Uganda: Female lawmakers propose compulsory couples testing to counter proposal for mandatory testing and disclosure to partners of pre-natally tested women in draft HIV law

Female lawmakers have proposed amendments to the controversial 2010 Prevention of HIV/Aids Bill, which if adopted, will make it compulsory for male partners to test for HIV/Aids with their spouses during antenatal care visits. The MPs also proposed that negligent health workers who cause the transmission of HIV/Aids to others while in their line of duty be liable to a five-year jail penalty. The Bill, which seeks to criminalise people who intentionally infect others with HIV/Aids, is before the Parliamentary Aids Committee for consideration.

The Committee began fresh consultations on the proposed law yesterday after the 8th Parliament failed to pass it. The MPs, in consultation with the hospices of the Uganda Network on Law, Ethics and HIV/Aids , during a workshop yesterday said women have always fallen victims of sexual offences. They say many men have not been going for routine HIV/Aids counselling and testing with their spouses.

Ms Betty Amongi, the Uganda Women Parliamentary Association chairperson, said the proposed law mandates health workers to disclose the status of tested pregnant women to their husbands. “In order to prevent domestic violence and ensure stable marriages, we are proposing that both couples must test together so that they jointly receive the results,” Ms Amongi said.

Ms Amongi said women shy away from attending antenatal clinics for fear of losing their marriages if their status is disclosed to their spouses without them testing together. Ms Noreen Kareeba, the founder of The Aids Support Organisation, urged the government to invest in voluntary testing and purchase of ARVs. Currently, the Ministry of Health programme for prevention of Aids requires that tests are conducted for pregnant women to reduce the risk of being abused.

Greece: Scientists and human rights campaigners condemn the reinstatement of Provision 39A allowing forced HIV testing of suspected sex workers, drug users and undocumented migrants

Reinstatement of controversial Health Provision slammed by HIV and Human Rights Groups, by Zoe Mavroudi

[Republished from the radiobubble blog, with thanks to Zoe Mavroudi]

A legal provision that led to mass arrests of HIV-positive women in Greece in 2012 has been reinstated, causing widespread condemnation by local and international organizations and human rights advocates.

Provision No 39A was voted by former socialist Health Minister Andreas Loverdos in April 2012 and led to an unprecedented case of HIV criminalization a few weeks later when the Greek police in cooperation with the country’s Center for Disease Control and Prevention, KEELPNO, rounded up hundreds of women from the center of Athens and force-tested them for HIV inside police stations. A total of 30 who tested positive were imprisoned on charges of felony and prostitution, in spite of a lack of significant evidence that they had been working as prostitutes or that they had infected anyone with the virus. Their mug-shots and personal data were then published upon order by a prosecutor on the Greek police website as well as on major TV channels.

The arrests prompted an international backlash against the Greek government when organizations like Amnesty International, Human Rights Watch, the European AIDS Treatment Group and UNAIDS called for the withdrawal of laws that enabled the targeting of HIV-positive people labeling them unproductive and in violation of international conventions.

The women were held in prison for a months-long detention period under inhumane conditions. The charges have since been dropped or reduced in the courts. After months of negotiations following Loverdos’ exit from the government and socialist PASOK party, non-governmental organizations and activist groups in Greece scored a victory in May 2013, when former Deputy Health Minister Foteini Skopouli finally repealed the provision.

The move was welcomed as a step toward correcting the damage inflicted on the country’s medical services by the 2012 arrests. Drug rehabilitation groups, which have been hit hard by austerity cuts, have repeatedly complained that the arrests had serious implications in the exercise of their outreach work among vulnerable groups.

But last Tuesday, newly-appointed health minister Adonis Georgiadis (pictured above), formerly a member of the far-right LAOS partly and currently a New Democracy majority party MP, reinstated the provision unexpectedly, the day after his swearing-in ceremony that followed a cabinet reshuffle of the country’s coalition government. In a short announcement, KEELPNO welcomed the reinstatement citing a necessity to “cover the country” until revisions to the provision were agreed on. Georgiadis addressed the reinstatement on twitter, saying the repeal by Skopouli had left a “legal void.”

But the legal grounds upon which the provision was voted into law were questionable. Last year, Loverdos signed 39A alone, in spite of a legal requirement for a minimum of four official signatures in order for a provision to be enacted into law.

At the time, he claimed that its content had originated in a 1940 regulation, which allowed for sanitation measures in public places for the protection of public health. However, new language included in 39A, pointed at immigrants, homeless people, intravenous drug users and sex workers as possible sources of epidemics. 39A also cited a need to perform mandatory tests on individuals from these groups as part of controlling diseases that are currently not endemic in Greece, such as malaria, polio and sexually transmitted diseases, including HIV.

Greece has seen a spike in HIV infections among injecting drug users during the crisis, mostly in the country’s capital, although there is no official data on a significant rise among sex workers or undocumented immigrants. Men who have sex with men remain the main population group that suffers most of the country’s new HIV infections.

In spite of citing a need for mandatory testing, the provision is also unclear about the nature of measures that the police and health authorities should take in order to test individuals without their informed consent. A law-suit has been brought by some of the women arrested in 2012 and by Greek NGOs against police officers present in the arrests as well as KEELPNO doctors for sharing test results with the police and violating patient confidentiality.

Calls to take back the measure came from abroad almost immediately after the reinstatement was announced. In her closing speech at the annual convention of the International Aids Society in Kuala Lumpur on Wednesday, French Nobelist Françoise Barré-Sinoussi, the scientist accredited with co-discovering the HIV virus, expressed her “strong disappointment.”

“As President of the IAS I strongly condemn this move and urge the Greek Government to rethink its position. HIV infections are already increasing in Greece due to the economic crisis and a mandatory policy of detainment and testing will only fuel the epidemic there.” Barré-Sinoussi added: “As we keep repeating over the years, there will be no end to the HIV epidemic without advancing human rights in parallel.”

Sinoussi’s concerns were echoed in a damning announcement by Human Rights Watch, which called the reinstatement “a big step backward for human rights and public health.“

“Addressing infectious diseases such as HIV, hepatitis, and tuberculosis requires investing in health services, not calling the police. If the government is serious about addressing HIV and other infectious diseases, it should focus on access to health care and public information,” wrote HRW in a statement earlier this week. “Any detention for public health reasons must have a lawful basis, be demonstrably necessary and proportionate, and be nondiscriminatory. Anyone detained, irrespective of the grounds, is entitled to guarantees of due process.”

On their part, local Greek NGOs and human rights initiatives saw the reinstatement as a betrayal of their year-long battle for its repeal. HIV NGOs and LGBT and human rights initiatives chided the new leadership in a joint statement, for ignoring the unanimous decision that prompted its repeal as well as the recent report by the Greek Ombudsman citing the provision’s unconstitutionality.

“We cannot allow the implementation of practices that lead our society to the Middle Ages,” the statement by Positive Voice, Center for Life and Praksis, among other groups, said. “Access to free and public health services, access to medical coverage and a respect for human rights are non-negotiable for us. Since the leadership of the Health Ministry obviously does not share this view, we have a responsibility to make it clear with our actions.”

Protests against the reinstatement of 39A are continuing with a gathering outside the Ministry of Health in Athens [on Monday July 8th].

Latest update July 16th: Greek Health Minister says he will not repeal health provision that led to forced HIV tests, says he welcomes proposals.

In a Parliamentary question to Minister Georgiadis on Friday July 12, SYRIZA opposition party MP Vassiliki Katrivanou asked for a new repeal of the provision. On the same day, four Greek NGOs (Positive Voice, Praksis, Act Up Hellas and Center for Lsife) said in a joined announcement that they requested that a health committee assigned by Georgiadis with negotiating changes to the provision provide them with documentation that substantiates the urgency of the provision’s recommendations to protect public health, before they can return to the negotiations.

Read more here

A new documentary produced by radiobubble about the 2012 arrests called “Ruins: Chronicle of an HIV witch-hunt,” is due for release this September. It features interviews by women who were arrested and their families. You can watch a trailer here:

US: Sero Project and Transgender Law Center highlight the threat to transgender health created by HIV criminalisation

People living with HIV (PLHIV) who identify as transgender or third sex are more likely than any other group to feel that it is reasonable to avoid HIV testing (58%), disclosure of one’s HIV positive status to sex partners (61%) or accessing HIV treatment (48%) because of fear of HIV criminalization and distrust of the U.S. criminal justice system. The new findings from the National HIV Criminalization Survey were presented at the National Transgender Health Summit on May 15, 2013.

“These findings don’t surprise us,” said Cecilia Chung, Senior Strategist at the Oakland, California-based Transgender Law Center. “The data speaks to the long-standing history of stigmatization and discrimination of trans people, especially trans people of color, by the criminal justice system, because of either their race or their gender identity.” Chung was the first trans woman elected to chair the San Francisco Human Rights Commission, and she is currently a board member of the Global Network of People Living with HIV (GNP+).

More than 3,000 people living with and affected by HIV participated in the National HIV Criminalization Survey from June to August 2012, conducted online by the Sero Project in conjunction with Eastern Michigan University. The principal investigator, Laurel Sprague, is the Sero Project’s Research Director, Regional Coordinator of GNP+ North America, and a PhD candidate at Wayne State University in Detroit, Michigan.

Sprague noted, “Laws that criminalize non-disclosure of HIV status raise key issues about community norms, expectations of fair treatment by authorities, privacy and the increased vulnerability of certain communities.”

While the results revealed that HIV criminalization can discourage HIV testing—nearly 25% of HIV-positive respondents said that they knew one or more people who did not get tested for fear of criminal prosecution—when researchers returned to the survey results to closely examine transgender and third sex responses, they found that these particular respondents faced increased levels of vulnerability in relation to the U.S. justice system.

The majority of transgender and third sex respondents living with HIV (57%) reported that they feared false accusations of non-disclosure either a few times or frequently—a figure higher than that of any other group surveyed. Only 14% of transgender and third sex respondents living with HIV felt that a U.S. person living with HIV could get a fair court hearing if accused of non-disclosure.

When transgender and third sex respondents were asked their opinions about HIV criminalization, two out of three respondents (67%) said that non-disclosure of HIV status should not be criminalized. When asked if a sex worker living with HIV should disclose to clients, most transgender and third sex respondents (41%) said it depends on the circumstances. In fact, transgender and third sex respondents were the most likely to focus on the context (“it depends on the circumstances”) when determining whether there should be criminal charges for non-disclosure related to sex, drug use or sex work.

The transgender community’s historically fraught relationship with public health authorities, law enforcement and the criminal justice system also likely affects transgender and third sex attitudes about HIV criminalization.

Sprague shared a range of quotes from the survey to illustrate various nuanced transgender and third sex experiences and opinions regarding HIV criminalization:

• One trans woman explained why she didn’t press charges for non-disclosure: “In order to file charges, I [would have] had to disclose my rape, my [HIV] status and I would have to give up my privacy and be subjected to public scrutiny.”

• A third sex respondent said, “I think in cases of rape, incest and other power- or force-related situations, prosecutions should go forward. Otherwise, NO!”

• Another trans woman said that she didn’t press charges for non-disclosure because of the “difficulty in proving in court that he had infected me—and also accepting that we took equal risk in being intimate without protection.”

For policy makers and public health workers, the transgender and third sex responses to Sero’s National HIV Criminalization Survey should raise concern, especially the survey results that show increased barriers to HIV testing and treatment, as well as deep feelings of legal vulnerability due to HIV criminalization.

The responses highlight a critical need for access to legal education and legal services, safe and confidential locations for accessing health care, and support for spaces where transgender people living with HIV can share their experiences, provide mutual support, and work together to identify resilience strategies and advocacy priorities.

UNAIDS launches first-ever Judicial Handbook on HIV, Human Rights and the Law: Interview with UNDP's Mandeep Dhaliwal

The meeting also looked at specific actions that can be taken by Judges, to create a more supportive environment for people with HIV and key populations that are at-risk. UNAIDS also launched the first-ever Judicial Handbook on HIV, Human Rights and the Law at the meeting.

UNDP releases collation of progressive jurisprudence on HIV, Human Rights and the Law

The Compendium of Judgments, HIV, Human Rights and the Law, is a collation of progressive jurisprudence on HIV-related matters that highlights how the law has been used to protect individual rights. The compendium presents a user-friendly compilation of judgments from different national and regional jurisdictions.

UNDP releases report highlighting experiences and lessons learned from national HIV laws in Asia and the Pacific

This report is a direct follow-up to Global Commission on HIV and the Law: Risks, Rights and Health (July 2012) and the Asia-Pacific Regional Dialogue of the Global Commission on HIV and the Law convened in Bangkok in February 2011.

Positive Women: Exposing Injustice

(45 min, Canadian HIV/AIDS Legal Network, Canada, 2012)

Positive Women: Exposing Injustice is a 45-minute documentary film that tells the personal stories of four women living with HIV in Canada — a Quebecker who was charged for not telling her partner that she had HIV at the beginning of an ultimately abusive relationship, a young woman who chose not to pursue charges against the man who infected her, an Aboriginal woman who has personally faced extreme stigma and threats, and a Latina woman who describes the challenges of disclosure and intimate relationships for women living with HIV. Their stories are real, raw and from the heart, and tell the truth about what it’s like to live in a society that all-too-often criminalizes intimate behaviour between consenting adults and discriminates against those living with HIV. Legal experts, doctors, counsellors and support workers also lend their voices to challenge current Canadian laws that are letting down the very women they are meant to protect.

Produced and Directed by Alison Duke
Directors of Cinematography: Kim Derko and Robin Bain
Camera: Sean Black and Richard Chong
Composer and Sound Mixing: Derek Brin
Editor: Eugene Weis
Co-producers: Janet Butler-Mcphee, Cécile Kazatchkine and Alison Symington
Executive Producer: Canadian HIV/AIDS Legal Network

Bahrain: Proposed law would require people with HIV to obtain judges' permission to marry

Bahrain citizens suffering from a hereditary or incurable disease – such as sickle cell anaemia, HIV, and hepatitis – will need to get permission from the courts to get married under a new draft bill currently being considered by the government, it has been reported. Under the current law, in place since 2004, it is compulsory for all engaged couples to get a certificate from the Health Ministry that states they have undergone premarital check-ups, where they are tested for hereditary diseases such as sickle cell anaemia and thalassaemia, and incurable diseases like HIV, and hepatitis.

While the outcome of the check-ups does not currently restrict them from going ahead with the marriage, a new bill could mean those who test positive for any of the hereditary or incurable diseases will need to get permission from the courts to pursue the marriage, according to a report by Gulf Daily News. A draft of the law is now before the National Assembly for revision. However, the Supreme Council for Islamic Affairs has already objected to the move and said it was against Sharia Law and basic human rights to stop anyone marrying someone they want to on the grounds of their health conditions. A doctor who is behind the proposal reportedly said “it was essential for judges to take the decision in such cases to prevent emotions from getting in the way.”

Botswana’s draconian Public Health Bill approved by Parliament, BONELA will challenge it as unconstitutional once President signs into law (Update 3)

Update: April 5th 2013

Very disappointing news from Botswana. The Public Health Bill – including all of its draconian provisions on HIV – has been approved by Parliament.

BONELA issued this press release last week just prior to the vote.

MEMBERS OF PARLIAMENT (MPs) ARE THE ONLY ONES WHO CAN SAVE US FROM THE PROPOSED PUBLIC HEALTH BILL…..IT IS IN THEIR HANDS

We knew that the Public Health Bill will be back in Parliament for further debate. However, we had anticipated that the Ministry of Health would heed calls made by stakeholders such as BONELA, UNAIDS, WHO, SALC, AIDS Alliance, ARASA, Ditshwanelo and other concerned Batswana and make amendments to the bill, particularly on the controversial, offensive and invasive provisions.

To our utter shock, the Ministry of Health intends to make no changes to the bill at all; even with the benefit of information on best practices availed to them. This to us; is a clear case of indifference and a deliberate plan to violate people’s rights.

BONELA and its stakeholders have done all that is possible to raise awareness, especially to the general public who would be affected by this law. It is now up to MPs to propose and vote on the amendments.

If MPs fail or decide not to discharge that constitutional mandate, as concerned stakeholders, we would know that our MPs are happy to see people’s rights being violated-that they are happy to see Batswana being tested for HIV without their consent, happy to give doctors sole mandates on deciding when and what to do with patients without consultations.

We would also know that MPs by failing to do their duty are happy to see litigants in court pleading not to be tested for HIV because their government want them to. Moreover, we would know that our MPs are happy to place responsibilities of sexual matters ONLY on those who are HIV positive by agreeing with forceful disclosure to all potential sexual partners by people living with HIV even if they are using protection.

Lastly, our MPs will be happy to see that whoever seeks dental services is required to do an HIV test before such services are meted.

It is therefore, in the hands of MPs to exercise their power to propose and vote for a sound Public Health bill. It is in your hands……

According to this APA piece, published on Wednesday, the Bill was approved by parliament. BONELA is now waiting for Botswana President, Ian Khama, to sign the Bill into law before it can approach the High Court to challenge the offending clauses as unconstitutional.

Botswana’s Health Minister, Dr John Seakgosing on Tuesday said the Public Health Bill, which seeks among other things, to isolate people who infect others with sexually-transmitted diseases such as HIV/AIDS, while knowing their status, will apply to Members of Parliament, cabinet ministers and even the president.

He explained to APA in an interview that the Bill that was passed last week, will not apply only to ordinary citizens.

According to Seakgosing, if the president, ministers and legislators are found to be infecting others carelessly, they will be brought before the courts where the magistrate will take a decision to isolate them from the public.

While he explained that the Bill does not seek to empower medical practitioners to force clients to undergo tests, but Clause 104 (3) (b) provides that “the director or a person authorised by him may where necessary and reasonable, require a person or a category of persons to undergo an HIV test”. Clause 104 (4) then provides that “where a person required to undergo a test under Clause 104 (3) refuses to do so, the director may apply to a magistrate for an order requiring that person to undergo the test.”

But some HIV/AIDS activists are up in arms saying the Bill will reverse the gains achieved in fighting the HIV scourge as it encourages discrimination.

AIDS advocacy group Botswana Network on Ethics Law and HIV/AIDS (BONELA) says it intends to take the government to court over the Public Health Bill that has been approved by parliament.

BONELA director, Uyapo Ndadi, said in an interview that his organisation is only waiting for President Ian Khama to sign the Bill into law before it can approach the high court to challenge certain clauses in it as they are unconstitutional.

Update: December 14th 2012

The Public Health Hill has been shelved until next February thanks to the advocacy against the “outrageous” HIV-related provisions (see below) spearheaded by the Botswana Network on Ethics, Law and HIV/AIDS (BONELA). That’s the good news this morning, according to Uyapo Ndadi, BONELA’s Executive Director:

I am happy to inform you that the outrageous Public Health Bill has been shelved, at least until next year February when parliament resumes business. Our collective advocacy has helped to thwart cabinet’s plans to have the bill passed into law during this sitting.

I am happy to further inform you that UNAIDS has also written to our government to remove the draconian provisions from the bill.

It is now hoped that in the intervening months, BONELA and other human rights advocates will add to the pressure created by UNAIDS to make the Government see that in order to save face internationally, they must either substantially rewrite the Bill or drop it completely.

Update: December 11th

Disappointing and worrying news today from BONELA:

Parliament yesterday voted in favour of passing the Bill from the 2nd reading stage to the Committee stage. Amendments to the Bill may be made at the Committee stage. It means that our efforts to get the Minister to withdraw the bill for lack of consultation have failed. Our hope now is that Parliament will remove from the bill the draconian parts of it.

A report in BOPA daily news highlights the debate yesterday

The Member of Parliament for Lobatse, Mr Nehemiah Modubule says he does not support the Public Health Bill in its current state. Debating the bill in parliament on Thursday, Mr Modubule said it should first be put into perspective, as some of the clauses are contradictory. He argued that they would have a hard time trying to amend such clauses if the bill passes to the committee stage. He noted that consultations with some stakeholders such as Botswana Network on Law and AIDS (BONELA) were not done. Furthermore, he said, the minister of health should have done justice to the bill by deferring it for further consultations, as some clauses touch on customs and practices of Batswana.

In his contribution, the MP for Moshupa, Mr Mokgweetsi Masisi supported the bill, arguing that prevention and control of diseases is not peculiar to Botswana, more so that new communicable diseases continue to emerge. Mr Masisi said the bill conforms to international practices in terms of public health, adding that consultations had been done and they should not delay the bill.

Original post: December 10th

On Friday, Botswana’s Parliament debated the proposed Public Health Bill which contains some shocking and regressive HIV-related provisions that, according to a strongly-worded press release from the Botswana Network on Ethics, Law and HIV/AIDS (BONELA) “have no place in a democratic and modern day Botswana..that are counter-productive, discriminatory, unconstitutional and barbaric.”

The relevant passages of the Bill are available to download here (Botswana Public Health Bill 2012.pdf, 1.4MB)

Some of the most problematic provisions as highlighted by BONELA, are below.

Clause 104 (3) b – empowering medical practitioners to force their patients to undergo HIV tests without their consent.

The Director, or any person authorised by him or her, may, where necessary and reasonable require a person or a category of persons to undergo an HIV test.

Clause 105 (2) b – empowering doctors to test patients without their knowledge.

A medical practitioner responsible for the treatment of a person may conduct an HIV test without the consent of that person where — (b) the medical practitioner believes that such a test is clinically necessary or desirable in the interests of that person.

Clause 109 (3) – allowing surgeons or dentists to test a patient for HIV before deciding on whether to carry out a non-urgent procedure.

Where, in the opinion of a medical practitioner, nurse or dental practitioner, the surgical or dental procedure is not urgently required in respect of a person, the medical practitioner, nurse or dental practitioner may require the person to undergo an HIV test before carrying out that procedure.

Clause 116 (1) – mandating HIV disclosure to all potential sexual partners or care giver and allowing prosecution for placing another at risk.

A person who is aware of being infected with HIV or is carrying and is aware of carrying HIV antibodies shall — (a) take all reasonable measures and precautions to prevent the transmission of HIV to others; (b) inform, in advance, any sexual contact or care giver or person with whom sharp instruments are shared, of that fact; and (c) not place another person at risk of becoming infected with HIV.

Clause 116 (7) empowering doctors to disclose their patient’s HIV status to their sexual partner without their consent.

A medical practitioner who is responsible for the treatment of a person and who becomes aware that the person has not, after a reasonable opportunity [disclosed their HIV status] may, after consultation with an approved specialist medical practitioner, inform any sexual contact or care giver of that person of the HIV or HIV antibody status of that person.

Clause 116 (9-12) – limiting the right to freedom of movement for people with HIV without sufficient legal checks and balances.

(9) The Director or any officer representing the Director may, in writing, apply to a magistrate for an order where the Director reasonably believes that a person infected with HIV — (a) is not complying with this Part; b) knowingly or recklessly places another person at risk of becoming infected with HIV without the knowledge of that person of the infected person’s HIV status; or (c) is likely to continue the behaviour referred to in paragraph (b). (10) For the purpose of subsection (9), a magistrate may make any or all of the following orders — (a) an order that the person infected with HIV undergo such medical and psychological assessment as the Minister determines; (b) an order imposing restrictions on the person for a period not exceeding 28 days; or (c) an order requiring that the person be isolated and detained by a person, at a place and in the manner specified in the order for a period not exceeding 28 days. (11) In making an order in respect of a person under subsection (10), a magistrate shall take into account the following matters — (a) whether, arid by what method, the person transmitted HIV; (b) the seriousness of the risk of the person infecting other persons; (c) the past behaviour and likely future behaviour of the person; and (d) any other matter the magistrate considers relevant. (12) The Director may, in writing, apply to a magistrate to renew an order made under subsection (10) for a further period or periods not exceeding 28 days.

According to BONELA, the Bill appeared from out of the blue without any public consultation.

We are concerned by government attitude and tendency of introducing Bills in Parliament and debating them before engaging all stakeholders, including the civil society and Batswana as a whole. We know that the Botswana Health Professions Council is not aware of this Bill for they have not been consulted on it. As custodians of health we expect them to be intimately involved as this Bill is going to affect the way they work. This bill is significant in the lives of all of us and we therefore call upon [Minister of Health] Reverend Dr. John G.N. Seakgosing [contactable via phone on +267313632521] to withdraw it and if he refuses to, we urge MPs to reject it.

Although the Bill was discussed last Friday – and a copy of the Bill obtained only then – Parliament adjourned before voting, but will continue this week. Action, therefore, is urgently required.

US: How well-meaning ideals of constitutional 'equality' are leading to a law that may be used to harass and control people with HIV in Kansas

A bill that a leading gay rights advocate says will lead to the harassment of people with AIDS appears headed toward approval. House Bill 2183 would repeal a 25-year-old law that prohibits state and local health officials from quarantining people with AIDS or HIV, the virus that causes AIDS.