Zimbabwe: Blame, responsibility, impact of criminalisation on women analysed

Excellent opinion piece in the Zimbabwean newspaper, The Herald, which discusses blame and responsibility and the impact of criminalisation of HIV transmission on women.

 

Blame Game Won’t Change a Thing

The Herald (Harare)

Beatrice Tonhodzayi

4 October 2008She is young and very striking. That type of girl that would give most of my male colleagues’ ideas; if she ever looked their way. She is very pretty, what my male colleagues term the “typical African queen.”

However when you look deeply into her eyes, you can tell she is sad.

But what would make such a pretty and young lady sad?

Mutsa (not her real name) is living with HIV. It is not that knowledge however that is responsible for the sadness that surrounds her very being.

It is anger and a sense of betrayal.

Anger and betrayal, that she feels towards her former lover, a medical doctor, who she says infected her with HIV.

When Mutsa got in touch with me about her story, I felt very betrayed on her behalf.

There she was, going out with a medical doctor, someone who has all the knowledge about HIV transmission. This was the first man she had ever been with and he had the nerve to infect her with HIV, I felt.

But then, I began to wonder!

Did he even know that he was HIV positive?

Yes, he may have slept with other women before or besides Mutsa but this does not mean he knew his status and therefore willingly infected his girlfriend.

And why did Mutsa have unprotected sex with him when she did not know his status?

I am a woman; I champion the women’s cause as much as I can because I sincerely believe that life has not been very kind to woman-kind.

However, I am a journalist and must look at both sides of the coin. I must be objective.

There are many women who are living angry lives unnecessarily. They are filled with so much bitterness at the fact that their husbands and partners have infected them with HIV.

This anger in some cases, is so intense that it eats up one’s very passion for life.

They wish these men could just be thrown into jail for committing such heinous crimes.

Is this necessarily fair to the men in question and the women themselves?

A cursory glance shows that most women who are living with HIV blame a man for their status and this is understandable.

It is a fact that most men sleep with several women at the same time. How many women can safely say they have never been played?

Definitely not me!

But if we know we are or have been played, should we not begin to look out for ourselves?

Another interesting truth is that even women, who have had other sexual encounters before marriage, are quick to point a finger to the man when they test positive.

This is despite the fact that some of them would not have tested before entering this relationship.

Ever think for a moment that you could actually have been positive before, sisters?

If the truth be told, there are some men who have also been infected by women. But how many times do you hear people sympathising with a man?

Is this because men do admit to having been around and done that, unlike their female counterparts?

Multiple concurrent partnerships, especially the “small house” syndrome, are very popular in southern Africa and this is a documented fact.

Such partnerships have been identified as a key driver of HIV in the region.

Because men keep the majority of small houses, whenever transmission occurs, a finger is pointed at them and quite rightly so, mostly.

But what does just blaming them achieve if women do not stand up and begin to look out for themselves.

For argument’s sake, let us say the man is responsible, does this mean by pointing a finger, the virus would disappear?

If we could even go on to punish someone for infecting someone, would we solve anything?

Some would argue that it is high time we criminalised HIV transmission but will this prevent the spread of HIV?

Would it make people more sexually responsible?

Justice Edwin Cameron of South Africa’s Supreme Court of Appeal at the just ended XVII International AIDS Conference in Mexico said criminalisation of HIV transmission makes for bad policy direction around the epidemic.

He said laws and prosecutions don’t prevent the spread of HIV but may actually continue to distract us from reaching our goals of ending deaths, stigma, discrimination and suffering.

He also said something else that I like.

“The prevention of HIV is not just a technical challenge for public health. It is a challenge to all humanity to create a world in which behaving is truly feasible, is safe for both sexual partners, and genuinely rewarding.

“When condoms are available, when women have the power to use them, when those with HIV or at risk of it can get testing and treatment, when they are not afraid of stigma, ostracism and discrimination, they are far more likely to be able to act consistently for their own safety and that of others.”

The responsibility lies with all of us surely?

At the International AIDS Conference Regional Feedback Meeting held at the Harare International Conference Centre, Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS) Executive Director, Mrs Lois Chingandu also echoed the same comments.

She said the challenge with sexual matters were that they were mostly a “heat of the moment” thing and therefore clearly ascertaining that someone has an intention of infecting someone would be difficult.

“One could look for a condom in the dark and fail to find it. Both parties would go ahead to have consensual sex. Could we blame someone here?” she asked.

Today my message is simple. I am just appealing to Mutsa and others like her who are failing to move on because of the anger and sense of betrayal they feel that someone infected them to let go of it and live their lives.

She once felt like taking him to court but then, she says, she realised there was really no point for her status would not change.

I am also inviting my readers out there to contribute their thoughts and comments to this issue of blame and criminalising HIV transmission. My e-mail address is beatrice@safaids.org.zw

Please note:

Each of us has the responsibility and right to protect ourselves from HIV infection and re-infection

Failing to manage one’s anger is one way of increasing stress levels

You can still enjoy a full and productive life, even if you are HIV positive

Beatrice Tonhodzayi is a Programme Officer-Media with SAfAIDS

Canada: Criminalising HIV may only fuel the epidemic

An excellent article published today in the online edition of Canada’s gay newspaper, Xtra, examines the impact of criminal prosecutions for HIV exposure (and transmission) in the country with currently the most prosecutions per capita in the world (that we know about, at least).

I must admit I may be somewhat biased about the article, since the writer, Shawn Syms, interviewed me for it; however, it does also include an interview with Richard Elliott of the Canadian HIV/AIDS Legal Network.

 

Criminalizing HIV may only fuel the epidemic

Laws create disincentive for testing

Shawn Syms / Xtra.ca / Thursday, July 17, 2008

Want to know a great way to increase the spread of HIV? Criminalize it.

In Canada, a person with HIV can be put in jail if they have unprotected sex with someone who didn’t ask about their HIV status. This means that HIV-negative people have the power to seek prosecution of HIV-positive people over sexual choices they made together, even if no HIV transmission occurs at all.

On first glance, this may sound fair. After all, isn’t the person with HIV being dishonest, hiding information that any HIV-negative person deserves to know so they can avoid hopping in the sack with them in the first place? If you judge by media coverage, or common public sentiment, or even the views of many gay men, you might agree. But things aren’t that simple.

The Supreme Court decided a decade ago that a person with HIV can be prosecuted if they engaged in sex that involved a “significant risk of serious bodily harm” — but the question of which activities meet that criteria and which don’t hasn’t been definitely settled.

If there are unanswered legal questions, the lack of community agreement is just as apparent. I think there’s a shared ethical consensus that it’s malicious to lie about HIV status to convince someone to have unprotected sex. Beyond that though, opinions are all over the map.

Some negative gay men assert their own responsibility to play safe and don’t discriminate based on known or perceived HIV status — while others express righteous indignation that anyone would engage in even the safest of activities without informing others if they have HIV.

Some men with HIV feel that if they disclose, any behaviour that both parties agree to is acceptable. Others think playing extra safe should be enough. And significant numbers of people with HIV actually support criminalization. Can we all come closer together as a community on these questions? And does criminal prosecution under the law offer us any assistance in that goal?

“These laws harm public health — and they don’t help anyone,” argues Edwin Bernard, a writer and researcher who studies HIV criminalization laws around the world. “The subtle but very real impact of these legal cases is that people with HIV don’t have the same sexual and reproductive rights as others.”

If you read the judgments in court cases of so-called “reckless” HIV-transmission risk — more and more of which are prosecuting gay men — they seem to send the message that people with HIV are completely responsible for protecting the sexual health of others, and that HIV-negative people don’t have any personal responsibility for the choices they make.

That’s not exactly the case, says Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, which has advocated for the legal rights of people with HIV since 1992. He points out the kinds of charges levelled in these cases — such as “criminal negligence causing bodily harm” — are specific to criminal law, which is only concerned with the innocence or guilt of the accused person. In fact, the responsibility of the other partner when it comes to safer sex isn’t even really considered.

So why could criminalizing the HIV-transmission risk actually increase the threat of HIV? Because it encourages the people at very greatest risk of passing HIV on — those who don’t even know they have it — to avoid testing, diagnosis and treatment.

“This creates yet another disincentive for people to get tested,” says Elliott, since knowing your HIV status makes you a target for criminalization — whether or not you consistently practice safer sex. That’s because there is very little to protect someone from an HIV-negative person lying about them — and it’s left to the judge to decide who is telling the truth.

Often the name of the person with HIV is dragged through the media in terms that are sensational at best, and inaccurate at worst — as was seen in the recent case of gay man Ryan Handy. The London Free Press headline blared “HIV positive man spread virus, jailed 8 months,” even though he didn’t do that at all. Consistently, the name of the accuser is withheld — potentially creating a safe space for malicious liars to attack responsible people with HIV with relative impunity.

“What’s happening in Canada is a witch hunt against HIV-positive people,” says Bernard. He points to the Quebec case earlier this month where a woman with HIV pressed charges against her boyfriend for domestic assault. The boyfriend countered that the woman had exposed him to HIV, even though the woman said she disclosed her HIV status early in the relationship and claimed the sex had been protected all along.

“This is a revenge case,” says Bernard. “Any time anybody has a grudge against an HIV-positive person, it is now possible to make a complaint and it will always end up being a ‘he-said/she-said’ or ‘he-said/he-said’ case in court.”

I’d like to expect that all judges and prosecutors are free of bias and well-informed about the real risks of HIV transmission — but that may be a foolish hope. Two months ago an American man with HIV was sentenced to 35 years in prison for spitting on someone. Late last year, an Ontario judge insisted that a witness with HIV and hepatitis C wear a protective mask in the courtroom despite zero risk to anyone in the room. And prosecutors have provided judges and juries with inaccurate information about the ability to medically determine which person infected which in HIV-transmission cases.

“So many of these cases are one person’s word against another — and juries are predisposed against HIV-positive people,” adds Bernard. “Condom use and disclosure must be proven. But unless people start using mobile phones to video the moment of disclosure and the condom being put on… it gets ridiculous.”

There is a common perception that people diagnosed with HIV represent a serious risk to others. But the far more grave threat lies elsewhere — with people who believe themselves to be HIV-negative and who, with little risk of legal prosecution, go around having unprotected sex with anyone they want, perhaps with little discussion of sexual risk and responsibility.

Placing a legal burden on people who know they are HIV-positive goes after the wrong people the wrong way. These women and men have taken the responsibility to get tested and are most likely to be on treatment, which itself significantly reduces their likelihood of infecting others. And when we punish them and throw them in jail, we put them in a situation where they have less access to medication, safer-sex supplies or clean needles — creating a dire epidemic of HIV and hep C in our prison system among people who will eventually be released in far worse shape.

Meanwhile, Bernard points out, studies in Canada and the US have concluded that people who don’t know their status — who may believe themselves to be negative — are the ones responsible for the majority of new HIV infections. “Nearly all new HIV infections can be attributed to HIV-positive persons unaware of their HIV status,” he wrote in an analysis of multiple research studies for the online resource Aidsmap.

This is because these people are more likely to practice unprotected sex and because the amount of HIV in someone’s system is dramatically elevated at the point of initial infection — making it easier to pass the virus on. (The ruling in one Canadian case has suggested these people may be legally liable as well, but this has not been definitively confirmed by the courts.)

All this means that practicing safer sex — rather than mandating that all people with HIV always disclose their status — is the best bet for everyone who wants to remain HIV negative. Disclosing HIV status doesn’t protect positive men and women from legal action, and it opens them up to discrimination, stigma and danger.

That can include the threat of physical violence. “Do I risk getting beaten up by disclosing? Or do I risk getting criminally prosecuted if I just stay quiet?” says Elliott of the situation faced by some people with HIV. “This is a really good example of how the criminal law is of very little use in a really complicated human interaction.”

“Disclosure is not the answer,” says Bernard. He points to the case of David Summers, who, according to a report in the Halifax (UK) Evening Courier, violently beat and brain-damaged a man who disclosed his HIV status after sex, “leaving his victim unconscious in his blood-spattered flat.” The report did not indicate that the sex was unprotected.

Bernard has reviewed legal cases of criminal HIV transmission from around the world. In his view, Canada’s record is one of the worst. Per capita, he says, “Canada is criminalizing more people with HIV than anywhere in the world.” The punishments in the US are the most severe, and the laws in Switzerland are most “draconian” — there, unlike in Canada, using a condom doesn’t protect someone from prosecution.

Bernard and Elliott both point to the response to criminalization in England and Wales as hopeful. The UK Crown Prosecution Service developed a guidance document to advise prosecutors on HIV criminalization cases, incorporating input from AIDS service organizations. But Elliott cautions that the comparatively decentralized nature of the Canadian system makes a similar response here unlikely.

Is there any way out of this mess? “The fewer of these laws there are, the better off we will be, in terms of the health of the public at large,” argues Bernard, suggesting that criminalization be replaced with a renewed focus on safer sex for everyone and testing, diagnosis and treatment for people who do acquire the virus. “HIV is everybody’s concern and sexual health is everybody’s responsibility.”

Canada: Another Ontario man accused of HIV exposure

A 24 year-old migrant has been arrested in a suburb of Toronto accused of aggravated sexual assault because he did not disclose his HIV status to a 21 year-old woman with whom he had consensual sex earlier in the year.

Although bloggers suggest the man is from Ethiopia, this is not clear in the Canadian reports, of which the one from CityNews is typical, which appear to be based on a police press release ‘fishing’ for more complainants.

Man Accused Of Knowingly Spreading HIV To Woman
Tuesday June 24, 2008
CityNews.ca Staff

A 24-year-old Brampton man is charged in a terrible case of aggravated sexual assault. But it’s what police say Yonatan Gezahegne Mekonnen didn’t tell his alleged 21-year-old victim that has cops worried.

Police contend the couple engaged in consensual sex back in January and February of this year, and that the accused was well aware that he was HIV positive at the time of the encounters – but never told the woman.

They accuse him of exposing her to the disease despite knowing he could easily pass it on to her – and by extension anyone else she may have been seeing. He was arrested on Thursday on two counts of aggravated sexual assault and made a court appearance last Friday.

But now cops are worried that other young women may have fallen under his spell and been exposed to the dangerous virus. They’re looking to speak to anyone who has had contact with Mekonnen in more than a casual way.

If you think you may have crossed his path, call the Peel Police Special Victims Unit at xxx-xxx-xxx or anonymously to Crime Stoppers at xxx-xxx-xxx.

US: Delaware considers mandatory HIV testing for alleged sex offenders

The US state of Delaware is proposing mandatory HIV testing of alleged sex offenders, within 48 hours of their arrest, if the alleged victim, or court, asks for it.

Unlike the existing law, the bill does not require that the state actually show some possibility that the virus may have been transmitted before requiring testing. The bill also authorizes testing around the time of arrest, instead of around the time of arraignment.


It’s not clear if this is primarily for the purposes of ascertaining whether PEP (post-exposure prophylaxis) might be necessary for the alleged victim – which can be the only ethical reason for a change in the law.

Although PEP is thought to be most effective when taken within a few hours of exposure, current guidelines have a recommended maximum window of 72 hours from exposure, so the alleged attacker would have to have been arrested immediately after for that specific purpose.

However, an HIV antibody test would not be accurate enough to detect whether the alleged offender was recently infected with HIV himself (making him much more likely to expose his alleged victim to high enough levels of HIV to transmit the virus).

In any event, PEP should be offered to all alleged victims of sexual assault regardless of the perceived status of their alleged attacker.

One wonders whether the charges would be harsher if the alleged offender did not know his HIV status and transmitted HIV, or did know his HIV status but did not?

However, the story, from the Associated Press, via delmarvanow.com, hints that the change in law is primarily for political, funding reasons.

Supporters say passage of the bill would allow the state to continue to receive up to $500,000 a year in federal grants through the Violence Against Women Act.

DELAWARE: HIV testing eyed for accused sex offenders
June 5, 2008
Associated Press

DOVER — A Delaware House committee has released a bill that would strengthen HIV testing for accused sex offenders.

The bill requires an accused sex offender to submit to HIV testing within 48 hours of arrest, in response to a request from the alleged victim or a court order.

Defendants, including those whose initial tests were negative, also would have to submit to follow-up tests as deemed appropriate.

Unlike the existing law, the bill does not require that the state actually show some possibility that the virus may have been transmitted before requiring testing. The bill also authorizes testing around the time of arrest, instead of around the time of arraignment.

Supporters say passage of the bill would allow the state to continue to receive up to $500,000 a year in federal grants through the Violence Against Women Act.

UK: Scottish man accused of criminal HIV transmission; sensationalist reporting

I am incensed and outraged that journalist Charles Lavery (c.lavery@sundaymail.co.uk) has written, and the (Scottish) Sunday Mail has published, the article below.

It features an interview from a complainant in an ongoing criminal HIV transmission investigation which names the man he believes infected him with HIV. As far as I can tell, the man is only under investigation, and this article appears to be libelous (should it not say “allegedly infected”?) and obviously prejudicial.

It is also not clear how the quotes attributed to the accused were obtained (were the recordings legal?), and the language used in the article (“sex predator”, “deadly fullblown AIDS”) is inaccurate and, obviously, stigmatising.

I understand how distressed and angry ‘Alan’ must be to discover he is now HIV-positive, but going to the gutter press as well as the police is so incredibly counterproductive: doesn’t he realise that he is only adding to the stigma of his own HIV infection?

I urge any readers who feel similarly incensed to email Mr Lavery and/or comment on the paper’s website.

My lover didn’t tell me he had HIV
Mar 30 2008
By Charles Lavery
Exclusive: Dad Says Sex Predator Gave Him Disease

A SEXUAL predator who infected a father-of-three with HIV is being investigated by police.

[Full name of man], 40, admits he did not tell his unsuspecting victim he had been diagnosed as HIV positive six years ago.

[Name of man] – who could face five years in jail for his deadly deceit – still trawls gay websites for “one-on-one sex” while police examine his sexual history.

They fear he could have slept with – and potentially infected – dozens of partners.

Police now face the difficult task of trying to track down his conquests, who will be offered HIV tests and counselling.

His victim Alan, whose identity we are protecting, tested negative for HIV two weeks before he met martial arts expert [Name of man].

Alan, 32, said [Name of man] assured him he was also clear of the disease – which can go on to develop into deadly fullblown AIDS.

But after being tipped off that [Name of man], of [town in Scotland], had the virus, Alan arranged another test and was told he too was HIV positive.

He said: “[Name of man] never had the decency to tell me he was a carrier. He has stolen 20 years of my life.”

In a taped confession [Name of man] admits:

“I gave him HIV. I have had a dozen sexual partners since I was diagnosed six years ago and I have told each and every one of them. Why I didn’t tell Alan I don’t know.

“I always meant to and then we had sex. By that time it was too late.”

The pair met on the Chatterbox UK website and struck up a friendship before arranging a date.

Alan says he asked about safe sex but [Name of man] told him he had been given the allclear so there was no need.

[Name of man] is still listed on various online gay exchange networks looking for sex. Alan told the Sunday Mail:

“[Name of man] told me he was clean because I asked him outright.

“He is a fit-looking guy who goes to the gym and has a good body for his age but that’s all to mask his illness.

“I know I was clear before I met him as I take regular health checks because of my lifestyle.”

Alan’s life fell apart when he got an email from one of [Name of man]’s friends asking: “How’s your health?”

He said: “I replied, ‘What do you mean?’ His reply made my heart stop.

“It said, ‘How are your bloods?’

“I called [Name of man] and he said he couldn’t bring himself to tell me because he couldn’t bear to lose me.

“His family and friends all knew too but they told me they assumed I must be HIV positive too.

“I have been at their home eating Sunday dinner and listened to them telling [Name of man] what a nice couple we make.”

Within 24 hours of the bombshell email Alan had been diagnosed as HIV positive. A counsellor broke the news over the phone.

He said: “I spent three weeks in my bed after that phone call. He never had the decency to tellme he was a carrier.”

Last Sunday Alan walked into a police station in Glasgow and made a formal complaint.

But [Name of man]’s profile was still on networking site Gaydar, advertising for one-night stands and claiming he would “discuss” the use of condoms with any sex date.

He describes himself online as “single, fit, honest and looking”.

Alan said: “How many more are there like me? He was always online and always off meeting new people. I can only assume they too are none the wiser.

“I want to stop this man doing this to people. It’s too late for me but not for the people he is planning to meet.

“I want the world to know this guy is HIV positive and sleeping around. I hope he goes to jail for a long time. He has robbedme ofmy life – what price do you put on that?”

We tracked [Name of man] down last week to a flat he rents in Paisley.

He said: “I probably gave him it but until it’s proved I don’t want to say anything. He might have had other partners.”

Strathclyde Police said: “A 32-year-old man has made a complaint. Inquiries are continuing.”

‘I hope he goes to jail for a long time ..he has robbed me of my life’ VICTIM ALAN

MAILFILE

HIV (Human Immunodeficiency Virus) attacks the body’s ability to defend against disease. An all-timehigh 73,000 people in the UK are infected. AIDS (Acquired Immune Deficiency Syndrome) is the latter stages of HIV when the sufferer has a life-threatening illness, such as pneumonia. For advice, call the Terrence Higgins Trust on 0845 1221 200 or the National AIDS Helpline on 0800 567123.

SUNDAY EMAIL

c.lavery@sundaymail.co.uk

Senegal: IAS outraged at arrest of gay HIV prevention workers

The International AIDS Society has issued a statement following the arrest of ten individuals some of whom are HIV education and prevention workers.

The full statement is below.

Statement on the Criminalization of Sexual Orientation in Senegal
19 February 2008 (Geneva, Switzerland / Abuja, Nigeria)

As the principal convener of the International AIDS Conference, and as an organizing partner of the International Conference on AIDS and STIs in Africa (ICASA), the International AIDS Society (IAS) is firmly committed to an evidence-based response to the HIV/AIDS epidemic, based on sound science. It is therefore with great concern that we note recent developments in Senegal that led to the arrest of 10 individuals based on their sexual orientation, some of whom are HIV education and prevention workers in Senegal.

The IAS is the world’s leading association of HIV professionals, with more than 10,000 members working at all levels of the global response to HIV/AIDS. Our members represent scientists, clinicians, and public health and community leaders on the frontlines of the epidemic in 171 countries worldwide.

The Society for AIDS in Africa (SAA) is an independent association of HIV professionals in Africa, and the custodian of ICASA, the biennial regional AIDS conference in Africa. The next ICASA is scheduled to be held in Dakar, Senegal, in December 2008. Specifically for this reason, and to echo recent statements made by human rights organizations, IAS and SAA express our deep concern with the recent arrests in Senegal.

Senegal has long been viewed as a model, given its success in controlling HIV/AIDS, which has affected other parts of Africa so severely. The success of the Senegalese response to HIV/AIDS has been the country’s ability to involve all segments of society as part of the national efforts on HIV education, prevention, care and treatment. Senegal is a country with strong faith traditions. And through tolerance and faithful collaboration, public health leaders in Senegal have long been able to work with socially marginalized populations such as commercial sex workers, migrant workers, and men who have sex with men, to create model HIV prevention programs. Central to this success is that Senegalese HIV programs have not discriminated against individuals based on sexual orientation. This approach in Senegal is a model for much of the world, and has proven successful despite concerns of some political and ideological leaders.

From the perspective of science and sound public health policy, the IAS believes that all countries around the world must work respectfully with all segments of their population to stem the tide of inequality and to support disease prevention. Criminalizing sexual orientation has never led to positive results – and has never shown to reduce the transmission of sexually transmitted infections, including HIV/AIDS. Evidence shows us that criminalizing and discriminating against any group of individuals only serves to fuel the HIV/AIDS epidemic by denying services and relevant prevention messages.

“The arrest of these men, based purely on their sexual orientation, is completely unfounded, and represents a major setback for the Senegalese response to HIV, which is widely viewed as a model in Africa,” said IAS President Dr. Pedro Cahn.

The Society for AIDS in Africa, the custodian of ICASA, considers Senegal as a model of best practices for AIDS work in the continent, but opposes any form of discrimination against individuals based on sexual orientation.

IAS would like to continue supporting the upcoming ICASA Conference in Dakar, Senegal, in December 2008. IAS and SAA would be better assured of the appropriateness of their continued support if it were to be made clear that those arrested recently in Dakar, primarily based on their sexual orientation, will not be charged as criminals. It would be further reassuring to know that the individuals who have been arrested, and their peers, are still welcomed to work alongside Senegalese public health officials on all aspects of HIV/AIDS programming in their country.

Egypt: More HIV-positive men arrested

The BBC NEWS website is reporting that four more men suspected of being HIV-positive have been arrested in Egypt, bringing the total to twelve. For more on this appalling human rights violation, see this post.

“These cases show Egyptian police acting on the dangerous belief that HIV is not a condition to be treated but a crime to be punished.”
Gasser Abdel-Razek
Human Rights Watch

Egypt police ‘widen HIV arrests’
 Published: 2008/02/15 16:28:10 GMT

Egyptian police have arrested four men suspected of being HIV positive, bringing the total detained in a recent crackdown to 12, rights groups say.

Human Rights Watch (HRW) said last week that HIV-positive Egyptian men had been chained to hospital beds and forced to undergo tests for the virus.

The latest arrests took place after police followed up information coerced from men already detained, HRW said.

The Egyptian interior ministry has not responded to the allegations.

In a joint press release, Amnesty International and HRW warned that Egypt’s efforts to prevent the spread of the deadly virus could be seriously damaged by the arrests.

“This not only violates the most basic rights of people living with HIV. It also threatens public health, by making it dangerous for anyone to seek information about HIV prevention or treatment,” said Rebecca Schleifer, who works on HIV/Aids issues at HRW.

Two of the newly-detained men tested positive for HIV, and are awaiting further hearings, HRW said.

Homosexuality ‘tests’

The rights organisations say a wave of arrests began in October 2007, when two men were arrested after a scuffle in central Cairo.

When one said he was HIV-positive they were taken to the police branch which deals with issues of public morality, HRW said.

Both men said they had been beaten for refusing to sign statements written by the police and subjected to anal examinations to “prove” that they had engaged in homosexual conduct, the group said.

Two more men were arrested when police found their photographs and contact numbers in the wallets of those detained, HRW said.

All four men, who have not been identified, remain in custody pending a prosecutor’s decision on possible charges.

Four further arrests were made in November when police raided the flat of one of those being held, which had been placed under surveillance, HRW reports.

Those four men were sentenced to one year in jail in January having been convicted of “habitual debauchery”, which Human Rights Watch says is a euphemism used to penalise consensual homosexual acts.

Their lawyers claimed the prosecution had produced no evidence against the defendants, who pleaded not guilty.

All those who have tested positive have been held, chained to their beds, in Cairo hospitals, the rights groups said.

While not explicitly referred to in Egypt’s legal code, homosexuality can be punished under several different laws covering obscenity, prostitution and debauchery.

Egypt has come under repeated criticism by both human rights groups and the international community for its treatment of homosexual people.

“These cases show Egyptian police acting on the dangerous belief that HIV is not a condition to be treated but a crime to be punished,” Gasser Abdel-Razek, HRW’s acting director of regional relations in the Middle East, told the BBC.

Singapore: Government plans to criminalise ‘risky sex’ without prior disclosure

An interesting article from Bloomberg (which is usually more associated with business news than with HIV policy) on Singapore’s worrying plans to criminalise people who do not disclose they have previously had “unsafe” sex, and have “reason to believe” they may be HIV-positive, previously reported here last September.

Offenders would face as much as 10 years in prison and a S$50,000 fine. Penalties for those who know they’re HIV-positive and don’t inform their partners, already a crime under legislation that took effect in 1992, would be increased to the same level. No one has been prosecuted under the existing law.

Enforcement would depend on an aggrieved partner filing a complaint and prosecutors proving that a defendant had a history of high-risk sexual behavior.

HIV Ignorance Is No Defense in Singapore Plan to Curb Risky Sex

By Simeon Bennett

Feb. 12 (Bloomberg) — Every weekend, men from Singapore take a one-hour ferry ride to Indonesia’s Batam Island for cheap golf, beer and sex.

About S$70 ($49) hires an island prostitute for the day, compared to just an hour with a Singapore hooker. The trade has contributed to a doubling of Singapore’s HIV infection rate in the past 10 years, the government says.

The city-state proposes to curb infections by making it a crime for those who engage in such unsafe practices, and thus have “reason to believe” they may be HIV-positive, to have sex without informing their partners of the risks. United Nations groups and AIDS activists say that would violate human rights and increase infection rates by encouraging anonymous sex.

“Stigma and discrimination are major drivers of the HIV epidemic,” Dr. Roy Chan, president of the Singapore advocacy group Action for AIDS, said in written comments on the legislation, which may be considered by parliament this month. “The net effect will be poorer control of HIV infection.”

The government disagrees, saying the bill would encourage people to get tested and avoid risky behavior such as having unprotected gay sex or frequenting prostitutes. Violators may be prosecuted even if they don’t test positive for HIV.

“We’re trying to find a way essentially to ask them to be responsible for their own actions,” said Koh Peng Keng, the Health Ministry’s senior director of operations. “There is a greater impetus to get more people to come forward for testing.”

No ‘Witch Hunt’

Offenders would face as much as 10 years in prison and a S$50,000 fine. Penalties for those who know they’re HIV-positive and don’t inform their partners, already a crime under legislation that took effect in 1992, would be increased to the same level. No one has been prosecuted under the existing law.

Enforcement would depend on an aggrieved partner filing a complaint and prosecutors proving that a defendant had a history of high-risk sexual behavior.

“It’s never the intention to go on a witch hunt,” Koh said. “It’s going to help in public education.”

The government also plans to double spending on AIDS prevention programs to S$8 million annually for the next three years, he said.

Zack, a self-employed electrical engineer who suspects he contracted HIV from a prostitute, isn’t convinced of the government’s motives, especially considering that gay sex is illegal in Singapore.

“People are going to hide,” said Zack, 36, who spoke on condition his real name not be used for fear of losing his business.

Infected for Years

Singapore’s HIV infection rate has doubled in the past 10 years. About 1 in 10,000 people were newly infected in 2006, compared with fewer than 0.5 in 1996, according to government statistics. More than half of those diagnosed in 2006 also had AIDS, indicating they’d been infected for years without knowing it, Koh said.

In total, about 7 of every 10,000 people in Singapore have HIV, the government says.

UNAIDS estimates the rate may be as high as 30 once undiagnosed cases are included. That’s higher than estimated infection rates in other developed Asian nations such as Japan and South Korea. Singapore’s rate is lower than in neighboring nations, including Malaysia and Thailand.

The UN agency calculated its figure from government data for high-risk groups — including prostitutes and their customers, gay and bisexual men, and intravenous drug users — and statistics provided by HIV and pregnancy clinics.

UN Opposition

Seema Paul, chief policy coordinator for Geneva-based UNAIDS, said the Singapore bill would force people to get HIV tests, putting them at risk of discrimination and violence if others learned they were HIV-positive.

“We have consistently advocated that HIV testing should be voluntary,” she said in an e-mail.

Stuart Koe, chief executive officer of media company Fridae Ltd., said those who contract HIV won’t disclose the names of their partners to doctors for fear of being prosecuted, and that will contribute to spreading the disease.

“There’ll be a lot of unexpected negative effects,” said Koe, who works with AIDS support groups in Singapore and whose company runs a gay Web site.

The groups primarily responsible for spreading HIV in Singapore are men who visit prostitutes, and gay and bisexual men, the government says.

Refusing Condoms

In Batam, brothels occupy storefronts scattered among homes, shops and bars like the PP Banana Laptop Lounge. Pimps ply their trade wherever foreigners are found.

The AIDS rate in the province including Batam is the third- highest in Indonesia after Papua and Jakarta, the national AIDS commission said on its Web site.

Ayu, a 28-year-old prostitute, said most of her clients are married Singaporean men and not all practice safe sex.

“Sometimes the customer does not want a condom,” she said, her purple eye shadow sparkling under neon lights. “I cannot force.”

Like many Indonesians, Ayu uses only one name.

Koh said the government works with activist groups to educate men before they get on the Batam ferry. Those efforts include handing out condoms and HIV prevention information.

“There’s this huge reservoir of people who are HIV-positive and may not know,” he said. “Once someone knows they’re positive, typically they change behavior.”

Canada: Ontario paper reflects on the impact of recent prosecutions

A surprisingly balanced piece of reporting from the London (Ontario) Free Press, regarding recent prosecutions for HIV exposure or transmission, appeared on Saturday.

Five local cases are highlighted:

  • Edward Kelly, who, in 2003, was convicted of aggravated sexual assault (HIV exposure) because he failed to disclose his HIV status to his female sexual partners. After serving almost three years in prison, he was charged again for the same offence with a different woman. His case is due in court tomorrow.
  • Tendai Mazambani, who was charged with four counts of aggravated sexual assault in October 2006. A preliminary hearing is due soon in an Ontario Court.
  • Mark Hinton, whose aggravated sexual assault charge was dismissed last week.
  • Ryan Handy, who was found guilty of aggravated sexual assault, and is due to be sentenced on March 27th.
  • Owen Antoine, who was found guilty of aggravated sexual assault and criminal negligence causing bodily harm last month.

Fair play or morality play?

There’s a debate brewing over whether the criminal courts are the proper jurisdiction for cases in which people have been infected with HIV by a sexual partner who knowingly didn’t disclose the condition, writes Free Press justice reporter Jane Sims

Barry Mann has been HIV-positive for 19 years and practises safe sex.

He learned to take precautions after watching many friends die of AIDS in the 1980s.

Now, at 53, he’s scared — not of infecting his sexual partners with the virus that causes AIDS, but of being accused of infecting them — and going to jail.

“To date, I haven’t had somebody who’s out to get me,” he says.

A recent criminal case in London — one of four HIV-related cases before the courts here and one in St. Thomas — has left Mann with an uneasy feeling the criminal courts are judging HIV-related cases on the basis of morality, not public protection.

Ryan Handy, 25, a young gay man with mental illness, was convicted last month of aggravated sexual assault. He testified that at one time he believed he had sweated out his HIV and was the Messiah.

After two unprotected sexual encounters with a 53-year-old man he met in an Internet chat room, Handy testified, he had a moment of clarity, realized he had the virus and immediately contacted the man and told him he was HIV-positive. His lack of disclosure of his HIV status required by law could send Handy to prison when he’s sentenced next month.

There is a debate brewing — and an opinion in the gay community — that the victim in the case, who has remained virus-free, should have taken care of his own sexual health while engaging in high-risk sexual behaviour and not be accusing a young, vulnerable man of a criminal act.

Mann says the courts should stay out of people’s bedrooms when it comes to disclosing HIV.

“It should not be tying up the courts,” he says. “It’s a health issue, not a criminal issue.”

Breakthroughs in treatment have allowed Mann and many other HIV-positive people to live with the virus for decades. He’s still legally obligated to tell his sexual partners he has the virus, something he admits doesn’t always happen because he uses protection.

“I am constantly floored by how many people are willing to have sex with me without taking precautions. I’m the one who has to stop them,” he says. “Society is still very nonchalant about this.”

– – –

It’s been 15 years since the death of Charles Ssenyonga, a man with a virulent strain of AIDS who was being tried for knowingly spreading the virus to several women — some of whom died — in London. He died just weeks before Superior Court Justice Dougald McDermid was to deliver a decision.

Half a generation later, there are suggestions it’s time for HIV to be taken out of the Criminal Code.

There have only been 29 HIV-related cases in Canada and six are before the courts. It appears the majority on trial now are in the London area. All the current London cases involve men — two straight and two gay — said not to have disclosed their HIV status to sexual partners.

In the cases of people maliciously spreading the virus, there’s a unified opinion inside and outside the criminal justice system those cases need to be tried criminally.

But in the Handy case, and in the Mark Hinton case that was dismissed this week, the facts involved allegations of consensual sex between people engaged in high risk activities. (Hinton, 41, who has been HIV-positive for 22 years, faced a charge of attempted aggravated sexual assault. A judge dismissed the charge).

Those cases, some activists say, could have best been handled by public health — not the criminal justice system that they say seems to judge morality and not promote public protection.

“If you take the HIV out of there, it’s still a crime,” says Peter Hayes, executive director of the AIDS Committee of London, about HIV cases involving sexual assault and intentional spread of the disease.

But, he says, “when we make it about HIV-only, the law can be misinterpreted, or situations are not being addressed in the best interests of public health.”

Hayes says cases like Handy’s and others go to the most intimate piece of a relationship and solidify the stigma attached to disease that has gone from a death sentence to an often controllable condition.

Prosecution of such cases leaves the community with a false sense of security, he says. The reality, he says, is that the vast majority of HIV-positive people disclose their status not just to their partners, but to family, employers, doctors and anyone they believe could be at risk.

The majority of new transmissions are in the straight community and come from people who haven’t been tested.

Brian Lester, director of prevention for the agency, says the best strategy to stop the transmission of the virus is to encourage testing and help people make informed decisions about their results. But criminalization “challenges that, he says.

“People don’t want to deal with what could be a reality in their life,” he says, and won’t get the test. “A fully informed individual making a choice not to use a condom is putting themselves at risk.”

Hayes says he’s concerned there’s not enough education in, and outside of, the criminal justice system about the virus and the disease.

He points to a 2003 study across Canada that showed people were less informed about HIV and AIDS than ever, with beliefs that only gay men and drug users and people living in Africa were at risk.

“Issues surrounding sex and drugs are being talked in a way that’s not about health but more about morality,” he says.

Lester says the health system has the tools to handle the cases.

Already, public health can issue orders that outline rules an HIV-positive person must follow, such as using condoms in all sexual encounters and not sharing needles. It also has the power to detain people, Lester says.

He adds the justice system adds to the stigma when prosecuting these cases as aggravated sexual assaults.

“I don’t understand the term sexual assault in consensual sex,” he says.

– – –

Even the failure to disclose during pillow talk needs to be prosecuted, some in legal circles say.

A London lawyer who successfully defended Hinton agrees HIV cases should be judged in criminal courts.

“It should absolutely be an offence,” says Ron Ellis. “Because you can’t consent to having sexual relations with someone if the act is so manifestly different than what you expected it was going to be.

“HIV changes the very nature and character of the sex you are consenting to such a degree.”

HIV still remains potentially life-threatening, he says, and although not necessarily a death sentence, it requires a lifetime of treatment and medications. It restricts freedoms and choice of sexual partners.

“It’s got to be worth something,” Ellis says.

If Hinton had been found guilty, Ellis notes, he would have faced a prison sentence of three to six years.

“I think its a crime to put somebody at risk,” Ellis says. “The law is you’ve got to disclose and it’s a good law. It’s there for the health and safety of the community.”

Dr. Bryna Warshawsky, associate medical officer of health for the Middlesex-London Health Unit, says the spread of the virus is “certainly a health issue,” and adds it’s “very rare and unusual for people with HIV not to be responsible.”

– – –

The Ryan Handy case has become a rallying point for some in the gay community — a group of supporters was with him at his sentencing hearing last month.

Handy can be seen in a three-part interview on the Xtra magazine website denouncing what he calls unfair treatment by the criminal courts.

An editorial by managing editor Matt Mills in the gay magazine criticizing the victim in December prompted the victim in the Handy case to not submit a victim impact statement.

Mills says he thinks “it’s really important that folks who are in the position he is in have the opportunity to tell their stories.” He says his publication believes some men, particularly gay men, get “the short end of the stick on this legislation and these sentencing guidelines.

“We believe the criminal justice system is singularly unqualified and ill-equipped to handle this issue.”

The Supreme Court of Canada, Mills says, in its decision that HIV-positive people have a duty to disclose their illness before having unprotected sex, “has put us in a position we are at each other’s throat and suspicious of each other when it is a public health matter.”

Mann, who also recently completed treatment for Hepatitis C, agrees.

“Nobody forced their pants down. Nobody forced them to have sex. Everybody’s responsibility is to protect themselves.”

He fears that whether he discloses his health status or not in the bedroom becomes hearsay in a courtroom.

“I can disclose to somebody and they can turn around and say I didn’t disclose,” he says, adding he fears the issue could evolve into civil cases in which former lovers are pitted against each other.

“We’re already dealing with living with this disease and the stigma attached. We don’t need this on top of it.”

—

HIV AND THE LAW

The Supreme Court of Canada ruled in 1998 that:

– HIV-positive people must disclose their status to sexual partners before having sex without a condom or sharing sex toys.

– They must tell people with whom they share drug equipment before sharing the equipment.

– Non-disclosure could lead to an order by a local public health unit that would outline rules that must be followed and could include using a condom in all sexual encounters or no sharing of needles.

– Criminal Code charges can be laid by a sexual- or needle-sharing partner. The charges range from common nuisance to aggravated sexual assault. Charges can be laid even if the partner is not infected.

CASES BEFORE THE COURTS

– Edward Kelly, 31, was charged with aggravated sexual assault in May 2006, after a woman told police she had sex with a man who didn’t tell her he was HIV-positive. He is next in Superior Court on Feb. 12.

– Tendai Mazambani, 33, was charged with four counts of aggravated sexual assault in October 2006. He is expected to set a date for an Ontario Court preliminary hearing.

– The case against Mark Hinton, 41, was dismissed this week after his complainant admitted HIV status was not a concern to him before engaging in “moderately high risk” sexual activities. Hinton, who didn’t get the chance to testify, maintained he never had sex with the man.

– Ryan Handy, 25, a gay man who testified he is mentally ill and believed he sweated out his HIV, is to be sentenced for aggravated sexual assault March 27.

– Owen Antoine, 41, of Aylmer was convicted by a jury in St. Thomas this month of four charges, including aggravated sexual assault and criminal negligence causing bodily harm. Antoine was diagnosed HIV-positive in December 2004. The victim, a 29-year-old woman, testified she was at a bar with Antoine in April 2006 and has no memory after she drank a shooter he said he took to her. She woke up hours later in bed with him and he told her they had unprotected sex. She has since tested positive for HIV. Antoine did not tell her he had the virus.