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

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

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

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

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

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

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and activist groups in Greece scored a victory in May 2013, when former Deputy Health Minister Foteini Skopouli finally repealed the provision.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read more here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

United States Conference of Mayors calls for “the elimination of HIV-specific criminal laws”

Today, the U.S. Conference of Mayors passed a resolution calling for “the elimination of HIV-specific criminal laws and implementation of approaches to HIV within the civil and criminal justice systems that are consistent with the treatment of similar health and safety risks.”

It goes on to support the REPEAL HIV Discrimination Act and endorses the recommendations of the Presidential Advisory Council on HIV/AIDS for ending federal and state HIV-specific criminal laws, prosecutions, and civil commitments.

Full text below.

HIV DISCRIMINATION AND CRIMINALIZATION

WHEREAS, The U.S. Conference of Mayors has been a national leader on strategies to address HIV/AIDS for three decades, establishing in 1984 an HIV/AIDS Program and implementing a HIV/AIDS Prevention Grants Program with funding from the Centers for Disease Control and Prevention (CDC); and

WHEREAS, The National HIV/AIDS Strategy (NHAS) released by the White House includes a statement on the problem and public health consequences of HIV criminalization and notes that many state HIV-specific criminal laws reflect long-outdated misperceptions of HIV’s modes and relative risks of transmission; that criminal law has been unjustly used in the United States to prosecute and disproportionately sentence people with HIV; and that legislators reconsider whether these laws further the public interest and support public health approaches to preventing and treating HIV; and

WHEREAS, nearly all HIV-specific criminal laws do not consider correct and consistent condom use and effective antiretroviral therapy that reduces the risk of HIV transmission to near-zero as evidence of a lack of intent or ability to harm; and behaviors that according to the Centers for Disease Control and Prevention (CDC) have negligible risk of transmitting HIV, such as spitting and biting, have resulted in sentences as long as 35 years: and

WHEREAS, sound criminal justice and public health policy toward people living with HIV is consistent with an evidence-based approach to disease control and research demonstrates that HIV-specific laws do not reduce transmission or increase disclosure and may discourage HIV testing; and

WHEREAS, The Presidential Advisory Council on HIV AIDS, the Centers for Disease Control, and the United Nations Global Commission on HIV and the Law have conducted extensive scientific research and evidence reviews, finding that public health is endangered by HIV discrimination and criminalization and calling for comprehensive revision of state and federal laws and regulations,

NOW, THEREFORE, BE IT RESOLVED, that the U.S. Conference of Mayors calls for the elimination of HIV-specific criminal laws and implementation of approaches to HIV within the civil and criminal justice systems that are consistent with the treatment of similar health and safety risks; and supports legislation, such as the REPEAL HIV Discrimination Act, that advances these objectives: and

BE IT FURTHER RESOLVED, that the U.S. Conference of Mayors endorses the recommendations of the Presidential Advisory Council on HIV/AIDS for ending federal and state HIV-specific criminal laws, prosecutions, and civil commitments.

Projected Cost: Unknown

US Conference of Mayors HIV Criminalization Resolution, June 25 2013

Tanzania: Editorial claims intentional HIV transmission is a problem in the country's 'AIDS fight'

Although Tanzania has made a remarkable headway in the fight against HIV/Aids, the road ahead remains long, rugged and challenging. Nevertheless, President Jakaya Kikwete is optimistic that given the intensity of the struggle the nation shall eventually win.Nevertheless, President Jakaya Kikwete is optimistic that given the intensity of the struggle the nation shall eventually win.

So, the good news at the moment is that the spread of the virus has come down and that a total of 653,000 people living with the Aids virus are on anti-retroviral drugs therapy. Despite this delightful news, however, a few ominous signs are looming on the horizon….

The other ominous aspect is that some people spread the Aids virus spitefully. Many are oblivious of the stark fact that such misconduct amounts to a felony that is punishable by law. It is these people with warped minds about Aids who should be tamed.

In fact, any person who intentionally transmits HIV to another person commits an offence and on conviction the culprit shall be liable to life imprisonment. The offence amounts to a heinous “attack” in contravention of the HIV and AIDS Prevention Control Act (2007).

The law is tailored to provide incisive prevention, care and control of HIV and AIDS and promotion of public health to persons who are free from HIV/aids. People living with HIV/Aids should be aware that they have a legal duty to protect others from infection.

US: LA Times publishes editorial in favour of REPEAL Act, highlights spitting and biting prosecutions

By The Times editorial board

A bipartisan bill introduced in the House calls for a review of state laws that criminalize behavior by people with HIV, including many laws that seem anachronistic or inappropriate given what has been learned during the last three decades about the transmission and treatment of the virus that causes AIDS. The bill should be passed.

The Repeal HIV Discrimination Act of 2013, introduced by Reps. Barbara Lee (D-Oakland) and Ileana Ros-Lehtinen (R-Fla.), would not by itself repeal any state laws. The federal government can’t do that. But the bill would encourage state governments to repeal laws that are based on outdated fears. It is backed by the Presidential Advisory Council on HIV/AIDS and is in line with the UN’s stand that criminalization should be limited to cases in which a person knows he or she has HIV, intends to transmit it and successfully does so.

There are HIV-specific criminal statutes on the books in 32 states, and some are fairly common sense. In California, which has one of the better laws, people who know they are HIV positive must disclose that fact to their sex partners before having unprotected sex. If they do not, and if they “act with intent to infect,” they may be charged with a felony.

But 13 states have laws that make it a crime for an infected person to spit at, bite or throw their blood on others. That might have seemed reasonable at the height of the panic over AIDS, but we now know it is not. According to the Centers for Disease Control and Prevention, only blood, semen, vaginal secretions and breast milk can transmit the virus. And to do so, they must come in contact with a mucous membrane or damaged tissue or be injected into the bloodstream. Saliva does not transmit HIV. It is extraordinarily rare for a human bite to transmit HIV.

In the last few years, there have been dozens of cases documented by the Center for HIV Law and Policy in which people have been charged with criminally transmitting HIV by biting or spitting (even though no transmission occurred) or convicted of failing to disclose to a sexual partner that they were HIV positive (even if the virus was not transmitted). In some states, people with these convictions have to register as sex offenders.

Though treatment has come a long way, HIV is still an extremely serious and basically incurable virus, and the House bill would not stop the prosecution of people who deliberately (and successfully) infect others. It is certainly wrong for infected people to cavalierly or maliciously have sex without disclosing their HIV-positive status and without taking precautions against transmitting the virus. But there is no reason to keep the laws against spitting and biting on the books. They are based on fears that have since been disproved by science.

GNP+ and the HIV Justice Network release ‘Advancing HIV Justice: a progress report of achievements and challenges in global advocacy against HIV criminalisation’

A new report released today by the Global Network of People Living with HIV (GNP+) and the HIV Justice Network highlights the tireless work of advocates around the world challenging inappropriate criminal laws and prosecutions for HIV non-disclosure, potential or perceived exposure and transmission.

Advancing HIV Justice shows that advocates around the working to repeal, modernise or otherwise limit laws and policies that inappropriately regulate and punish people living with HIV have achieved considerable success. This is especially the case when policymakers or criminal justice system actors are open to learning more about scientific and medical advances in HIV prevention, treatment, care and support, and involve civil society – led by people living with HIV – to ensure that critical criminal law and human rights principles are followed.

“That is why we welcome the new, detailed guidance on limiting overly broad HIV criminalisation that was released last week by UNAIDS,” says Kevin Moody, International Coordinator and CEO of GNP+. “The guidance will help to continue advancing HIV justice, serving as a powerful new tool for people living with HIV, and those advocating on our behalf, in our work with policymakers and criminal justice system actors.”

Writing in the foreword, Susan Timberlake, Chief, Human Rights and Law Division, UNAIDS Secretariat, notes that Advancing HIV Justice “powerfully demonstrates that civil society advocacy on this issue is not only alive – it goes from strength to strength.”

In the 18-month period covered by the report (September 2011 to March 2013), significant advances were made in terms of:

building the global evidence base in order to better understand the ‘who, what, where, when and why’ of laws and prosecutions around the world;
generating persuasive social science that shows exactly why overly broad HIV criminalisation does more harm than good, often achieving exactly the opposite of what law- and policymakers intend in terms of public health and human rights;
challenging inappropriate or overly broad new laws in Africa, Asia, the Caribbean, Latin America and the United States;
advocating for law reform in Europe and the United States, including successful repeal in Denmark and modernisation of one of Switzerland’s two laws used to prosecute potential or perceived HIV exposure; and
addressing legal processes and enforcement, including the creation of prosecutorial guidelines in Scotland.

However, the report also highlights that the road to law and policy reform is not always straightforward or easy, due not only to complex intersections of laws, policies and practices, but also because of each country’s unique social, epidemiological and cultural contexts.

“Despite the many incremental successes of the past 18 months, more work and more funding is required to strengthen advocacy capacity,” says the HIV Justice Network’s co-ordinator, Edwin J Bernard, who co-authored the report with Sally Cameron. “HIV criminalisation is a complex issue. It entails a detailed understanding of diverse aspects of the criminal justice system; collection and analysis of evidence of the scope and impact of prosecutions across local and national boundaries; articulation and argument about complex moral and ethical issues of trust, blame and responsibility; and inclusion of HIV prevention and human rights priorities. Development of strategies against HIV criminalisation relevant to each individual jurisdiction requires time, effort, and the involvement of multidisciplinary experts.”

Advancing HIV Justice: A progress report of achievements and challenges in global advocacy against HIV criminalisation is available as a 52 page pdf that can be read or downloaded at: http://www.advancing.hivjustice.net

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

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

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

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

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

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

Positive Women: Exposing Injustice

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

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

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