US: Discussion about the decriminalisation of HIV takes centre stage at World AIDS day panel in Georgia

A panel of HIV activists and LGBT organizers took aim at laws in Georgia that criminalize people with HIV and can leave them facing prison sentences of up to 20 years.

The discussion about decriminalizing HIV took center stage at a World AIDS Day panel on Nov. 30. People with HIV in Georgia can face a prison term of up to 10 years for having sex with someone without disclosing their HIV status. Even acts like spitting – which do not transmit HIV – are criminalized when directed towards a law enforcement officer with penalties that include up to 20 years of prison time.

Last year, a gay Atlanta man was charged in South Carolina with exposing a sex partner to HIV. Tyler Orr said he did disclose and as the panelists pointed out during the recent discussion, what counts as disclosure and how to avoid “he said, she said” debates in court is unclear.

“What advocates have tried to encourage folks to do in this really unwinnable situation is to have a notarized document or affidavit before you engage in one of these punishable acts,” Mel Medalle of SisterLove told the crowd of about 40 people.

“Which almost never happens, but that is how extreme and absurd this situation is,” Medalle added.

Nina Martinez, a member of the Coalition to End HIV Criminalization in Georgia, pointed out that disclosure laws can also create safety risks for people with HIV.

“Every single time, especially as a woman, every single time, it’s me risking my personal safety,” Martinez said.

Marxavian Jones, who serves as one of Georgia Equality’s Youth HIV Policy Advisors, echoed agreed with Martinez.

“Who is going to defend me when I disclose my status to someone and they take it to social media and decide they want to tell everybody,” Jones said.

The Center for HIV Law & Policy has pointed to the increased risk of intimate partner violence that can come with disclosure, writing that disclosure can “provide an additional excuse, or cover, for physical violence.”

The ongoing stigma of HIV-positive individuals also means that – as Jones pointed out – a disgruntled lover posting a partner’s HIV status to social media can have real consequences, including job loss or being outed to family.

During the National HIV Prevention Conference in Atlanta last year, public health experts and HIV activists argued that rather than criminalizing HIV-positive people, and adding to the stigma they face, people with HIV should be pushed to treatment options.

At the recent panel, participants also highlighted legislation being drafted by the Coalition to End HIV Criminalization in Georgia. The coalition is currently reaching out to legislators to find a sponsor for the bill.

“[The legislation is] so we can repeal, which would completely get rid of it,” Medalle said. “The other option would be to reform it, so to make changes to it but to ultimately have some semblance of it.”

While Medalle said it may seem like a “no brainer that we wouldn’t want this [law],” stigma and other means of criminalizing HIV-positive individuals makes the issue more complicated. In Texas and a handful of other states, there are no specific statutes that target people with HIV but they are still prosecuted under other laws including reckless endangerment.

Reforming the law means that advocates can create better standards for prosecutions, and can “craft a law that comports with modern HIV science, what we know about the routes of transmission,” Medalle said.

Martinez, who is a member of the coalition, said the HIV criminalization law in Georgia also falls short in other aspects.

“The law in Georgia doesn’t require intent to infect, it doesn’t require likelihood of transmission because it has things like spit, urine, feces in it. It doesn’t require transmission,” Martinez said.

The Georgia law also doesn’t take into account issues like condom usage or advising a partner to take PEP (post-exposure prophylaxis) after sexual intercourse – acts which reduce the likelihood of transmission. The reforms to the law would change that, the panelists said.

Emily Halden Brown, a Georgia Equality field organizer who organized the panel discussion, said the event highlighted how people with HIV are impacted by it.

“I think the most valuable moment in all of the discussions I’ve ever been a part of on this, are the moments where people living with HIV share the stories of how they are directly impacted,” Brown said. “Anytime someone shares their personal story you can just feel the change in the audience.”

The event was hosted by Georgia Equality, SisterLove, and The Counter Narrative Project at Gallery 874. The panel discussion coincided with the “Living With” art exhibit, which featured art about the experiences of living with HIV. A closing reception helped raise funds for Georgia Equality’s HIV policy work.

Published in Project Q on Dec 12, 2016

Canada: Canada’s sexual assault laws, as currently applied, put women living with HIV at increased risk of harm

Women living with HIV facing double jeopardy

Canada’s sexual assault laws are being applied in ways that, ironically, put some women at increased risk of harm. Women living with HIV are stuck between a rock and a hard place. If they disclose their HIV status to an intimate partner, they may be exposed to violence. If they don’t, they could go to jail for sexual assault.

People who fail to disclose HIV can be charged with fraud, invalidating sexual consent. They can be prosecuted for aggravated sexual assault, the most serious form of the crime, normally reserved for rapes compounded by physical violence. Conviction carries a penalty up to life in prison, and lifelong registry as a sex offender — even when there is no transmission of HIV nor any meaningful risk.

There is broad scientific consensus that when HIV is managed with anti-retroviral therapies, the risk of transmission is negligible, even without a condom. Today’s treatments can reduce viral loads to undetectable levels. Unfortunately, our courts haven’t caught up with the science. Legal practices are at odds with public health. Rather than hazard jail, people at risk of HIV may seek refuge in ignorance, choosing not to get tested.

Recently, Attorney General and Justice Minister Jody Wilson-Raybould acknowledged: “The criminal justice system must adapt to better reflect the current scientific evidence. . . . This could include a review of existing charging and prosecution practices.”

The statement was welcomed by Cécile Kazatchkine, senior policy analyst with the Canadian HIV/AIDS Legal Network and a member of the Ontario Working Group on Criminal Law and HIV Exposure. The organization has been working since 2009 to engage provincial attorneys general in developing prosecutorial guidelines that would limit prosecution to cases of intentional transmission. Foot-dragging on change has exposed Canada to increasing international criticism.

Kazatchkine believes the International AIDS Conference in Durban this past July may have been a turning point in the evolving federal position. During a plenary session Justice Edwin Cameron, South Africa’s first openly gay and HIV-positive Constitutional Court judge, singled out two nations with terrible records on HIV criminalization. “He mentioned Zimbabwe and he mentioned Canada,” she notes.

This message was compounded in the recent report by the UN Committee on the Elimination of All Forms of Discrimination Against Women, which called attention to Canada’s “harsh criminal sanctions” for nondisclosure. The report joins a chorus of international organizations recommending criminalization be limited to intentional transmission of the virus.

Criminalizing nondisclosure has had a particularly harsh impact on women, who often fear admitting they are HIV-positive will provoke violent reactions. Of some 180 prosecutions to date, Kazatchkine says, at least 18 of the defendants are women, many of whom were already marginalized by poverty or abuse.

Some of the women contracted the virus while being sexually assaulted themselves; now they’re being labelled sex offenders. The law’s application also has a disproportionate impact on Aboriginal women, who comprise at least six of 18 known female defendants.

Kazatchkine sees progress toward meaningful dialogue: Minister Wilson-Raybould’s statement “is having an impact.” At a roundtable Monday with several provincial ministries, participants got a keen sense of how women with HIV are caught between prosecution and potential violence. Kazatchkine was encouraged when Tracy MacCharles, the minister responsible for women’s issues, suggested the issue could be brought before the Ontario Roundtable on Violence Against Women.

The government has not committed to specific action. But advocates are cautiously optimistic that things are finally moving in the right direction.

Published in St. Catharines Standard on Dec 10, 2016

Canada: Criminalisation of people with HIV is based on and perpetuates misinformation

Health Economist, Assistant Professor at the University of Toronto

HIV Stigma Can Be More Dangerous Than The Disease Itself

In the past 20 years the medical implications of an HIV diagnosis have changed completely, almost miraculously. Antiretroviral drugs allow people living with HIV to have unprotected sex without passing the virus to their partners, to have HIV-negative children and to live healthy lives well into old age.

In fact, in 2016 the stigma surrounding HIV is probably more life-threatening than HIV itself. The fear of being “outed” as HIV positive stops a lot of people from seeking treatment. A delay in treatment allows the virus to spread, and in many cases, leads to death.

Stigma has many causes, one of which is a genuine fear of contagion. Despite the fact that HIV is now a treatable condition, “educational” messages on HIV prevention are still based on fear, and almost universally exaggerate the risks of HIV infection and its consequences.

Many of us still seem to view HIV as a life-threatening disease rather than a relatively mild condition.

Most people think that HIV is transmitted easily through unprotected sex, though the transmission rate is less than one per cent per act. When a person is taking antiretroviral drugs, the virus is suppressed and transmission is nearly impossible. Many of us still seem to view HIV as a life-threatening disease rather than a relatively mild condition.

In Canada, a person who is diagnosed with HIV and has unprotected sex can be sent to jail for aggravated sexual assault, even if they are taking medication and are virally suppressed. Such criminal convictions are based on and perpetuate misinformation. When it comes to HIV prevention, proper adherence to antiretroviral drugs is actually more effective than condoms.

What’s more, Canadian policy specifically discourages testing and treatment, because a diagnosis makes you criminally responsible. Treatment prevents the spread of HIV, so a policy that criminalizes HIV transmission could actually increase the spread of the virus. Even worse — high-risk individuals (those who frequently engage in unprotected sex) are the most susceptible to a conviction and therefore the least likely to get tested and treated. In November, the United Nations urged Canada to limit criminalization to cases of intentional transmission.

I study barriers to HIV testing in Malawi, a small country in southern Africa with an HIV infection rate of around 15 per cent. I recently ran a large-scale information experiment to correct a common misconception: most participants didn’t know that an HIV-infected person who is taking antiretroviral drugs is not contagious. Providing this information reduced stigma at the community level which caused a significant increase in HIV testing.

While Canada is a long way from Malawi, the social issues surrounding HIV are in some ways similar. Approximately one in five people living with HIV are undiagnosed. Misinformation and an inflated fear of HIV infection are widespread.

In a 2012 survey of Canadians commissioned by the Public Health Agency of Canada, nearly half believed that AIDS was always fatal, and only one-third believed that antiretroviral drugs were very effective. Half of survey respondents were not comfortable drinking from a glass once used by an HIV-infected person.

I understand the instinct to overstate the risks of HIV in order to encourage prevention, but messages that stoke fear and stigmatize HIV come with serious unintended consequences. Antiretroviral drugs are our best hope of ending the HIV epidemic.

In fact, “treatment as prevention” was a strategy developed right here in Canada, at the B.C. Centre for Excellence in HIV/AIDS. It has now been embraced by both the UN and the WHO. Rather than pushing prevention through fear, we should mobilize to support people living with HIV.

Good policy should focus not on fear, but on providing accurate information, encouraging HIV testing and providing universal access to life-saving medication.

US: Four out of five LGBT people live in states with HIV criminalization laws.

A majority of LGBT Americans—about 81 percent—live in states with HIV criminalization laws, according to a new report from the Movement Advancement Project (MAP), a group that provides research and data related to LGBT equality.

Titled LGBT Policy Spotlight: HIV Criminalization Laws, the free report explores why these laws are problematic and how they harm public health and the justice system, according to MAP press release.

“Over the past 35 years, 38 states have passed laws that have not kept up with modern medical research and facts about the risks, likelihood, and modes of transmission of HIV,” states the press release. “These HIV criminalization laws therefore often criminalize a range of behaviors that are now known to carry no or a negligible risk of transmission. Most of these laws also not only criminalize the intentional transmission of HIV, but also criminalize behaviors that unintentionally or accidentally exposed others to the virus. Together, these laws perpetuate dangerous stigmas and misinformation about the disease and people living with HIV, create a strong disincentive for individuals to find out their HIV status, and disproportionately target—and add to higher rates of incarceration for—LGBT people.”

While offering a national look at HIV criminalization, the report also looks at the degree of punishment for these laws—for example, whether a violation is considered a felony and whether offenses will result in registration as a sex offender. The report also examines how HIV laws disproportionately affect the LGBT population and people of color.

Published in Poz on Dec 7, 2016

Matthew Weait, from the University of Portsmouth, writes on how stigma and the law affect the lives of people with HIV

HIV Stigma and the Criminal Law

December 1st marks World AIDS Day, an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. Matthew Weait, from the University of Portsmouth, writes here on how stigma and the law affect the lives of people with HIV.

Today, December 1st, is World AIDS Day.  According to the latest available data from UNAIDS, 1.1 million people died from AIDS-related causes in 2015, there are just over 2 million new HIV infections globally every year, and just under 40 million people are living with the virus.  These are depressing figures, particularly in light of the advances in our understanding of HIV, its prevention and treatment, the laudable rise in the number of people accessing antiretroviral therapy (ART) (up from 7.5 million to 18 million in the past five years), and the massive impact of ART on reducing the likelihood of onward transmission.

Despite the fact that the life expectancy of people on ART has improved significantly, especially for those who receive a timely diagnosis, and that there exist effective ways of avoiding infection, the stigma associated with HIV remains.  The impact of this stigma, and the associated discrimination which people living with HIV (PLHIV) and those in key populations are subjected to, is substantial and undermines the work being done to promote access to health and other services critical to curtailing the epidemic.

Stigma is not only correlated with adverse health outcomes for PLHIV (including depression and lower adherence to medication), but also with non-disclosure of status and with less safe sexual practices.  It is for these reasons that combating stigma, and the factors which contribute to it, has long been identified as a public health priority.

Among the most pernicious contributors to HIV stigma is the widespread and inappropriate use of criminal laws against PLHIV and those at heightened risk of infection.  For example, PLHIV or those suspected of being HIV-positive have been and are at risk of being investigated, prosecuted and imprisoned for exposure offences – where no transmission takes place – even where there is negligible risk (as when a PLHIV is on effective treatment and has an undetectable viral load), where there is no risk (e.g. through biting or spitting), and even where a partner has consented to the risk involved.

In some countries, such as Canada, the very fact of non-disclosure of status can, irrespective of risk, turn otherwise consensual sex into sexual assault.  And where transmission does in fact occur (which is more likely when someone does not know their status and is not on treatment than when they do know and are), PLHIV are at risk of extended custodial punishment, even if it is not their intention to cause harm.

These laws serve no public health purpose and, because it is typically only those that have a positive diagnosis who may be found criminally liable, do nothing to incentivise the testing which is a pre-requisite of treatment and care.

It is not only those already living with HIV who suffer from the enforcement of punitive laws.  The social opprobrium associated with and / or criminalization of transgender people, homosexuality, sex work, and injecting drug use in many countries of the world (including nations with high HIV prevalence) reinforces stigma, makes it harder to support those at heightened risk of acquiring the virus, and in fact makes infection more likely.

If the possession of condoms is treated as evidence of sex work, sex workers may not carry them; and if the possession of syringes is treated as evidence of drug use, the chance that these will be shared increases, as does the risk of transmitting blood-borne viruses (including HIV and hepatitis C).  Put simply, the policing of these communities, and the absence of harm reduction opportunities in the carceral settings they may find themselves in as a result of that policing, exacerbate risks which are already greater than for the general population.

The adverse impact of using criminal law in the fight against HIV, and on those directly and indirectly affected by it, has been extensively researched and documented.  The consensus among expert bodies such as UNAIDS and the Global Commission on HIV and the Law is that countries should review their punitive laws and significantly restrict their use, and there have been a number of progressive and welcome developments both in law reform and in policing, many of these led by coalitions of activists and clinicians.  At the same time, and despite the evidence of the harm that they cause, and the stigma which it feeds and sustains, countries continue to pass and enforce these laws.

Irrespective of any moral or ethical questions there may be about HIV transmission, exposure, or non-disclosure, it is incontrovertible that the criminal law makes the elimination of HIV harder.  If we are going to end the epidemic, this needs to be recognised and acted on as a priority. If not, more people will become infected, more people will get sick, more people will have a lower quality of life – even when virally suppressed – and more people will die.

Published in BioMed Central on Dec 1, 2016

Canada: Canadian Report highlights a "clear pattern of racism" in media reporting of HIV-related offences

Media accused of racism in reporting HIV-related crime

Black males with HIV account for 20 per cent of the 181 people charged for no disclosing HIV status to sexual partners, but 62 per cent of newspaper articles focused on their cases.

Canadian mainstream media disproportionally focus on black immigrant men criminally charged for not disclosing HIV status to their sexual partners when the majority of offenders are white, says a new study.

To mark World AIDS Day on Wednesday, a team of Canadian researchers released the pioneering study last week identifying “a clear pattern of racism” toward black men in the reporting of HIV non-disclosure in Canadian newspapers.

“The most striking revelation of this report was the grand scale of stereotyping and stigmatizing by Canadian media outlets in their sensationalistic coverage of HIV non-disclosure cases,” said Eric Mykhalovskiy, a York University sociology professor, who leads the team.

“It’s upsetting to read myths masquerading as news and repeating the theme of how black men living with HIV are hypersexual dangerous ‘others.’ This approach not only demeans journalism, but it inflames racism and HIV stigmatization, undermining educational and treatment efforts.”

Based on the database of Factiva, an English-language Canadian newspaper articles from 1989 to 2015, researchers from York, University of Toronto and Lakehead University identified 1,680 reports of HIV non-disclosure cases. Of those reports 68 per cent, or 1,141 of the articles, focused on racialized defendants.

According to court records of HIV-related criminal cases in Canada, African, Caribbean and black men living with HIV, the virus that causes AIDS, account for 20 per cent or 36 of the 181 people charged for these offenses. However, 62 per cent or 1,049 of the 1,680 media reports focused on these 20 per cent of the cases.

Immigrants and refugees receive particularly higher amount of coverage. While only 32 of the 181 accused are known to be migrants to Canada, yet stories about their offences represented 62 per cent (1,046 of 1,680) of the media coverage.

“The report documents the media’s stigmatizing and unjust racial profiling of black heterosexual immigrant men in HIV non-disclosure cases that perpetuates systematic discrimination,” said Christian Hui, an HIV activist and co-founder of the Canadian Positive People Network.

“We know next to nothing about them other than their name, age, residence, occupation, the charges they face,” said the report. “What is distinct about the coverage of African, Caribbean and black male defendants is how (they) are linked with racializing forms of representation in ways that amplify connections between HIV, criminality, race and ‘foreignness.’”

Mykhalovskiy said the research team recognized that accused criminals often refuse to speak with the media at their counsel’s advice, but it does not change the fact black immigrant offenders are disproportionally represented in the coverage.

The study urges the Canadian media to treat HIV non-disclosure as a health issue and not simply a crime story; to stop using mug shots that further stigmatizing and discriminate people with HIV as criminals; and to reach out to AIDS service organizations when interviewing sources for these stories.

Published in The Star, on Dec 1, 2016

HIV Criminalization: Masking Fear and Discrimination (Sero, US, 2016)

A short documentary for the Sero Project produced by Mark S King, written by Christopher King, and edited by Andrew Seger.

Canada: New report explores mainstream Canadian newspaper coverage of HIV non-disclosure criminal cases, highlighting stigmatizing representations of African, Caribbean and Black men living with HIV

Abstract:

This report explores mainstream Canadian newspaper coverage of HIV non-disclosure criminal cases in Canada. It pays particular attention to how defendants’ race and immigration status figure into the newspaper representations of such cases. We empirically enquire into claims that African, Caribbean and Black (ACB) people living with HIV are negatively portrayed and overrepresented in Canadian newspaper stories about HIV non-disclosure cases. Our analysis is based on what, to our knowledge, is the largest data set of news coverage of the issue: a corpus of 1680 English-language Canadian newspaper articles about HIV non-disclosure criminal cases in Canada written between 1 January 1989 and 31 December 2015. Our quantitative and qualitative findings show that Canadian mainstream newspapers are a source of profoundly stigmatizing representations of ACB men living with HIV. For example, Black immigrant men living with HIV are dramatically overemphasized in Canadian mainstream newspaper stories about such cases. While these men account for only 15% of defendants charged they are the focus of 61% of newspaper coverage. Mainstream newspapers rely on forms of language that transfer a long history of exaggerated connections between criminality, race, sex, and otherness to the site of HIV. The result is that ACB men living with HIV are repeatedly represented as dangerous, hypersexual, foreigners who pose a threat to the health and safety of individuals (White women) and, more broadly, the imagined Canadian nation.
The report is available to download here

 

Czech Republic: Police drop charges against all 30 gay men living with HIV following Prague Public Health Authority ‘witch hunt’

All criminal charges have been dropped against the 30 gay men living with HIV who were reported to the police by the Prague Public Health Authority earlier this year after they were diagnosed with an STI, Czech media report today.

The draconian behaviour of Prague Public Health led to widespread condemnation by human rights defenders.

A change.org petition initated by the European AIDS Treament Group (EATG) was signed by more than 1000 supporters, including the HIV Justice Network.

Today’s media report in Aktuálně.cz notes that three of the 30 men had been indicted for potential HIV transmission (under a law criminalising ‘the spread of infectious human diseases‘) but prosecutorial authorities withdrew the charges due to lack of evidence.

Police spokesman, Jan Danek, told the paper that following an investigation there was no case to prove against any of the 30 men and all charges had been dropped.