Spain: Supreme Court upholds nine year sentence for ‘reckless’ HIV transmission; BBC Mundo publishes analysis

Spain’s Supreme Court last week upheld a nine-year prison sentence for a man, known as ‘ABM’, who did not disclose his HIV-positive status to his former partner, who is now also living with HIV. Although the reports do not state under which general law he was prosecuted, it is likely to be Article 149 of the Criminal Code, grievous bodily harm.

According to a recent analysis of all previous cases that reached Provincial or Supreme Courts (1996-2012), Article 149 has used for similar cases, using the ‘state of mind’ of ‘dolus eventualis’ similar to concept of ‘recklessness.’ The nine year sentence is similar to two previous cases for alleged HIV transmission during otherwise consensual sex in Spain. (Sixteen sentences and 9 writs belonging to 19 cases were included in the analysis; 17 judged by criminal and two by civil jurisdictions – full text at the bottom of the page).

The Court’s judgment, dated December 4, 2014 but published last week, noted that that the Cantabria Provincial Court’s ruling was “sufficiently motivated” and dismissed ABM’s appeal which cited a violation of his right to the presumption of innocence and lack of credibility of his accuser, with whom he maintains a dispute over ownership of property.

The Supreme Court upheld the Provincial Court’s sentence of nine years in prison. He also has to pay his former partner compensation of 70,000 euros.

According to the judgment, cited in several Spanish language media reports (the most detailed of which was in 20 minutos), ABM was diagnosed in April 2000. In 2007 he began a romantic relationship with the complainant which lasted until 2012. It was alleged that ABM did not disclose to her that he was living with HIV despite having condomless sex. In 2011, she began to suspect that her partner may be living with HIV.

The Court found there was nothing to suggest that she was already HIV-positive when she arrived in Spain (from Peru), based on her own testimony, her medical history and her GP, although there is no mention of phylogenetic analysis being used to attempt to show a link between the viruses. The Court also noted that the woman is asymptomatic and on antiretroviral treatment.

BBC report and analysis

On Friday, BBC Mundo (the BBC’s Spanish language BBC World website) published a longer analysis of the implications of overly broad HIV criminalisation in Spanish-speaking countries. I was interviewed for the piece, and am delighted to report that the journalist, Leire Ventas, produced a very good, balanced report.

Below is an approximate English translation of the Spanish language original.

Should knowing transmission of HIV be a crime?

January 30, 2015

A jail sentence in Spain rekindles debate over whether criminal law should apply to people who transmit the human immunodeficiency virus.Spain’s Supreme Court upheld the sentence of nine years in prison for a man who hid his HIV positive status from partner, infecting her with HIV.

The Court did not admit the appeal filed by the defendant.

This appeal had alleged violation of the right to presumption of innocence and lack of credibility of the victim, who maintains a dispute over ownership of a property.

According to the facts in the case, the convicted man was diagnosed HIV-positive in April 2000 and began a relationship with the woman in 2007.

They were together until 2012.

According to the Court, during those five years the defendant hid that he was HIV-positive from his partner and had sex without protection.

In 2011, woman began to suspect that her partner may have the virus and subjected to analysis, which confirmed infection.

“Intentional transmission”

Given this statement of facts, the Court found that the defendant had deliberately concealed his condition and that was the reason it upheld the ruling.

In the same vein, intentional transmission is the only case in which the Joint United Nations Programme on HIV / AIDS, UNAIDS, considers appropriate to apply the criminal law to people who transmit HIV or expose others to the virus.

“That is, when the person knows their HIV-positive serostatus and acts with intent to transmit or indeed does transmit,” says the report Criminalization of HIV Transmission, 2008 and its revision in 2013 the agency told the BBC.

“If a person known to be HIV-positive acts with the intention of transmitting the virus and transmits it (…), the damage justifies punishment,” it adds.

“In other cases, legislators, prosecutors and judges should reject the application of criminal law”.

Other cases

According to UNAIDS, the law should not apply to cases where there is no “significant risk” of transmission or where the person did not know they were HIV-positive, did not understand how HIV is transmitted, disclosed their status to the person at risk, or did not for fear of violence.

And neither should the law be used against someone who took “reasonable steps” of protection to reduce the risk of transmission or who previously agreed with the other person “a level of mutually acceptable risk”.

Thus, the agency recommends that governments legislate specifically to prevent HIV and only apply general criminal law to cases of intentional transmission.

They should also “develop guidelines to limit the discretion of the police and prosecutors in the application” of criminal law.

And UNAIDS believes that the latter creates “a real risk” of increasing stigma and discrimination.

“It is very likely that prosecutions and convictions fall on members of marginalized groups such as sex workers, men who have sex with men and people who inject drugs,” it says.

Obligation to disclose

For that reason, the agency also recommends repealing the legal obligation to disclose one’s HIV status or that of others, in the case of health workers, that exist in some countries.

“Everyone has the right to privacy regarding their health and should not be required by law to disclose such information, especially when it may cause serious stigma and discrimination and possible violence.”

It considers inappropriate to enact laws criminalising mother-to-child transmission of the virus.

“Everyone has the right to have children, including women living with HIV,” said UNAIDS.

It adds: “When pregnant women are advised on the benefits of antiretroviral therapy, almost all access treatment”.

The position of Edwin Bernard, co-ordinator of HIV Justice Network, a network of advocates providing information and international legal policy advice on HIV criminalisation, is not far from the recommendations of the UN programme.

“The only cases where it is appropriate to apply the criminal law is when there has been intent and these are usually very rare,” he tells the BBC.

He stressed that “not disclosing you have the virus, and keeping it a secret is not the same as wanting to spread it.”

There are several reasons not to tell, according to the activist: stigma, violence, even denying the condition itself.

Awareness, not persecution

Therefore he believes that laws around HIV in countries should be aimed at raising awareness and support for the eradication of the disease, and not the prosecution.

Latin America is a region particularly aware of this, he says.

“It has a good record of understanding that with regard to HIV the law should support and not persecute”.

“There have been very few known cases of prosecution for HIV transmission in Latin America. Most have taken place in Brazil and under a general, not specific, criminal law”.

In Spain, by contrast, between 1996 and 2012, 19 legal [or civil] cases were recorded.

This is registered in the report Temporal trends, characteristics and evidence of scientific progress in legal complaints for alleged sexual HIV transmission: 1996-2012.

However, the country with the most prosecutions is the United States, where 30 states have specific legislation on HIV.

“After eight years following up the issue, I can say that judicial systems, prosecutors and judges do not understand how the science has advanced, how the life expectancy of those with the virus has increased. They should know that the risk of transmission is very low “, says Bernard.

For the activist, the ideal situation would be to only have one or two lawsuits per year related to the topic.

“The law should be used, for example, in cases of rape. But when sex is consensual and those involved are aware of the risks, responsibility should also be shared.”

F. Bolúmar-Montero, M.J. Fuster-Ruiz de Apodaca, M. Weait, J. Alventosa & J. Del Amo (2015) Time trends, c…

US: In depth interview with Ken Pinkela whose change.org campaign to review his unjust court-martial has more than 73,000 signatures

Bob Leahy: Thank you for talking to PositiveLite.com about your case. Now before we get in to that, I want you to tell me first your background. Ken Pinkela: Sure! Ken Pinkela is still a card-carrying Lieutenant Colonel in the (US) army.

US: Texas man who pled guilty to murdering woman after learning she had HIV sentenced to 50 years

A Lufkin man has accepted a 50-year prison sentence after pleading guilty to killing a woman after learning she had HIV after he had sex with her. Justin Welch, 23, entered the plea in District Judge Bob Inselmann’s courtroom. “Guilty,” Welch said. “Are you pleading guilty because you are guilty?” Yes sir,” Welch said.

Welch was arrested in June in San Antonio after the Angelina County Sheriff’s Office issued a warrant for his arrest for first-degree murder of Elisha Henson, 30. An arrest affidavit states Welch killed her after he learned she had HIV and they had already had sex.

According to another arrest affidavit, Welch’s co-conspirator, Rosalind Smith, told investigators the three of them were getting high on meth when Smith talked to Henson about her having HIV. Welch appeared to have heard the conversation and “appeared astonished to know” Henson had HIV. Smith told investigators that Welch later told her that Henson was dead. Smith is accused of disposing of the body in Rivercrest.

Smith is scheduled for jury selection on Jan. 20.

Welch’s Lawyer Al Charanza said that Welch was remorseful for what he did. But Hensen’s mom, Brenda Carrell, said the damage is done. After Welch pleaded guilty, Hensen’s mother gave her impact statement. “You have no heart.” Carrell said. “You are a killer in my eyes.You must pay for what you did. Elisha was a mother of two amazing boys, who today have a grave to visit.” “I am sorry,” Welch said.

China: Warranted fears of stigma and discrimination in healthcare settings resulting in people with HIV not disclosing their status

“I was so desperate, and I could not imagine the future if I was really infected,” Fu Yi (pseudonym), a maternity doctor at Sichuan Provincial People’s Hospital in Chengdu, recalled her feelings when she was exposed to HIV-infected blood during a birth in 2010.

Fu accidentally exposed her injured foot to the blood of the HIV-positive patient who was delivering a baby – Fu did not know the patient was HIV-positive, until the blood test results came out the next day.

Fu immediately started to take anti-AIDS emergency prevention pills. She suffered from the side effects, vomit and nausea, for a month, and lived in an abyss of fear for over half a year until she was eventually declared HIV free, she told the Global Times.

This incident was made public recently when the media began to report on the danger of exposure to infectious diseases that medical professionals face.

“We call [what Fu experienced] ‘occupational exposure,'” Xiang Qian, with the healthcare associated-infections division at Sichuan Provincial People’s Hospital, told the Global Times.

Occupational exposure for medical staff can be defined as coming into contact with infectious virus or toxic substances at work, which can pose health risks, according to Xiang.

Fu was not the only medical worker who has been exposed to infectious diseases at work. As of press time, there are no national statistics available, but in the hospital where Fu works a total of 122 medical staff reported being exposed to infectious diseases in 2013, including AIDS, hepatitis B and syphilis, according to Xiang.

From January to November this year, 88 medical workers, 43 percent of them nurses and 29 percent of them doctors, were exposed to infectious diseases at work. Hepatitis B topped the list, with 45 percent of the incidents of exposure involving the disease, followed by syphilis with 14 percent and HIV with 7 percent.

Among those infectious diseases that medical staff are exposed to, HIV is the most serious.

The risk is heightened as many patients do not disclose their HIV infection to physicians when being treated for other conditions. Meanwhile, many physicians do not take the kinds of precautions necessary to avoid becoming infected.

Concealment

Pregnant women usually go through a full blood test for possible infectious diseases before the delivery, and the result comes the day of the birth.

But in Fu’s case, the patient’s critical condition meant that she had to perform the delivery immediately, Fu said.

The patient’s family concealed her medical history and told Fu the patient had no infections. Fu, who had no time to take extra precautions, went into the operating room with an injured foot.

“From the doctor’s perspective, concealing infectious diseases is unfair,” Fu said.

But in some HIV patients’ eyes, disclosing their disease would jeopardize their access to healthcare as some hospitals may transfer them to designated infectious disease hospitals that offer inferior treatment.

Bi De, (pseudonym), 26, an AIDS patient who organized a debate in Shenzhen in November on whether HIV carriers should disclose their disease to doctors not treating their HIV, said he understood the ethical necessity to disclose one’s infections.

“But after my experience, I would not tell them [doctors] again,” Bi said. He first learnt he was HIV positive was two years ago when he went to a hospital in Henan Province to receive treatment for facial paralysis, and the hospital told him about his disease and transferred him to a designated hospital in Zhengzhou.

“But the infectious disease hospital did not have enough resources, and I finally recovered [from his paralysis]after visiting a Traditional Chinese Medicine doctor,” Bi said.

In another high-profile case that came to light last year, an HIV-positive cancer patient sued a Tianjin hospital that refused to treat his cancer due to his HIV. The case was the first well-known case of an HIV carrier suing a hospital for discrimination.

After hearing of the case, then vice-premier Li Keqiang [now premier] immediately called for better treatment of HIV/AIDS patients.

But the Tianjin Hexi District Court last week rejected the case as the plaintiff failed to provide a legal basis for his claims, according to Beijing-based newspaper The Mirror.

Chinese media has reported many cases of hospitals delaying or refusing treatment to HIV carriers despite the regulation issued by the State Council in 2006 which stipulates that clinics and hospitals should not refuse or delay treatment for HIV/AIDS patients.

According to Xiang, hospitals should only transfer patients to designated infectious disease hospitals when their conditions could pose public health risks, such as if they have SARS or bird flu.

Shao Yiming, an AIDS expert at the Chinese Center for Disease Control and Prevention, told the Global Times that hospitals are obliged to treat the diseases of HIV carriers.

“The HIV virus has a lower transmission level than many other infectious diseases such as hepatitis B. Why can they [doctors] treat [the disease] of hepatitis B carriers but not those of HIV carriers?” Shao said.

By the end of 2013, the number of people infected with HIV/AIDS hit 810,000 in China, according to the National Center for AIDS/STD Control and Prevention.

Shao suggested the country should put the related laws into practice while making more effort to promote knowledge of HIV/AIDS among medical staff and society.

Safety protection awareness

Xiang’s hospital laid out protection guidelines for medical staff to minimize their exposure to infectious diseases, but many are reluctant to adopt them.

“For example, some doctors following extra safety protection guidelines have to wear two sets of gloves, which they believe affect their surgical performance,” Xiang said.

Who should pay for the safety protection equipment in a long run is another headache for Xiang.

As the government subsidy does not cover it, hospitals that make an insufficient profit find it difficult to afford the equipment, he said.

“Some hospitals would not even pay for their medical workers to have a hepatitis B vaccine,” He said.

But Fu, who has performed gynecological surgeries on two HIV carriers after she was exposed, has been extra careful since the exposure.

“I wear special masks to prevent the blood splashing, safety protection suits, shoes and other extra safety protection equipment when I perform surgeries,” she said.

Canada: Judge rules that police violated constitutional rights by disclosing man's HIV status in press release

An Oshawa judge’s decision to sentence a man to house arrest for Internet child luring rather than jail because police publicly revealed his HIV status is the latest example of judges finding creative ways to manoeuvre around mandatory minimum sentences.

Former youth pastor Kris Gowdy was given two years less one day house arrest and three years’ probation last week by Ontario Court Justice Michael Block rather than the mandatory minimum sentence of one year in jail. Justice Block found Durham Regional Police violated Mr. Gowdy’s constitutional rights when they indicated in a news release shortly after his arrest in August 2012 that he was HIV-positive.

The story of the “HIV-positive ex-youth pastor” made headlines around the world, causing significant emotional trauma to Mr. Gowdy, Justice Block wrote in his decision.

“Mr. Gowdy had a right to make his own choices concerning the disclosure of his HIV status,” he wrote. “No doubt he would have chosen his own method and different timing if he ever determined to inform those near to him. Absent evidence of serious risk of transmission and rigorous compliance with statute, no one had the authority to make that decision for him.”

South Africa: Forced or involuntary disclosure in healthcare settings disproportionately affecting women resulting in discrimination and gender-based violence, despite constitutional protections

Editor’s note: This story is part of a Special Report produced by The GroundTruth Project called “Laws of Men: Legal systems that fail women.” It is produced with support from the Ford Foundation. Reported by Tracy Jarrett and Emily Judem.

An HIV diagnosis is no longer a death sentence, thanks to advances in medicine and treatment in the last 30 years. But stigma against HIV/AIDS and fear of discrimination still run strong in South Africa, despite legal protections, as well as drastically improved treatment, prevention techniques and education. Today an estimated 19 percent of South African adults ages 15-49 are living with HIV.

And women, who represent about 60 percent of people living with HIV in South Africa, face a disproportionately large array of consequences, including physical violence and abuse.

“Upon disclosure of women’s HIV positive status,” reads a 2012 study by the AIDS Legal Network on gender violence and HIV, “women’s lives change, due to fear and the continuum of violence and abuse perpetrated against them.”

Although forced or involuntary disclosure of one’s HIV status — along with any discrimination that may result from that disclosure — was made illegal by South Africa’s post-apartheid constitution, experts and advocates say that public knowledge of these laws is limited and the legal system is not equipped to implement them.

Not only are women disproportionately affected by HIV, but they are also more likely to know their status. More women get tested, said Rukia Cornelius, community education and mobilization manager at the NGO Sonke Gender Justice, based in Johannesburg and Cape Town, because unlike men, women need antenatal care.

And often, she said, clinics give women HIV tests when they come in for prenatal visits.

The way hospitals and clinics are set up also are not always conducive to protecting privacy, said Alexandra Muller, researcher at the School of Public Health and Family Medicine at the University of Cape Town.

“People who provide services in the public system, at the community level, are community members,” said Muller. “This is an important dynamic when we think about stigma and disclosure.”

Doctors and nurses can see 60 to 80 patients per day in an overcrowded facility with shared consultation rooms, Muller said.

“There’s not a lot of consideration for how is a clinic set up,” added Cornelius, so that “a health care worker who has done your test and knows your status doesn’t shout across the room to the other health care worker, ‘okay, this one’s HIV-positive, that file goes over there.’”

Once HIV-positive women disclose their status, willingly or not,they are disproportionately affected by stigma because of the direct link between HIV and gender violence.

Uganda: HIV Prevention and Management Act should be seen in context with Anti-Pornography Act, Anti-Homosexuality Act and Narcotics Law says OSF

On November 20, Uganda’s parliament passed the Narcotic Drugs and Psychotropic Substances (Control) Bill, also known as the Narcotics Law. A draconian piece of legislation, the law purports to deter drug abuse by imposing inhumanely long prison sentences-a conviction for simple possession can land a person in a cell for 25 years.

Sex, criminal law & HIV non-disclosure: What is wrong with Canada’s approach to HIV non-disclosure? (Canadian HIV/AIDS Legal Network, 2014)

This is the second of two short videos from the Canadian HIV/AIDS Legal Network explaining what the law currently is relating to HIV non-disclosure (covered in Part 1) and what is wrong with this approach. Watch Part 1 here: http://bit.ly/1oMs1DM

The Criminalization of HIV in Canada

(32 mins, BearPaw Media, Canada, 2014)

The Canadian Aboriginal population is one of the fastest growing groups being diagnosed with HIV today. Due to a lack of education, people living with HIV continue to face fear and discrimination. Court and legislator involvement in their lives makes matters even more complicated. This video features four Aboriginal Canadians diagnosed with HIV. In hearing their stories, the viewer will learn how they cope with the stigma surrounding their illness and live within the new rules governing the most intimate part of their lives.

See more at: http://ncsa.libguides.com/bearpawvideos

Canada: Social media campaign ‘Think Twice’ uses video to ask gay men to reconsider pressing charges for HIV non-disclosure

Last week saw the launch of a new phase of a targeted social marketing campaign by AIDS ACTION NOW! (AAN) that features 42 short videos from members and allies of Toronto’s LGBTQI community.

‘Think Twice’ asks HIV-negative and untested gay, bi, queer and trans men to reconsider pressing charges for HIV non-disclosure (where there was no alleged HIV transmission) when they discover that a sexual partner has not disclosed their HIV-positive status before sex.

In October 2012, the Supreme Court of Canada confirmed that non-disclosure of known HIV status can be charged as aggravated sexual assault – with up to life imprisonment and sex offender registration – even if the person with HIV uses a condom: in order to avoid legal liability, they must also have a low viral load.

‘Think Twice’ is an AAN campaign originally launched just prior to the Supreme Court’s ruling aimed at decreasing the number of criminal prosecutions related to HIV non-disclosure. AAN want people involved in the criminalisation of HIV non-disclosure—people living with HIV, their sexual partners, police, Crown prosecutors, health care providers and others—to consider the complexity and uncertainty of Canada’s overly broad approach to HIV criminalisation, and the implications of their role in criminal prosecutions for HIV non-disclosure.

The first part of their campaign targeted Crown prosecutors since they play a pivotal role in driving criminal prosecutions.

Since December 2012, the ‘Think Twice’ campaign has also focused on another key advocacy target – potential complainants.

This new phase of the ‘Think Twice’ campaign focuses specifically on gay, queer, and trans men and other men who have sex with men, due a change in community norms in the past few years that has resulted in an increase in the numbers of men going to the police to lay charges against other men living with HIV.

According to the Canadian HIV/AIDS Legal Network, while the majority of cases in Canada are against men who had sex with women, an increasing number of gay men and other men who have sex with men are being charged and prosecuted in Canada. Whereas there were only five known cases prior to 2006, a further 25 cases have been tracked up to December 2013.

In 2014, there has been at least one new case against a gay man. Another – where two men met in a Montreal sauna – dating back to 2005, is due to be heard by the Supreme Court of Canada next month.

For this latest phase of the ‘Think Twice’ campaign, AAN placed an open call for gay, queer, bi and trans men, and their allies, to make a video that answered the question: ‘In 45 seconds what would you say to gay men to convince them to think twice before going to the police when a sex partner hasn’t disclosed to them.’

Although they only expected to make 25, a total of 42 individuals made videos, in a project organised by Jordan Bond-Gorr, Lauryn Kronick, Tim McCaskell and Eric Mykhalovskiy and filmed by multi-disciplinary artist, John Caffery, in Toronto over one weekend in August.

The videos – along with the website www.thinktwicehiv.com – were launched on 18th November at Toronto’s Buddies in Bad Times theatre.