US: New Report from the William Institute finds HIV criminalisation laws in California do not reflect medical science

LOS ANGELES —  In California, outdated HIV criminalization laws do not reflect the highly effective medical advances for reducing the risk of HIV transmission and extending the quantity and quality of life for people living with HIV.

HIV criminalization is a term used to describe laws that either criminalize otherwise legal conduct or that increase the penalties for illegal conduct based upon a person’s HIV-positive status.  California has four HIV-specific criminal laws.

In HIV Criminalization in California: Evaluation of Transmission Risk, researchers Amira Hasenbush and Dr. Brian Zanoni suggest that these HIV criminal laws in California are not in line with medical science and technology related to HIV and may, in fact, work against best public health practices.

“Nine out of ten convictions under an HIV-specific criminal law or sentence enhancement have no proof of exposure to HIV, let alone transmission,” said Amira Hasenbush.  “No HIV criminal laws in California require transmission for a conviction.”Key findings include:

  • From 1988 until June 2014, 379 incidents resulted in convictions for an HIV-specific felony or sentence enhancement.
    • Of those, 100 percent required no actual transmission of HIV.
    • 98 percent did not require intent to transmit HIV.
    • 93 percent involved no specific allegation of conduct that is likely to have transmitted the virus:
      • Ninety percent of convictions were in solicitation incidents in which it is unknown whether any contact beyond a conversation or an exchange of money was initiated, thus possibly not having any exposure to HIV.
      • Three percent of incidents involved oral sex, a sex act whose transmission risk is estimated as “low” by the CDC.
      • Only seven percent of incidents involved vaginal or anal sex by definition of the crime.

HIV criminal laws have been disproportionately applied to sex workers. This has a disproportionate impact on women and people of color. Since solicitation by definition includes survival and subsistence sex work, these laws are also likely to disproportionately impact LGBT youth and transgender women of color.

Laws that criminalize conduct of a person who knows that they are HIV-positive may disincentivize testing and work against best public health practices.

The Williams Institute, a think tank on sexual orientation and gender identity law and public policy, is dedicated to conducting rigorous, independent research with real-world relevance.

Full report can be read here

 

Czech Republic: Police drop charges against all 30 gay men living with HIV following Prague Public Health Authority ‘witch hunt’

All criminal charges have been dropped against the 30 gay men living with HIV who were reported to the police by the Prague Public Health Authority earlier this year after they were diagnosed with an STI, Czech media report today.

The draconian behaviour of Prague Public Health led to widespread condemnation by human rights defenders.

A change.org petition initated by the European AIDS Treament Group (EATG) was signed by more than 1000 supporters, including the HIV Justice Network.

Today’s media report in Aktuálně.cz notes that three of the 30 men had been indicted for potential HIV transmission (under a law criminalising ‘the spread of infectious human diseases‘) but prosecutorial authorities withdrew the charges due to lack of evidence.

Police spokesman, Jan Danek, told the paper that following an investigation there was no case to prove against any of the 30 men and all charges had been dropped.

Australia: Australian experts publish statement urging courts to consider current scientific evidence in criminal cases involving alleged HIV transmission or exposure

A group of leading HIV experts are calling for “caution to be exercised” when considering criminal charges against people who recklessly spread the disease.

In a consensus statement published in the Medical Journal of Australia, Australian researchers and scientists — including Professor Sharon Lewin and Professor Andrew Grulich — argue that “criminal cases involving HIV transmission or exposure require that courts correctly comprehend the rapidly evolving science of HIV transmission and the impact of an HIV diagnosis”.

The statement cites scientific evidence that shows the risk of HIV transmission to be negligible if a person is on treatment and has an undetectable viral load. It also claims that HIV isn’t as serious a condition as it used to be: “Most people with HIV are able to commence simple treatment providing them a normal and healthy life expectancy, largely comparable with their HIV-negative peers.”

“Given the limited risk of HIV transmission per sexual act and the limited long-term harms experienced by most people recently diagnosed with HIV, appropriate care should be taken before prosecutions are pursued,” says the statement.

While acknowledging that cases of deliberate transmission of HIV are “extremely unusual”, the group urge authorities to change behaviours through counselling rather than the courts.

“Careful attention should be paid to the best scientific evidence on HIV risk and harms, with consideration given to alternatives to prosecution, including public health management.”

The statement has been welcome by HIV advocacy groups.

“It’s incredible to see these experts come together and make a bold statement regarding HIV and the law,” said Richard Keane, President of Living Positive Victoria.

“The impact of HIV criminalisation or even the threat of it is a dangerous form of stigma and we’re still feeling the ripple effect more than two decades later.”

There have been at least 38 Australian criminal prosecutions for HIV sexual transmission or exposure since 1991.

“You don’t have to be convicted or even prosecuted for HIV criminalisation to affect you,” said Keane.

“The HIV community lives with the threat that a complaint can be made against us and the stigma that criminal prosecutions amplify and perpetuate.”

Keane hoped the statement’s focus on utilising the public health system rather the criminal courts in dealing with behaviour change would lead to better outcomes on policy.

“Most people on treatment are able to achieve an ‘undetectable’ viral load which makes it highly likely that the person will remain healthy and pose a negligible risk of transmitting HIV,” Keane said.

“The evidence outlined in this statement shows that the per-act risk of HIV transmission from even the most risky sex is still low. The message should be to encourage individuals to take care of their health and eliminate barriers to accessing treatment rather than intimidation through the justice system.

“By focusing on what the studies and science is telling us about treatments, relative risk and harm, that’s how we reduce HIV transmission whilst protecting the rights and dignity of people living with HIV. HIV is a health issue, not a criminal justice issue.”

Additional reporting Positive Living.

Published in Gay News Network on Nov 6, 2016

Mexico: Civil association in San Luis Potosi State urges parliament to rethink proposition to criminalise HIV transmission

English translation (Para artículo en español, desplácese hacia abajo)

Civil association urges a rethink of the criminalisation of HIV transmission as such an amendment to the penal code would promote higher levels of stigma and discrimination.

San Luis Potosi, SLP.- With regard to the initiative presented during the Ordinary Session No. 44, on October 27, 2016 in the State Congress by the State Governor Juan Manuel Carreras Lopez and Erika Velasquez Gutiérrez, the president of the Women Institute in San Luis Potosi, the civil association Amigos Potosinosen Lucha Contra el Sida condemned the initiative which they say, stigmatize people living with the Human Immunodeficiency Virus (HIV), and have therefore called for reconsideration of the initiative put forward, conveying the following position:

1. It is important to promote actions that recognise the human rights of women through the varied international tools signed and ratified in this matter by the Mexican State,  and which have been become mandatories following the constitutional reform of 2011 in the field of Human Rights.

2. It is not advisable to seek to punish conducts that are perceived to be fraudulent with regard to HIV and other sexually transmitted infections, as the evidence tell us that HIV prevention is not achieved through punitive measures, but by public health policies which promote changes at the structural level, to facilitate equal access to services that guarantee the sexual and reproductive health of women, and also strengthen programmes and activities that promote equality between women and men.

3. Criminalisation promotes stigma and discrimination against people with HIV, including girls, children, adolescents and women, contradictorily promoting actions that violate the dignity of these vulnerable groups.

4. It is very difficult to determine causality, fraud and intention and other varied factors involved in HIV transmission such as: the possibility of transmission, the type of exposure, the use of condoms or not, at what stage of infection the person is, whether the person is on antiretroviral treatment, if their viral load is undetectable, if there is any concomitant infection, the health status of the receiving partner and the agreements between spouses or casual partners, among others.

5. It is important to emphasize that punitive measures such as those intended to legislate through this initiative, could hinder and affect various multisectoral actions in prevention, detection and HIV care in our state.

6. It might influence people who perceive themselves as having  risk factors for HIV, to not undergo testing in order not to know their status and avoid any potential criminal proceedings made possible by testing. Such legislation may affect the continuous detection, prevention and care of HIV in Mexico [1], which seeks to facilitate the early diagnosis of people who perceived themselves to at risk so they can receive timely treatment to improve their quality of life and also help to curb the transmission chain.

7. Scientific evidence indicates that to stop the chain of transmission of HIV from one person to another, it is essential to combine prevention strategies, which include biomedical, behavioural and structural change, the latter emphasizing the need for actions that contribute to the eradication of stigma and discrimination associated with HIV-AIDS, and a punitive law does not contribute to these strategies.

8. The specific content of this initiative “Risk of contagion” could result in the legal responsibility for HIV prevention to fall only on those living with HIV, and could conceal the public health message that sexual partners have shared responsibility for their sexual health. People may mistakenly assume that their partners are HIV-negative because they are unaware of their status or do not disclose it, and they would therefore stop taking preventive measures.

9. Such amendments to the penal code will promote higher levels of stigma and discrimination against diverse HIV populations and their families.

Amigos Potosinos en lucha contra el Sida urges the State governor Juan Manuel Carreras Lopez and Erika Velázquez Gutiérrez president of the Women Institute in San Luis Potosi (sic), to reconsider the criminalization of HIV, as to do so would place people with HIV under a status of being possible criminals, which is contrary to their dignity as persons, violating their human rights and stigmatising them for their health condition.

Better yet, we encourage you to promote the creation of the State Council for the control of HIV, AIDS and STIs in San Luis Potosi, and to increase resources to prevent, detect and address HIV in a timely manner; to improve the quality and comprehensiveness of care services in the State that are provided by CAPASITS and by hospitals in the health system; to generate and strengthen empowerment programs for women and actions that seek to promote equal opportunities between women and men; finally to reduce stigma and discrimination against key populations affected by HIV and other STIs incorporating the MIPA principle [3] which speaks of greater involvement of people living with HIV as part of the solution and response, thereby contributing to a democratic, inclusive and non-discriminatory Mexico.

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Asociación Civil pide reconsiderar tipificar como delito trasmisión del VIH. Este tipo de adecuaciones al código penal promoverán mayores niveles de estigma y discriminación.

San Luis Potosí, SLP.- En relación a la iniciativa presentada, en la Sesión Ordinaria No. 44, día 27 de octubre del 2016 al Congreso del Estado, por el gobernador del Estado Juan Manuel Carreras López y Erika Velázquez Gutiérrez presidenta del Instituto de las Mujeres en San Luis Potosí la asociación civil Amigos Potosinos en Lucha Contra el Sida condenaron la iniciativa que a decir de ellos, estigmatiza a las personas con contagiadas con el Virus de Inmunodeficiencia Humana (VIH), por lo que llaman a reconsiderar la iniciativa formulada, difundiendo el siguiente posicionamiento:

1.- Es importante impulsar acciones a favor del reconocimiento de los derechos humanos de las mujeres en el orden internacional de los diversos instrumentos que en esta materia ha suscrito y ratificado Estado Mexicano, lo cual se convierte en obligatorio a partir de la reforma Constitucional del año 2011 en materia de Derechos Humanos.

2.-No es recomendable buscar castigar las conductas que se perciben como dolosas en relación al VIH y otras infecciones sexuales, ya que la evidencia científica nos señala que la prevención del VIH no se logra con medidas punitivas, sino con políticas en salud pública que faciliten acciones que promuevan cambios a nivel estructural que faciliten la igualdad en el acceso a servicios que garanticen la salud sexual y reproductiva de las mujeres, así también fortalecer los programas y acciones que promuevan la igualdad entre mujeres y hombres

3.- La penalización favorece el estigma y la discriminación hacia personas con VIH, incluyendo a las niñas, niños, adolescentes y mujeres, por lo que resulta contradictorio impulsar acciones que contravienen a la dignidad de estos grupos vulnerables.

4.- Es muy difícil determinar la causalidad, el dolo, la intencionalidad ya que intervienen diversos factores en la trasmisión del VIH, como son: la posibilidad de la trasmisión, el tipo de exposición, el uso o no de condón, la etapa de la infección en la que se encuentra la persona, si lleva tratamiento antirretroviral, si tiene carga viral detectable o indetectable, si existen enfermedades concomitantes, el estado de salud de la pareja receptora y los acuerdos establecidos entre cónyuges o parejas ocasionales, entre otros.

5.- Es importante enfatizar que medidas punitivas como las que se pretende legislar a través de esta iniciativa, podrían obstaculizar y afectar las diversas acciones multisectoriales en materia de prevención, detección y atención del VIH en nuestro Estado.

6.- Podría influir a que las personas que se perciban con factores de riesgo ante el VIH, omitan realizarse una detección temprana a fin de no conocer su estado serológico en virtud de prevenir un posible proceso penal. Este tipo de legislaciones pueden afectar al Continuo de la detección, prevención y atención en VIH en México[1], el cual busca que las personas que se perciban en riesgo se realicen un diagnóstico temprano, puedan recibir un tratamiento oportuno que mejore su calidad de vida y además contribuya a frenar la cadena de transmisión.

7. La evidencia científica señala que para detener la cadena de trasmisión del VIH de una persona a otra es indispensable realizar estrategias de prevención combinada, entre las cuales, destacan las biomédicas, las comportamentales y las de cambio estructural, estas últimas enfatizan las acciones que contribuyen a erradicar el estigma y la discriminación asociado al VIH-sida, y una ley con acciones punitivas no contribuye con estas estrategias.

8.- El contenido en específico de esta iniciativa de “Peligro de contagio” podría provocar que la responsabilidad jurídica de la prevención del VIH recaiga solamente en quienes viven con VIH, y podría invisibilizar el mensaje de salud pública de que las parejas sexuales tienen responsabilidad compartida sobre su salud sexual. Las personas podrían suponer erróneamente que sus parejas son VIH-negativas porque desconocen o no revelan su estado serológico, por tal dejarían de incorporar medidas de prevención.

9.-Este tipo de adecuaciones al código penal promoverán mayores niveles de estigma y discriminación hacia las diversas poblaciones con VIH y sus familias.

Amigos Potosinos en lucha contra el Sida exhorta al gobernador del estado Juan Manuel Carreras López y a Erika Velázquez Gutiérrez presidenta del Instituto de las Mujeres en San Luis Potosí (sic), a reconsiderar la penalización del VIH, de hacerlo colocarían a las personas con VIH bajo un estatus de posibles criminales, contraviniendo a su dignidad como personas, atentando a sus derechos humanos y estigmatizándoles por su condición de salud.

Mejor aún, le exhortamos a impulsar la creación del Consejo Estatal Para el control del VIH, Sida e ITS en San Luis Potosí, además incrementar los recursos  para prevenir, detectar y atender oportunamente el VIH; mejorar la calidad e integralidad de los servicios de atención en el Estado que son otorgados desde los CAPASITS y hospitales del sector salud; generar y fortalecer programas de empoderamiento para las mujeres y acciones que busquen promover la igual de oportunidades entre mujeres y hombres; por último a disminuir el estigma y la discriminación hacia las poblaciones clave y personas afectadas por el VIH y otras ITS incorporando el principio MIPA[3] que habla del mayor involucramiento de las personas con VIH como parte de la solución y respuesta, con ello contribuir a un México democrático, incluyente y sin discriminación.

Mexico: Quintana Roo activists submit proposal for a change in the State HIV criminalisation law

Submission to eliminate the criminalisation of people with HIV (Desplácese hacia abajo para el artículo original)

This initiative has been proposed by the organisation ‘Vida Positiva’.

PLAYA DEL CARMEN, Q. Roo

A proposition to eliminate the criminalization and general criminalization of people with HIV having sex, focussing on cases of willful intent by amending Article 113 of the Criminal Code of Quintana Roo, is being put forward.

This initiative has been proposed by the civil association ‘Vida Positiva’ and delivered to deputy Laura Beristain Navarrete, president of the Commission for Health and Social Welfare of the XV Legislature to be adapted and submitted to the State Congress at the beginning of October.

Rudolf Geers, president of the activist group said that its aims are for the legislation mentioned to be replaced by a new article which sanction the transmission of a chronic or fatal disease deceitfully and when protection methods have not been used.

“What we propose is that the law be changed to only prosecute cases of actual transmission, removing talks of risks, and cases where there was actual deception and where people did not use protection, in order to qualify the intent of the situation. In the case of pregnant women, to only prosecute cases where the mother had the express intention of infecting the baby. There was one prosecution in January this year, “said the leader of Vida Positiva.

On this matter, Deputy Beristain Navarrete said it was an issue that will be analyzed in a responsible manner, which will be reviewed properly to be subsequently pass on to the committee because every project must be adapted for proper submission, especially when concerning such a sensitive issue as health risks.

Background information

Meanwhile, Geers highlighted that looking at the history of the law, this Article has only served to motivate cases of blackmail and extortion, which have threatened to expose people because of their HIV status, even without evidence, and even when cases did not proceed, the name of the person with the condition had been made public.

“This year, we have had  reports of four cases and the advice was to ignore them and just 3 years ago, a lawsuit under this law was recorded. Furthermore this legislation is based on a federal law adopted in 1991; a time when it was a deadly disease with no treatment; It also violates several national and international standards and is counterproductive to an effective response to HIV.

According to CENSIDA, this measure was taken internationally, including in Mexico since the last decade of the last century as a preventive measure against transmission or as a punishment of behaviours that are perceived as ‘willful’, however, we can state that this has not worked with punitive measures, and without public health policies.

“We need to increase resources and efforts with recommended HIV prevention strategies, improve the quality and comprehensiveness of care and reduce stigma and discrimination towards key populations and people living with HIV and other STIs, considering them as part of the solution and contributiors to a fair, inclusive and democratic Mexico”, stated the  National Center for the Prevention and Control of HIV and AIDS on the criminalisation of HIV and other STIs transmission.

Rudolf Geers, president of the civil association Vida Positiva stressed that in these cases the responsibility to prevent further transmission is shared; anyone who has casual sex should use a condom.

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Proponen eliminar la criminalización de las personas con VIH

Esta iniciativa ha sido propuesta por la asociación civil ‘Vida Positiva’.

PLAYA DEL CARMEN, Q. Roo.- Proponen eliminar la criminalización y la penalización general de las personas con VIH por tener relaciones sexuales, especificando casos de intencionalidad consumada, mediante la modificación del artículo 113 del Código Penal de Quintana Roo.

Esta iniciativa ha sido propuesta por la asociación civil ‘Vida Positiva’ y entregada a la diputada Laura Beristaín Navarrete, presidenta de la Comisión de Salud y Asistencia Social de la XV Legislatura para su adecuación y presentación ante el Congreso del Estado a inicios del mes de octubre.

Rudolf Geers, presidente de dicha agrupación activista explicó que se tiene como objetivo que dicha legislación se sustituya por un nuevo artículo el cual sancione una transmisión de una condición de salud crónica o mortal con engaño y sin usar métodos de protección.

“Lo que nosotros proponemos que se cambie esta ley para que solo se castigue en caso de existir una transmisión, quitar la palabra peligro,  castigando los casos en que hubo engaño y que no usaron protección, para poder calificar la intencionalidad de la situación. En el caso de la mujer embarazada, solo cuando la madre tiene la intención expresa de infectar al bebé sea castigado. De estos tuvimos un caso en enero de este año”, dijo el dirigente de Vida Positiva A.C.

Antecedentes registrados

Al respecto la diputada Beristain Navarrete señaló que es un tema que se estará analizando de manera responsable, que se revisará de manera adecuada para posteriormente pasarla a comisión, ya que todo proyecto hay que adecuarlo para su correcta presentación, en especial un tema delicado en referencia a riesgos sanitarios.

Por su parte, Geers aseguro que de acuerdo a los antecedentes registrados, este artículo solo ha servido para motivar casos de chantajes y extorsiones, que han amenazado con exponer a personas por su condición de VIH, incluso sin pruebas y aunque posteriormente no proceda la demanda, pero si haciendo público el nombre de la persona con este padecimiento.

“De estos hemos tenido este año reportes de cuatro casos y el consejo simplemente fue ignorarlos y hace 3 años se registró un caso de una demanda por esta ley. Además esta legislación, está basada en una federal de 1991; época en que era un padecimiento mortal al no haber tratamiento; además viola varias normas nacionales e internacionales y es contraproducente para una respuesta eficiente ante el VIH.

De acuerdo a CENSIDA, esta medida había sido tomada a nivel internacional, incluyendo a México desde la última década del siglo pasado como una medida de prevención de transmisión o castigo de conductas que se perciben como ’dolosas’, sin embargo, aseguran que esto no tendrpa éxito con medidas punitivas si no políticas de salud públicas.

Prevención y control

“Es necesario incrementar recursos y esfuerzos en las estrategias recomendadas para prevenir la transmisión del VIH, mejorar la calidad y la integralidad de la atención y disminuir el estigma y la discriminación hacia las poblaciones clave y las personas afectadas por el VIH y otras ITS, considerándolas como parte de la solución y contribuyendo a un México justo, incluyente y democrático”, señala sobre la penalización por transmisión del VIH y otras ITS en Centro Nacional para la Prevención y Control del VIH y el Sida.

Rudolf Geers, presidente de la asociación civil Vida Positiva enfatizó que en estos casos la responsabilidad para evitar nuevas transmisiones es compartida; cualquier persona que tenga relaciones sexuales casuales sebe de usar condón.

HIV criminalisation advocacy must extend beyond HIV specific statutes

By Kate D’Adamo

From TheBody.com

September 29, 2016

The fight to combat HIV criminalization is not new. After years of activism, gains are finally being made to repeal statutes that turn a person’s knowledge of their HIV status into a crime.

Just this year, Colorado’s HIV modernization bill comprehensively repealed almost all of the HIV-specific statutes in the state. This is an evidence-based success: Criminalizing people’s HIV status does not inhibit HIV transmission, but instead turns their knowledge and treatment of that status into evidence of a crime. This weaponizes their knowledge and their enrollment in the very care public health officials recommend, forcing people to weigh testing and treatment against fear of arrest.

With the growing success in fighting HIV criminalization, it is now time for advocates to take the conversation beyond the repeal of HIV-specific statutes and to confront the larger context of how criminalization encourages HIV transmission.

The growing data on where and when laws criminalizing a person’s status are implemented show that the people in the crosshairs of these laws are often those already criminalized through their engagement in sex work. The ostensible targets of HIV criminalization laws may be people who are not otherwise criminalized, but the data clearly show who faces most of their impact. The more common way that people who are HIV positive are criminalized for their status is not through general HIV criminalization statutes, but through laws that upgrade a misdemeanor prostitution charge to a felony if a sex worker is HIV positive.

The Williams Institute looked at who is charged and convicted of HIV-specific statutes in California found that “[t]he vast majority (95%) of all HIV-specific criminal incidents impacted people engaged in sex work or individuals suspected of engaging in sex work.” Research out of Nashville, Tennessee, corroborated this picture, with charges disproportionately targeting people arrested for prostitution, who then faced a felony upgrade and (until last year) were required to register as sex offenders for being HIV positive. However, these laws are not the only way criminalization increases sex workers’ vulnerability to HIV transmission, and advocacy must expand its vision to include the fuller context.

At the Sex Workers Project, we work with individuals who trade sex across the spectrum of choice, circumstance and coercion. For sex workers, the relationship between criminalization and health is complex and deeply interwoven.

When we look at the role of HIV transmission in the lives of our clients and community, it is not simply HIV-specific statutes, but the tactics of policing and the instability created through criminalization that increase people’s vulnerability. If the long-term goal is to end the spread of HIV, advocacy should target criminalization more holistically and see HIV modernization, or the on-going state-by-state push to repeal these statutes, as just one of the initial steps needed to explore the nexus between public health and criminalization.

When we expand our scope beyond these specific statutes to look at how policing and criminalization encourage HIV transmission, a more complex and multi-layered picture emerges. For instance, the relationship between evidence of a crime and transmission of HIV does not end with simply knowing one’s status. Law enforcement’s use of condoms as evidence of prostitution has a chilling effect. In research on the impact of policing that uses safer-sex supplies as evidence of a crime, many sex workers reported that they were afraid to carry condoms or take condoms from outreach workers, regardless of whether they were engaging in prostitution at that time. Most impacted by these policing practices were transgender women of color, a population acknowledged to be already at higher risk for HIV transmission. Transgender women are commonly profiled as being engaged in sex work, and therefore, were most at risk for being arrested for the mere possession of condoms. This means that policing practices are actively putting the community with the highest vulnerability to HIV at even higher risk of transmission.

Further, policing procedures that inundate areas “known for prostitution” with law enforcement push sex workers into isolated locations to avoid arrest. This means isolation from peers who can provide harm reduction and safety, and from outreach workers who may offer resources — in addition to making sex workers vulnerable to physical and sexual assault, as physical isolation carries its own risk of HIV transmission.

The fight for HIV modernization bills across the country is already having a demonstrable success. The recent Colorado HIV modernization bill shows what a comprehensive policy can look like. Many other state-based efforts have made sure their work encompasses those most impacted by HIV-specific statutes and fought to include in their advocacy sex workers and organizations serving people who trade sex.

But these policy changes should not be where the momentum ends. HIV criminalization is only one part of the larger on-going dialogue on the nexus between criminalization and public health that deeply impacts the lives of marginalized communities. When more people understand how criminalization affects individual and public health, we can expand the impact of our work to address these larger issues and shift our goals to not just avoiding the criminalization of HIV, but also stemming its spread.

Kate D’Adamo is the national policy advocate at the Sex Workers Project at the Urban Justice Center, focusing on laws, policies and advocacy that target folks who trade sex, including the criminalization of sex work, anti-trafficking policies and HIV-specific laws. Previously, Kate was a community organizer and advocate for people in the sex trade with the Sex Workers Outreach Project-NYC and Sex Workers Action New York. She holds a BA in political Science from California Polytechnic State University and an MA in international affairs from the New School University.

Originally published in The Body on 29/09/2016

Canada's HIV disclosure laws are out of date and bad for public health – Opinion piece by Robin Baranyai

Canada’s laws governing HIV disclosure are dangerously out of date. Anyone who tests positive and doesn’t warn their lover can be charged with aggravated sexual assault, carrying a penalty up to life in prison and lifelong registry as a sex offender. Fearing the potential criminal consequences of knowing, some people at risk won’t get tested.

Anyone, naturally, would hope an intimate partner would reveal if he or she was HIV-positive. But the criminal law is a blunt instrument with which to enforce honesty in a relationship. It sends a dangerous message people can assume their sexual partners are HIV-negative unless they reveal otherwise. And it further marginalizes a group already beset by stigma and discrimination.

People with HIV have many reasons for keeping the diagnosis to themselves. They may reasonably fear rejection, damaging public exposure or violence. But sex without disclosure, under the law, is rape; the omission invalidates consent.

Perhaps that made sense in the epidemic’s early days, when the risk was equated with death. But medical advances have changed the landscape.

Sex with HIV is no longer tantamount to Russian roulette. For this we can thank condoms and antiretroviral therapy (ART), which can bring a person’s viral load to undetectable levels. Either one of these measures reduces the risk of transmission to “negligible.” That’s not my opinion — it’s the scientific consensus of 70 leading HIV physicians and medical researchers across Canada.

In cases where there is virtually no risk of transmitting the virus, it’s hardly logical to prosecute non-disclosure. A 2012 Supreme Court ruling has already clarified disclosure is not required in cases where the risk of transmission is extremely low — specifically, when the viral load is undetectable and condoms are used.

Legislators should heed the scientists.

Their verdict is clear: The data supports decriminalizing non-disclosure if just one of these measures — effective ART or condom use — is in place to protect one’s partner. The consensus paper was published in 2014 to remedy the poor understanding of HIV transmission among prosecutors and judges. The authors expressed an ethical duty not only in the interest of justice, but also “to remove unnecessary barriers to evidence-based HIV prevention strategies.” Two years later, we’re still not listening.

Canada is a world leader in HIV criminalization, according to the Canadian HIV/AIDS Legal Network. At least 180 people have been prosecuted for non-disclosure. Half of these were in Ontario, with at least three new charges just this summer.

The double standard is no longer appropriate. ARTs have transformed HIV from a death sentence into a manageable chronic condition. Yet there are no criminal penalties for failing to notify a partner of an array of STDs, some of which can lead to infertility or cancer. Instead, quite logically, we promote self-protection through safer sex.

People withhold information about their sexual histories. One hardly expects a full accounting of partners, past STD treatments or other details one might be inclined to omit in the blush of a budding romance. The point is, people can’t assume their partner has told them everything — nor knows everything there is to tell.

According to the Public Health Agency of Canada, one in four people with HIV don’t know they are infected. If knowledge of the virus can turn sex into a criminal act, it creates a significant disincentive to seek testing and treatment. That’s a public health disaster.

Put simply: Treatment reduces transmission. If it’s good public policy to encourage HIV testing, then it’s good public policy to make it safe to know the results.

Published in the Melfort Journal on 23/09/2016

Canada: ‘HIV is not a crime’ documentary premieres in Montreal at Concordia University’s ‘The Movement to End HIV Criminalization’ event

Last week, Concordia Unversity in Montreal, Canada, held the world premiere public screening of HJN’s ‘HIV is not a crime training academy’ documentary, followed by three powerful and richly evocative presentations by activist and PhD candidate, Alex McClelland; HJN’s Research Fellow in HIV, Gender, and Justice, Laurel Sprague; and activist and Hofstra University Professor, Andrew Spieldenner.

The meeting, introduced by Liz Lacharpagne of COCQ-SIDA and by Martin French of Concordia University – who put the lecture series together – was extremely well-attended, and resulted in a well-written and researched article by student jounrnalist, Ocean DeRouchie, alongside a strong editorial from Concordia’s newspaper, The Link.

(The full text of both article and editorial are below.)

Presentations included:

  • Edwin Bernard, Global Co-ordinator, HIV Justice Network: ‘The Global Picture: Surveying the State of HIV Criminalisation’
  • Alex McClelland, Concordia University: ‘Criminal Charges for HIV Non-disclosure, Transmission and/or Exposure: Impacts on the Lives of People Living with HIV’
  • Laurel Sprague, Research Fellow in HIV, Gender, and Justice, HIV Justice Network: ‘Your Sentence is Not My Freedom: Feminism, HIV Criminalization and Systems of Stigma’
  • Andrew Spieldenner, Hofstra University: ‘The Cost of Acceptable Losses: Exploring Intersectionality, Meaningful Involvement of People with HIV, and HIV Criminalization’

Articles based on a number of these important presentations will be published on the HJN website in coming

weeks.

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The Movement to End HIV Criminalization

Decrying Criminalization

Concordia Lecture Series Prompts Discussion on HIV Non-disclosure

by Ocean DeRouchie — Published September 19, 2016 in The Link

The sentiment surrounding HIV/AIDS is often one of discomfort. But the reluctance to speak openly about such a significant and impactful disease is hurting the people closest to it.

Under current Canadian legislation, HIV non-disclosure is criminalized. It exercises some of the most punitive aspects of our criminal justice system, explained Alexander McClelland, a writer and researcher currently working on a PhD at Concordia.

McClelland was one of four panelists speaking under Concordia’s Community Lecture Series on HIV/AIDS on Thursday, Sept. 15 in the Hall building. The collective puts on multiple panel-based events in order to address the attitudes, laws, and intersections of political and socioeconomic stigma surrounding HIV/AIDS.

Talking About HIV, Legally

There are three distinct charges that guide prosecutors in HIV cases—transmission (giving the disease to someone without having disclosed your status), exposure (e.g. spitting or biting) and non-disclosure (not informing a sexual partner about your HIV/AIDS status).

Aggravated sexual assault and attempted murder are some of the charges that defendants often face, explained Edwin Bernard, Global Coordinator for the HIV Justice Network, during the discussion.

While there are clearly defined situations in which you are legally obligated to tell a sex partner about your HIV status, there are no HIV-specific laws. This results in the application of general law in cases that are anything but general.

In 2012, the Supreme Court of Canada established that “people living with HIV must disclose their status before having sex that poses a ‘realistic possibility of HIV transmission.’”

Aidslaw.ca presents a clear map of situations in which you’d have to tell a sex partner about your status because, in fact, it is not in all scenarios that you’d be legally required to have the discussion.

A lot of it depends on your viral load—the amount of measurable virus in your bloodstream, usually taken in milliliters. A “low” to undetectable viral load is the goal, and is achieved with anti-viral medication.

Treatment serves to render HIV-positive individuals non-infectious, and therefore lowering the risk of transmission. A “high” viral load indicates increased amounts of HIV in the blood.

If protection is used and with a low viral load, one might not have to disclose their status at all.

That said, there is a legal obligation to disclose one’s HIV-positive status before any penetrative sex sans-condom, regardless of viral load. You’d also have to bring it up before having any sex with protection if you have a viral load higher than “low.”

But not all sex is spelled out so clearly.

Oral sex, for instance, is a grey area. Aidslaw.ca says, “oral sex is usually considered very low risk for HIV transmission.” They write that “despite some developments at lower level courts,” they cannot say for sure what does not require disclosure.

There are “no risk” activities. Smooching and touching one another are intimate activities that, as health professionals say, pose such a small risk of transmission that there “should be no legal duty to disclose an HIV-positive status.”

Moving Up, and Out of Hand

Court proceedings are based on how the jury and judge want to apply general laws to specific instances. There are a lot of factors that can influence the outcome.

The case-to-case outlook leads to the criminal justice system dealing with non-disclosure in such a disproportionate way, said McClelland.

The situation begs the question: “Why is society responding in such a punitive way?” asked McClelland.

This isn’t to say that not disclosing one’s HIV status “doesn’t require some potential form of intervention,” he explained, adding that intervention could incorporate counseling, mental-health support, encouragement around building self-esteem and learning how to deal and live with the virus in the world. “But in engaging with the very blunt instrument that is the criminal law is the wrong approach.”

He continued to explain that the reality of the criminalization of HIV ultimately doesn’t do anything to prevent HIV transmission.

“It’s just ruining people’s lives,” said McClelland, who has been interviewing Canadians who have been affected by criminal charges due to HIV-related situations. “It’s a very complex social situation that requires a nuanced approach to support people.”

“It’s just ruining people’s lives. It’s a very complex social situation that requires a nuanced approach to support people.” – Alexander McClelland, Concordia PhD student

Counting the Cases

The Community AIDS Treatment Information Exchange, a Canadian resource for information on HIV/AIDS, states that about 75,500 Canadians were living with the virus by the end of the 2014, according to the yearly national HIV estimates.

That number has gone up since. On Monday, Sept. 19, Saskatoon doctors called for a public health state of emergency due to overwhelmingly increasing cases of new infections and transmission, according to CBC.

In Quebec, there have been cases surrounding transmission and exposure. In 2013, Jacqueline Jacko, an HIV-positive woman, was sentenced to ten months in prison for spitting on a police officer—despite findings that confirm that the disease cannot be transmitted through saliva.

In this situation, Jacko had called for police assistance in removing an unwelcome person from her home. Aggression transpired between her and the officers, resulting in her arrest and eventually her spitting on them, according to Le Devoir.

“[This case] is so clearly based on AIDS-phobia, AIDS stigma and fear,” added McClelland, “and an example of how the police treat these situations and use HIV as a way to criminalize people.”

Police intervention is crucial in the fight against HIV criminalization. McClelland urged people to consider the consequences of involving the justice system in these kinds of situations.

“It’s important to understand that the current scientific reality for HIV is that it’s a chronic, manageable condition. When people take [antivirals] they are rendered non-infectious,” he said. “They should then understand that the fear is grounded in a kind of stigma and historical understanding of HIV that is no longer correct today.”

The first instinct, or notion of calling the police in an instance where one feels they may have been exposed to the virus in some way is “mostly grounded in fear and panic,” he said.

“[Police] respond in a really disproportionate, violent way towards people—so I would consider questioning, or at least thinking twice before calling the police,” McClelland explained.

On the other hand, he suggested approaching the situation in more conventional, educational and progressive methods.

“I think it could be talked through in different ways—by going to a counselor, talking to a close friend, engaging with a community organization, learning about HIV and what it means to have HIV, and understanding that the risk of HIV transmission are very low because of people being on [antivirals].”

As for the current state of Canadian legislation, there are a lot of complexities that hinder heavy-hitting changes to the laws.

Due to the Supreme Court’s rulings in 2012, they are unlikely to review the decision for another decade. For now, the main course of action is “on the ground,” said McClelland. From mitigating people from requesting police involvement in order to “slow down the cases,” to raising awareness through events such as Concordia’s Community Lecture Series, and engaging with the people to resolve issues in community-based ways and collective of care.

Then, McClelland said, “trying to do high-level political advocacy to get leaders to think about how they can change the current situation” would be the next step.

Editorial: Community-Based Research is the Key to HIV Destigmatization and Decriminalization

Opinions by The Link — Published September 19, 2016

Receiving an HIV-positive diagnosis is already a life sentence. The state of Canada’s legal system threatens to give those living with the virus another one.

An HIV diagnosis is accompanied by its own set of complexities that are not encompassed in Canada’s criminal law. By pushing HIV non-disclosure cases into the same box as more easily defined assault cases, we are generalizing an issue that frankly cannot be simplified.

This does not reflect the reality that one faces when living with HIV. Criminalizing the virus further stigmatizes what should and could be everyday activities.

This puts the estimated 75,000 Canadians living with HIV at risk of being further isolated. This takes us backwards, considering the scientific progress that has been made to make living with the virus manageable. Under the proper antiviral medication, one’s risk of transmitting the disease is incredibly low. This stigma is rooted in an antiquated understanding of what HIV is and the associated risks—much of that fear having emerged primarily as a result of homophobia.

Further, with over 185 cases having been brought to court, Canada is leading in terms of criminalizing HIV non-disclosure. This pushes marginalized communities farther away. According to estimates from 2014, indigenous populations have a 2.7 higher incidence rate than the non-indigenous Canadian average. Gay men have an incidence rate that is 131 times higher than the rest of the male population in Canada.

As of Sept. 19, doctors in Saskatchewan are calling on the provincial government to declare a public health state of emergency, with a spike in HIV/AIDS cases around the province.

In 2010, it’s reported that indigenous people accounted for 73 per cent of all new cases in the province. Outreach and treatment for these communities are at the forefront of Saskatchewan’s doctor’s recommendations for the government.

With such a highly treatable virus, however, the problem should never have gone this far. It is an excerpt from a much bigger issue.

As we can see from the available statistics, HIV—both the virus and its criminalization—is a mirror for broader inequalities that exist within society. HIV related issues disproportionately affect racialized people, gender non-conforming people, and other marginalized groups.

Discussions around HIV also must include discussions around drug use. The heavy criminalization of injection drugs has created a context where users are driven deep underground, thus putting them at an incredibly high risk for contracting the virus. Treating drug use as a health rather than a criminal issue is an integral part of any effective HIV prevention strategy. Safe injection sites, such as Vancouver’s InSite, have made staggering differences in their communities and prove to be a positive way of combating the spread of HIV.

This is just one of the many ways that we can control the spread of HIV without judicial intervention, without turning the HIV-positive population into criminals.

Using community-based research enables us to not only understand the needs of the affected population—particularly when it comes to understanding the almost inherent intersectionality associated with the spread of HIV—but also allows us to better target our resources towards those who need it most.

Often times, that stretches to include those closest to HIV-positive individuals. Spreading awareness, and developing resources and a support network for them is just as important in fighting the stigmatization of the virus.

The Link stands for the immediate decriminalization of HIV non-disclosure, and the move towards restorative justice systems in non-disclosure cases. As always, those directly affected by an issue are the ones with who are best positioned to create a solution—something that the restorative justice framework embraces.

The disclosure of one’s HIV status is important. Jailing those who don’t disclose it, however, won’t make the virus go away. It simply isolates the problem, places it out of site and out of mind.

Criminalizing HIV patients is less about justice than it is about appeasing the baseless fears of the general population. It’s time for a more effective solution.