Watch all the videos of Beyond Blame @HIV2020 – our “perfectly executed…deftly curated, deeply informative” webshow

Earlier this month, advocates from all over the world came together for two hours to discuss the successes and challenges of the global movement to end HIV criminalisation.

All of the recordings of Beyond Blame: Challenging HIV Criminalisation for HIV JUSTICE WORLDWIDE are now available on the HIV Justice Network’s YouTube Channel.

“HUGE pleasure 2B at #BeyondBlame2020 conference – deftly curated, deeply informative; speakers were great; the passion & commitment to #HIVjustice was palpable. Much progress yet a sober reminder that the work is far from over.”

Kene Esom, Policy Specialist: Human Rights, Law and Gender, United Nations Development Programme (UNDP)

 

The full-length director’s cut version – with enhanced audio and video – is now available in English as well as with the audio track of the recorded simultaneous translation in French, Spanish, Russian, and Portuguese.

The English version is also available as a YouTube playlist in ‘bite-size’ chunks, with each segment of the webshow available as standalone videos.  This means, for example, if you just want to watch (or share) the segment on ‘women challenging HIV criminalisation in Africa‘, or on ‘bringing science to justice, and justice to science‘, it’s now possible.

“That webinar was perfectly executed. Great sound, engaging transitions (they actually played people on and off!), and multiple speakers in various collections. Having ALL OF THEM back at the end showed the breadth of this technical accomplishment and the depth of the speakers’ field of expertise. Not everyone may notice these things but boy, I sure do, and it was totally pro. I’ve seen big name conferences who couldn’t get this right… Congratulations all around, and especially to [director] Nicholas Feustel.

Mark S King, My Fabulous Disease

 

We have also made available for the first time the standalone recording of Edwin Cameron’s closing speech, which inspired so many.  The transcript is included in full below.

“We have been being battling this fight for many years. Since the start of the HIV epidemic we as gay men, as gay women, as queers, as transgender people, as sex workers, as people using drugs, have been persecuted by the criminal law. And I’m here to say, “Enough! Enough!

We have achieved a great deal with our movement, with the HIV Justice Network. We have achieved a great deal in conscientizing law makers, law givers and the public. It is now time for us to join in unison to demand the end of these stigmatising, retrograde, unproductive, hurtful, harmful laws.

It is a long struggle we’ve engaged in. And it’s one that has hurt many of us. Some of us here today, some of us listening in, some of us who have spoken, have felt the most brutal brush of the law. They have been imprisoned, unjustly prosecuted, unjustly convicted, and unjustly sent away.

HIV is not a crime. But there is more to it. Criminalising HIV, criminalising the transmission or exposure of HIV, as many countries on my own beautiful continent Africa do, is not just stupid and retrograde. It impedes the most important message of the HIV epidemic now, which is that this epidemic is manageable. I’ve been on antiretroviral treatment now for very nearly 23 years. My viral load has been undetectable for more than 20.

We can beat this, but we have to approach this issue as public health issue. We have to approach it rationally and sensibly, and without stigma, and without targeting people, and without seeking to hurt and marginalise people.We’ve made calamitous mistakes with the misapplication of the criminal law over the last hundred years, in the so-called ‘war on drugs’. We continue to make a calamitous mistake in Africa and elsewhere by misusing the criminal law against queer people like myself. We make a huge mistake by misusing the criminal law against people with HIV.

Let us rise today and say, “Enough!”

 

Criminalization laws impact public health and perpetuate discrimination

HIV and LGBTQ Criminalization Laws are Both Human Rights and Public Health Issues, Experts Say

A panel at the 23rd International AIDS Conference (AIDS 2020, gone virtual this year due to COVID-19) discussed the growing right-wing populist movements around the world that threaten advances made by activists toward ending criminalization of people living with HIV and LGBTQ people.

Poland just re-elected President Andrzej Duda, whose party, PiS, declared “The LGBT and gender movement threatens our Polish identity, the nation, and the state.” PiS wants to “protect children from the LGBT ideology,” defines marriage in strictly heterosexual terms, and aims to outlaw adoptions by LGBTQ people. Around 100 localities in the country have declared themselves to be “LGBT-free zones.”

Botswana goes even further, reported Tebogo Gareitsanye of BONELA, a legal and advocacy organization in that country. Consensual sex between same-sex partners is illegal and prosecuted as “unnatural offenses” and “indecent practices.” That statute originally applied only to men who have sex with men. Sex between women was not outlawed until 1998.

Botswana law distinguishes between sexual orientation per se—which is, in fact, a protected category under employment discrimination law—and acting on one’s orientation, which is illegal. After a campaign by BONELA and others, the country’s High Court recently decriminalized private, consensual sex acts. However, Botswana’s government has appealed that decision, and a final ruling is still pending.

Beyond human rights implications, such laws also impact public health, since LGBTQ people will not seek health services for fear of being prosecuted, Gareitsanye noted. Similarly, laws that criminalize certain acts if someone is living with HIV impede public health, said Edwin J. Bernard of the HIV Justice Network. “Communicable diseases are public health issues, not criminal issues.”

HIV criminalization laws generally require the person in question to know their status. They therefore discourage people from being tested. Sean Strub of the Sero Project summed this up in a video shared by Bernard at the conference: “Take the test and risk arrest.” Another interviewee in that video, Patrick O’Byrne, Ph.D., RN-EC, of the University of Ottawa, reported that participants in their study were unable to distinguish between the public health department and the police. “That’s problematic,” O’Byrne commented.

In California, for example, people living with HIV (PLWH) can be prosecuted for four HIV-specific “offenses,” explained Ayako Miyashita Ochoa, J.D., of the University of California Los Angeles: solicitation while seropositive, exposure with intent to transmit HIV, exposure to a communicable disease, and an enhanced sentence for forced sex, if the rapist lives with HIV. Sex workers account for 95% of HIV-related prosecutions in the state, Ochoa reported.

Exposure to a communicable disease could, of course, be applied to many different viruses—including SARS-CoV-2, the virus that causes COVID-19. So far, there are no reports of people refusing to wear masks being prosecuted under that law. Nonetheless, in many countries, human rights have taken a backseat to the pandemic response, noted Thokozile Phiri Nkhoma of Facilitators of Community Transformation in Malawi. Civil society must address criminalization as well as rights and resource issues in the wake of the pandemic, Nkhoma demanded.

Beyond their effect on individual persons prosecuted under them, criminal laws perpetuate structural inequalities, discrimination, and xenophobia, argued Susana T. Fried of CREA, an international feminist organization based in India. To counter such effects, we need to strengthen solidarity between and with affected people. We also must be aware of the unintended effects some laws meant to protect vulnerable communities might have. For example, raising the age of marriage can protect young girls. However, it can also be used to outlaw consensual sex between young people, if it ties age of consent to age of marriage.

The consequences of these and other laws regulating sex and sexuality are quite intentional, concluded Marco Castro-Bojorquez of HIV Racial Justice Now: “The systems of oppression that we have created specifically to oppress certain communities were working very well in the criminalization of PLWH.”

Australia: Proposed mandatory HIV testing in New South Wales is neither necessary nor useful

HIV testing people who spit at police or health workers won’t actually protect them

People who expose a police officer or emergency worker to body fluids would be compelled to have their blood tested for HIV, hepatitis B and hepatitis C, under a proposed law in NSW.

But this law isn’t needed to protect first responders. We already have evidence-based protocols that are working well to protect them from blood-borne infections.

Rather, the proposed law is a political reaction to a problem that doesn’t need fixing. It is also not supported by scientific evidence or Australian government policy on HIV testing.

What is NSW proposing?

In November last year, the NSW government proposed legislation which gives authorities the power to test a person for HIV, hepatitis B or hepatitis C if they have deliberately exposed a front-line worker to their body fluids (saliva or blood).

Examples might be if a person bites a police officer restraining them during an arrest or protest; someone biting or scratching a youth justice or corrections officer; or a person behaving unpredictably, exposing ambulance officers to their body fluids.

The mandatory testing order would come from senior officers within the worker’s own agency. If the person does not comply, they can be forced to do so. They have 48 hours to appeal to the NSW chief health officer. Anyone who refuses a mandatory testing order will be committing an offence, with a maximum 12 months prison term or an A$11,000 fine, or both.

Is this happening elsewhere?

Five states have legislation that allows mandatory testing, according to a report by the National Association of People Living with HIV.

The proposed NSW model is closest to the one Western Australiaintroduced in 2014, where police can order testing. This resulted in 377 testing orders in the first four years.

In contrast, in Victoria the chief health officer has the power to order a test or issue a public health order to enforce it if necessary. In those same four years, not a single person was ordered to be tested.

What’s the risk of transmission anyway?

Outside of sexual transmission, HIV is transmitted through blood. Police and corrections officers are far less likely to be exposed to a blood-borne virus than hospital workers. When exposure does occur, it tends to be less serious.

There does not appear to be any recorded case of an Australian police officer being infected with HIV in the course of their duties.

Rates of HIV infection in the community are dropping anyway. Around 0.1% of the Australian population is living with HIV. The vast majority are on effective treatment which reduces transmission to zero. By 2022, Australia’s aiming for virtual elimination.

As hepatitis C and HIV are blood-borne viruses, saliva alone cannot transmit them. Sometimes, the mouth can be contaminated with blood, particularly if there has been traumatic injury. But contact between bloody saliva and intact skin does not transmit hepatitis C or HIV.

A 2018 study bringing together more than 30 years of studies in HIV transmission concluded:

There is no risk of transmitting HIV through spitting, and the risk through biting is negligible.

A similar 2018 study looked at the risk of hepatitis C transmission and concluded the risk “appears to be very low”.

Of the blood-borne viruses, hepatitis B, the most transmissible of these viruses, is completely preventable through a vaccine all front-line workers receive.

What’s happening now?

In NSW and nationally, if someone is exposed to another person’s body fluids at work, they are assessed by health care workers in their agency.

The nature of the exposure, the possibility the other person could have a blood-borne virus (or if known, whether they are infected) and the resulting risk are considered when evaluating both the injury and the need for testing. If needed, they are tested according to policies informed by scientific evidence.

But the overwhelming majority of injuries, including bites, do not carry a risk of transmision.

In the rare scenario, where the risk of HIV infection cannot be ruled out, the worker may be offered medications to prevent infection, and follow-up blood tests. These medicationsdramatically reduce risk of transmission but must be taken within 72 hours of the exposure.

Workers potentially exposed to hepatitis C can be monitored for infection, and given medications with near 100% cure rate if required.

So current measures are more than adequate to deal with all situations a police officer or other front-line worker will confront, and have been so since these issues were first addressed in the early 1990s.

Compulsory testing could cause harm

Front-line workers deserve our support and protection. But if these workers feel anxiety or distress related to their risk of contracting blood-borne viruses then their health services must more adequately reassure them.

New measures won’t help reduce their already low risk of transmission and therefore don’t provide any additional reassurance. Focussing on getting the other person tested might increase their anxiety when the risk is negligible, irrespective of the person’s status.

In the rare higher risk situations, perhaps an ambulance officer injured while at a car accident where there is massive blood loss, the risk of a blood-borne infection needs to be assessed and preventive medicine offered. Delaying this assessment while waiting for the results of compulsory testing has the real potential to harm the worker.

The proposed legislation also stigmatises people living with blood-borne viruses, incorrectly depicting them as dangerous, creating unnecessary fear, leading to discrimination.

We are working with the board of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (the peak body representing HIV, viral hepatitis and sexual health workers) and oppose mandatory testing measures as neither necessary nor useful.

When considering the criminalisation of COVID-19, lessons from HIV should be retained

Marginalised communities will not get justice from criminalising Covid-19 transmission

The criminalisation of the virus would create greater barriers to accessing healthcare systems already preventing many people from getting treatment.

After it was announced that no further action would be taken by police regarding the death of Belly Mujinga, a railway worker who contracted coronavirus after reportedly being spat on, there was national outcry. Her name has been plastered on placards at Black Lives Matter protests, while the public has pointed out that a man in Scotland who spat on a police officer while “joking” about coronavirus in April has been jailed for a year. But while this outrage is valid in the face of a government who continues to show their blatant disregard for black lives, criminalisation of diseases has been proven to be an ineffective tool for justice.

Over the past few months, parallels have been drawn between the Covid-19 pandemic and the HIV epidemic. Both viruses are communicable (they can be passed between people); both have been racialised, leading to racist and xenophobic attacks and stereotyping; community mobilisation has demanded adequate government public health responses for both health emergencies; and the impact of both viruses has highlighted the need for a global health approach which transcends borders. 

When the World Health Organisation (WHO) declared Covid-19 a pandemic, many HIV organisations and activists advocated that the transmission of the novel coronavirus should not be criminalised. As public fear of Covid-19 grew, HIV advocates predicted the negative impact on public health and possibility of human rights violations, similar to those seen for people living with HIV. 

“Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself”

This strain of coronavirus is new and scientists are developing their understanding of it. In the past few weeks, there has been confusion about the probability of asymptomatic transmission (transmitting the virus when a person does not have Covid-19-like symptoms), as the WHO had previously commented that it was “very rare” and later stated that this wording had misled people. Despite the evolving scientific knowledge, criminalisation laws have been written and implemented across the world faster than the development of the general understanding of the virus itself. Globally, countries have implemented or have proposed laws against Covid-19 transmission and even exposure, without transmission, including Canada, France, India, and South Africa.

Often, the aim of criminalisation is to facilitate a tool for prevention and deterrence (to discourage people from passing on a virus) or as punishment for those who have or may have passed on a virus. HIV advocacy has illustrated over the years that the criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health.

In their Statement on Covid-19 Criminalisation, published in March, the HIV Justice Worldwide Steering Committee wrote that hastily drafted laws, as well as law enforcement, driven by fear and panic, are unlikely to be guided by the best available scientific and medical evidence – especially where such science is unclear, complex and evolving. “Given the context of a virus that can easily be transmitted by casual contact and where proof of actual exposure or transmission is not possible, we believe that the criminal justice system is unlikely to uphold principles of legal and judicial fairness, including the key criminal law principles of legality, foreseeability, intent, causality, proportionality and proof.”  

Since that statement was issued, internationally coronavirus laws have been weaponised against the most marginalised within society, as is the case with HIV criminalisation laws. The Ugandan government, for example, has used coronavirus laws to target marginalised LGBTQI+ groups, and in the UK, people of colour are fined more than the white population under coronavirus laws, in some cases leading to unlawful charges. In some cases people were even charged under the wrong law (e.g. enforcing Welsh law in England).

The director of legal services at the Crown Prosecution Service (CPS), the public agency that conducts criminal prosecutions in England and Wales, found that 24% of cases reviewed had been charged incorrectly. In May a CPS press statement cited the speed and pressure to implement the laws as the cause of the wrongful charges. Across the Global North, it has been well documented that racialised communities are disproportionately impacted by Covid-19 and the Human Rights Campaign Foundation anticipates that LGBTQI communities will be disproportionately impacted by the virus. This is due to a myriad of reasons underpinned by systemic discrimination.

“Criminalisation of transmission or exposure is ineffective, and disproportionately impacts marginalised communities and negatively impacts public health”

HIV research has shown little evidence that criminalisation laws prevent transmission, in fact, it’s evidenced that such laws are bad for public health and fuel reluctance to get tested and treated. In the UK, testing and treatment of Covid-19 is free, as is the case with many other communicable diseases to remove the barrier to testing and treatment. Free testing and treatment access, irrespective of immigration status, is important, however, a briefing paper from Medact, Migrants Organise and New Economics Foundation (NEF), has shown that migrant communities blocked from healthcare because of the hostile environment, that “the coronavirus ‘exemption’ from charging and immigration checks is not working” and people have been asked to show their passports, and that people face additional obstacles such as language barrier and digital exclusion from emergency services. 

Criminalisation exacerbates public health issues: in a Channel 4 report, Migrants Organise spoke of a man who died at home for fear of being reported to immigration authorities if he accessed healthcare. The threat of immigration enforcement disproportionately impacts those in precarious work and those with precarious migration status, all of whom are more likely to come from racialised groups and in some cases groups which are hyper-surveilled and criminalised.

The role of healthcare and access to it needs to be reimagined, where people are viewed as patients not passports and healthcare professionals are not the extended arm of the Home Office. Governments must implement better employment rights, so that employers are held to account and do not put staff such as Belly Mujinga, in harmful positions. Governments must provide better statutory sick pay so those in precarious work do not have to choose between their health and putting food on the table. We need to overhaul systemically discriminatory processes that don’t look after the most vulnerable, rather than implementing laws – such as criminalisation – that will systematically punish them.

HIV criminalisation laws affect women negatively and impede the effectiveness of implementing state programmes

Can HIV criminalisation protect women from becoming infected?

Translated from Original article in Russian via Deepl.com – For article in Russian, please scroll down.

In many countries, HIV-related criminal liability still exists. At least 68 countries have laws that specifically criminalize hiding information about HIV infection from your sex partner, putting another person at risk of HIV infection, or transmitting HIV. The leaders in the number of criminal cases related to HIV in the region of Eastern Europe and Central Asia are Belarus and Russia.

In 2018, 20 scientists from around the world developed an Expert Consensus Statement on the Science of HIV in the context of Criminal Law. It describes a detailed analysis of the available scientific and medical research data on HIV transmission, treatment efficacy, and evidence to better understand these data in a criminal law context.

Legislation regarding HIV transmission should be reviewed. I point out various facts to this – HIV treatment is available, antiretroviral therapy (ART) effectively reduces the viral load to undetectable and reduces the risk of HIV transmission during sexual contact to zero [1,2,3,4], criminalization initially stigmatizes people who are HIV-positive people and violates their human rights.

One of the arguments in favour of criminal liability for HIV transmission is the alleged protection of women in situations where their husbands or partners become infected with HIV. This argument is often used in Central Asian countries. Let’s look at real-life examples and statistics on how much women are actually protected by existing laws.

In early 2018, thanks to human rights defenders and human rights defenders, the article “Vikino Delo” appeared in the media, about a 17-year-old pupil of an orphanage, who was convicted under subsection 122 (1) of the Criminal Code of the Russian Federation for knowingly putting another person at risk of HIV infection. In 2017, Vika met a man F. (31 years old) on a social network. When they had an intimate relationship, the girl offered to use a condom, but F. refused. Vika did not tell F. that she had HIV. From the girl’s testimony provided in court, it was clear that she did not want to put the victim at risk of infection, and did not say the diagnosis because she was afraid. She tried to hint at him, telling about her HIV-infected friend. F. proposed to be tested for HIV together. As a result, he has a minus, she has a plus. F. filed a complaint with Vic to the police. The man decided to punish the girl for insufficient, in his opinion, sincerity. Following the verdict, Vicki’s lawyer filed a complaint with the Supreme Court. On the recommendation of the Supreme Court, given that at the time of the commission of the “crime” she was a minor, apply a sentence of warning to her. At the same time, no one took the blame from her. The leading role in protecting and supporting Vicki was played by the female community in the guise of Association “EVA”.

The situation with the Vicki case is commented on by human rights activist Elena Titina, head of the Vector of Life Charity Fund, who acted as a public defender in court: “Women are subjected to even greater stigma, condemnation, and therefore do not protect themselves. Vicki’s case is very revealing in this. For three years, during the whole trial, the girl simply had to listen to insults, humiliation against her, the remarks were incorrect – and on the part of the plaintiff, this 31-year-old man, on the part of judges, prosecutors, even lawyers sometimes behaved like elephants in a china shop. She, in my opinion, is the heroine. I’m not sure that an adult woman would have endured what Vick had endured and come to the end, defending her rights. Her criminal record was removed. A unique thing, I am very proud that I participated in it. “This is the only thing that has ended so far because I don’t know of any more such precedents with a conditional happy ending. ”

In the Criminal Code of the Russian Federation , in which almost one and a half million cases of HIV infection among citizens are only officially registered, there is article 122 “Transmission of HIV infection”. Disaggregation of data began in 2017, from 01/01/2017 to 12/31/2019, in total, within the framework of 122 articles, 150 sentences were sentenced according to the main qualification in parts 1-4. 93 sentences were pronounced against men (62%), 57 (38%) – against women. It is noteworthy that in Part 1, “Knowingly putting the other person at risk of HIV infection” is condemned by more women: 56.4% versus 43.6% of men.

According to the Ministry of Health of the Republic of Tajikistan for 2018, there were 10.7 thousand people with HIV in the whole country, of which about 7 thousand were men. It was noted that in 54.6% the virus was transmitted sexually, and in some regions, the proportion of such cases reaches 70%.

For reference: since July 2015, to register a marriage in Tajikistan, you must undergo a medical examination, which includes an HIV test.

Tajikistan became one of the few countries (and the only one in the EECA region) to which CEDAW issued a recommendation dated November 9, 2018: “Decriminalize the transmission of HIV / AIDS (Article 125 of the Criminal Code), and repeal government decrees of September 25, 2018 and October 1, 2004 years prohibiting HIV-positive women from getting a medical degree, adopting a child, or being a legal guardian. ”

Instead, on January 2, 2019, President Emomali Rahmon signed a series of laws, including those aimed at “strengthening the responsibility of doctors, beauty salons, hairdressers and service enterprises, which are due to non-compliance with sanitary, hygiene, anti-epidemic rules and regulations caused HIV / AIDS. ” From that moment, a lot of publications appeared in the media, illustrating not only the widespread informing of Tajik citizens about the requirements being followed but also the increase in the number of publications on criminal penalties related to HIV.

According to the results of media monitoring conducted by the Eurasian Women’s AIDS Network, in 2019, 23 publications on HIV were registered in the electronic media of Tajikistan. Among them, two topics were divided equally: general information on the responsibility for HIV transmission and statistics, as well as publications that women are accused of, such as:

“27-year-old woman suspected of having HIV / AIDS deliberately infecting”,

“Two women in northern Tajikistan convicted of HIV infection”,

“In Tajikistan, a woman convicted of“ deliberate HIV infection ”by 23 men was sentenced”,

“A resident of Kulyab of Tajikistan is suspected of intentionally acquiring HIV”,

“Two women in Khatlon have infected dozens of men. ”

Among these publications, there is not one that describes particular cases of men. We already wrote about the vulnerability of women in August last year in our interview with attorney Zebo Kasimova.

We could not obtain statistical data on the number of cases brought under article 125 of the Criminal Code of the Republic of Tajikistan, “HIV infection”. Particularly important would be information disaggregated by sex – that is, disaggregated data, the collection of which makes special sense, in view of the state’s argument for the protection of women. The importance of disaggregated statistics is stated in the Sustainable Development Goals – the Resolution adopted by the UN General Assembly in 2015: only accurate, reliable, comprehensive thematic data will help us understand the problems we are facing and find the most suitable solutions for them.

Olena Stryzhak, one of the founders of the Eurasian Women’s AIDS Network and the head of the Positive Women BO, is actively promoting the decriminalization of HIV in Ukraine  “I have been on the committee for the second year in the validation of elimination of mother-to-child transmission of HIV and syphilis at the Ministry of Health of Ukraine, and actively participate not only in the activities of the committee in our country but also attend international meetings of the Committee at WHO, communicate with many people working in this field.

One of the obstacles for women to seek medical help and treatment on time is the fear of prosecution, the fear of possible criminal liability. In Ukraine, I was able to obtain statistics on the number of criminal cases under article 130 of the Criminal Code of Ukraine, disaggregated by sex. I was surprised by the statistics, because, starting in 2015, only women were convicted under this article. This negatively affects not only the women themselves but also the effectiveness of implementing state programs, including the process of validating the elimination of mother-to-child transmission of HIV. ”

From the last case in Ukraine, for 2018: “… Since the defendant refused, the specialist for child services extended her hands to the child in order to pick her up, but the defendant bit her left hand.” From the conviction: “The court decided to qualify the actions of the defendant … Part 4 of Art. 130 of the Criminal Code of Ukraine as a complete attempt on intentional infection of another person with human immunodeficiency virus. “

Does it mean that if only women were convicted, the fact that only women are sources of infection? From an alternative shadow report of the Tajikistan Network of Women Living with HIV, presented at the 71st session of the UN Committee on the Elimination of All Forms of Discrimination against Women in November 2018: “In violation of their rights, as a rule, women do not go anywhere. During the study of the situation when writing this report, violations of the rights of women living with HIV and women from affected groups were identified, only a few decided to defend their rights and because they were provided with a lawyer at the expense of the project. The reasons for this behaviour are different. One of the main reasons is the lack of financial resources to pay for the services of a lawyer. Secondly, many women living with HIV and women from HIV-affected groups have low legal literacy; they do not have information about who to contact on a particular issue. Thirdly, self-stigmatization and the fear of confidentiality also prevent women living with HIV and women from HIV-affected groups from defending their rights. ”

It is clear from the report that women do not defend their rights, especially on such sensitive issues, for fear of feeling even more condemned and becoming even more vulnerable. In addition, in the countries of Central Asia, families have traditions when a daughter-in-law must tell her husband or mother-in-law where she goes and what she is going to spend or spent money on (by the way about paying a lawyer). Women depend on other family members, and often do not have their own money.

Violence against women increases their risk of HIV infection, while the very presence of HIV infection in a woman also increases the risk of violence, including from relatives, due to her vulnerability and low self-esteem.

The criminalization of HIV does not work, either as a preventive measure nor as a way to protect women from infection, as decision-makers try to imagine. On the contrary, with specific examples, we observe that women are more vulnerable.

Sources:

[1] – Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11; 365: 493-505.

[2] – Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016; 316: 171-81.

[3] – Grulich A, Bavinton B, Jin F, Prestage G, Zablotska, Grinsztejn B, et al. HIV transmission in male serodiscordant couples in Australia, Thailand and Brazil. Abstract for 2015 Conference on Retroviruses and Opportunistic Infections, Seattle, USA, 2015.

[4] – Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016 Sep 1; 375 (9): 830-9. 

Может ли криминализация ВИЧ защитить женщин от инфицирования?

Во многих странах все еще существует уголовная ответственность, связанная с ВИЧ. По меньшей мере 68 стран имеют законы, которые специально предусматривают уголовную ответственность за сокрытие информации о наличие ВИЧ-инфекции от своего партнера по сексу, поставление другого лица в опасность инфицирования ВИЧ или передачу ВИЧ. Лидерами по количеству уголовных дел, связанных с ВИЧ, в регионе Восточной Европы и Центральной Азии являются Беларусь и Россия.

В 2018 году, 20 ученых из разных стран мира разработали Заявление об экспертном консенсусе в отношении использования научных данных о ВИЧ в системе уголовного правосудия. В нем описан подробный анализ имеющихся данных научных и медицинских исследований о передаче ВИЧ, эффективности лечения и доказательства, позволяющие лучше понять эти данные в уголовно-правовом контексте.

Законодательные нормы в отношении передачи ВИЧ должны быть пересмотрены. На это указываю различные факты — лечение ВИЧ-инфекции доступно, антиретровирусная терапия (АРТ) эффективно снижает вирусную нагрузку до неопределяемой и снижает риски передачи ВИЧ при сексуальном контакте до нуля [1,2,3,4], криминализация изначально клеймит людей ВИЧ-положительных людей и нарушает их права человека.

Один из аргументов в пользу существования уголовной ответственности в отношении передачи ВИЧ — это якобы защита женщин, в тех ситуациях, когда их мужья или партнеры инфицируют их ВИЧ. Этот аргумент довольно часто используют в странах Центральной Азии. Давайте рассмотрим на реальных примерах и статистических данных, насколько женщины на самом деле защищены существующими законами.

В начале 2018 года, благодаря правозащитницам и правозащитникам, в СМИ появилась статья «Викино дело», о 17-ти летней воспитаннице детского дома, которую осудили по части 1 статьи 122 УК Российской Федерации за заведомое поставление другого лица в опасность заражения ВИЧ-инфекцией. В 2017 году Вика познакомилась в социальной сети с мужчиной Ф. (31 год). Когда у них была интимная связь, девушка предложила использовать презерватив, но Ф. отказался. Вика не сказала Ф., что у нее ВИЧ. Из показаний девушки, предоставленных в суде, было видно, что она не желала ставить потерпевшего в опасность заражения, и не сказала о диагнозе, потому что боялась. Она пыталась намекнуть ему, рассказывая о ВИЧ-инфицированной подруге. Ф. предложил вместе сдать анализы на ВИЧ. В результате у него — минус, у нее — плюс. Ф. подал на Вику заявление в полицию. Мужчина решил наказать девушку за недостаточную, на его взгляд, искренность. После вынесенного приговора адвокатом Вики была подана жалоба в Верховный Суд. По рекомендации Верховного Суда, учитывая, что на момент совершения «преступления» она была несовершеннолетней, применить к ней наказание в виде предупреждение. При этом вину с неё никто не снял. Ведущую роль в защите и поддержке Вики сыграло женское сообщество в лице Ассоциации “ЕВА”.

Ситуацию с делом Вики комментирует правозащитница Елена Титина, руководительница БФ «Вектор жизни», которая выступала общественой защитницей в суде: «Женщины подвергаются еще большей стигме, осуждению, поэтому не защищают себя. Дело Вики очень показательно в этом. Девочке пришлось в течение трех лет, пока длился весь судебный процесс, просто выслушивать оскорбления, унижения в свой адрес, реплики некорректные — и со стороны истца, этого 31-летнего мужчины, со стороны судей, прокуроров, даже адвокаты порой вели себя как слоны в посудной лавке. Она, на мой взгляд, героиня. Я не уверена, что взрослая женщина выдержала бы то, что выдержала Вика, и дойти до конца, защищая свои права. С нее сняли уголовную статью. Уникальное дело, я очень горжусь, что я в нем участововала. Это единственное на сегодняшний момент дело, которое так закончилось, потому что больше таких прецедентов, с условным хэппи-эндом я не знаю».

В Уголовном кодексе Российской Федерации, в которой только официально зарегистрировано почти полтора миллиона случаев ВИЧ-инфекции у граждан, существует статья 122 “Заражение ВИЧ-инфекцией”. Дезагрегация данных начата в 2017, с 01.01.2017 по 31.12.2019 всего в рамках 122 статьи вынесено 150 приговоров по основной квалификации по частям 1-4. 93 приговора вынесено в отношении мужчин (62%), 57 (38%) — в отношении женщин. Примечательно, что по части 1 “Заведомое поставление другого лица в опасность заражения ВИЧ-инфекцией” осуждается больше женщин: 56,4% против 43,6% мужчин.

По данным Министерства здравоохранения Республики Таджикистан за 2018 год, всего по стране насчитывалось 10,7 тысяч людей с ВИЧ, из них порядка 7 тысяч — мужчины. Отмечено, что в 54,6% вирус передался половым путем, а в некоторых регионах доля таких случаев достигает 70%.

Для справки: с июля 2015 года для регистрации брака в Таджикистане необходимо пройти медицинское обследование, которое включает тест на ВИЧ.

Таджикистан стал одной из немногих стран (и единственной в регионе ВЕЦА), которой КЛДЖ дал рекомендацию от 09 ноября 2018 года: “Декриминализировать передачу ВИЧ/СПИДа (статья 125 Уголовного кодекса), и отменить постановления правительства от 25 сентября 2018 года и 1 октября 2004 года, запрещающие ВИЧ-положительным женщинам получать медицинскую степень, усыновлять ребенка или быть законным опекуном”.

Вместо этого, 02 января 2019 года президент страны Эмомали Рахмон подписал ряд законов, в том числе направленных на «усиление ответственности врачей, работников салонов красоты, парикмахерских и предприятий по обслуживанию, которые из-за несоблюдения санитарно-гигиенических, санитарно-противоэпидемических правил и норм стали причиной заражения вирусом ВИЧ/СПИД». С этого момента в СМИ появилось множество публикаций, иллюстрирующих не только широкое информирование граждан Таджикистана о выполняемых предписаниях, но и увеличение количества публикаций об уголовных наказаниях в связи с ВИЧ.

По результатам медиа-мониторинга, который проводит Евразийская Женская сеть по СПИДу, в 2019 году в электронных СМИ Таджикистана зарегистрировано 23 публикации по теме ВИЧ. Среди них поровну разделили места две темы — это общая информация относительно ответственности за передачу ВИЧ и статистика, а также публикации, в которых обвиняются женщины, как, например:

“27-летняя женщина подозревается в преднамеренном заражении ВИЧ/СПИД”,

“Двух женщин на севере Таджикистана осудили за заражение ВИЧ-инфекцией”,

“В Таджикистане вынесли приговор женщине, обвиняемой в «умышленном заражении ВИЧ» 23 мужчин”,

“Жительница Куляба Таджикистана подозревается в преднамеренном заражении ВИЧ”,

“Две женщины в Хатлоне заразили десятки мужчин”.

Среди этих публикаций нет ни одной, описывающей частные случаи в отношении мужчин. Об уязвимости женщины мы уже писали в августе прошлого года в нашем интервью с адвокатессой Зебо Касимовой.

Статистические данные о количестве дел, возбужденных по статье 125 УК Республики Таджикистан, “Заражение ВИЧ-инфекцией”, нам получить не удалось. Особенно важной была бы информация с разбивкой по полу — то есть дезагрегированные данные, сбор которых имеет особый смысл, ввиду аргументации государства о защите женщин. О важности дезагрегированной статистики говорится в Целях устойчивого развития — Резолюции, принятой Генеральной Ассамблеей ООН в 2015 году: только точные, достоверные, всесторонние тематические данные позволят понять проблемы, стоящие перед нами, и найти для них самые подходящие решения.

Елена Стрижак, одна из основательниц Евразийской Женской Сети по СПИДу и руководительница БО “Позитивные женщины”, активно продвигает тему декриминализации ВИЧ в Украине: “Я уже второй год состою в комитете по валидации элиминации передачи ВИЧ и сифилиса от матери к ребенку при Министерстве здравоохранение Украины, и активно принимаю участие не только в деятельности комитета в нашей стране, но и посещаю международные заседания Комитета в ВОЗ, общаюсь со многими людьми, работающими в этой сфере.

Одним из препятствий к тому, чтобы женщины вовремя обращались за медицинской помощью и за лечением, служит страх обвинения, страх перед возможной криминальной ответственностью. У нас в Украине я смогла получить статистические данные о количестве уголовных дел по статье 130 УК Украины, с разбивкой по полу. Была удивлена статистикой, потому что, начиная с 2015 года, по этой статье были осуждены исключительно женщины. Это негативно отражается не только на самих женщинах, но и на эффективности реализации государственных программ, в том числе на процессе валидации элиминации передачи ВИЧ от матери к ребенку”.

Из последнего кейса по Украине, за 2018 год: «…Так как подсудимая отказалась, специалист службы по делам детей протянула руки к ребенку с целью забрать ее, но подсудимая укусила ее за левую руку». Из обвинительного приговора: «Суд принял решение квалифицировать действия подсудимой … ч. 4 ст. 130 УК Украины как оконченное покушение на умышленное заражение другого лица вирусом иммунодефицита человека».

Означает ли, что если осужденными оказались только женщины, тот факт, что только женщины являются источниками инфицирования? Из альтернативного теневого доклада Таджикистанской сети женщин, живущих с ВИЧ, представленного на 71-й сессии Комитета ООН по ликвидации всех форм дискриминации в отношении женщин в ноябре 2018 года: “При нарушении их прав, как правило, женщины никуда не обращаются. В ходе изучения ситуации при написании данного отчета выявлены нарушения прав женщин, живущих с ВИЧ, и женщин из затронутых групп, только единицы решились защищать свои права и то, потому что им был предоставлен адвокат за счет проекта. Причины такого поведения различны. Одна из основных причин, это отсутствие финансовых средств на оплату услуг адвоката. Во-вторых, многие женщины, живущие с ВИЧ, и женщины из затронутых ВИЧ групп имеют низкую правовую грамотность, у них нет информации о том, к кому обратиться по тому или иному вопросу. В-третьих, самостигматизация и боязнь разглашения конфиденциальности также мешает женщинам, живущим с ВИЧ, и женщинам из затронутых ВИЧ групп защищать свои права.”

Из доклада ясно, что женщины не защищают свои права, особенно по таким чувствительным вопросам, из-за страха почувствовать еще больше осуждения и стать еще более уязвимыми. Кроме того, в странах Центральной Азии, в семьях есть традиции, когда невестка должна сказать мужу или свекрови, куда она идет, и на что она собирается тратить или потратила деньги (к слову об оплате адвоката). Женщины зависят от других членов семьи, и часто не имеют своих собственных денег.

Насилие в отношении женщин увеличивает для них риск инфицирования ВИЧ, в то же время само наличие ВИЧ-инфекции у женщины также увеличивает опасность насилия, в том числе и со стороны родственников, из-за ее уязвимости и заниженной самооценки.

Криминализация ВИЧ, ни как превентивная мера, ни как способ защиты женщин от инфицирования не работает, как это пытаются представить люди, принимающие решения. Наоборот, на конкретных примерах мы наблюдаем, что женщины оказываются более уязвимыми.

Источники:

[1] — Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11; 365:493-505.

[2] — Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016; 316:171-81.

[3] — Grulich A, Bavinton B, Jin F, Prestage G, Zablotska, Grinsztejn B, et al. HIV transmission in male serodiscordant couples in Australia, Thailand and Brazil. Abstract for 2015 Conference on Retroviruses and Opportunistic Infections, Seattle, USA, 2015.

[4] — Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016 Sep 1; 375(9):830-9. 

Uzbekistan: Careless and distorted headline highlights why HIV criminalisation law must be reformed

Why HIV is no longer a sentence for medicine, but still a scourge for society

Automatic Deepl translation. For article in Russian, scroll down. 

Attitudes towards people with the immunodeficiency virus in Uzbekistan remain difficult, if not discriminatory. The problem lies not only in public intolerance and the negligence of the media, but also in the imperfection of legislation in this area.

TASHKENT, June 8 – Sputnik. In early June, an article on the problem of the spread of HIV infection among young people was published on the website of the Tashkent police department. It focused on the fact that the threat of infection is considered a criminal offence, and a case from 2019 was cited for clarity.

The aim of the publication is to draw the attention of parents and young people themselves to this topic so that they are responsible for their health and are not frivolous in sexual relations. However, a good cause has turned out to be a scandal. A local publication published an article titled “In Tashkent, a schoolchild infected his girlfriend with HIV”. As a result, the participants in last year’s story suffered twice because of the notorious positive status of one of the partners: first the young man was given a suspended sentence for an act that had no serious consequences, and then journalists with an easy hand “gave” his girlfriend an unconfirmed diagnosis of HIV.

Love against HIV
The trial of the young man took place in 2019, but it has only now become known. The young man was charged with a crime under Part 4 of Article 113 of the Uzbek Criminal Code – “Knowingly putting a person at risk of HIV infection”. The young people (he is 17 years old, she is 16) have known each other since childhood, and started dating as teenagers. The defendant fully confessed and explained that he knew about his diagnosis and since 2009 (from the age of seven) has been registered with the AIDS Centre and has been regularly examined.
The couple did not plan a family relationship, but, as usual, everything happened spontaneously, without using contraception. According to the young man, he warned his girlfriend about possible danger. It wasn’t until the fifth month that she was pregnant. As a result, neither the mother nor the child born later was diagnosed with HIV. The couple, of course, registered their marriage, but the husband got a suspended sentence for doing it.
An already unpleasant story, though with a happy ending, could have ended there, but the careless mentioning and distorted headline in the media, which is called, added oil to the fire. This example revealed a long overdue problem of the imperfection of the judicial system with regard to HIV-positive people, who are almost discriminated against twice.

A new perspective on the disease
According to experts, the law as it stands only contributes to the stigma and harassment of HIV-positive people in society, in particular adolescents. The legislation on HIV/AIDS is morally outdated. When it was drafted, it was indeed a fatal disease and there was no antiretroviral therapy. A few years ago, WHO officially declared HIV to be a chronic and non-fatal disease.

In Uzbekistan, free antiretroviral therapy has been available since 2006. There is scientific evidence that a person with a depressed (undefined) viral load (the amount of the virus in the blood), as a convicted young man, has a risk of transmitting the virus to zero. But practice shows that the law is sometimes not heeded to science.

Azizbek Boltayev, a psychotherapist from Bukhara, was one of the first to react to the publication of the GUVD and then reprint it in an Internet publication with an ignorant headline.

“Special attention should be paid to the age when the guy was registered – 7 years old, i.e. he was very likely to be infected in one of the medical institutions of the country. It turns out that the person was punished for the condition he had because of the lack of supervision of state controlling bodies. After all, if the guy had not been infected as a child, today’s problem simply would not have happened. Who would want to register with the AIDS Center after such news?” – noted the expert.
Today medicine allows HIV-positive people to really live a full life, have families without any risk for their partner and have absolutely healthy children. This is why amendments to the legislation are so necessary.

“According to international practice, having a separate article on HIV only reinforces stigma, so it is recommended to apply common articles on harm to health. In addition, only wilfully malicious infections or attempts to infect should be criminalized. If no infection has occurred, the act will usually be decriminalised,” said lawyer Timur Abdullayev.
Article 113 of the Uzbek Penal Code consists of five parts, with HIV being devoted to part of the Criminal Code. 4 и 5. And in one part, two notions are combined: “infection” and “knowingly put in danger.

“The latter refers to any action that involves any risk above zero. So, protected sexual intercourse with contraception does not exclude liability, because it does not protect 100%. Thus, all that is not equal to zero is in any case an article, and it does not matter whether there is a transmission or not, whether there is intent or not. In addition, the Code does not explain what “known” means and what intention it means – direct, indirect or no intention at all,” explains the lawyer.
Thus, the outcome of the trial depends on the interpretation of the law by the investigation bodies and the court.

“In Russia, Belarus and Kazakhstan, notes were added to the article that if the HIV-negative partner was warned and agreed to the risk and there is a receipt, then the liability is cancelled,” Abdullayev continues. – However, the Uzbek Criminal Code does not have such a note, which means that all HIV-positive partners in discordant couples (where only one of them is infected) are de jure criminals”.

A humane approach
Over the past few years, Uzbekistan has achieved impressive results in the fight against HIV infection. In addition, the most comfortable conditions for people with status are being created. For example, within the limits of the decision of the president of Uzbekistan “About measures on the further perfection of system of counteraction to distribution of the disease caused by a virus of immunodeficiency of the person, in the Republic of Uzbekistan” pre-contact prophylaxis by antiretroviral preparations for HIV-negative persons in discordant pairs is already practiced.

However, the judicial and legal system requires immediate reforms, dictated by international recommendations and human rights organizations. In the experts’ view, article 113 of the Convention on the Elimination of All Forms of Discrimination against Women. 4 of the Criminal Code contradicts several provisions of the Constitution – articles 18 and 27, as well as article 4 of the Family Code. Lawyers are convinced that amendments to the current legislation will contribute to a humane approach to the HIV response.
In the case of the described pair of infected girls did not occur, HIV activists have achieved the correction of the scandalous false title, but how to deal with its consequences now? One indiscreet word crosses out years of work by specialists in eliminating discrimination against HIV-positive people.

“We still find it shameful to stigmatize people already suffering from a serious chronic disease who face restrictions because of their status. Happening of such a situation among healthy teenagers is unlikely to cause public resonance,” believes Zulfiya Tairova, international expert on public health and HIV/AIDS programs.
Hardened stereotypes and a craving to denounce the culprit, to punish it and to make it public so that others would not be harmed, she said.

Imaginary phobias and real barriers
The prevailing opinion in society is still that HIV is a problem exclusively for risk groups (drug addicts, sex workers, prisoners, etc.). Did the convicted young person, who was infected at the age of 7, belong to any of these categories? Was it his or her fault for the infection? Why does he now have to live with the label of a person with a criminal record?

Another problem is related to the restriction of the rights of young people with HIV: the inability to study at a foreign university, a ban on entering foreign countries for a long period of time for work or study, where a certificate of absence of this diagnosis is required.
Even physicians avoid such patients once they are diagnosed with HIV status, sometimes refusing to provide services or transferring the patient to another doctor.

With regard to youth education, Tairova said it is time to stop covering up real problems and not ignore the physiology of adolescents.

“We need to talk to children in their language and teach them how to protect their health, and stop covering up sexual education with a veil of “comfort” (shame, shame). Teenagers should know how to use a condom and that this is the safest way to protect themselves from infection and unwanted pregnancy,” she said.
In 2019 Moldova hosted the first Regional Forum of Eastern European and Central Asian Judges on HIV. Unfortunately, representatives of Uzbekistan were not there. A second meeting is planned this year. Due to the coronavirus pandemic, the format of the meeting is still unknown. HIV activists hope that this time the republic will not be left out of discussion on a very important topic. The purpose of this forum is to raise awareness of judges and change their attitude towards HIV-positive defendants.

Почему ВИЧ – уже не приговор для медицины, но все еще бич для общества

Отношение к лицам с вирусом иммунодефицита в Узбекистане остается сложным, если не сказать дискриминационным. Проблема кроется не только в нетерпимости общества и неосторожности СМИ, но и в несовершенстве законодательства в этой сфере.

ТАШКЕНТ, 8 июн — Sputnik. В начале июня на сайте ГУВД Ташкента была опубликована статья, посвященная проблеме распространения ВИЧ-инфекции среди молодежи. В ней был сделан упор на то, что угроза заражения считается уголовно наказуемым преступлением, а для наглядности приведено дело 2019 года.

Цель публикации – обратить внимание родителей и самих молодых людей к этой теме, чтобы они ответственно относились к своему здоровью и не были легкомысленны в половых отношениях. Однако благое начинание обернулось скандалом. Одно из местных изданий опубликовало статью с заголовком “В Ташкенте школьник заразил свою девушку ВИЧ-инфекцией”. В результате участники прошлогодней истории дважды пострадали из-за пресловутого положительного статуса одного из партнеров: сначала молодой человек получил условный срок за не имевшее тяжелых последствий деяние, а затем еще и журналисты с легкой руки “поставили” его девушке неподтвержденный диагноз ВИЧ.

Любовь против ВИЧ

Судебное разбирательство в отношении молодого человека проходило в 2019 году, однако известно о нем стало только сейчас. Юноше инкриминировалось преступление по части 4 статьи 113 УК Узбекистана — “Заведомое поставление человека в опасность заражения ВИЧ-инфекцией”. Молодые люди (ему 17 лет, ей – 16) знакомы с детства, еще подростками начали встречаться. Обвиняемый полностью сознался в содеянном и пояснил, что о своем диагнозе знает и с 2009 года (с семилетнего возраста) состоит на учете в Центре по борьбе со СПИДом, а также регулярно проходил обследование.

Семейных отношений пара не планировала, но, как водится, все произошло спонтанно, без использования контрацептивов. По признанию молодого человека, он предупредил свою девушку о возможной опасности. Беременность выявили лишь на пятом месяце. В итоге ни у матери, ни у родившегося позже ребенка не был обнаружен ВИЧ. Пара, конечно, зарегистрировала свой брак, но супруг получил за содеянное условный срок.

И без того неприятная история, хоть и со счастливым финалом, на этом могла бы закончиться, но неосторожное упоминание и искаженный заголовок в СМИ, что называется, подлили масла в огонь. Этот пример выявил давно назревшую проблему несовершенства судебной системы в отношении ВИЧ-инфицированных, которые подвергаются чуть ли не двойной дискриминации.

Новый взгляд на заболевание

По мнению экспертов, закон в нынешнем виде только способствует укреплению в обществе стигмы и притеснениям по отношению к ВИЧ-положительным, в частности, подросткам. Законодательство по ВИЧ/СПИДу морально устарело. Когда оно составлялось, это действительно было смертельным заболеванием, отсутствовала антиретровирусная терапия. Несколько лет назад ВОЗ официально объявила ВИЧ хронической и несмертельной болезнью.

В Узбекистане бесплатная АРВ-терапия доступна с 2006 года. Есть научные данные, что у человека с подавленной (неопределяемой) вирусной нагрузкой (количество вируса в крови), как у осужденного молодого человека, риск передачи вируса равен нулю. Но практика показывает, что закон порой к науке не прислушивается.

Одним из первых на публикацию ГУВД, а затем ее перепечатку в интернет-издании с невежественным заголовком отреагировал Азизбек Болтаев, психотерапевт из Бухары.

“Особое внимание общественности должен привлечь возраст, когда парень встал на учет – 7 лет, т. е. с большой вероятностью его заразили в одном из медучреждений страны. Получается, что человека наказали за состояние, которое возникло у него по причине недосмотра государственных контролирующих органов. Ведь если бы парня не заразили в детстве, сегодняшней проблемы попросту бы не было. Кто после подобных новостей захочет вставать на учет в Центр по борьбе со СПИДом?” — заметил эксперт.

Сегодня медицина позволяет ВИЧ-положительным людям действительно жить полноценной жизнью, заводить семьи без какого-либо риска для своего партнера и иметь абсолютно здоровых детей. Вот почему поправки в законодательстве так необходимы.

“В соответствии с международной практикой, наличие отдельной статьи о ВИЧ лишь усиливает стигму, поэтому рекомендуется применять общие статьи о причинении вреда здоровью. Кроме того, уголовная ответственность должна быть предусмотрена только за случаи предумышленного злонамеренного инфицирования либо попытки инфицировать. Если инфицирования не произошло, деяние, как правило, декриминализируют”, — отметил юрист Тимур Абдуллаев.

Статья 113 УК РУз состоит из пяти частей, ВИЧ посвящены ч. 4 и 5. Причем в одной части объединены два понятия: и “заражение”, и “заведомое поставление в опасность”.

“Последнее обозначает всякое действие, предполагающее любой риск выше нуля. Получается, защищенный половой контакт с использованием контрацептива не исключает ответственность, потому что он не защищает на 100%. Таким образом, все, что не равно нулю, – это в любом случае статья, и не важно, есть факт передачи или нет, есть умысел или нет. Кроме этого, Кодекс не объясняет, что значит “заведомое” и какой умысел оно означает – прямой, косвенный или вообще его отсутствие”, — объясняет юрист.

Таким образом исход судебного разбирательства зависит от трактовки закона органами следствия и судом.

“В России, Беларуси, Казахстане были добавлены примечания к статье, что в случае если ВИЧ-отрицательный партнер был предупрежден и согласился с риском и об этом имеется расписка, то ответственность отменяется, — продолжает Абдуллаев. — Однако в УК Узбекистана нет и такого примечания, а значит, все ВИЧ-положительные партнеры в дискордантных парах (где лишь один из них инфицирован) – де-юре преступники”.

Гуманный подход

За последние несколько лет Узбекистан достиг внушительных результатов в борьбе с ВИЧ-инфекцией. Кроме этого, создаются максимально комфортные условия для людей со статусом. Например, в рамках постановления президента Узбекистана “О мерах по дальнейшему совершенствованию системы противодействия распространению заболевания, вызываемого вирусом иммунодефицита человека, в Республике Узбекистан” уже практикуется доконтактная профилактика антиретровирусными препаратами для ВИЧ-отрицательных лиц в дискордантных парах.

Однако судебно-правовая система требует незамедлительных реформ, продиктованных международными рекомендациями и правозащитными организациями. По мнению экспертов, статья 113 ч. 4 УК РУз противоречит ряду положений Конституции – статье 18 и 27, а также статье 4 Семейного кодекса. Юристы убеждены, что поправки в текущее законодательство поспособствуют гуманному подходу в противодействии ВИЧ.

В случае с описанной парой заражения девушки не произошло, ВИЧ-активисты добились исправления скандального неправдивого заголовка, но как теперь быть с его последствиями? Одним неосторожным словом перечеркивается многолетняя работа специалистов по искоренению дискриминации ВИЧ-положительных.

“До сих пор мы констатируем факты позорного клеймения и без того страдающих тяжелым хроническим заболеванием людей, которые сталкиваются с ограничениями из-за статуса. Случись подобная ситуация среди здоровых подростков, вряд ли это вызвало бы общественный резонанс”, — убеждена Зульфия Таирова, международный эксперт по вопросам общественного здравоохранения и программ по борьбе с ВИЧ/СПИДом. 

По ее словам, в обществе еще сильны закостенелые стереотипы и жажда обличить виновника, наказать, предать огласке, чтобы другим не повадно было.

Мнимые фобии и реальные барьеры

В социуме все еще доминирует мнение о том, что ВИЧ – это проблема исключительно групп риска (наркозависимых, лиц, оказывающих платные секс-услуги, заключенных и т. д.). Относился ли осужденный молодой человек, зараженный в 7-летнем возрасте, к какой-то из этих категорий? Есть ли его вина в заражении? Почему теперь он вынужден жить с ярлыком человека с уголовным прошлым?

Другая проблема связанна с ограничением прав молодых людей с ВИЧ: невозможность учиться в иностранном вузе, запрет на въезд в иностранные государства на длительный срок по работе или учебе, где требуется сертификат об отсутствии этого диагноза.Даже медики сторонятся таких пациентов после выявления у них ВИЧ-статуса, порой отказывая в предоставлении услуг или передавая больного другому врачу.

Что касается воспитания молодежи, то, по словам Таировой, пора перестать прикрывать реальные проблемы и не игнорировать физиологию подростков.

“Нужно говорить с детьми на их языке и учить их способам защиты своего здоровья, прекратить прикрывать сексуальное воспитание завесой “уят” (стыд, позор). Подростки должны знать, как пользоваться презервативом и что это самый надежный способ защиты от инфекций и нежелательной беременности”, — уверена она.

В 2019-м в Молдове впервые прошел Региональный форум судей Восточной Европы и Центральной Азии по ВИЧ. К сожалению, представителей Узбекистана там не было. В этом году планируется второе заседание. В связи с пандемией коронавируса формат его проведения пока неизвестен. ВИЧ-активисты надеются, что на этот раз республика не останется в стороне от обсуждения очень важной темы. Цель этого форума – повысить информированность судей и изменить их отношение к ВИЧ-положительным подсудимым.

Australia: Director of Public Prosecutions uses HIV case to argue in favour of lowering burden of proof for prosecutions

Easing proof for violent crime would bring legal ‘turmoil’, court told

A push to make it easier to obtain convictions in serious violence cases would throw criminal law into “turmoil”, the Court of Appeal has heard.

Director of Public Prosecutions Kerri Judd last year took the unusual step of challenging the precedents that set the threshold to prove the offence of recklessly causing serious injury after a man was acquitted of a near-fatal assault on an English backpacker in Melbourne.

The 28-year-old backpacker was kicked in the head when a fight broke out between two groups of men in Southbank in February 2017. His skull was fractured when his head hit a hard surface, leaving him on life support for three weeks.

The 18-year-old accused of kicking the backpacker was acquitted last year of both intentionally and recklessly causing serious injury, after he argued his actions were in self-defence. Prosecutors also couldn’t prove the probability the teenager knew he was going to cause serious injury by kicking the backpacker.

Now Ms Judd wants to lower the standard so prosecutors would have to prove an accused person was “possibly” aware their actions would cause serious harm, rather than “probably”.

Chris Boyce, QC, acting on behalf of the DPP, said the burden of proof was set at an unreasonably high level.

“We have to prove a state of mind that is verging on intent for an offence which was intended to be of a lesser morality in terms of culpability, yet the definition merges between the two,” Mr Boyce told the Court of Appeal on Monday.

But Dermot Dann, QC, acting for the acquitted teenager, said no other DPP has “complained” about the definition before, nor has Parliament sought to change it.

He said such a change would affect any offence that contains recklessness.

“This root and branch alteration … would result in turmoil in terms of the operation of the criminal law and expansion of criminal liability,” Mr Dann said.

Justice Phillip Priest, one of the judges hearing the appeal, said: “My impression, I must say, [is that] it’s been applied satisfactorily for 25 years.”

The precedent that defines predicting consequence as a probability, rather than a possibility, was set by the High Court in 1985 in a case of a truck driver who drove his vehicle into a building and fled the scene.

Five people died and he was convicted of murder but on appeal the High Court found that “the question is whether the accused knew or foresaw that his actions would probably cause death or grievous bodily harm”.

This position was solidified in a 1997 Victorian case against a man accused of attempted murder and recklessly causing injury after a gun went off and injured someone nearby.

The DPP asked the Court of Appeal to instead look to another High Court case, that of a NSW man who knew he had HIV and infected a sexual partner.

In that case, it was sufficient to establish an accused foresaw the possibility that sex would result in contraction of a grievous bodily disease.

A decision in the case, heard by Court of Appeal President Chris Maxwell and justices Stephen McLeish, Stephen Kaye, Karin Emerton and Justice Priest, will be made at a later date.

Canada: British Columbia’s appeal court orders new trial for man accused of reneging on promise to wear condom

Sex with condom is legally different from sex without, B.C. court rules in consent-case appeal

New sexual assault trial ordered for man accused of reneging on promise to wear protection

B.C.’s appeal court has ordered a new trial for a man acquitted of sexual assault after he allegedly reneged on a promise to wear a condom during sex.

In a case that explores the boundaries and definitions of sexual activity and consent, the three appeal court judges all reached the same conclusion — while apparently disagreeing with each other on exactly why.

Two of the judges agreed that sex without a condom is a fundamentally different activity — legally — from sex with a condom. 

And one of those judges then switched sides to join the dissenting judge in finding there was evidence the accused had defrauded the alleged victim into having sex with him.

Either way, X faces another trial.

No ‘evidence of dishonesty’

The original B.C. provincial court trial in Surrey in 2018 ended in acquittal without X’s testimony. A provincial court judge found there was no evidence to support either the woman’s contention that she hadn’t consented to sexual activity or that her consent had essentially been obtained through fraud.

“I am unable to find any evidence of dishonesty on the part of the accused that could result in a conviction,” the trial judge wrote.

In the appeal, however, Justice Harvey Groberman concluded: “As there was evidence indicating that the accused engaged in sexual intercourse without a condom, knowing that the complainant required him to wear one, the judge erred in granting the no-evidence motion. In the result, I would set aside the acquittal and remit the matter to the provincial court for a new trial.”

In the opening to his majority reasons for judgment, Groberman wrote: “The question on this appeal is a simple one: where a person consents to engage in sexual intercourse on condition that their sexual partner wear a condom, can that partner ignore the condition without being subject to criminal liability?”

Insisted on use of condoms

The alleged offence occurred in March 2017, a few days after the couple first met in person. They had spoken online prior to that meeting and, face-to-face, they discussed sexual practices.

The woman said she told X she insisted on the use of condoms.

“The accused agreed that such a practice was safest for all concerned,” the appeal judgment says.

A few days later, the woman went to X’s house just after midnight, where they went up to his bedroom and undressed.

“She asked if he had a condom, and added that if he did not, she did,” the judgment says. 

Awoke in the night

“He replied that he did, and reached onto a side table to get one, which he put on. The two then engaged in vaginal intercourse.”

According to the ruling, the woman awoke in the night to find X sexually aroused. She claimed she pushed him away and he turned briefly to the side table.

“Although the complainant believed that he was getting a condom, he was not doing so,” Groberman wrote. “The two then engaged in sexual intercourse.”

The woman said X told her he was “too excited to wear a condom.”

She took the matter to the police.

Related Nova Scotia case

Complicating matters in the appeal was a Supreme Court of Canada decision in which the country’s highest court considered questions of sexual activity and consent in a Nova Scotia case involving a man who poked a pin in a condom before having sex with a woman who then became pregnant.

In that ruling, the judges upheld the man’s sexual assault conviction, finding that while the victim consented to have sex, her consent was nullified by the accused’s deception.

“The accused’s condom sabotage constituted fraud … the result that no consent was obtained,” Chief Justice Beverley McLachlin and Justice Thomas Cromwell wrote on behalf of the court.

“A person consents to how she will be touched, and she is entitled to decide what sexual activity she agrees to engage in for whatever reason she wishes.”

But in X’s case, the implications of their ruling were interpreted differently by each of the B.C. appeal court judges.

What is ‘sexual activity’?

The question at the heart of the case concerns the definition of “sexual activity” and whether intercourse with a condom is a different type of activity from intercourse without.

Groberman and Justice Mary Saunders agreed that it was — and that as such, the woman had not consented to the sexual activity Kirkpatrick engaged in without protection.

“This is a case about sexual activity that the complainant consented to,” Groberman wrote.

“On her evidence, she did not consent to the accused penetrating her with his unsheathed penis.”

But Justice Elizabeth Bennett disagreed, saying the woman had consented to sexual activity.

Sided with Groberman

She said she didn’t think the Supreme Court of Canada judges meant to distinguish sex with a condom from sex without in defining “the basic physical act” of intercourse, in part because that could lead to the criminalization of defective condoms.

However, she still thought the lower court judge was wrong — because Bennett said there was enough evidence to conclude that Kirkpatrick had obtained the alleged victim’s consent through fraud to warrant holding a new trial.

Saunders — the judge who agreed with Groberman on the first part of the ruling — sided with Bennett and against Groberman on that part of the opinion.

X’s lawyer said his client is seeking leave to appeal the decision to the Supreme Court of Canada.

US: Ohio Supreme Court upholds the constitutionality of the State’s HIV Disclosure law

Statute Requiring Disclosure of HIV Positive Status to Sexual Partners Is Constitutional

The Supreme Court today unanimously upheld the constitutionality of R.C. 2903.11(B)(1), Ohio’s HIV-disclosure statute, which makes it a crime for a person who has tested positive for HIV to knowingly engage in sexual conduct with another without disclosing that information, concluding that it does not violate either the free speech provision of the First Amendment or the Equal Protection Clauses of the United States or Ohio Constitutions.

In a majority opinion authored by Justice Terrence O’Donnell, the Court concluded that because R.C. 2903.11(B)(1) regulates conduct, not speech, it does not violate the First Amendment, and because it is rationally related to the state’s legitimate interest in preventing the transmission of HIV to sexual partners who may not be aware of the risk, it does not violate equal protection.

Chief Justice Maureen O’Connor, Justice William M. O’Neill, and Eleventh District Court of Appeals Judge Thomas R. Wright, sitting for Justice Patrick F. Fischer, joined the majority opinion.

In a concurring opinion, Justice R. Patrick DeWine wrote that the law regulates speech as well as conduct. The concurrence found, however, that the law constitutionally regulates speech because it is narrowly tailored to achieve a compelling governmental interest and is the least-restrictive way of doing so. Justice DeWine’s concurrence was joined by Justices Sharon L. Kennedy and Judith L. French.

Batista Indicted for Violating R.C. 2903.11(B)(1) In 2001, while Orlando Batista was incarcerated on an unrelated charge, the Ohio Department of Rehabilitation and Correction tested him for HIV and informed him that he was positive for the disease. After his release, he began a relationship with a woman identified in court documents as R.S. and engaged in intercourse with her without disclosing his HIV positive status to her prior to engaging in that conduct. Two months later, R.S. learned of Batista’s HIV positive status. When R.S. confronted him about it, he acknowledged he had tested positive for the virus and told her he had been infected since he was a teenager. In a subsequent interview with police, Batista admitted to having intercourse with R.S. without telling her he was HIV positive.

A grand jury indicted Batista for violating R.C. 2903.11(B)(1). He moved to dismiss the indictment, arguing the law violated the First Amendment right to free speech and the Equal Protection Clauses of both the United States and Ohio Constitutions. The trial court denied the motion, and Batista subsequently pleaded no contest to the charge. The trial court found him guilty and sentenced him to eight years in prison.

The First District Court of Appeals affirmed the conviction, concluding the statute did not violate the First Amendment or the Equal Protection Clauses of the United States and Ohio Constitutions. Batista appealed to the Supreme Court, which agreed to hear the case.

Statute Regulates Conduct, Not Speech Justice Terrence O’Donnell, writing for the majority, explained that the First Amendment does not prohibit statutes that regulate conduct from imposing incidental burdens on speech.

The Court noted that the Missouri and Illinois supreme courts have held that statutes similar to R.C. 2903.11(B)(1) did not regulate speech and therefore did not violate the First Amendment.

Referencing those decisions, the majority concluded that “[a]lthough R.C. 2903.11(B)(1) requires those who know they are HIV positive to disclose their status if they choose to engage in sexual conduct with another person, the disclosure is incidental to the statute’s regulation of the targeted conduct. Thus, this statute regulates conduct, not speech, and therefore does not violate the First Amendment right to free speech.”

Statute Does Not Violate Right to Equal Protection Justice O’Donnell pointed out that R.C. 2903.11(B)(1)’s treatment of individuals with knowledge of their HIV-positive status who fail to disclose that status to a sexual partner furthers the state’s interest in “curbing HIV transmission to individuals who may not be aware of the risk,” and concluded that the statute does not violate equal protection because “there is some conceivable basis to support the legislative arrangement.”

He further explained that “the existence of other sexually transmitted diseases that may have serious public health and safety consequences does not eliminate the rational relationship between the classification here—individuals with knowledge of their HIV-positive status who fail to disclose that status to sexual partners—and the goal of curbing HIV transmission.”

The majority opinion concluded “that there have been advancements in the treatment of individuals with HIV that may have reduced the transmission and mortality rates associated with the disease. However, we cannot say that there is no plausible policy reason for the classification or that the relationship between the classification and the policy goal renders it arbitrary or irrational.”

Concurrence Finds Speech Regulation Justice DeWine wrote that he agrees with the majority that Batista’s rights were not violated, but reaches that conclusion “by a different path.”

“The statute plainly regulates both conduct and speech: one who tests positive for the human immunodeficiency virus (‘HIV’) must tell his partner that he is HIV positive before engaging in sex. When the government tells someone what he must say, it is regulating speech,” he wrote.

Justice DeWine explained that any law compelling content-based speech must pass the U.S. Supreme Court’s “strict scrutiny” test, which requires that a speech regulation be narrowly tailored to achieve a compelling government interest and use the least restrictive means to achieve it.

The concurrence stated that Ohio has an interest in limiting the spread of HIV and an interest in ensuring informed consent to sexual relations. The opinion noted that Batista essentially argued that because of the advancements of treatment, the health risks for HIV “are not really all that bad.”

“But the question is who gets to evaluate that risk: should the HIV-positive individual get to assess that risk for his sexual partner or should the partner get to make her own decision. Fair to say that most—if not all—people would insist on the right to make that decision for themselves,” the opinion stated.

The concurrence concluded that protecting public health and ensuring informed consent are compelling government interests, and that the law uses the least restrictive limit on speech by only requiring HIV-positive individuals to disclose their status to their sexual partners.

“I cannot fathom—and Batista has not advanced—any less restrictive or more narrowly tailored means that could have been employed by the government to achieve its interests here,” Justice DeWine wrote.

2016-0903. State v. Batista, Slip Opinion No. 2017-Ohio-8304.

 View oral argument video of this case.

Please note: Opinion summaries are prepared by the Office of Public Information for the general public and news media. Opinion summaries are not prepared for every opinion, but only for noteworthy cases. Opinion summaries are not to be considered as official headnotes or syllabi of court opinions. The full text of this and other court opinions are available online.

US: Advocates who fought to modernise HIV criminalisation laws for years are wary about what could happen around coronavirus

Will COVID-19 Make Modernizing HIV Criminal Laws Harder?

As states and municipalities struggle with how to enforce COVID-19 distancing and shutdown measures, many HIV criminal law reform advocates are looking warily at the news and waiting for history to repeat, or at least rhyme. Advocates expect new criminal laws on COVID-19 transmission, just like statutes enacted around HIV transmission, to come sooner or later.

These advocates say getting ahead of such laws is crucial—and that now is the time to remind lawmakers and law enforcement that statutes around infectious diseases must be grounded in public health and science, not inflamed by hysteria; in other words, avoid what happened with HIV laws decades ago.

It’s speculation at this point: In the three months since COVID-19 emerged in the U.S., no new criminal laws around transmission of the virus have been enacted. But prosecutions of transmission of COVID-19, deliberate or not, are probably going to happen, and there will be open questions: Did the victim contract the virus from one person who can be identified?

Belly Mujinga, a 47 year-old Black rail worker in the UK who was spat on by a man while on duty, died of COVID-19, but prosecutors will have a difficult time proving whether he contributed to Mujinga’s death, even if they find him and even if he does have the virus. Here in the U.S., most cases involving spitting usually occur when someone with HIV (and sometimes hepatitis C) is accused of spitting at police officers when arrests are being made—even though saliva is not a route of HIV transmission.

But if more incidents like this surface around COVID-19, lawmakers might be tempted to pass laws subjecting anyone coughing or spitting on another person—or just coughing in public—to misdemeanors, or even felonies. That’s something HIV advocates hope to prevent. They’ve been trying to overturn criminal laws like that for decades.

TheBody asked several HIV criminal law modernization advocates about what the novel coronavirus pandemic could mean for HIV laws, and vice versa. Most were cautiously optimistic that their years of educating lawmakers and law enforcement could make it easier to prevent new, draconian laws around criminal transmission of the COVID-19 virus. Some say that, if done right, the COVID crisis could present an opportunity to renew efforts in educating law enforcement, lawmakers, and the public that HIV criminal statutes are still on the books, still being enforced, and have done nothing to slow the transmission of the virus.

Trepidation in Iowa

A provision of the federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act in 1990 required states to certify their ability to prosecute any HIV-positive person who knowingly exposed another person, whether they actually transmitted it or not. Some states relied on existing statutes; others, like Iowa, wrote new ones around transmitting HIV. In almost every case, these new HIV laws went far beyond laws on the books.

Iowa revamped some of its HIV laws in 2014, allowing a tiered-sentencing system of felonies and misdemeanors, rather than a flat 25-year prison term. Those convicted under the law no longer have to register as sex offenders. But Iowa activists say there is much more to be done.

Tami Haught, organizing and training coordinator for the Sero Project, fought to modernize Iowa’s laws for years, and she’s wary about what could happen around coronavirus.

“I’m a pessimist,” Haught tells TheBody. “The fear of the unknown makes society reach for criminal laws. We don’t have a strong public health knowledge. People don’t understand disease, generally. If deaths continue to rise (from COVID-19), it worries me that legislators will create new laws to prosecute, spurred on by an uneducated public demanding new laws.”

Haught says new COVID-19 laws could be stopped, but that will require a broad and diverse team of advocates. “In Iowa, it took years for all [HIV] advocates to speak with one message, before going to the legislature. We shared our talking points with the League of Women Voters, not a usual subject, and the League made one of their top four goals the repeal of HIV laws in 2014. They had relationships with politicians that we didn’t have.”

Partisan Divide in Washington State

Lauren Fanning, with the Washington HIV Justice Alliance, is still celebrating a significant revision of that state’s HIV criminal laws, which reduce penalties for HIV exposure from a felony to a misdemeanor, require specific intent to transmit HIV and for transmission to occur, and remove the requirement for sex offender registration. It was accomplished on a party-line vote and signed into law by Gov. Jay Inslee in March.

“No Republican voted for [the reform],” Fanning says. Advocates didn’t get everything they wanted: Republicans demanded an amendment to keep one felony for limited circumstances—if an HIV-positive person transmits HIV to a minor or vulnerable adult, that is still a first-degree felony.

“A lot of Republicans in the legislature want to keep HIV laws and also criminalize other diseases,” Fanning says. “As long as it is not part of their reality, they will make it criminal. They don’t believe these diseases can affect them. They also wanted to quarantine people during the Ebola crisis.”

That’s why Fanning expects Republicans to introduce new COVID-19 transmission criminal laws, and she and other advocates will fight them. “We don’t need a new law. COVID-19 could apply to noxious or poisonous substances under existing law,” she says.

“We will be checking laws next year when the legislature is in session to see if something is slipped in. I told the health department to be prepared to step in front of any laws.”

Don’t Fill the Jails

Catherine Hanssens, founder and executive director of The Center for HIV Law and Policy (CHLP), says COVID presents an opportunity to build on the groundwork laid by HIV criminal law reform advocates, by “pointing out the futility and cruelty of criminal penalties.”

“[COVID] gives state advocates the opportunity to talk to lawmakers about responding to a virus with a police approach, and let them know that if you arrest someone without a mask to prevent transmission and then put them in jail, in close quarters, that is not productive.”

Hanssens and other advocates are calling for limited prisoner release. Correctional facilities, along with nursing homes, meat-packing plants, and anywhere people are confined to tight spaces, have very high rates of transmission of COVID-19.

As for how the COVID-19 pandemic might impact HIV criminal law reform, Hanssens said it might not hurt the movement, but it might put it on pause. “States are focused on dealing with the immediate pandemic. Getting legislators to focus on something that is not COVID-19 might not work now, and practically, it may not be strategically the best choice to push HIV criminal law reform right now.”

But that doesn’t mean continuing education and coalition-building can’t take place, Hanssens says. “This is a chance for all in anti-criminalization to see the necessity of looking outside our silo and make intersectionality a reality.” Out of concern that people with HIV would not be prioritized for scarce resources in emergency care in New York City, last month CHLP worked with the disability rights movement to draft principles for allocating resources. The principles say that older people and those with disfavored statuses should have equal access to other respiratory therapies, testing, medications, critical care beds, and staff time, which current guidance fails to adequately protect.

A Silver Lining in a Red State

Indiana, one of the nation’s highly conservative states, has several HIV criminal laws. If you know you have HIV and are accused of HIV nondisclosure to sexual or needle-sharing partners, or you attempt to donate or sell blood, semen, or plasma—you could face a felony. The state also has HIV-related sentence enhancements to its criminal battery in the form of bodily fluid laws, including fluids that do not transmit HIV.

IUPUI associate professor and HIV modernization activist Carrie Foote, Ph.D., says Indiana is making progress to modernize many of its draconian HIV criminal laws, but much work remains. Unlike most other states, Indiana also criminalizes transmission of viral hepatitis and tuberculosis, which is transmitted in similar ways to COVID-19. Because of that, Foote thinks lawmakers could try to criminalize COVID-19 as well.

At least one Indiana prosecutor has vowed to prosecute anyone who knowingly attempts to infect others with COVID-19 but didn’t say whether a new law was needed.

Foote hopes for the best-case scenario as the COVID-19 epidemic plays out: lawmakers not adding COVID-19 laws, and a new opportunity for advocates to show the problems of antiquated HIV and other disease-related criminal laws.

“For any disease, we need to say that laws should be science-based,” Foote says. “Any criminal laws should be based on intent to harm, which is hard to prove, and it should be hard to prove. It shouldn’t be so easy to take away freedom.”