Livestream: Beyond Blame – Challenging HIV Criminalisation: Plenary 2 (HJN, 2018)

Welcome to BEYOND BLAME – Challenging HIV Criminalisation, live from De Balie in Amsterdam, 23 July 2018.

11:20 – 12:10 What About Human Rights? The Benefits and Pitfalls of Using Science in Our Advocacy to End HIV Criminalisation Facilitator: Laurel Sprague (UNAIDS) With: Chris Beyrer (John Hopkins Bloomberg School of Public Health), Edwin Cameron (Constitutional Court of South Africa), Richard Elliott (Canadian HIV/AIDS Legal Network), Lynette Mabote (ARASA), Paula Munderi (IAPAC)

12:10 – 13:00 Women and HIV Criminalisation: Feminist Perspectives Facilitator: Naina Khanna (Positive Women’s Network – USA) With: Sarai Chisala-Tempelhoff (Women’s Lawyers Association, Malawi), Michaela Clayton (ARASA), Kristin Dunn (AIDS Saskatoon), Deon Haywood (Women With A Vision)

New report from the Global Commission on HIV and the Law states that discrimination and punitive laws hamper the global HIV response

Bad laws and discrimination undermining AIDS response

AMSTERDAM, July 22 – Discrimination against vulnerable and marginalized communities is seriously hampering the global effort to tackle the HIV epidemic according to a groundbreaking new report by the Global Commission on HIV and the Law. Despite more people than ever before having access to antiretroviral treatment, the new report emphasizes that governments must take urgent action to ensure rights-based responses to HIV and its co-infections (tuberculosis and viral hepatitis). The new report comes on the eve of the biannual global AIDS conference, which is taking place in Amsterdam.

The Global Commission on HIV and the Law – an independent commission convened by UNDP on behalf of UNAIDS – operates with the goal of catalyzing progress around laws and policies that impact people affected by HIV. In 2012, the Commission highlighted how laws stand in the way of progress on AIDS while citing how to institutionalize laws and policies that promote human rights and health. The 2018 supplement to the Commission’s original report assesses new challenges and opportunities for driving progress on HIV, tuberculosis and viral hepatitis through evidence and rights-based laws and policies.

“Progress on tackling the AIDS epidemic shows that when we work together we can save lives and empower those at risk,” said Mandeep Dhaliwal, the Director of Health and HIV at UNDP. “However, the new report is also a warning that unless governments get serious about tackling bad laws, the overall AIDS response will continue to be undermined and we will fail those who are left behind.”

For the past six years, the Global Commission has made clear how marginalized groups are continually left behind in the global HIV response. Men who have sex with men, people who use drugs, transgender people and sex workers face stigma, discrimination and violence that prevents their ability to receive care, and LGBT populations are still under attack in many countries around the world.

Young women and adolescent girls are also uniquely affected by HIV and are not receiving adequate care. In 2015, adolescent girls and young women comprised 60 percent of those aged 15 to 24 years living with HIV and almost the same percentage of new HIV infections were among this cohort. Sexual and reproductive health care, including HIV testing and treatment, have consistently been kept out of the hands of the women and girls who need them.

“Global politics are changing, and repressive laws and policies are on the rise,” said Michael Kirby, former Justice of the High Court of Australia. “In recent years, political trends have negatively impacted the global HIV response: civic space has shrunk, migrants don’t have access to health care, and funding has dropped.”

The report warns that shrinking civil society space due to government crackdowns is hampering the HIV response as marginalized groups are seeing key health services cut off. The fight against HIV, tuberculosis and viral hepatitis will only be won if civil society is empowered and able to provide services, mobilize for justice and hold governments accountable.

“In the wake of the ongoing global refugee crisis, borders have tightened and access to health services has been restricted for millions of migrants – exactly the opposite of what is needed,” said Dr. Shereen El Feki, Vice-Chair of the Commission. “Condemning people who have left their homes to seek safety strips them of their human rights and in the process increases their vulnerability to HIV and its co-infections.”

Refugees and asylum seekers are often at high risk of HIV and overlapping infections like tuberculosis, but harsh laws restrict health care access. Laws must change to ensure that everyone, no matter where they are from, can receive quality health services. The world is also still off track in funding responses to HIV, tuberculosis and viral hepatitis: in 2015 – the same year that countries adopted the 2030 Agenda for Sustainable Development and its pledge to leave no one behind – donor funding for AIDS fell by 13 percent. Sadly the small uptick in donor funding for HIV in 2017 is at best an anomaly.

Despite these challenges, UNDP together with its UN and civil society partners have helped 89 countries revise their laws to protect people’s health and rights since 2012. Successes include:

·         HIV criminalization laws have been repealed in Ghana, Greece, Honduras, Kenya, Malawi, Mongolia, Switzerland, Tajikistan, Venezuela, Zimbabwe and at least two US states.

·         Leaders are taking steps to address gender inequities to bolster the rights of women and girls who are disproportionately affected by HIV: Tunisia recently passed a law to end violence against women in public and private life, and Jordan and Lebanon have strengthened legislation on marital rape.

·         Access to health care is being prioritized with emphasis on emerging illnesses that target people vulnerable to HIV, including Portugal instituting universal access to hepatitis C treatment in 2015, and France following suit in 2016. A court ruling in India led the Government of India to change its policy on who is eligible for tuberculosis treatment.

·         Governments are taking steps to protect the rights of vulnerable groups: Canada, Colombia, Jamaica, Norway and Uruguay have decriminalized possession of small amounts of cannabis and Jamaica erased the criminal records of low-level drug offenders.

The success and sustainability of the global HIV response will be determined in large part by urgent action on laws and policies. The Commission calls on governments and leaders around the world to institute effective laws and policies that protect and promote the rights of people affected by HIV and its co-infections. Since 2012, there have been positive changes in transforming laws and policies, and advancements in science that make it possible to further accelerate progress. The future will be determined by legal environments that drive universal health and human dignity.

Media contact:

In Geneva: Sarah Bel, Communications Specialist, sarah.bel@undp.org, Tel: +41 79 934 1117

In New York: Sangita Khadka, Communications Specialist, UNDP Bureau for Policy and Programme Support, sangita.khadka@undp.org; +1 212 906 5043

The Global Commission on HIV and the Law is an independent body, convened by the United Nations Development Programme (UNDP) on behalf of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Additional information is available at www.hivlawcommission.org.

Published in UNDP website on July 22, 2018

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.

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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