIV/AIDS (UGANET), together with other advocates and activists, continue to challenge the Ugandan law and constitutionality of the criminalisation provisions contained in the HIV Prevention and Control Act of 2014. The Southern Africa Litigation Centre (SALC) spoke to the extensive work that they furthered in Malawi, which included a focus on arbitrary arrests and dentition. Malawi has taken the centre stage where HIV criminalisation is concerned, as they are currently in the process of tabling a decade-old Draft HIV and AIDS (Prevention and Management) Bill, which contains draconian provisions around HIV criminalisation.

Amplifying the voice of survivors of HIV criminalisation, the meeting was privileged to engage with Kerry Thomas via telephone from a state correctional facility in Boise, Idaho in the United States of America. Mr Thomas, who was prosecuted for HIV non-disclosure and the sentence that he is serving, reinforced the unjust nature of these laws. Mr Thomas is currently serving his eighth year out of a 30-year sentence for non- disclosure to his ex-partner, despite there being no proof of transmission and the fact that he had consensual and protected sex. His appeal on the unconstitutionality of Idaho’s non-disclosure law, was overturned in the District courts in 2016.

The meeting concluded with very strong calls for everyone to joining the global HIV JUSTICE WORLDWIDE movement and organisations committed to utilise their existing resources to galvanise advocacy focusing on ending HIV criminalisation.

Participants agreed that there was a need to focus on the inter-sectionalities within the HIV criminalisation discourse, as well as a need for coordination and collaboration amongst legislators, members of the judiciary, parliamentarians, health care workers and civil society organisations to further advocacy related to this issue.

The participants also agreed that transformative approaches to HIV criminalisation, require both legal and social reforms, such as sensitisation of community members and the media. ARASA has committed to working with colleagues in developing a timeline of key events and advocacy opportunities, at which colleagues could participate.

Revolutionising approaches to Criminalisation of HIV Non-disclosure, Exposure and Transmission was supported by a grant from the Robert Carr civil society networks Fund.

Since its inception, ARASA has played an active role in addressing HIV criminalisation in the region and globally. ARASA has strengthened the capacity of civil society on the issue and supported partners to work with the media, parliamentarians, members of the judiciary and lawyers to address HIV criminalisation.

To read more about the meeting, follow #Decrim4Health on Facebook and Twitter. You can also view a gallery of photos taken during the meeting here.