UK: New Crown Prosecution Service guidance on cases of alleged HIV transmission states that undetectable viral load stops HIV transmission

U=U acknowledged in prosecutors’ guidance in England and Wales

Krishen Samuel

New Crown Prosecution Service guidance on cases of alleged HIV transmission state that an undetectable viral load stops HIV transmission. While the previous guidance stated that a person’s viral load at the time may provide a defence because it was believed to reduce transmission risk, it did not clearly set out the medical consensus is that this risk is zero. Cases should no longer be taken to court in England and Wales when a person has an undetectable viral load and is aware that Undetectable = Untransmittable (U=U).

In England, Wales and Northern Ireland, concealing or lying about living with HIV is not viewed as a sexual offence. This is unlike jurisdictions that have specific HIV non-disclosure laws. However, reckless or intentional transmission of an STI is viewed as a form of grievous bodily harm that can result in criminal charges.

Since 2019, the National AIDS Trust has been working with the Crown Prosecution Services (CPS) to update their guidance to accord with medical knowledge regarding the lack of risk if someone has an undetectable HIV viral load. The latest guidance issued last week clearly specifies the conditions that must be met for a charge of this nature to occur. Importantly, this only applies to sexual transmission and not to other modes, such as needle-sharing.

Prior to seeking out expert witnesses to rule out other sources of infection, and to confidently ascertain if one person transmitted HIV to another, prosecutors need to work through a series of conditions that need to be met for there to be sufficient evidence for a criminal charge. Gathering information for these conditions involves police investigation and will likely be intrusive for both the accuser and the accused.

To begin with, the person making the accusation must have an STI that amounts to a form of grievous bodily harm. While this harm need not be either permanent or dangerous, it should require treatment and have lasting consequences. Based on previous court judgements, the two STIs that qualify are HIV and herpes. Since 2001, there have been more than 30 people convicted of reckless HIV transmission, one of intentional HIV transmission and one of recklessly transmitting herpes in England and Wales. The rest of this article will focus on cases related to HIV.

The second condition is that the accused must have HIV at the time of having sex with the accuser. This can be proven in several ways, including via medical records, during interrogation or upon the discovery of medications such as antiretrovirals.

The next condition is that the accused knew they had HIV at the time of sex. If they were unaware of their status, and only diagnosed or became aware after having sex with the accuser, there would be insufficient evidence to meet this condition. If the couple had sex multiple times, and the accused was diagnosed or became aware during this period, it would similarly be difficult to prove that they knew their status at the time of transmission. Additionally, it could be the accuser who transmitted HIV to the accused, instead of the other way around. Thus, prosecutors need to carefully consider dates of diagnoses and other relevant evidence.

This condition is not completely straightforward: there is the possibility that the accused was not necessarily diagnosed with HIV but could otherwise have known they had it (through showing clear symptoms, or transmission to other sexual partners, for instance).

The fourth condition is central to building the prosecution’s case: the person living with HIV must have intended to transmit it or knew there was a risk and went on to have sex with the accuser anyway. Intentional cases of HIV transmission are few and far between.

For most cases – those related to reckless transmission – there are several important factors to consider. If the person living with HIV believed that they took reasonable steps to prevent transmission, such as using a condom or having an undetectable viral load, this could be a defence against this condition. However, as transmission can occur even in the instance that reasonable steps are taken, the central question is whether the accused believed they were putting the other person at a significant risk of HIV infection.

Here, a range of factors need to be considered, including what the accused was told about prevention, their level of infectiousness, their knowledge of how treatment works, whether they understood the information, if they ejaculated inside their partner and the number of sexual encounters. The possibility that inadequate information was provided by the medical practitioner also needs to be considered.

Importantly, the updated guidance specifically references an undetectable viral load. It acknowledges that a person living with HIV with a known undetectable viral load cannot be seen to recklessly transmit the virus if they were relying on their undetectable status as a means of preventing infection. Here, it is crucial to determine if the person living with HIV was undetectable at the time of sex, or whether they believed that they were, based on both viral load tests and consultations with their doctor.

While there is no legal obligation for the person living with HIV to inform their sexual partners of their HIV status, if the accuser consented to sex when they knew their partner had HIV, evidence of this knowledge is a defence against a reckless transmission charge.

The final condition is that the accused (and nobody else) in fact infected the accuser with HIV. The guidance acknowledges that this condition may be challenging to prove, especially in cases where a person has multiple sexual or needle-sharing partners. It is also intrusive and can require a great deal of investigation, time and expert evidence. Thus, this step should only be undertaken when the previous conditions are confidently met. If the prosecution cannot rule out the possibility that the infection came from another sexual or needle-sharing partner, there is insufficient evidence to meet this condition and therefore to prosecute, regardless of whether the preceding steps could be proven.

In the instance that expert evidence is required to prove that the accused infected the accuser, the guidance mentions methods such as phylogenetic analysis. It correctly states that this form of evidence may prove with certainty that the accused did not infect the accuser, but not that they did – as both people could have acquired the genetically similar virus from a third person. Additionally, recency assays can be used to determine whether an HIV infection is recent or longstanding, which can form part of the evidence. There is currently no objective scientific method to determine that one person transmitted HIV to another with complete certainty.

The National AIDS Trust has commended the updated guidance, as it is notable that it aligns with current scientific understanding. However, they also acknowledged that HIV criminalisation remains inherently problematic.

“We believe treating the reckless transmission of HIV as a criminal issue does more harm than good and does not result in reduced transmissions or a greater public understanding of HIV,” they say. “The updates to the guidance can go some way to ensure that cases are handled sensitively and consider the facts around HIV today. It’s essential that the CPS continue open dialogue with people living with HIV, community organisations and clinicians to ensure that the guidance reflects the most up to date evidence and that it is supporting good practice.”

References

The Crown Prosecution Service. Intentional or reckless sexual transmission of infection. Published online 29 March 2023.

Illinois fully repeals its HIV criminalisation law

This week, the Governor of the US state of Illinois signed a bill that fully repeals its HIV criminalisation law, becoming only the second US state ever to do so.

Illinois’ HIV-specific criminal law was first enacted in 1989, and then “modernized” in 2012. An in-depth investigational analysis examining the history of the law and how it has been applied, published in June by Injustice Watch and the Chicago Reader, found that the law had been used at least 80 times since 1989.

Even after the law was amended in 2012 to include “intent to transmit” as an element of the ‘crime’, it appears to have been (ab)used in 22 criminal cases over the past nine years.

That’s why the Illinois HIV Action Alliance was formed in 2019 with the lofty goal of completely repealing the law. This coalition of more than 25 state and national organisations  – including our HIV JUSTICE WORLDWIDE partners, Positive Women’s Network-USA and the Sero Project – undertook a huge amount of awareness, education, and outreach.

Read this excellent article published by The Body in June to learn exactly what they did, and how.

Key to their surprisingly rapid success were two political champions, State Senator Robert Peters, and State Representative Carol Ammons.

“Illinois’ HIV criminalisation law was rooted in fear and racial biases,” Senator Peters noted in an Illinois HIV Action Alliance press release. “It was used to abuse people in our state, targeting people living with HIV and disproportionately affecting LGBTQ+ people, women, and Black and Brown communities.”

“Not a single study throughout the country shows HIV criminalisation has reduced HIV transmission in any jurisdiction where it exists,” added Representative Ammons. “It was far past time to get rid of this harmful law, and we thank Governor Pritzker for repealing it once and for all.”

Illinois Governor J.B. Pritzker’s Facebook page live-streamed the bill signing event, held at the LGBTQ Center on Halsted in Chicago’s ‘Boystown’ on Wednesday. The repeal of the HIV criminalisation law was part of a package of legislation that also included measures to make it easier for couples to receive marriage certificates with gender-neutral language, and to get new certificates if one or both legally change their names subsequent to the initial document being issued.

At the signing, Governor Pritzker called HIV criminalisation laws archaic: “They don’t decrease infection rates, but they do increase stigma,” he said. “It’s high time we treat HIV as we do other treatable transmissible diseases.”

The law’s repeal was effective immediately on signing, but the advocacy doesn’t stop there.

First, the bill does not expunge the records of those who’ve already been prosecuted under the original or updated law.

And second, the first US state to repeal its HIV criminalisation law was Texas, in 1994. However, since then, there have been many unjust prosecutions under general laws, including that of a homeless man whose saliva was considered to be a ‘deadly weapon’ when he spit on a policeman who was arrested him for vagrancy, resulting in a 35 year prison sentence.

Consequently, advocacy is still required to ensure that police and prosecutors implement guidance to limit the overly broad and unjust use of other kinds of criminal laws when dealing with HIV-related cases.

Watch a special 4-minute 30-second edit, produced by HJN, of the bill signing ceremony that features Timothy Jackson of AIDS Foundation Chicago, who led the Illinois HIV Action Alliance, along with Senator Peters, Representative Ammons, and Governor Pritzker.

WATCH HIV Justice Live! (Ep 4): How to advocate for prosecutorial guidance for HIV-related cases

The fourth episode of HIV Justice Network’s web show, HIV Justice Live! that streamed live on July 14 is now available to watch on YouTube.  The episode, which our colleagues at the HIV Legal Network called a “master class in advocacy” discussed the newly launched UNDP’s Guidance for Prosecutors on HIV-related criminal cases and provided insights into how to work with prosecutorial authorities so that they have a clear understanding of how to – and more importantly how not to – use HIV criminalisation laws.

Guidance like this is a good example of a ‘harm reduction’ approach if you can’t change or repeal HIV criminalisation laws, and adopting such guidance can result in fewer miscarriages of justice, as well as improve the criminal legal system’s understand of, and approach to, people living with HIV.  Once implemented it’s also a good way of holding prosecutors to account.

The Guidance was developed for UNDP by our HIV JUSTICE WORLDWIDE colleagues, Richard Elliott and Cécile Kazatchkine of the HIV Legal Network. The process, which took two years, involved multiple consultations. Several other colleagues, including HJN’s Executive Director Edwin J Bernard, HJN Supervisory Board member Lisa Power, and HJN Global Advisory Panel member Edwin Cameron were part of the Project Advisory Committee.

The episode, hosted by Edwin J Bernard and featuring UNDP’s Kene Esom alongside Lisa Power and Richard Elliott, also included a special edit of HJN’s documentary, “Doing HIV Justice”, which demystifies the process of how civil society worked with the Crown Prosecution Service of England and Wales to create the world’s first policy and guidance for prosecuting the reckless or intentional transmission of sexual infection.

The full-length, 30-minute version of this documentary is now available as part of a YouTube playlist that also features two other educational and informative videos: an introduction by the CPS’s Arwel Jones with some useful tips about how to engage with prosecutors, and a workshop that took place after the world premiere screening in Berlin, featuring Lisa Power and Catherine Murphy (who helped advocate for the implementation of guidance in England & Wales, and Scotland, respectively) as well as former UNAIDS Senior Human Rights and Law Adviser, Susan Timberlake.

Canada: New directive to limit unjust prosecutions against people living with HIV to be issued by Attorney General of Canada

OTTAWA, Dec. 1, 2018 /CNW/ – The Government of Canada is committed to a fair, responsive and effective criminal justice system that protects Canadians, holds offenders to account, supports vulnerable people, and respects the Canadian Charter of Rights and Freedoms. Today, on the 30th anniversary of World AIDS Day, the Honourable Jody Wilson-Raybould, Minister of Justice and Attorney General of Canada, announced that she will issue a directive related to the prosecution of HIV non-disclosure cases under the federal jurisdiction of the Public Prosecution Service of Canada.

In issuing the Directive, the Government of Canada recognizes the over-criminalization of HIV non-disclosure discourages many individuals from being tested and seeking treatment, and further stigmatizes those living with HIV or AIDS.

This Directive is a real step toward ensuring an appropriate and evidence-based criminal justice system response to cases of HIV non-disclosure. In so doing, it will harmonize federal prosecutorial practices with the scientific evidence on risks of sexual transmission of HIV while recognizing that non-disclosure of HIV is first and foremost a public health matter.

On December 1, 2016, Minister Wilson-Raybould committed to working with her provincial and territorial counterparts, affected communities, and medical professionals to examine the criminal justice system’s response to non-disclosure of HIV status. A year later, on December 1, 2017, the Department of Justice issued its report, The Criminal Justice System’s Response to Non-Disclosure of HIV. The Directive will draw upon the recommendations made concerning prosecutorial discretion. It will provide guidance to federal prosecutors in the three territories, ensuring coherent and consistent prosecution practices.

In its 2012 Mabior decision, the Supreme Court of Canada made it clear that persons living with HIV must disclose their HIV status prior to engaging in sexual activity that poses a “realistic possibility of transmission”; and the most recent scientific evidence on the risks of sexual transmission of HIV should inform this test.

The Directive to be issued by the Attorney General of Canada will reflect the most recent scientific evidence related to the risks of sexual transmission of HIV, as reviewed by the Public Health Agency of Canada, as well as the applicable criminal law as clarified by the Supreme Court of Canada. The Directive will state that, in HIV non-disclosure cases, the Director:

  • shall not prosecute where the person living with HIV has maintained a suppressed viral load (i.e. under 200 copies of the virus per millilitre of blood) because there is no realistic possibility of transmission;
  • shall generally not prosecute where the person has not maintained a suppressed viral load but used condoms or engaged only in oral sex or was taking treatment as prescribed unless other risk factors are present, because there is likely no realistic possibility of transmission in such cases;
  • shall prosecute using non-sexual criminal offences instead of sexual offences where this would better align with the individual’s situation, such as cases where the individual’s conduct was less blameworthy; and
  • must take into account whether a person living with HIV has sought or received services from public health authorities, in order to determine whether it is in the public interest to pursue criminal charges.

The criminal law will continue to apply to persons living with HIV if they do not disclose, or misrepresent, their HIV status before sexual activity that poses a realistic possibility of HIV transmission.

The Director of Public Prosecutions Act requires that directives from the Attorney General of Canada be published in the Canada Gazette. The Directive will take effect upon publication in Part I of the Canada Gazette on Saturday, December 8, 2018.

Quote

“Our criminal justice system must be responsive to current knowledge, including the most recent medical science on HIV transmission. I am proud of this important step forward in reducing the stigmatization of Canadians living with HIV while demonstrating how a scientific, evidence-based approach can help our criminal justice system remain fair, responsive and effective.”

The Honourable Jody Wilson-Raybould, P.C., Q.C., M.P.

Minister of Justice and Attorney General of Canada

Quick Facts

  • World AIDS Day originated at the 1988 World Summit of Ministers of Health on Programmes for AIDS Prevention. It is marked on December 1 of every year. This year’s theme is “Know your status”.
  • Canada’s efforts to detect and treat HIV have resulted in the majority of persons living with HIV in Canada knowing their status and receiving appropriate treatment.
  • There is no HIV-specific offence in the Criminal Code. However, persons living with HIV who do not disclose their status may be charged with aggravated sexual assault because the non-disclosure is found to invalidate their partner’s consent to engage in sexual activity in certain circumstances. This is the most serious sexual offence in the Criminal Code.
  • The Directive will take into consideration current scientific evidence and research on HIV transmission. It will provide clear direction to federal prosecutors in the territories when exercising their discretion to decide whether to prosecute HIV non-disclosure cases. The research supporting the development of the Directive was compiled by the Public Health Agency of Canada, informed the Department of Justice Canada’s Report on the Criminal Justice System’s Response to Non-Disclosure of HIV, and was published in the Canadian Medical Association Journal.
  • The Directive is the result of significant engagement and consultation with LGBTQ2+ advocates, including the HIV/AIDS Legal Network, leading academics in the field, health professionals, as well as the Director of Public Prosecutions.

Associated Links

Stay Connected

SOURCE Department of Justice Canada

For further information: media may contact: Célia Canon, Communications Advisor, Office of the Minister of Justice, 613-862-3270; Media Relations, Department of Justice Canada, 613-957-4207, media@justice.gc.ca

Related Links

http://www.justice.gc.ca/

Canada: Lawyers are asking for current cases and past convictions of non-disclosure to be revisited in light of federal justice department report

Lawyers urge second look at HIV non-disclosure cases, convictions following report

Monday, December 11, 2017 @ 9:25 AM | By Terry Davidson

Lawyers are urging Crown attorneys to re-examine HIV non-disclosure cases past and present following a federal report calling for a curbing of criminal prosecutions in light of evolving science around risk of transmission.

Various Canadian criminal lawyers are saying current cases and past convictions of non-disclosure should be revisited by provincial prosecutors and their attorneys general against the backdrop of the new report, which lays out various scenarios which would involve a low — or even non-existent — possibility of transmission, even if a condom is not used.

The Criminal Justice System’s Response to Non-Disclosure of HIV warns of the overcriminalization of infected people who don’t disclose their condition but are on treatment, have a low viral load and pose a “negligible” risk to a non-infected sex partner.

It goes on to classify HIV as “first and foremost a public health issue.”

After the report’s release, Ontario Attorney General Yasir Naqvi and Health Minister Eric Hoskins announced they would tell their Crowns to now limit non-disclosure prosecutions, particularly in cases where the infected person “is on antiretroviral therapy” and “where an individual has a supressed viral load for six months.”

Toronto criminal lawyer Michael Lacy, a partner with Brauti Thorning Zibarras and president of the Criminal Lawyers’ Association, said the report should give “guidance” to Crown prosecutors.

“From a legal perspective, the report provides guidance that should eliminate criminal prosecution in those cases,” said Lacy. “Non-disclosure alone will not vitiate consent. Non-criminal responses are being recommended for the vast majority of cases involving public health authorities. At the same time, the report recognizes that there will be some, now hopefully limited, circumstances where the blunt instrument of the criminal law will be the appropriate way to respond to deliberately high-risk behaviour.”

Current standards used to prosecute non-disclosure cases need to catch up with evolving science, the report states.

“Sexual activity, regardless of condom use, with an HIV positive person who is taking HIV treatment as prescribed and has maintained a suppressed viral load … poses a negligible risk of transmission,” it reads.

Still, it stresses “criminal law applies to HIV-positive persons where they fail to disclose, or misrepresent, their HIV status prior to sexual activity that poses a realistic possibility of transmission.”

Criminal law, it states, should not apply to non-disclosing infected people as long as they’ve maintained a suppressed viral load of under 200 copies per millilitre of blood, and that “a person living with HIV who takes their treatment as prescribed is acting responsibly.”

Also, the law should not apply to those who are not on treatment but use condoms or to those who engage only in oral sex, “because the realistic possibility of transmission test is likely not met in these circumstances.”

Instances where risk increases, it states, includes “multiple acts of sexual intercourse,” particularly when condoms are not used, and oral sex involving ejaculation with an untreated infected partner.

It also states that “persons from marginalized backgrounds,” such as gay, Indigenous and black people, are disproportionately impacted.

Released Dec. 1, the federal paper could potentially trigger a new legal chapter in this issue.

In 2012, the Supreme Court ruled in R. v. Mabior [2012] SCC 47 that an infected person was not legally required to disclose their HIV-positive status to a sex partner if the former carried a low viral load and used a condom. But the SCC also left room for tweaking should laws need to adapt with scientific findings and shifting risk factors.

This report instructs all Crown attorneys that they need to examine the science underlying their individual prosecutions and decide whether or not it is still in the public interest to prosecute the cases, and whether or not there is still a reasonable prospect of conviction,” said Toronto lawyer Daniel Brown, head of Daniel Brown Law and author of Prosecuting and Defending Sexual Assault Offence Cases: A Practitioner’s Handbook. “Because the science has evolved so quickly and so much … our perceptions of what created a realistic possibility of transmission, even five years ago, has changed to where we’re at today, and we have to re-examine all of the cases in the court system to determine whether or not they still meet that standard.”

Provincial attorneys general should turn their eyes toward past convictions, he said.

“We can see that there was a substantial amount — not just those who were convicted after a trial — but many people who pled guilty perhaps to minimize the type of punishment that could come to them had they proceeded to a trial … and it is uncertain whether or not they pled guilty in the face of evidence that would no longer withstand scrutiny,” said Brown. “Were these cases where there was a realistic possibility of transmission, or were these cases where the law hadn’t caught up with the science?”

Alberta criminal lawyer Markham Silver also talked about revisiting non-disclosure convictions, using as an example the launching of a coroner’s inquiry into years of botched examinations by disgraced child pathologist Charles Smith.

“Realistically, the attorney general or the ministry of justice of any province can engage in reviews as they see fit,” said Silver. “When they had the situation … in Ontario with Smith … the Crown reviewed a whole rack of cases that dealt with his evidence and made determinations based on new information they had obviously received. … So it’s certainly open to the Crown to do as the Crown sees fit … in any particular provinces.”

Vancouver lawyer Troy Anderson, who recently acted in a non-disclosure case, agrees.

“If you’re looking at the science that says it is essentially no risk of HIV transmission if you are being treated and acting responsibly, then yes, I agree with that absolutely,” he said. “The prosecution services vary from province to province … [but] I think it is absolutely going to follow. I think there is will be a drop in the number of people being prosecuted for this.”

Jamaica: Office of the Director of Public Prosecutions recommends legislation making wilful transmission of STIs a crime

Prosecutors want Law making wilful transmission of sexual disease a crime

Jovan Johnson, Parliamentary Reporter

The Office of the Director of Public Prosecutions has recommended that the Parliament make it clear in law that knowingly transmitting a sexual disease is a crime.

Assistant DPP, Adley Duncan, said the offence exists at common law but there is no legislation explicitly stating that the act is illegal.

He made the recommendation this afternoon during a parliamentary committee reviewing Jamaica’s sex laws.

Duncan said the position of the Office of the DPP stemmed from last year’s case involving George Flowers, who was ordered extradited from Jamaica to Canada on allegations he knowingly transmitted HIV to four women in the North American country between 1996 and 2012.

Flowers reportedly fled to Jamaica in 2012, the same year Canadian police issued an arrest warrant and later an extradition request.

Jamaica and Canada have an extradition treaty, which has the DPP’s office as the central authority or the representative of the requesting foreign state.

Duncan said an issue developed following the request in 2013 as Flowers argued that the offence was in Canadian law but not in Jamaica’s and therefore by the rules, he could not be extradited.

The assistant DPP said prosecutors successfully argued that the offence is recognised at common law and the courts upheld the order.

He also noted that under Jamaica’s marital rape law, knowingly or recklessly transmitting a sexual offence is a crime.

But Duncan said, making it clear in law that such an action is a criminal offence would remove any doubt.

Canada: Eye-opening document on how Crown attorneys approach prosecuting HIV non-disclosure cases disclosed

Document on HIV non-disclosure prosecutions disclosed

Written by Alex RobinsonFriday, 13 January 2017

A newly disclosed document sheds some light on how Crown attorneys may have approached prosecuting HIV non-disclosure cases.

The Ministry of the Attorney General has released a document written by an assistant Crown attorney detailing her approach to prosecuting HIV non-disclosure cases.

The document discusses the admissibility of an accused person’s statements to public health as incriminating evidence — something human rights lawyers and HIV activists find troubling.

“The risk has always been that the use of an accused’s statements to public health would put a damper on HIV positive peoples’ willingness to be frank with public health, which puts their own health at risk and the population also at risk as well,” says Toronto lawyer Marcus McCann.

McCann says this approach could have a chilling effect on whether people with HIV will seek help from health professionals.

McCann obtained the document through a Freedom of Information request and subsequent years-long legal battle with the provincial government over whether the document should be disclosed.

Karen Shea, an assistant Crown attorney, wrote the document during the 2009 case of Johnson Aziga, an HIV-positive man who was convicted of murder for failing to disclose his status when he had unprotected sex with two women.

In the absence of an official set of prosecutorial guidelines for HIV non-disclosure cases, McCann first requested the document in the hope it could help discussions between the government and organizations that have been pushing the issue.

In November, the Divisional Court ordered MAG to release the document, and the provincial government decided not to appeal the decision.

The document includes a list of arguments against HIV non-disclosure criminalization and responses to them, which McCann says shows the government was aware of those critiques and had discarded them.

McCann says in the past there has been a view among HIV activists that they could push MAG to make meaningful change in the area if they could educate the ministry on current science.

“One of the things this document shows is that MAG knew full well what the concerns were with their approach and they were proceeding full steam ahead,” McCann says.

“It really is a document to my mind that is focused on prosecution at all costs and doesn’t take into consideration the kinds of situations in which a more lenient approach might be justified.”

Clare Graham, a spokeswoman for Attorney General Yasir Naqvi, says the document is not an official set of prosecutorial guidelines.

“The document is the work product of an individual Assistant Crown Attorney based on her knowledge and experience prosecuting HIV exposure and transmission cases,” she said in an email.

“The Assistant Crown Attorney prepared this document not only for her own use but also to assist her colleagues in a difficult and complex area of the law; however, this document is not a Ministry issued policy or guideline.”

In the legal proceedings concerning the document’s disclosure, MAG conceded that multiple versions of the document existed and that it had been shared on an intranet accessible to all Crown attorneys.

The document was disclosed as the Ontario Working Group on Criminal Law and HIV Exposure called for a moratorium on prosecutions in HIV non-disclosure cases, unless they involve allegations of intentional transmission, while discussions take place to develop an official set of guidelines.

The working group and its member organizations have been working for years towards the development of a set of prosecutorial guidelines.

The working group has obtained a commitment in the past from the provincial government, only to never see any guidelines materialize, Peck says.

“Unfortunately the dialogue over the past seven or more years, from our perspective, has not been meaningful,” says Ryan Peck, the executive director of the HIV & AIDS Legal Clinic Ontario, who sits on the working group.

But Peck says the working group is hopeful that it will be able to engage in meaningful dialogue with Naqvi, who has been attorney general since June.

Peck says the guidelines will need to be developed to bring the prosecutions of these cases in line with up to date science and human rights principles.

The group most recently met with Naqvi at a roundtable discussion on the topic on Dec. 5.

The federal government issued its own statement on World AIDS Day in early December acknowledging the effects of the over-criminalization of HIV non-disclosure. The statement, attributed to Justice Minister Jody Wilson-Raybould, committed to examining “the criminal justice system’s response to non-disclosure of HIV status,” saying this could include a “review of existing charging and prosecution practices, as well as the possible development of prosecutorial guidelines.”

Graham says MAG is committed to working with the federal government to “examine the law in this important area.”

McCann says he hopes the disclosure of the document will mean that both CLHE and MAG are starting future discussions on and equal footing.

“My hope is that Yasir Naqvi, the attorney general, and the ministry of the attorney general approach the next phase of this process with honesty and integrity and that they come open to making some changes,” he says.

“I feel like this document is part of a story and the last chapter is yet to be written.”

Canada: Guidelines on prosecuting HIV non-disclosure in Ontario to be released

The Divisional Court has ordered the Ministry of the Attorney General to release a set of draft guidelines for prosecuting HIV non-disclosure cases.

An assistant Crown attorney developed the guidelines in the unprecedented 2009 case of Johnson Aziga, an HIV-positive man who was convicted of first-degree murder for failing to disclose his status when he had unprotected sex with two women.

The guidelines were shared throughout the province with Crowns involved in HIV prosecutions and uploaded to their intranet, says Toronto lawyer Marcus McCann, who sought the document as part of a larger Freedom of Information request.

The ministry refused to grant McCann’s request, arguing the guidelines were subject to solicitor-client privilege, but the Information and Privacy Commissioner sided with McCann.

“The fundamental unfairness that motivated me was that MAG has been able to avoid disclosure of this document simply by allowing Crowns to use this document created off the side of the desk without adopting it as official policy,” McCann says.

MAG sought judicial review of the privacy commissioner’s decision, but it was recently rejected by the Divisional Court.

The privacy commissioner, and later the Divisional Court, determined that solicitor-client privilege had actually been waived by the assistant Crown attorney who developed the draft guidelines, as they had been shared with a program manager with the Sexual Health and Harm Reduction of the City of Hamilton.

MAG said the document was shared with the official in order to get her “expert input, advice and assistance in relation to legal advice” in the guidelines, and it said that her input was necessary in order to ensure the document was accurate.

MAG also argued that the commissioner erred by failing to consider whether the ministry and the program manager had common interests, which would have preserved solicitor-client privilege. The ministry said the common interest was the reduction of harm and the protection of society, but the Divisional Court sided with the privacy commissioner, who said that interest was too broad and that the two entities have very different practical mandates.

“The Commissioner’s rejection of the common interest was reasonable. The result is justified, transparent and intelligible,” Justice Carolyn Horkins wrote in the Divisional Court decision, Ontario (Attorney General) v. Ontario (Information and Privacy Commissioner), which was released on Nov. 15.

It is not clear whether the provincial government plans to appeal the decision, but McCann says that if and once the document is released, it could help those being prosecuted in HIV-related cases understand how Crown prosecutors are approaching these matters.

For years, AIDS services organizations have pushed the provincial government to develop an official set of guidelines for prosecuting HIV non-disclosure cases, but with little progress. Between 1989 and 2013, around 155 people were criminally charged in Canada for not disclosing they had HIV and a majority of these prosecutions occurred in Ontario, according to the Canadian HIV/AIDS Legal Network.

Human rights lawyers say the problem with the lack of official guidelines for these HIV non-disclosure cases is that there is such a wide scope of charges defendants can face, some of which are very serious.

Ryan Peck, the executive director of HIV & AIDS Legal Clinic Ontario, says those prosecuted in these cases often face aggravated sexual assault charges, which are used to prosecute serious forced sex acts.

In 2010, a group called the Ontario Working Group on Criminal Law and HIV Exposure launched a campaign calling on MAG to create a set of prosecutorial guidelines. The ministry agreed to do so, but after years of consultations and delays, an official set of guidelines has not materialized yet.

“The current use of the criminal law is simply out of step with science and human rights,” Peck says. A handful of lawyers, including Peck, on the working group were allowed to review draft guidelines in November 2014. It is unclear whether these are the same draft guidelines McCann requested, as the lawyers who reviewed the guidelines are not permitted to discuss their contents.

The lawyers who viewed the draft guidelines asked that the ministry not issue the guidelines, and MAG complied with that request. The working group plans to meet with Attorney General Yasir Naqvi at a “minister’s roundtable” discussion, which is set to take place Dec. 5.

“They appear to be at loggerheads on the issue of not just should prosecutorial guidelines be drafted but what the content of them should be, and it’s my hope that this document being made public will help break that logjam,” says McCann.

Brendan Crawley, a spokesman for MAG, said it would be inappropriate for the ministry to comment, as the Divisional Court’s decision is still within the appeal period.

Published in Law Times on Nov 28, 2016

Sweden: Civil societies organisations call for guidelines to prosecutors in cases of HIV-criminalisation

“Major Uncertainty about HIV in Courts – The Prosecutor must act”

Open letter to the Prosecutor General Anders Perklev:

The organizations Hiv-Sweden, RFSL and RFSU call for guidelines for prosecutors for prosecutions against people living with HIV who are at risk of transmitting the virus via sexual contacts.

Signatory organizations promote the development of HIV in Sweden, how people living with HIV perceive their situation, the way in which case law looks and the medical successes in the field. Since 2013, the knowledge base “Infectiousness in Treated HIV Infection” has been developed by the Public Health Authority and the Reference Group for AntiViral Therapy (RAV), which shows that there is a negligible risk of HIV transmission during well-treated treatment.

Since 2016, there is also a document written by medical experts in which the disability rate in HIV is reduced from 40-60% to 0-10%.

These documents should have a major impact on the prosecution of persons, for whom crimes are prosecuted, how damages for a possible transfer should be measured and how seriously the chronic disease HIV should be considered.

RFSU, RFSL and Hiv-Sweden can say that there is great uncertainty in courts and justice in general how to handle the progress made in the medical field regarding HIV. There is no precedent since the knowledge base came and, as the Prosecutor is aware, no trial was given in the Supreme Court for Case B 2152-13, the Court of Appeal over Skåne and Blekinge, in which a person living with HIV and had a so-called well-treated treatment was released from criminal liability.

Signatory organizations welcome the Court of Appeal’s judgment, which clearly takes into account medical success, contagiousness and other facts in the case. Unfortunately, the Supreme Court (in connection with the grant of a review) did not refer to the decision NJA 2004 p. 176, which means that the judgment of the Court of First Instance can not be regarded as prejudicial.

Signatory organizations find it deeply unfortunate that the Supreme Court did not test the case partly referring to precedents no longer based on current knowledge. This means that the legal situation is unchanged and unclear, which creates legal uncertainty for people living with HIV.

Regrettably, we can say that the courts have begun to take care of the medical successes that have been made since 2004, and in the days a new intelligence judgment in which a man living with HIV and standing on a well-treated treatment is released from criminal liability (see Day’s Juridics 2016- 05-31 ). We hope that Objective B 212-15 from Uppsala District Court will proceed in the judicial system and create a new practice in this area.

The judgment states that the risk of HIV transmission to unprotected intercourse is so small in case of well-being treatment that one can not reasonably expect the effect of transfer and thus does not fulfill the objective crimes for the development of danger to another.

Even though the profession assesses the risk of HIV transmission to be neglected in well-preserved HIV even in unprotected intercourse, prosecutors continue to famble as to which acts will lead to prosecutions and which crimes are prosecuted. For example, some prosecutors choose to prosecute people living with HIV, with well-treated treatment, without the intention of transmitting HIV and there was no transfer for attempted abuse, which is neither reasonable nor correct.

RFSU, RFSL and HIV-Sweden want guidelines from the RA to the prosecutor who takes into account the major medical achievements and the knowledge base available to create a fairness in how the judicial system manages this already vulnerable group of people living in our society HIV.

—————————————————————————-

“Stor osäkerhet om HIV hos domstolar och rättsväsende – riksåklagaren måste agera“

Öppet brev till riksåklagaren Anders Perklev:

Organisationerna Hiv-Sverige, RFSL och RFSU efterlyser riktlinjer för åklagare avseende åtal mot personer som lever med hiv och som riskerar att överföra viruset via sexuella kontakter.

Undertecknande organisationer följer utvecklingen noga avseende hiv i Sverige, hur personer som lever med hiv uppfattar sin situation, hur rättspraxis ser ut och de medicinska framgångar som görs på området. Sedan år 2013 finns kunskapsunderlaget “Smittsamhet vid behandlad hivinfektion” framtaget av Folkhälsomyndigheten och Referensgruppen för AntiViral terapi (RAV), i vilket det framgår att det föreligger försumbar risk för överföring av hiv vid välinställd behandling.

Sedan år 2016 finns det även ett dokument skrivet av medicinska experter i vilket invaliditetsgraden vid hiv sänks från tidigare 40-60 % ned till 0-10 %.

Dessa dokument borde få stor inverkan på när personer åtalas, för vilka brott personer åtalas, hur skadestånd vid en eventuell överföring bör mätas och hur allvarlig den kroniska sjukdomen hiv skall betraktas vara.

RFSU, RFSL och Hiv-Sverige kan konstatera att det råder stor osäkerhet i domstolar och rättsväsendet i övrigt hur de ska hantera de framsteg som görs på det medicinska området gällande hiv. Det saknas prejudikat sedan kunskapsunderlaget kom, och som riksåklagaren väl känner till gavs inte prövningstillstånd i högsta domstolen för mål B 2152-13, Hovrätten över Skåne och Blekinge, i vilket en person som lever med hiv och hade en så kallad välinställd behandling friades från straffansvar.

Undertecknande organisationer välkomnar hovrättens dom, som tydligt tar hänsyn till medicinska framgångar, smittsamhetsdokumentet och fakta i övrigt i målet. Dessvärre hänvisade Högsta domstolen (i samband med att prövningstillstånd inte gavs) till avgörandet NJA 2004 s. 176 vilket innebär att hovrättens dom inte kan anses vara prejudicerande.

Undertecknande organisationer finner det djupt olyckligt att Högsta domstolen dels inte prövade målet dels hänvisade till prejudikat som inte längre baserar sig på aktuell kunskap. Detta innebär att rättsläget är oförändrat och otydligt, vilket skapar en rättsosäkerhet för personer som lever med hiv.

Glädjande nog kan vi konstatera att domstolarna ändock har börjat ta till sig av de medicinska framgångar som gjorts sedan 2004 och i dagarna kom en ny underrättsdom i vilken en man som lever med hiv och står på välinställd behandling frias från straffansvar (se Dagens Juridik 2016-05-31) . Vi hoppas att mål B 212-15 från Uppsala tingsrätt skall gå vidare inom rättsväsendet och skapa en ny praxis på området.

I domen konstateras att risken för överföring av hiv vid oskyddade samlag är så pass liten vid välinställd behandling att man inte rimligen kan förvänta sig effekten att överföring sker, och att det därmed inte uppfyller de objektiva brottsförutsättningarna för framkallande av fara för annan.

Trots att professionen bedömer risken för överföring av hiv vara försumbar vid välinställd hiv även vid oskyddade samlag fortsätter åklagare att famla när det gäller vilka gärningar som skall leda till åtal och vilka brott som åtalas för. Vissa åklagare väljer till exempel att åtala personer som lever med hiv, med välinställd behandling, utan uppsåt att överföra hiv och där ingen överföring skett för försök till misshandel vilket varken är rimligt eller korrekt.

RFSU, RFSL och Hiv-Sverige önskar riktlinjer från RÅ till landets åklagare som tar hänsyn till de stora medicinska framgångar som gjorts och det kunskapsunderlag som finns, för att skapa en rimlighet i hur rättsväsendet hanterar denna redan utsatta grupp personer i vårt samhälle som lever med hiv.

US: Landmark statement from State Prosecutor calling for modernisation of HIV criminal law in Illinois

Cook County State’s Attorney Anita Alvarez, representing the second largest prosecutor’s office in the nation, recently conducted an interview with the Windy City Times where she spoke about the work that needs to be done to modernize HIV criminal laws in Illinois. Alvarez, an inaugural member of CHLP’s National Prosecutor’s Roundtable on HIV Law and Policy, a joint project with the Association of Prosecuting Attorneys, shared this reply:

Windy City Times: Are you in favor of criminal penalties for transmission of HIV/failure to truthfully disclose HIV status?

Anita Alvarez: Frankly, the Illinois law entitled “Criminal Transmission of HIV” is a relic of the now debunked notions of HIV infection from the 1980s. This law, if we are going to keep it, is in need of a serious revision. For example, as it stands, it is a defense to the charge if an individual can show that a condom was used during the sex act but it is not a defense if the individual was currently taking anti-retroviral drugs. The CDC estimates that condoms are 80% effective at reducing the risk of transmission of HIV while a modern drug regimen will render an HIV positive person “undetectable” and reduce the risk of transmission by more than 95%. Furthermore, with modern medical intervention, HIV, while still a serious health issue for people, has become a manageable condition that can be treated without serious impairment to living a normal, healthy and active life. There are many other diseases nowadays that are far more life impairing than HIV and are transmittable through sexual contact yet we don’t specifically criminalize those conditions. That simply makes no sense and is clearly out of date and out of line with modern science. I have been actively engaged in discussions with Catherine Hanssens, the Director of the Center for HIV Law and Policy, on ways that we can address this issue that make sense and balance the need to protect people from someone who might wish to intentionally transmit a serious disease while not unjustly targeting people who are HIV positive. I am hopeful that we can create best practices for prosecutors across the nation on this subject and that, in Illinois, we can move to statutory revision that makes sense on this issue.

 Interview originally published in The Center for HIV Law and Policy