Making Media Work for HIV Justice: An introduction to media engagement for advocates opposing HIV criminalisation now available in Spanish, French and Russian

Today, HIV JUSTICE WORLDWIDE has published “Making Media Work for HIV Justice: An introduction to media engagement for advocates opposing HIV criminalisation” in three additional languages: Spanish, French and Russian. [Click on the image to download the pdf]

The pMedia toolkit - Frenchurpose of this critical media toolkit is to inform and equip global grassroots advocates who are engaged in media response to HIV criminalisation–and to demystify the practice of working with, and through, media to change the conversation around criminalisation.

The toolkit provides an introduction to the topic of HIV criminalisation and the importance of engageMedia toolkit - Spanishment with media to change narratives around this unjust practice.

The toolkit also includes reporting tips for journalists, designed to educate writers and media makers around the nuances of HIV criminalisation, and the harms of inaccurate and stigmatising coverage.

Finally, the toolkit also includes a number of case studies providing examples of how media played a significant role in the outcome, or the impetus, of HIV criminalisation advocacy.

Media toolkit - RussianPositive Women’s Network – USA (PWN-USA), the HIV JUSTICE WORLDWIDE Steering Committee member organisation that produced the toolkit, has been working on HIV criminalisation for many years, and was an instrumental part of the coalition that brought HIV criminal law reform to the US state of California.

The original English version of “Making Media Work for HIV Justice: An introduction to media engagement for advocates opposing HIV criminalisation” along with the translations, were supported by a grant from the Robert Carr Fund for Civil Society Networks.

The new translations are the latest additions to the HIV JUSTICE Toolkit, currently available in English and French, and soon to be available in Spanish and Russian, which provides resources from all over the world to assist advocates in approaching a range of advocacy targets, including lawmakers, prosecutors and judges, police, and the media.

New report analyses the successes and challenges of the growing global movement against HIV criminalisation

A new report published today (May 29th 2019) by the HIV Justice Network on behalf of HIV JUSTICE WORLDWIDE provides clear evidence that the growing, global movement against HIV criminalisation has resulted in more advocacy successes than ever before. However, the number of unjust HIV criminalisation cases and HIV-related criminal laws across the world continue to increase, requiring more attention, co-ordinated advocacy, and funding.

Advancing HIV Justice 3: Growing the global movement against HIV criminalisation provides a progress report of achievements and challenges in global advocacy against HIV criminalisation from 1st October 2015 to 31st December 2018.

Although the full report is currently only available in English, a four-page executive summary is available now in English, French, Russian and Spanish.  The full report will be translated into these languages and made available later this summer.

The problem

HIV criminalisation describes the unjust application of criminal and similar laws to people living with HIV based on HIV-positive status, either via HIV-specific criminal statutes or general criminal or similar laws. It is a pervasive illustration of how state-sponsored stigma and discrimination works against a marginalised group of people with immutable characteristics. As well as being a human rights issue of global concern, HIV criminalisation is a barrier to universal access to HIV prevention, testing, treatment and care.

Across the globe, laws used for HIV criminalisation are often written or applied based on myths and misconceptions about HIV and its modes of transmission, with a significant proportion of prosecutions for acts that constitute no or very little risk of HIV transmission, including: vaginal and anal sex when condoms had been used or the person with HIV had a low viral load; oral sex; and single acts of breastfeeding, biting, scratching or spitting.

Our global audit of HIV-related laws found that a total of 75 countries (103 jurisdictions) have laws that are HIV-specific or specify HIV as a disease covered by the law. As of 31st December 2018, 72 countries had reported cases: 29 countries had ever applied HIV-specific laws, 37 countries had ever applied general criminal or similar laws, and six countries had ever applied both types of laws.

Cases infographic During our audit period, there were at least 913 arrests, prosecutions, appeals and/or acquittals in 49 countries, 14 of which appear to have applied the criminal law for the first time. The highest number of cases were in Russia, Belarus and the United States. When cases were calculated according to the estimated number of diagnosed people living with HIV, the top three HIV criminalisation hotspots were Belarus, Czech Republic and New Zealand.

Screenshot 2019-05-29 at 10.27.51The pushback

Promising and exciting developments in case law, law reform and policy took place in many jurisdictions: two HIV criminalisation laws were repealed; two HIV criminalisation laws were found to be unconstitutional; seven laws were modernised; and at least four proposed laws were withdrawn. In addition, six countries saw precedent-setting cases limiting the overly broad application of the law through the use of up-to-date science.

Screenshot 2019-05-29 at 10.29.06The solution

Progress against HIV criminalisation is the result of sustained advocacy using a wide range of strategies. These include:

  • Building the evidence base Research-based evidence has proven vital to advocacy against HIV criminalisation. In particular, social science research has been used to challenge damaging myths and to identify who is being prosecuted, in order to help build local and regional advocacy movements.
  • Ensuring the voices of survivors are heard HIV criminalisation advocacy means ensuring that HIV criminalisation survivors are welcomed and supported as advocates and decision-makers at all stages of the movement to end HIV criminalisation.
  • Training to build capacity Successful strategies have focused on grassroots activists, recognising that training events must be community owned and provide opportunities for diverse community members to come together, hold discussions, set agendas, and build more inclusive coalitions and communities of action.
  • Using PLHIV-led research to build community engagement capacity Research led by people living with HIV (PLHIV) provides a mechanism to engage communities to develop in-depth understanding of issues and build relationships, mobilise and organise.

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  • Using science for justice HIV criminalisation is often based on outdated and/or inaccurate information exaggerating potential harms of HIV infection. In addition, HIV-related prosecutions frequently involve cases where no harm was intended; where HIV transmission did not occur, was not possible or was extremely unlikely; and where transmission was neither alleged nor proven beyond a reasonable doubt.
  • Engaging decision-makers through formal processes Activists have worked to bring about legal and policy changes not only by lobbying local decision-makers, but also by engaging in other formal processes including using international mechanisms to bring HIV criminalisation issues to the attention of state or national decision-makers.
  • Acting locally and growing capacity through networks Many community organisations working to limit HIV criminalisation are actively supporting grassroots community advocates’ participation at the decision-making table.
  • Getting the word out and engaging with media Activists have employed diverse strategies to extend the reach of advocacy against HIV criminalisation including pushing the issue onto conference agendas, presenting messaging through video, working through digital media forums, using public exhibitions to push campaign messaging, and holding public demonstrations. Sensationalist headlines and misreporting of HIV-related prosecutions remain a major issue, perpetuating HIV stigma while misrepresenting the facts. Activists are endeavouring to interrupt this pattern of salacious reporting, working to improve media by pushing alternative, factual narratives and asking journalists to accurately report HIV-related cases with care.

Acknowlegements

Advancing HIV Justice 3 was written on behalf of HIV JUSTICE WORLDWIDE by the HIV Justice Network’s Senior Policy Analyst, Sally Cameron, with the exception of the Global overview, which was written by HIV Justice Network’s Global Co-ordinator, Edwin J Bernard, who also edited the report.

We would especially like to acknowledge the courage and commitment of the growing number of advocates around the world who are challenging laws, policies and practices that inappropriately regulate and punish people living with HIV. Without them, this report would not have been possible.

rcnf 346x228We gratefully acknowledge the financial contribution of the Robert Carr Fund to this report.

A note about the limitations of the data

The data and case analyses in this report cover a 39-month period, 1 October 2015 to 31 December 2018. This begins where the second Advancing HIV Justice report – which covered a 30-month period, 1 April 2013 to 30 September 2015 – left off. Our data should be seen as an illustration of what may be a more widespread, but generally undocumented, use of the criminal law against people with HIV.

Similarly, despite the growing movement of advocates and organisations working on HIV criminalisation, it is not possible to document every piece of advocacy, some of which takes place behind the scenes and is therefore not publicly communicated.

Despite our growing global reach we may still not be connected with everyone who is working to end HIV criminalisation, and if we have missed you or your work, we apologise and hope that you will join the movement (visit: www.hivjusticeworldwide.org/en/join-the-movement) so we can be in touch and you can share information about your successes and challenges.

Consequently, this report can only represent the tip of the iceberg: each piece of information a brief synopsis of the countless hours and many processes that individuals, organisations, networks, and agencies have dedicated to advocacy for HIV justice.

Suggested citation: Sally Cameron and Edwin J Bernard. Advancing HIV Justice 3: Growing the global movement against HIV criminalisation. HIV Justice Network, Amsterdam, May 2019.

Colombia: Constitutional court to examine whether the law criminalising HIV transmission is discriminatory

Source: El Tiempo, April 27, 2019 – Google translation, for article in Spanish, please scroll down.

Is Penalising HIV infection discriminating?

Should a person who transmit HIV or hepatitis B go to jail for 6 years? That is the debate that the Constitutional Court will have to settle in the coming days, by resolving a lawsuit against the law that criminalizes the transmission of these diseases.

The plaintiff considers that Article 370 of the Criminal Code violates the rights to equality and restricts the free development of personality, in particular, sexual freedom. This law establishes that there will be imprisonment of 6 to 12 years for those who, knowing that they have HIV or hepatitis B, “perform practices through which they may contaminate another person, or donate blood, semen, organs or, in general, anatomical components”

According to the lawsuit, this penalizes the fact that a person living with these diseases has sex, and makes it a crime regardless of whether preventive measures, such as antiretroviral treatments and others, are taken that make the transmission of diseases unlikely.

Thus, the plaintiff says that although the purpose of this mechanism is to protect public health, this does not justify prohibiting a population group from freely expressing their sexuality, and adds that there would be no harm when there are consensual relationships in which measures are taken to prevent infections.

On the violation of equality, the plaintiff says that the article only refers and penalizes people with HIV or hepatitis B, and not others with potentially contagious and sensitive diseases.

The debate is broad, in total the Court received 15 statements of opinion from different organizations, ministries, universities, and even the Constitutional Court of South Africa, to feed its considerations. And there are almost as many arguments in favour as there are against.

For example, the Colombian Anti-AIDS League supported the demand because it considered that rights were violated, adding that laws that criminalize exposure to HIV leave the burden of prevention to the people who live with it and said that the real challenges are more education and better access to medical testing services and counselling

The statement sent by Edwin Cameron, magistrate of the Constitutional Court of South Africa and who lives with HIV since 1985, points out the harm of criminalizing people living with HIV, as it increases the stigma and makes it harder for them to dare to seek medical help and prevention information

He also said that to resort to norms that criminalize HIV, the UN recommends to governments that they address only those who intentionally spread the virus and concluded that if the goal is to safeguard public health, it is more effective to have better prevention and care programmes.

The statement sent by the Ministry of Justice gives the plaintiff reason that the rule is discriminatory because it is directed only to people with HIV – who have also been recognized as subjects of special constitutional protection – or hepatitis B and adds that there is no justification for the rule to be for people with these two diseases and not for others who are aware of having different infectious-contagious diseases

However, with regard to the restriction on sexual freedom, the Justice Department considered that the rule “does not violate the right to the free development of personality, but is limited to establishing the criminal consequences resulting from its abusive and harmful exercise against the rights of other people and the community “ For all this, it asks the Court to study the lawsuit and decide.

The Ministry of Health indicated, on the contrary, that the rule does not violate either the right to equality or the free development of the personality, but rather that the demand is based on an inference from the plaintiff that this restricts sexual freedom, and therefore asks to leave the rule as it is.

The Attorney General agrees that the plaintiff interpretation is that the law punishes the fact of having sex even when there is no transmission of the disease, which, says the Public Ministry, is not true. For the Attorney General’s Office, the rule is clear that in order for the offense to be established there must be an intention to cause harm by carrying out practices that could end in transmission. Because of this, the reasons for the claim are not valid and the Court is being asked not to study it and declare itself inhibited

In any case, the decision will be made by the Court, the lawsuit was handed over to Judge Cristina Pardo, who has already made a presentation that will be debated in the next few days by the Court’s full chamber.

¿Penalizar el contagio de VIH es discriminar?

Demanda dice que tipificar la propagación del virus discrimina a personas con VIH o hepatitis B.

Por: María Isabel Ortiz Fonnegra

27 de abril 2019 , 08:00 p.m.

¿Debe ir a la cárcel por 6 años una persona que contagie a otra de VIH o hepatitis B? Ese es el debate que deberá zanjar la Corte Constitucional en los próximos días, al resolver una demanda contra la ley que penaliza la propagación de estas enfermedades.

El demandante considera que el artículo 370 del Código Penal vulnera los derechos a la igualdad y restringe el libre desarrollo de la personalidad, en particular, la libertad sexual. Esta ley establece que habrá prisión de 6 a 12 años para quien, sabiendo que tiene VIH o hepatitis B, “realice prácticas mediante las cuales pueda contaminar a otra persona, o done sangre, semen, órganos o en general componentes anatómicos”.

De acuerdo con la demanda, esto penaliza el hecho de que una persona que viva con estas enfermedades tenga sexo, y lo convierte en delito sin importar si se toman las medidas preventivas que hacen improbable la transmisión de enfermedades, como tratamientos antirretrovirales y otros.

Así, el demandante dice que aunque el fin de esta media es proteger la salud pública, esto no justifica prohibirle a un grupo poblacional expresar libremente su sexualidad, y agrega que no habría afectación cuando se tienen relaciones consensuadas en las que se toman medidas para prevenir contagios.

Sobre la vulneración a la igualdad, dice que el artículo solo se refiere y penaliza a personas con VIH o hepatitis B, y no a otras con enfermedades también potencialmente contagiosas y delicadas.

El debate es amplio, en total la Corte recibió 15 conceptos de diferentes organizaciones, ministerios, universidades, e incluso de la Corte Constitucional de Sudáfrica, para alimentar sus consideraciones. Y hay casi tantos argumentos a favor como los hay en contra. 

Por ejemplo, la Liga Colombiana de Lucha contra el Sida apoyó la demanda pues consideró que sí se vulneran los derechos, agregó que leyes que penalizan la exposición al VIH dejan toda la carga de la prevención a las personas que viven con él y dijo que los verdaderos desafíos son más educación y mejor acceso a servicios de pruebas médicas y consejería.

El concepto enviado por Edwin Cameron, magistrado de la Corte Constitucional de Sudáfrica y quien vive con VIH desde 1985, señala los perjuicios de criminalizar a las personas que viven con esa enfermedad, pues incrementa el estigma y hace más difícil que se atrevan a buscar ayuda médica e información sobre prevención. 

También dijo que de recurrir a normas que criminalicen el VIH, la ONU recomienda a los gobiernos que estas se dirijan solo a quienes intencionalmente propagan el virus y concluyó que si el objetivo es salvaguardar la salud pública, es más efectivo tener mejores programas de prevención y atención.

El concepto enviado por el Ministerio de Justicia le da la razón al demandante en que la norma es discriminatoria pues está dirigida únicamente a personas con VIH –que además han sido reconocidas como sujetos de especial protección constitucional– o hepatitis B y agrega que no se advierte justificación para que la norma sea para personas con esas dos enfermedades y no para otras que son conscientes de tener enfermedades infectocontagiosas riesgosas distintas. 

Sin embargo, frente a la restricción a la libertad sexual, la cartera de Justicia consideró que la norma “no vulnera el derecho al libre desarrollo de la personalidad, sino que se limita a establecer las consecuencias penales que acarrea su ejercicio abusivo y lesivo frente a los derechos de las demás personas y la comunidad”. Por todo esto, le pide a la Corte que estudie la demanda y decida.

El Ministerio de Salud indicó, al contrario, que la norma demandada no vulnera ni el derecho a la igualdad ni el libre desarrollo de la personalidad, sino que la demanda se basa en una inferencia del accionante de que esto restringe la libertad sexual, por lo que pidió dejar la norma tal y como está.

La Procuraduría coincide en que el demandante interpreta que la norma castiga el hecho de tener sexo aun cuando no exista transmisión de la enfermedad, lo cual, dice el Ministerio Público, no es cierto. Para la Procuraduría, la norma es clara en que para que se configure el delito debe existir una intención de causar daño realizando prácticas que podrían terminar en contagio. Por esto, las razones para la demanda se caen y le pidió a la Corte no estudiarla y declararse inhibida.

En todo caso, la decisión será de la Corte, la demanda le correspondió por reparto a la magistrada Cristina Pardo, quien ya hizo una ponencia que será debatida en los próximos días por la sala plena de la Corte.

US: Closing session of CDC's national HIV Prevention conference highlights stigma and HIV-specific criminalisation laws as barriers to improving outcomes in prevention and care

HIV Stigma in Focus at Closing Session of CDC’s National HIV Prevention Conference

HIV-related stigma and its impact on HIV-related health disparities were the topic of the final plenary session at CDC’s National HIV Prevention Conference. The March 21 session examined social and cultural factors that have contributed to stigma as well as efforts to combat the effects of HIV-related stigma on specific populations. Moderator Johanne Morne, director of the New York State Department of Health AIDS Institute, reminded the conference participants that stigma is an historic and continuing theme that must be addressed to improve outcomes along both the HIV prevention and care continuums.

HIV Stigma and What Can Be Done to Combat It

Greg Millett, vice president and director of public policy at amfAR, delivered the keynote address, “Progress: Same or Different? HIV Stigma at 37.” He noted that while many of the most extreme forms of stigma from the early days of the HIV epidemic have dissipated over time, inaccurate beliefs about the HIV risk of casual social contact persist.

Such stigmatizing beliefs are supported by societal factors such as HIV criminalization laws, Mr. Millett said. He pointed to the fact that 29 states still have HIV-specific criminalization laws on the books and while over 800 people have been prosecuted using these laws, none of the prosecutions were for any actual HIV transmission. He highlighted a CDC assessment that found that HIV criminalization laws have no detectable HIV prevention effect given there was no association with HIV diagnosis rates or AIDS diagnoses in states with such laws.

Further, he observed that not only are people with or at risk for HIV too often stigmatized, but the effective tools to prevent HIV such as PrEP are also stigmatized. A recent study found that individuals who experienced a high degree of stigma around their choice to use PrEP were 50% less likely to be on PrEP at their next clinical visit. Additionally, he pointed to syringe services programs (SSPs) that are known to reduce the risk of HIV transmission among people who inject drugs. Yet, stigma related to both HIV and people who use drugs limits public support for SSPs, limiting their expansion in many communities that could benefit from them, he said.

One factor that may enable this enduring stigma, Mr. Millett posited, is Americans’ lack of personal knowledge of people living with HIV. A Kaiser Family Foundation study found that only 45% of Americans say they know someone with HIV. To counter that, he encouraged more people living with HIV to be open about their status since that would contribute to stigma reduction. He also applauded creative efforts from the HIV community to combat stigma. These included public announcements by people living with HIV of their status on social media, anti-stigma campaigns, and even a series of social media videos about living with HIV.

Combatting HIV-related Stigma and Improving Outcomes for Specific Populations

A series of presentations followed, each discussing unique approaches to combating HIV stigma and offering recommendations on how to help reduce it to improve HIV prevention and care outcomes.

  • Daniel Driffin, co-founder of THRIVE SS, discussed building innovative, community-driven solutions to address HIV disparities among African American men living with HIV. Originally founded as a support group in Atlanta, the program has grown to an online platform that engages and offers support to more than 3,500 people across the southeast United States. Among THRIVE SS’s innovations are programs to re-engage and retain men in HIV care, a mental health group, and a photo campaign. Mr. Driffin shared results of a 2018 program participant survey that revealed that 92% of the men surveyed self-reported being virally suppressed. “Black men living with HIV are achieving viral suppression,” Mr. Driffin declared. “I challenge you to no longer say these men are ‘hard to reach.’” His advice for others seeking similar outcomes included: using the lived experiences of people living with HIV to inform HIV care and prevention, re-imagining everything, and supporting community-created approaches.
  • Omar Martinez, assistant professor at Temple University’s School of Social Work, examined HIV-related stigma among sexual and gender minority Latinx individuals. He observed that members of this community often experience stigma related to many aspects of their lives including culture, language, and immigration status, all of which impact their HIV risk. Dr. Martinez profiled several programs that have demonstrated success, including a number that engage non-traditional partners or that address legal and other needs. He advised stakeholders to focus on affirming models of care; to examine immigration status as a social determinant of health; and to continue to invest in the development and replication of “locally-grown” HIV prevention, treatment, and anti-stigma interventions that have proven effective.
  • Gail Wyatt, PhD, professor and director of the UCLA Sexual Health Program, discussed HIV stigma and disparities among African American women, reminding the audience of the importance of the inclusion of women’s perspectives in HIV prevention, care and treatment, and research. She discussed the impact of trauma on women’s health-seeking behaviors and treatment retention. She emphasized that an effective HIV response requires attention to holistic health, including mental health, to improve outcomes for women living with HIV. She also argued that some health care providers need to be re-educated about African American women given that many have biases about Black women that may hinder their delivery of effective health care services.
  • Cecilia Chung, co-director of programs and policy at the Transgender Law Center, shared her personal story as an Asian transgender woman living with HIV and discussed the power of personal storytelling to change hearts. She remarked, “Storytelling can help us get past differences, stigmas, and biases, and humanize individuals.” Being able to confidently tell one’s story affects the listener and also empowers the storyteller as they move forward on their path as a person living with HIV.

Dr. Eugene McCray, Director of CDC’s Division of HIV/AIDS Prevention, closed the session, thanking the participants from across the nation and the more than 500 of them who had shared results of their work with others in sessions, poster presentations, and exhibits during the conference. He noted that CDC was pleased to have been able to share more details of the Ending the HIV Epidemic Plan through several plenary session addresses and in a community engagement session. Implementing that Plan, he observed, will require ongoing dialogue and collaboration. With the powerful tools now available, the insights that data offer, leadership from all sectors, and community-driven and -developed plans, Dr. McCray indicated that he was confident that the nation could achieve the goal of reducing new HIV infections by 90% in ten years.

To view all or part of this plenary session, view CDC’s National Prevention Information Network video of Wednesday’s plenary session on their Facebook page .

Kazakhstan: Women living with HIV submit report to CEDAW, recommending repeal of HIV criminalisation provision in Kazakhstan penal code

Source: EWNA, published on March 11, 2019

For the first time, HIV+ women in Kazakhstan submitted a shadow report to CEDAW 

Today in Geneva, at the pre-sessional working group of the 74th meeting of the UN Committee on the Elimination of All Forms of Discrimination against Women (CEDAW) , representatives of the community of women living with HIV, women who use drugs and sex workers from Kazakhstan presented for the first time a shadow report from civil society on rights situations for women from key groups.

In July 2018, civil society organizations submitted the Shadow Civil Society Report on Discrimination and Violence against Women Living with HIV, Women Using Drugs, Sex Workers and Women from Prisons, to the UN Committee on the Elimination of All Forms of Discrimination against women. The report is based on studies of cases of violation of rights registered by non-governmental organizations in 2015-2017. The full report is available on the EZSS website, in Russian and English .

Here is the text of the oral statement presented by Lyubov Vorontsova, Kazakhstan Union of People Living with HIV (english text below):

“Thank you, Madam Chair.

I am a woman living with HIV from Kazakhstan and I represent the voices of women from my community.

We consider it extremely important to solve the problems of institutionalized discrimination that violates the rights of women and impedes access to health and social services, as well as contribute to social and economic vulnerability.

Women living with HIV have limited access to residential services in existing crisis centers designed to help women affected by violence. In the capital of Kazakhstan, a young girl with a child who was abused by her husband in winter is refused to be placed in an orphanage, since there is such a law and she has HIV. Article 118 of the Criminal Code of Kazakhstan provides for criminal penalties for putting people at risk of HIV infection, which has the opposite effect – this contributes to a higher risk of HIV infection, violence and gender inequality in the family, in the health care system, in society.

According to a study of the Stigma Index, 24.2% of women living with HIV, medical workers forced to terminate a pregnancy (abortion), 34% of women living with HIV never received advice on reproductive opportunities.

We recommend:

  • Revise Article 118. “Infection with Human Immunodeficiency Virus (HIV / AIDS)” of the Criminal Code of the Republic of Kazakhstan dated July 3, 2014 No. 226-V SA-RC to abolish the provision criminalizing the risk of acquiring HIV
  • To set up offices in crisis centers to work with drug addicts and HIV-positive women. Mobilize state efforts to expand the network of crisis centers and other emergency services for women who have experienced domestic violence, and to ensure adequate public funding for these institutions.
  • Introduce changes to the Order of the Minister of Health and Social Development of the Republic of Kazakhstan dated December 21, 2016 No. 1079 “On approval of the standard for providing special social services to victims of domestic violence”, limiting the possibility of women living with HIV in crisis centers.

Women who use drugs report the extreme prevalence of police brutality. Due to stigmatization, pregnant drug-addicted women cannot take advantage of necessary medical services, including drug treatment, antenatal care and post-natal care. Opioid substitution therapy is not available for women when they are hospitalized in any medical institution (including maternity hospitals, tuberculosis dispensaries, etc.).Immediately after childbirth, women are forced to travel independently to the substitution therapy program in order to receive drug support with methadone.

The rights of sex workers by medical personnel are violated, in particular, the humiliation of dignity, the infliction of physical and psychological violence, and the disclosure of HIV-positive status to third parties. For this reason, sex workers refuse timely diagnosis in medical institutions.

We recommend:

  • Develop and adopt a humanization policy for women who use drugs, laws and practices based on respect for human rights, which will protect and eliminate any discrimination and violence against women.
  • Include in the complex of preventive programs to combat HIV and AIDS at the local and national levels, training for police officers to reduce stigma and discrimination against women from vulnerable groups.
  • Actively investigate incidents of violence and any unlawful acts committed by law enforcement officers against sex workers, women who use drugs, and reported by public organizations.
  • Develop mechanisms for ensuring personal security and confidentiality that will allow women to report incidents of violence without fear for their safety.
  • Provide government funding for the provision of free family planning services, in particular contraception for marginalized and vulnerable women.
  • Provide training for medical personnel in providing quality sexual and reproductive health services for women living with HIV, sex workers and women who use drugs.
  • Include a substitution therapy program in the national health care system and drug practice, with further expansion and scaling in Kazakhstan, as well as develop mechanisms for access to treatment of opioid substitution therapy in hospitals (tub dispensary, maternity hospitals and others)

In Kazakhstan, there are no studies and disaggregated data in open sources regarding women prisoners. In the fifth periodic report, the state provides data on legislation that provides access to medical services for female prisoners. But this does not answer the question of whether it meets the needs of female prisoners.

We recommend:

  • Conduct research on the degree of satisfaction with women’s sexual and reproductive health services in places of detention, including data on women living with HIV and drug addicts, characterizing their access to antiretroviral treatment and drug treatment, including opioid substitution therapy. ”

ВПЕРВЫЕ ВИЧ+ ЖЕНЩИНЫ КАЗАХСТАНА ПРЕДСТАВИЛИ ТЕНЕВОЙ ОТЧЕТ В КЛДЖ

Сегодня в Женеве, на предсессионной рабочей группе 74 заседания Комитета ООН по ликвидации всех форм дискриминации в отношении женщин (CEDAW), представительницы сообщества женщин, живущих с ВИЧ, женщин употребляющих наркотики и секс-работниц из Казахстана, впервые представили теневой отчёт от гражданского общества о ситуации с нарушением прав в отношении женщин из ключевых групп.

В июле 2018 г. организациями гражданского общества был подан «Теневой отчет гражданского сообщества о дискриминации и насилии в отношении женщин, живущих с ВИЧ, женщин, употребляющих наркотики, секс — работниц и женщин из мест лишения свободы» в Комитет ООН по ликвидации всех форм дискриминации в отношении женщин. Отчет основан на исследованиях, случаях нарушения прав, зарегистрированных неправительственными организациями в 2015-2017 гг. С полным отчетом можно ознакомиться на сайте ЕЖСС, на русскоми английском языках.

Приводим текст устного заявления, которое представила Любовь Воронцова, Казахстанский Союз Людей, Живущих с ВИЧ (english text below):

«Спасибо, госпожа Председатель.

Я женщина, живущая с ВИЧ из Казахстана, и представляю голоса женщин из своего сообщества.

Мы считаем крайне важным решить проблемы институционализированной дискриминации, которая нарушает права женщин и препятствует доступу к медицинским и социальным услугам, а также способствуют социальной и экономической уязвимости.

Женщины, живущие с ВИЧ, имеют ограниченный доступ к услугам проживания в существующих кризисных центрах, предназначенных для помощи женщинам, пострадавшим от насилия. В столице Казахстана молодая девушка с ребенком, которая зимой подверглась насилию со стороны мужа, получает отказ быть помещенным в приют, поскольку существует такой закон и у нее ВИЧ. Cтатья 118 Уголовного Кодекса Казахстана предусматривает уголовное наказание за постановку в риск заражения ВИЧ, что имеет обратный эффект — это способствует более высокому риску заражения ВИЧ, насилия и гендерного неравенства в семье, в системе здравоохранения, в обществе.

По результатам исследования Индекс Стигмы 24,2% женщин, живущих с ВИЧ, медицинские работники принуждали к прерыванию беременности (аборту), 34% женщин, живущих с ВИЧ, никогда не получали консультацию по репродуктивным возможностям.

Мы рекомендуем:

  • Пересмотреть Статью 118. «Заражение вирусом иммунодефицита человека (ВИЧ/СПИД)» Уголовного кодекса РК от 3 июля 2014 года № 226-V ЗРК, чтобы отменить норму, устанавливающую уголовную ответственность за риск заражения ВИЧ.
  • Создать отделения в кризисных центрах для работы с наркозависимыми и ВИЧ-положительными женщинами. Мобилизовать усилия государства по расширению сети кризисных центров и других служб экстренной помощи женщинам, пережившим домашнее насилие, гарантировать адекватное государственное финансирование для этих учреждений.
  • Внести изменения в Приказ Министра здравоохранения и социального развития Республики Казахстан от 21 декабря 2016 года № 1079 «Об утверждении стандарта оказания специальных социальных услуг жертвам бытового насилия», ограничивающий возможность пребывания в кризисных центрах женщин, живущих с ВИЧ.

Женщины, употребляющие наркотики, сообщают о крайней распространенности жестокости полиции. Из-за стигматизации беременные наркозависимые женщины не могут воспользоваться необходимыми медицинскими услугами, в том числе наркологической, дородовой и послеродовой помощью. Опиоидная заместительная терапия не доступна для женщин при госпитализации в любые медицинские учреждения (включая родильные дома, противотуберкулезные диспансеры и т.д.). Сразу после родов женщины вынуждены самостоятельно добираться до программы заместительной терапии, чтобы получить лекарственную поддержку метадоном.

Нарушаются права секс-работниц со стороны медицинского персонала, в частности, унижение достоинства, причинение физического и психологического насилия, раскрытие ВИЧ-положительного статуса третьим лицам. По этой причине секс-работницы отказываются от своевременной диагностики в медицинских учреждениях

Мы рекомендуем:

  • Разработать и принять политику гуманизации в отношении женщин, употребляющих наркотики, законов и практик, основанных на уважении прав человека, которые обеспечат защиту и исключают любую дискриминацию и насилие в отношении женщин.
  • Включить в комплекс профилактических программ по противодействию ВИЧ и СПИД на местном и национальном уровнях обучающие мероприятия для полицейских о снижении стигмы и дискриминации по отношению к женщинам из уязвимых групп.
  • Активно расследовать случаи насилия и любых незаконных действий, совершенных сотрудниками правоохранительных органов против секс-работниц, женщин, употребляющих наркотики, зарегистрированных и сообщенных общественными организациями.
  • Разработать механизмы обеспечения личной безопасности и конфиденциальности, которые позволят женщинам сообщать о случаях насилия без страха за свою безопасность.
  • Обеспечить государственное финансирование на предоставление бесплатных услуг по планированию семьи, в частности контрацепции для маргинализированных и уязвимых женщин.
  • Обеспечить подготовку медицинского персонала по предоставлению качественных услуг по сексуальному и репродуктивному здоровью для женщин, живущих с ВИЧ, секс-работниц и женщин, употребляющих наркотики.
  • Включить программу заместительной терапии в национальную систему здравоохранения и наркологическую практику, с дальнейшим расширением и масштабированием в Казахстане, а так же разработать механизмы для доступа к лечению опиоидной заместительной терапии в условиях стационаров (тубдиспансер, родильные дома и другие)

В Казахстане отсутствуют исследования и дезагрегированные данные в открытых источниках в отношении женщин-заключенных. В пятом периодическом докладе государство приводит данные о законодательных актах, которые обеспечивают доступ к медицинским услугам для женщин-заключенных. Но, это не отвечает на вопрос о том, удовлетворяет ли это потребности женщин-заключенных.

Мы рекомендуем:

  • Провести исследования о степени удовлетворения услугами по сохранению сексуального и репродуктивного здоровья женщин в местах лишения свободы, включая данные о женщинах, живущих с ВИЧ и наркозависимых, характеризирующие их доступ к антиретровирусному лечению и наркологической помощи, включая опиоидную заместительную терапию.»

US: Five laws categorised as “bad” laws by the Human Rights Campaign in Missouri , including HIV/AIDS criminalisation laws

Missouri ranked in lowest category for LGBTQ protections, nondiscrimination

The Human Rights Campaign recently released their fifth annual State Equality Index — a state-by-state report detailing statewide laws and policies that affect LGBTQ people, assessing how well states are doing to protect LGBTQ individuals from discrimination.

This year, Missouri received the lowest rating, “High Priority to Achieve Basic Equality.” This rating is given to states that focus on raising suport for basic LGBTQ equality laws, such as non-discrimination laws, and for states focusing on municipal protections for LGBTQ people including opposing negative legislation.

Twenty-eight states earned this rating. Seventeen states earned the highest rating, “Working Toward Innovative Equality,” while the remaining five earned “Solidifying Equality” or “Building Equality.”

Karis Agnew, field director for PROMO, Missouri’s statewide LGBTQ advocacy organization, explained that they expected this rating for Missouri.

“It does not surprise me because there are basic protections that LGBTQ people lack in Missouri and those include protection of employment, housing and public accommodations,” Agnew said.

Missouri has a total of six laws that benefit LGBTQ people — hate crime laws, a college and universities non-discrimination law, a sexual orientation non-discrimination policy for state employees, an anti-bullying law specifically for cyberbullying, transgender inclusion in sports, and name and gender updates on identification documents for drivers licenses.

Missouri has five laws that the HRC categorizes as “bad” laws including HIV/AIDS criminalization laws, a state Religious Freedom Restoration Act, and transgender exclusions in state Medicaid coverage.

Missouri lacks all parenting laws such as parental presumption for same-sex couples, second parent adoption, and foster care non-discrimination. Missouri also lacks basic non-discrimination laws for employment, housing, public accommodation, education, adoption, foster care, insurance, credit, and jury selection.

The absence of youth laws in Missouri include anti-bullying laws, protection from conversion therapy, and laws to address LGBTQ youth homelessness. In the health and safety category, Missouri lacks laws including LGBTQ nondiscrimantion protections in Affordable Care Act exchanges, transgender healthcare coverage, and name and gender updates on identification documents for birth certificates.

Alex Padilla, co-president of Spectrum, an LGBTQ group at Missouri State Univerity, explained his fear regarding how few laws Missouri has protecting LGBTQ individuals like himself.

“Whenever I first came out, I was working at a fast food job and I was worried that I could be fired for who I was,” Padilla said.

He explained that he did a quick search online and found that there were no laws protecting him from being harassed or fired because of who he was.

Agnew, who prefers using gender-neutral pronouns, explained that although this rating is low, organizations like PROMO are working hard behind the scenes to make sure Missouri’s laws are progressing.

“When it comes to passing laws that are pro-equality, the thing that we really need the most to be able to do that is make sure that we don’t have bills that are anti-LGBTQ,” Agnew said.

Agnew explained that in 2018 five anti-LGBTQ laws were filed but PROMO worked to ensure zero made it to the governor’s desk to be signed.

“When those are filed, that is our priority, so it is really hard for us to file proactive legislation and pass proactive legislation when we have legislation that is harmful to LGBTQ people that we work so hard to prevent from passing,” Agnew said.

Agnew said a big reason why Missouri is far behind other states in passing pro-LGBTQ legislation is that Missouri legislators are not aware of what it is like to live as an LGBTQ individual.

“I think a lot of our legislators in Missouri honestly don’t know what it’s like to be LGBTQ — the majority of our legislators are not LGBTQ themselves,” Agnew said. “And because of that, I think a lot of them have a lot to learn from their constituents that are.”

Agnew said this year is the 21st year that PROMO has worked to file the Missouri Nondiscrimination Act, which would add protections for sexual orientation and gender identity in places of employment, housing and public accommodations.

“When their constituents aren’t bringing it up they assume it’s not important and not needed,” Agnew said. “The number one thing people can do is engage their elected officials and talk to them about why something like the Missouri Nondiscrimination Act is so important to them.”

Padilla explained how important it is for students to get involved.

“Help us lobby for equality, Padilla said. “Advocating for these things and showing that you are an ally is really helpful to all of Missouri and all of Missouri’s LGBTQ people.”

PROMO is hosting an “Equality Day,” a day of lobbying where people in the community come up to Jefferson City and talk to legislators about the Missouri Nondiscrimination Act on April 10.

Uganda: Mapping of the legal environment shows how the current criminal justice system discriminates against people living with HIV

Published in the Daily Monitor on Febraury 22, 2019

Report shows how laws discriminate against HIV positive people

KAMPALA- Various existing laws criminalise people living with HIV/ Aids, according to a new report released in Kampala on Thursday.

The report is titled: “Draft report on the assessment and mapping of the legal environment on provisions of HIV and TB services to let populations, persons living with HIV and tuberculosis”

“The existing legal framework is not favourable for some categories of the key, vulnerable and priority populations to freely access health services in Uganda. Specifically, the lifestyles sex workers, men who have sex with men, transgender persons and makes them most affected by the existing legal framework in Uganda,” read part of the report

It adds: “The laws criminalise sex work, same sex relationships and drug use. This results into violence, harassment, disappointment of sex workers and their legal recourse to address injustice against them.” “The other law, the HIV and Aids prevention and Control Act although not specifically targeting key vulnerable and priority populations, has implications for both the general affected by HIV in Uganda.”

The report indicates that the HIV and Aids Prevention and Control Act 2014 provides for voluntary HIV testing in Sub Section 9. However, the voluntarism is not considered if a person commits a sexual offense as part of the criminal proceedings and yet Section 8 provides for identity of a person tested with HIV not to be disclosed or released to any person except in accordance with the law and medical standards.

The report was carried out by civil society organisation Center for Health, Human Rights and Development (CEHURD) in conjunction with Aids and Rights Alliance for South Africa (ARASA).

The current criminal justice system is also discriminative as it hands down more deterrent jail terms to those suspects found to be living with HIV than their counterparts that are not.

Reacting to the aforementioned finding, a law professor at Makerere University, Prof. Ben Twinomugisha, explained that sometimes it’s prudent for the prosecution to take an HIV test of a suspect accused of committing a sexual offense for purposes of securing a conviction.

However, he was also quick to say that this compulsory HIV testing will lead to violation of their human rights and that this will drive those infected away instead of going to hospital to get medication.

“But a civil society organisation and I, have since petitioned court challenging Section 43 of the HIV Prevention and Control Act about criminalization of HIV,”  Prof. Twinomugisha said

“Why is it that a person suffering from Hepatitis B, which is more deadly than HIV are not subjected to a test when they commit a crime,” he wondered.

The study was carried out in three districts of Gulu, Mbarara and Tororo.

The study was mainly about the extent to which laws and policies protect and promote the rights of persons living with HIV/ Aids, let populations like sex workers, truck drivers and fishermen can access health care and services.

The HIV prevalence in Uganda stands at 6.2%. In 2016, approximately 1.4 million people were living with HIV and 28,000 Ugandans were estimated to have died of Aids-related illness.

Travel and long-stay restrictions for foreign nationals with HIV have no logical basis and have been deemed a human rights violation by the United Nations

Published in South China Morning Post on February 5, 2019

Visa restrictions for HIV-positive immigrants still in place in dozens of countries

  • Recent leak in Singapore of data of HIV-positive people renewed attention on its curbs on long-term stays by those who have the virus
  • Countries with restrictions include Russia and the United Arab Emirates; there’s no logical basis for them any more, UNAids says

A data leak of Singaporean medical records exposing the HIV-positive status of 14,200 people last month triggered concerns about a backlash for those whose health status was made public in a country that continues to stigmatise the disease.

But the case, involving the records of 8,800 foreign nationals who tested positive for HIV in Singapore, also shines a spotlight on the city state’s restrictive policies towards foreigners with HIV, who face barriers to staying in the country for more than 90 days unless married to a Singaporean national.

The records were leaked by a foreigner in just such a situation, American Mikhy Farrera Brochez, who was deported after serving jail time for drug-related crimes and fraud, including hiding his HIV status. He was able to access the records with help from his boyfriend, a Singaporean doctor.

Singapore is one of only a handful of developed nations that still have laws restricting the long-term stay of foreign nationals with HIV – laws that have been deemed a human rights violation by the United Nations.

“When this [1998] law was brought in there was a lot more fear of unknown issues around disease … but [today] the logic is just not borne out by any scientific or medical basis,” says Eamonn Murphy, UNAids regional director for Asia and the Pacific.

Instead, countries that still have such restrictions in place often do so because of “historical convention, ideology, or even passivity”, Murphy says. He notes that UNAids is renewing its focus on the issue this year, compiling a new report on national restrictions.

UNAids most recent comprehensive report on HIV-related travel and immigration laws in 2015 listed 35 countries with such restrictions.

However, incomplete data published in 2018 by UNAids named at least 18 countries that have policies restricting entry, stay or residence for people living with HIV. Information from many countries were left off the list, and will be updated this year to reflect the true extent. The same report found that 60 countries require testing for residence or other permits, including marriage, not limited to foreigners.

The exact numbers, however, are difficult to pin down, experts say. An independently researched global database counts 49 countries with HIV-related restrictions on long-term stay in 2018, based on information sourced from local embassies and reports from travellers and immigrants. Countries with restrictions include Russia, Singapore, and the United Arab Emirates.

“The data the countries present about themselves in diplomatic settings can be different from the policies that are actually executed,” says American epidemiologist Jessica Keralis, who has researched the public health impacts of such HIV-related restrictions.

For example, countries may not have regulations “on the books”, but employers can revoke visas for HIV-positive employees, or state insurance policy can make it difficult for immigrants to afford treatment, she says.

In other cases, official policy may not be known by regional or local officials and institutions.

These distinctions matter for HIV-positive immigrants, whether white-collar workers, migrant labourers or students, according to David Haerry, who publishes the Global Database on HIV-Specific Travel and Residence Restrictions, which names the 49 countries.

“Oftentimes people [sent abroad for work] don’t know and they fall in the trap: if you don’t know and you have to be tested on the ground, and then you are sent back on health grounds, your company knows,” he says. “It’s a big issue.”

Haerry receives daily emails through the database from people around the world wondering how to travel or relocate safely while living with HIV. In recent years, he’s seen restrictive policies become more of an issue for students looking to study abroad, but who fear the consequences of mandatory HIV testing even in countries where there is no explicit restriction on those who are HIV-positive.

For such situations, “we have no solution”, Haerry says.

Many national restrictions are holdovers from the 1980s, before the disease’s transmission was understood and the antiretroviral therapies and daily medications that can prevent its spread became widely available, according to UNAids’ Murphy. But he has seen progress globally.

A number of countries changed their policies after UNAids launched a 2008 campaign against the 59 governments that had bans at that time. The United States, South Korea and China were among the nations to remove restrictions in 2010, although South Korea retained some related to immigration, while China reportedly has mandatory HIV testing for some visas.

Singapore revised its own regulations in 2015 to allow people living with HIV to enter the country for short-term stays of less than three months, while South Korea in 2017 removed its final restriction, which mandated the testing of foreign teachers.

But conservative cultures, social stigma and inertia have kept some restrictions in play in other nations, experts say. The majority of such restrictions are found in conservative countries; more countries in the Middle East than anywhere else have them.

“The basis of discrimination is misconception and fear, and with HIV these boil down to drug use, men who have sex with men, and all these realities that countries don’t want to face,” says Peter Wiessner, who co-authors the global database. “There’s also xenophobia mixed in.”

That element can have a negative public health impact, according to Keralis.

“It communicates that HIV is a foreign contagion and a foreigners’ problem, and if [citizens] don’t mix with foreigners then they are not at risk,” she says. She notes that, paired with a lack of proper sex education, this can create a dangerous situation.

“There’s no incentive for people to seek more information or modify their behaviours,” she says.

Canada: Workshops find that HIV non-disclosure laws are little known amongst women living with HIV and contribute to social injustices

Published in aidsmap on February 4th, 2019

HIV non-disclosure laws perpetuate social injustices against women in Canada

Krishen Samuel
Published: 05 February 2019
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People living with HIV in Canada can be charged with aggravated sexual assault and be registered as sexual offenders if they do not disclose their HIV status, but many HIV-positive women have little knowledge of this law, according to a recent qualitative study. The law contributes to increased HIV-related stigma, social injustices and vulnerability to violence for women living with HIV, argue Dr Saara Greene and colleagues.

Forty eight women took part in seven arts-based workshops which each took place over a four-day period. Each workshop included an education session regarding the legal implications of non-disclosure, followed by a focus group discussion that allowed women to share thoughts, feelings and concerns regarding the law.

Canada is one of many countries that continues to criminalise non-disclosure of HIV positive status in sexual acts between consenting individuals. Transmission of the virus does not need to occur: a person can be prosecuted for exposure to the virus in the absence of transmission.

In 2012, the Supreme Court of Canada clarified its position on HIV transmission, ruling that people living with HIV are legally required to disclose their status to sexual partners before engaging in sexual activities that pose a ‘realistic possibility of transmission’. According to the Court, two combined factors could be used as a defense against this realistic possibility of transmission: a low plasma viral load (under 1500 copies/ml) and the use of a condom.

Thus, the law does not acknowledge biomedical advances that conclusively show transmission is impossible if the infected individual is virally suppressed (see our factsheet on undetectable viral load and transmission). The ruling leaves room for those engaging in condomless sex with an undetectable viral load to be prosecuted. In Canada, a charge of aggravated sexual assault could carry a maximum sentence of life imprisonment and registration on the sex offender registry.

A more recent 2018 federal directive issued by the attorney general states that a person living with HIV who has maintained a suppressed viral load (under 200 copies/ml of blood) should not be prosecuted, because there is no realistic possibility of transmission. However, this directive only applies in Canada’s three territories and not in the provinces where the vast majority of the population live. Advocates are calling on the provinces to issue similar directives.

The workshops were carried out in 2016 and 2017, in three Canadaian provinces (Ontario, Saskatchewan and British Columbia). The median age of participants was 47 (range: 30-59); the majority of women were Indigenous (60%), with only a small percentage of white women (8%). It was important for minority women to be oversampled as HIV prevalence is nearly three times higher in Indigenous peoples across Canada, with high rates of HIV diagnoses occurring in young Indigenous women. Additionally, 42% of women charged with HIV non-disclosure are Indigenous.

Most women were heterosexual (73%), cisgender (94%) and born in Canada (79%). One-third of women were single, with 29% reporting a common-law relationship.

Analysis of the focus group discussions revealed the following themes:

Confusion and concerns regarding the law

Overall, the education sessions revealed that women were largely unfamiliar with and poorly-informed about laws pertaining to non-disclosure. Questions and concerns were related to legal implications (such as a whether charges could be brought against them for exposure in the absence of transmission or for sexual interactions several years ago). Several women asked what it meant to have a low viral load.

Social and legal injustice

Women felt that the law perpetuates existing injustices in the lives of diagnosed HIV positive women. Thus, factors such as stigma, sexism, racism, colonialism and a lack of education might put those already disadvantaged at a higher risk of being criminalised.

“Like even this isn’t accessible or something understandable for some of my people because we have literacy issues. Some of our people, they left residential school at grade 6 and grade 8…” (Jaqueline, Saskatchewan, speaking about a legal factsheet given to participants)

A contradiction inherent in HIV non-disclosure criminalisation law is that while individuals who are unaware of their HIV status and have a high viral load are more likely to unknowingly infect others, these individuals cannot be prosecuted under Canadian law as intent cannot be proven. The women expressed that the law unjustly targets those who are diagnosed:

“…When I was first diagnosed, I had a higher viral load because I wasn’t being treated. And so actually the silent people who don’t know are more at risk of passing it on. So, who is this [law] even protecting? We are the least likely to pass it on.” (Lori, British Columbia)

As a result of assault laws being used in non-disclosure cases, a common sentiment expressed by women living with HIV was that they were carrying a biological weapon. Thus, HIV stigma was internalised, as a result of the legal system depicting women as capable of inflicting serious harm on their partners:

“…If I was going to go over there and stab [participant] with a knife, that’s aggravated assault. So, they’re taking that knife away and using HIV. I may not have given it to her. So, it’s like the knife never even touched her or the knife wasn’t used. I’m still charged.” (Rachelle, British Columbia)

Sexual surveillance

Participants expressed a sense that they were under surveillance by the criminal justice system when it came to their sex lives. In order to prove innocence, women would need to provide evidence of both a low viral load and condom use, or of disclosure.

The researchers labelled this an ‘intimate injustice’, with HIV-positive women needing to prove their innocence within an inherently unjust and oppressive system. The lengths that women would have to go through to prove this innocence is reflected here:

“So how many people do you have in that room? You have the lawyer that’s witnessing the paper that you’re signing that you’ve disclosed. You have the doctor to say, ‘Yeah, you’re under a viral load’. You’ve got the forensic scientist there getting any evidence. You know, everybody is watching.” (Lilian, British Columbia)

A common question related to undetectability was:

‘So when I look at it, I’m undetectable. So, I cannot transmit HIV to who I’m going to have sex with. So why is it any of their business that I have it when I’m undetectable?’

Another common question was how to prove that a condom was used or that disclosure had occurred after a sexual encounter had taken place. It could come down to a ‘he said, she said’ situation, with the HIV-positive woman needing some form of conclusive proof that she had used a condom or disclosed her status prior to engaging in sexual contact.

“Okay, so say I had a sexual partner. I just met this guy. And my CD4 count is 880. I’m undetectable. But I’ve got to tell him before we get into bed. Do I need to make him sign a document and lock it up and have it witnessed by the neighbor?” (Zainab, Ontario)

Vulnerability to violence

Non-disclosure laws may place women at greater risk for violence. As many as 80% of Canadian women living with HIV have experienced violence in adulthood and the requirement to disclose HIV status to sexual partners could increase the likelihood of intimate partner violence by placing women in a vulnerable position.

Women expressed that they do not always have control over when or how sex occurs with their partners; this negates their agency when it comes to negotiating condom use or disclosing their HIV status.

There was also the question of how disclosure applied in cases of domestic abuse and rape. The law would require women to disclose to abusive partners, placing them at risk of even more violence. The troubling nature of this was expressed in this quote:

“I was raped by three [people] in [Canadian city]. They broke into my home and they held me prisoner for 24 hours and beat me and raped me. And if I had told him I was HIV positive, I would have been dead. I know it. So where does that fit in the picture?” (Julie, British Columbia)

Additionally, the law could be used against HIV-positive women by vindictive partners wishing to ‘punish’ them. Many women had been threatened with charges for non-disclosure by disgruntled partners:

“Could they turn around and even if you’re honest and told them, then … they lied and said, ‘Well, I caught it from her’, or him. And they go to the police and get them charged, just out to be spiteful and mean.” (Catherine, Saskatchewan)

Concerns over violence were particularly salient for Indigenous women:

“When you include the Indigenous community and the numbers and statistics there, like we’re already like 10 times the rate of being gone missing, murdered and, you know, facing violence every day. So, when you throw in … you know, HIV, you know, like it just becomes sometimes not even safe. A lot of people stay in very vulnerable situations because of this law…” (Jaqueline, Saskatchewan)

Conclusion

The researchers conclude that for women living with HIV in Canada, non-disclosure laws can lead to unjust victimisation, perpetuating legal and social injustices. Many of the women did not have the necessary legal knowledge to fully understand the implications of their sexual behaviour to begin with. HIV-related stigma has become legally entrenched and results in women who are anxious about sexual encounters and fearful that they will need to find ways of proving their innocence. Non-disclosure laws may also lead to increased violence against women.

When combined with factors such as sexism, racism, colonialism and violence against women, HIV criminalisation results in continued oppression and thus, advocacy for legal reform is necessary and urgent. The recent federal directive is a step in the right direction but it will still take some time for this to filter down to provincial police and prosecutors.

Reference

Greene S et al. How women living with HIV react and respond to learning about Canadian law that criminalises HIV non-disclosure: ‘how do you prove that you told?’ Culture, Health & Sexuality online ahead of print, 2019. (Abstract).

Webinar: Media Strategy in HIV Criminalization Reform Efforts: After HIV Is Not a Crime III Series (PWN-USA, 2019)

For advocates working on campaigns to repeal or reform HIV criminalization laws in their states, the question about when it is and isn’t a good idea to seek press coverage, how to talk about the campaign to the press, and what options are available for controlling the message are all fundamental strategic questions. Positive Women’s Network-USA Communications Director Jennie Smith-Camejo talks strategy and best practices in this webinar based off the in-person breakout session at HIV Is Not a Crime III Training Academy in 2018 as part of the After HINAC III webinar series.