Senegal: “The application of criminal law is an injustice against people living with HIV”

A magistrate laments the ‘unfair’ criminalisation of HIV transmission

Translated from French with Deepl.com. Scroll down for the original article.

The deputy director of human rights, Babacar Diouf, deems it unfair to criminalise the transmission of HIV-AIDS, except in cases of intentional transmission.

‘The application of criminal law is an injustice against people living with HIV, unless a person deliberately decides to infect another person’, said the magistrate.

He was hosting a conference on the theme of ‘Following the path of rights to eliminate AIDS in Senegal’, an event organised on Wednesday as part of the celebration of World AIDS Day by the National AIDS Council.

According to the deputy director of human rights at the Ministry of Justice, the right to health in Senegal is not subject to judicial review. ‘What’s not working is criminalisation. This is an obstacle to the fight against AIDS’, he maintained.

‘The criminalisation of HIV is detrimental to rights. It is unfair when it targets a person who cannot disclose his or her status’, he argued.

‘We need to be aware that proclaimed rights that are not effective are of no use’, he said, pointing out that “the law on AIDS is unknown to some judicial actors”.

‘The lack of information among the judiciary is a hindrance to the fight against AIDS. They have no information about certain health data’, he said.

With this in mind, Babacar Diouf called on the National AIDS Council to ‘equip the judiciary’ so that they can play a greater role in the fight against AIDS.

He believes it is imperative to combat stigmatisation and discrimination.

Samba Cor Sarr, Director of Cabinet at the Ministry of Health and Social Action, pointed out that the theme of World AIDS Day, ‘Following the path of rights to eliminate AIDS in Senegal’, revived the issue of human rights in the fight against HIV.

‘The path of the fight against AIDS is strewn with rights-related issues: the right to health, the right to access to care and treatment, the right to a favourable environment, the right to a fairer, more equitable world’, listed the representative of the Minister of Health.

He also spoke of ‘the right to life, to a positive life for all those directly or indirectly affected by HIV’.

He also emphasised that Senegal, like other countries, still faces ‘significant challenges in the fight against HIV/AIDS’, including strengthening the fight against HIV at community level.

These challenges include stepping up the fight against HIV at community level. These challenges include stepping up care for children living with HIV, engaging young people and combating stigma and discrimination. Samba Cor Sarr also cited the fight against inequalities in access to care and the strengthening of support mechanisms.

In the Senegalese context, he added, this year’s theme ‘takes on its full meaning insofar as it enables a more specific and tailored response to the needs of communities affected by HIV/AIDS in order to reduce stigma and discrimination’.


Un magistrat déplore la pénalisation de la transmission du Sida, « une injustice »

Dakar, 12 déc (APS) – Le directeur adjoint des droits humains, Babacar Diouf, juge injuste la pénalisation de la transmission du VIH Sida, sauf dans les cas de contamination intentionnelle.

« L’application du droit pénal est une injustice contre les personnes vivant avec le VIH, sauf si une personne décide délibérément de contaminer une autre personne », a déclaré le magistrat.

Il animait une conférence sur le thème « Suivre le chemin des droits pour l’élimination du Sida au Sénégal », une activité organisée mercredi dans le cadre de la célébration de la Journée mondiale de lutte contre le Sida par le Conseil national de lutte contre le Sida.

Selon le directeur adjoint des droits humains au ministère de la Justice, le droit de la santé n’est pas judiciarisé au Sénégal. « Ce qui ne va pas, c’est la pénalisation. Il s’agit d’un obstacle à la lutte contre le Sida », a-t-il soutenu.

« La pénalisation du VIH nuit au droit. Elle est injuste lorsqu’elle vise une personne qui ne peut pas dévoiler son statut », a-t-il argumenté.

« Nous devons savoir que des droits proclamés qui ne sont pas effectifs n’ont pas d’utilité », a-t-il dit, en faisant observer que « la loi sur le Sida est inconnue de certains acteurs judiciaires ».

« Le manque d’information des acteurs judiciaires est un frein à la lutte. Les acteurs n’ont pas d’information sur certaines données sanitaires », a-t-il indiqué.

Dans ce sens, Babacar Diouf invite le Conseil national de lutte contre le Sida à « outiller les acteurs judiciaires », afin qu’ils puissent mieux participer à la lutte contre le Sida.

Il juge impératif de lutter contre la stigmatisation et la discrimination.

Samba Cor Sarr, directeur de cabinet du ministère de la Santé et de l’Action sociale, a pour sa part relevé que le thème consacré à la Journée mondiale de lutte contre le Sida, à savoir « Suivre le chemin des droits pour l’élimination du Sida au Sénégal », fait renaitre la question des droits humains dans la lutte contre le VIH.

« Le chemin de la lutte contre le Sida est parsemé de problématiques liées aux droits : droit à la santé, droit à l’accès aux soins et aux traitements, droit à un environnement favorable, droit à un monde plus juste, plus équitable », a énuméré le représentant du ministre de la Santé.

Il a également évoqué « le droit à la vie, à une vie positive pour toutes les personnes touchées directement ou indirectement par le VIH ».

Il a par ailleurs souligné que le Sénégal, à l’instar des autres pays, demeure « confronté à des défis significatifs dans la lutte contre le VIH/Sida », parmi lesquels le renforcement de la lutte contre le VIH au niveau communautaire.

Le renforcement de la prise en charge des enfants vivant avec le VIH fait partie de ces défis, de même que l’engagement de la jeunesse, la lutte contre la stigmatisation et la discrimination. Samba Cor Sarr a également cité la lutte contre les inégalités en matière d’accès aux soins et le renforcement des mécanismes de soutien.

Dans le contexte sénégalais, ajoute-t-il, le thème retenu cette année « prend tout son sens dans la mesure où il permet une réponse plus spécifique et plus adaptée aux besoins des communautés touchées par le VIH/Sida afin de réduire la stigmatisation et la discrimination »

Canada: Calls for action grow as political calculations leave HIV law reform in limbo

Government abandons efforts to decriminalise people living with HIV

Translated from French with Deepl.com – For original article, please scroll down.

In the run-up to World AIDS Day on 1 December and the federal election of 2025, the Government of Canada has informed the Canadian Coalition to Reform HIV Criminalisation (CCRCV) of its decision to abandon any plans for legislative reform concerning the criminalisation of HIV. People living with HIV are left with no explanation, knowing only that their rights are being set aside once again. Anger and disappointment at this abandonment.

A critical moment

This decision could not have come at a worse time. Canada currently ranks last among G7 countries when it comes to reducing new HIV infections. The number of reported cases has been rising steadily in Canada since 2020, taking us further and further away from our targets. The criminalization of HIV and the resulting stigma contribute to this alarming trend, in addition to placing Canada at odds with science and outside the global consensus on how best to reduce HIV transmission and respect the rights and dignity of people living with HIV. In a press release issued on November 26, UNAIDS pointed out that ‘the criminalization and stigmatization of marginalized communities hinders access to life-saving HIV services’.

The current situation

Currently, people living with HIV in Canada are subject to criminal prosecution under sexual assault laws, resulting in convictions, imprisonment and inclusion on the sex offender registry even in cases where there is little or no risk of transmission. Legal and medical experts around the world agree that this is not in line with current scientific knowledge about transmission and can deter people from getting tested and accessing treatment and support. In Canada, it is well documented that the harms of HIV criminalisation are uniquely, disproportionately and often insidiously experienced by black and aboriginal people.

A call to action

‘We’ve had enough of the lives of people living with HIV being used to play political games,’ says Alex McClelland of the CCRVC. ‘Good intentions and scrapped action plans don’t change the reality of life for people in Canada who are persecuted because of their health status. Law reform requires a concrete effort, a real commitment and the political will to do the right thing. Unfortunately, the Canadian government seems to be putting people living with HIV on the back burner in favour of political calculations for an election’.

A history of broken commitments

Members of the CCRCV have been working with the current federal government to reform the criminalisation of HIV since it was elected in 2015. The CCRCV had hoped that change would come soon, following national consultations launched by the government in December 2022. These consultations followed numerous acknowledgements by the government that the status quo is harmful:

  • In 2016, Canada’s Minister of Justice acknowledged for the first time that the criminalisation of HIV non-disclosure in this country is excessive.
  • In 2018, the Minister implemented a directive to limit charges related to HIV non-disclosure from federal jurisdictions (which is limited to the three territories), ending the use of sexual assault laws in this context. This recommendation was reiterated in a 2019 government report following its own review of HIV criminalisation.
  • In 2022, Canada launched a Federal 2ELGBTQI+ Action Plan promising to hold consultations on reforming the Criminal Code. These consultations, announced on the world stage on the eve of the 2023 International AIDS Conference, concluded in January 2023. The report of the consultations reaffirmed that the use of sexual assault laws was inappropriate.
  • Then the Prime Minister of Canada, Justin Trudeau, reiterated in his statement on World AIDS Day last year: ‘The current criminal law regarding non-disclosure punishes people living with HIV and AIDS too harshly and stigmatises them, discouraging them from seeking treatment and testing.’

Members of the CRCVC met with the Minister of Justice on several occasions after the consultations ended (in early 2023) and were promised concrete reform measures. To date, the Government of Canada has still not publicly informed people living with HIV why the promises made to them will not be kept, and why it is abandoning the path of law reform.

A new call to action

On World AIDS Day, the CCRCV is once again calling on the federal government to show good faith, leadership and concrete action to end the excessive criminalisation of people living with HIV in this country. The community has been fighting this battle for a long time, and what is lacking today is the government’s will to adopt a reform that is consistent with human rights and scientific consensus. The Canadian Coalition to Reform HIV Criminalization remains committed to this long-overdue change – and the power of the community’s collective voice will not be silenced.

The Canadian Coalition to Reform HIV Criminalization is a national coalition of people living with HIV, community organizations, advocates, researchers and others. It was formed in October 2016. To find out more, click here.

The Community Consensus Statement 2022, which details the community’s demands for law and policy reform, following consultation, is online here.

What is HIV criminalisation?

HIV criminalisation describes the unfair application of criminal law against people living with HIV solely on the basis of their HIV status. This includes the application of specific criminal law provisions or the application of general criminal law to prosecute people living with HIV for unintentional transmission of HIV, perceived or potential exposure to HIV and/or non-disclosure of HIV by a person who knows their status.

The criminalisation of HIV is a growing global phenomenon that undermines public health and human rights, thereby weakening the response to HIV.

What behaviours are targeted by these laws?

The criminalisation of HIV exists through the application of specific criminal law provisions or through the application of general criminal law exclusively or disproportionately against HIV-positive people.

In many cases, laws relating to the criminalisation of HIV are overly broad, either in their explicit wording, or in the way they have been interpreted and applied, leaving people living with HIV (and those perceived by the authorities to be at risk of HIV) extremely vulnerable to numerous human rights violations.

In general, these laws are used to prosecute individuals who are aware of their HIV status, who are presumed not to have disclosed their HIV status prior to having sex (HIV non-disclosure), or who are perceived to have potentially exposed others to HIV (HIV exposure), or who are perceived to have transmitted HIV (HIV transmission).

In many countries, a person living with HIV convicted of other ‘crimes’, including, but not limited to, sex work, or a person who spits or bites a member of law enforcement at the time of arrest or during incarceration, often faces harsher sentences, even when HIV exposure or transmission was not possible, or at most represented a very small risk.

How widespread is the criminalisation of HIV?

As of March 2023, 91 countries (114 jurisdictions) have some form of HIV-specific criminal law, and a further 41 countries (61 jurisdictions) are known to have applied general criminal provisions to prosecute people living with HIV for presumed non-disclosure of HIV, perceived or potential exposure to HIV, and/or unintentional transmission.

What impact does the criminalisation of HIV have on the HIV response?

The criminalisation of HIV compromises public health objectives in many ways.

Prosecutions, and the media attention that follows, isolate and dramatise HIV in a highly stigmatising way, presenting the HIV diagnosis as a catastrophe and HIV-positive people as an inherent threat to society. Suggesting criminal prosecution as a first or appropriate response to perceived or potential exposure to HIV is not an appropriate approach. This type of stigma makes it even more difficult to disclose HIV to intimate partners. Some evidence suggests that the criminalisation of HIV may discourage individuals from getting tested, particularly among communities most vulnerable to HIV infection. Encouraging HIV testing is an essential element of an effective response: a positive diagnosis is the first step towards access to health-enhancing antiretroviral treatment, and a negative result is the first step towards access to pre-exposure prophylaxis, two essential tools in HIV prevention.

The criminalisation of HIV can also undermine the therapeutic relationship between a person living with HIV and healthcare staff, and thus reduce the ability of carers to offer frank support and advice on risk reduction strategies. Indeed, some healthcare providers have been forced to testify in court about their exchanges with their patients.

The criminalisation of HIV also undermines research into HIV prevention, treatment and care because researchers and participants fear that data normally kept confidential will be seized by law enforcement agencies and used in a criminal case. It also reinforces concerns about the use of new technologies to monitor the epidemic, such as HIV molecular surveillance.

What impact does the criminalisation of HIV have on human rights?

The criminalisation of HIV undermines the rights of people living with HIV, many of whom also belong to marginalised or criminalised communities. Threats of denunciation to the police for non-disclosure of HIV have been used as a form of abuse or reprisal against current or former HIV-positive partners. The criminalisation of HIV exposes people living with HIV – particularly women (but not only) – to increased risks of violence and abuse and ignores the fact that some people are unable to safely disclose their status or ask their partner to use a condom.

Stigmatising statements by law enforcement or public health agencies, and media coverage, including the publication of full names and photos of people being prosecuted – even if they are only allegations – can have dramatic consequences for people living with HIV whose HIV status is publicly revealed in this way and who are portrayed as criminals. Such revelations can lead to loss of employment or housing, social ostracism or even physical violence. Investigations and prosecutions often have a disproportionate impact on racial and sexual minorities, migrants and women. Defendants with few resources do not necessarily have access to adequate legal representation.

In some cases, the most serious offences under a country’s criminal law (e.g. aggravated assault, sexual assault and attempted murder) are used to prosecute alleged HIV non-disclosure prior to consensual sex. Penalties are often disproportionate to the harm caused, such as long prison sentences and/or registration as a sex offender. People who do not have the nationality of their country of residence also risk deportation if found guilty, which for some may mean the end of their treatment or access to care.


À l’approche de la Journée mondiale du sida, 1er décembre, et des élections fédérales de 2025, le Gouvernement du Canada a communiqué à la Coalition canadienne pour réformer la criminalisation du VIH (CCRCV) sa décision d’abandonner tout projet de réforme législative concernant la criminalisation du VIH. Les personnes vivant avec le VIH sont laissées sans explication, sachant seulement que leurs droits sont mis de côté une fois de plus. Colère et déception devant cet abandon.

Un moment critique

Cette décision ne pourrait pas tomber à un pire moment. Le Canada se classe actuellement dernier parmi les pays du G7 en ce qui concerne la réduction des nouvelles infections à VIH. Le nombre de cas déclarés est en hausse constante au Canada depuis 2020, nous éloignant de plus en plus de nos objectifs. La criminalisation du VIH et la stigmatisation qui en résulte contribuent à cette tendance alarmante, en plus de placer le Canada en contradiction avec la science et hors du consensus mondial sur la meilleure façon de réduire la transmission du VIH et de respecter les droits et la dignité des personnes vivant avec le VIH. L’ONUSIDA a souligné dans son communiqué de presse, le 26 novembre dernier, que « [l]a criminalisation et la stigmatisation des communautés marginalisées entravent l’accès aux services de lutte contre le VIH qui peuvent sauver des vies ».

La situation actuelle

Actuellement, les personnes vivant avec le VIH au Canada sont passibles de poursuites pénales en vertu des lois sur les agressions sexuelles, entraînant des condamnations, l’emprisonnement et l’inscription au registre des délinquants sexuels même dans des cas où le risque de transmission est faible ou nul. Des expert-es juridiques et de la médecine, aux quatre coins du monde, s’accordent pour dire que cela ne correspond pas aux connaissances scientifiques d’aujourd’hui sur la transmission et peut dissuader des personnes de se faire dépister et d’accéder aux traitements et à du soutien. Au Canada, il est bien documenté que les préjudices de la criminalisation du VIH sont vécus de manière unique, disproportionnée et souvent insidieuse par les personnes noires et les autochtones.

Un appel à l’action

« Nous en avons assez de voir la vie des personnes vivant avec le VIH servir à des jeux politiques! », déclare Alex McClelland, de la CCRVC. « Les belles intentions et les plans d’action mis au rancart ne changent pas la réalité de la vie pour les personnes au Canada que l’on persécute en raison de leur état de santé. La réforme du droit exige un effort concret, un véritable engagement et une volonté politique de faire ce qui est juste. Malheureusement, le gouvernement canadien semble mettre de côté les personnes vivant avec le VIH au profit d’un calcul politique en vue d’une élection. »

Un historique d’engagements non respectés

Des membres de la CCRCV travaillent avec le gouvernement fédéral actuel pour réformer la criminalisation du VIH depuis son élection en 2015. La CCRCV espérait que le changement ne tarde plus, après les consultations nationales lancées par le gouvernement en décembre 2022. Ces consultations faisaient suite à de nombreuses reconnaissances, par le gouvernement, que le statu quo est néfaste :

  • En 2016, la ministre de la Justice du Canada a reconnu pour la première fois que la criminalisation de la non-divulgation du VIH au pays est excessive.
  • En 2018, la ministre a mis en œuvre une directive visant à limiter les accusations liées à la non-divulgation du VIH, de la part des instances fédérales (ce qui se limite aux trois territoires), mettant fin à l’utilisation des lois sur les agressions sexuelles dans ce contexte. Cette recommandation a été réitérée dans un rapport gouvernemental de 2019 à l’issue de sa propre étude de la criminalisation du VIH.
  • En 2022, le Canada a lancé un Plan d’action fédéral 2ELGBTQI+ promettant de tenir des consultations sur la réforme du Code criminel. Ces consultations, annoncées sur la scène mondiale à la veille du Congrès international sur le sida de 2023, se sont conclues en janvier 2023. Le rapport des consultations a réaffirmé que le recours aux lois sur l’agression sexuelle était inapproprié.
  • Puis le premier ministre du Canada, Justin Trudeau, a réitéré dans sa déclaration à l’occasion de la Journée mondiale du sida de l’an dernier : « Le droit pénal actuel en ce qui a trait à la non-divulgation réprime trop durement les personnes vivant avec le VIH et le sida et les stigmatise, ce qui les décourage de se faire soigner et dépister.»

Des membres de la CCRVC ont rencontré le ministre de la Justice à plusieurs reprises après la fin des consultations (début 2023) et se sont vu promettre des mesures de réforme concrètes. À ce jour, le Gouvernement du Canada n’a toujours pas informé publiquement les personnes vivant avec le VIH des raisons pour lesquelles les promesses qu’on leur a faites ne seront pas tenues, et des raisons pour lesquelles il abandonne la voie de la réforme du droit.

Un nouvel appel à l’action

Dans le cadre de la Journée mondiale du sida, la CCRCV appelle une fois de plus le gouvernement fédéral à démontrer sa bonne foi, à faire preuve de leadership et à agir concrètement pour mettre fin à la criminalisation excessive des personnes vivant avec le VIH dans ce pays. La communauté mène depuis longtemps cette bataille, et ce qui manque aujourd’hui est la volonté du gouvernement d’adopter une réforme en accord avec les droits humains et le consensus scientifique. La Coalition canadienne pour réformer la criminalisation du VIH reste engagée en faveur de ce changement qui est dû depuis longtemps – et le pouvoir de la voix collective de la communauté ne sera pas réduit au silence.

Rappelons que la Coalition canadienne pour réformer la criminalisation du VIH est une coalition nationale de personnes vivant avec le VIH, d’organismes communautaires, d’avocat-es, de chercheur(-euse)s et d’autres intéressé-es. Elle a été formée en octobre 2016. Pour en savoir plus, cliquez ici.

La Déclaration de consensus communautaire 2022, qui décrit en détail les demandes de la communauté pour réformer le droit et les politiques, après des consultations, est en ligne ici.

Qu’est ce que la pénalisation du VIH?

La criminalisation du VIH décrit l’application injuste du droit pénal contre les personnes vivant avec le VIH sur la seule base de leur statut sérologique. Ceci comprend l’application de dispositions pénales spécifiques ou l’application du droit pénal général pour poursuivre des personnes vivant avec le VIH pour transmission involontaire du VIH, exposition perçue ou éventuelle au VIH et/ou non-divulgation du VIH par une personne qui connaît son statut.

La criminalisation du VIH est un phénomène mondial croissant qui nuit à la santé publique et aux droits humains, affaiblissant ainsi la riposte au VIH.

Quels sont les comportements visés par ces lois?

La pénalisation du VIH existe avec l’application de dispositions pénales spécifiques ou par l’application du droit pénal généralexclusivement ou disproportionnellement contre les personnes séropositives

Dans de nombreux cas, les lois se rapportant à la pénalisation du VIH sont trop générales, que ce soit dans leurs formulations explicites, ou dans la façon dont elles ont été interprétées et appliquées, ce qui rend les personnes vivant avec le VIH (et les personnes perçues par les autorités comme exposées aux risques de VIH) extrêmement vulnérables à de nombreuses violations des droits de l’homme.

En général, ces lois sont utilisées pour poursuivre les individus conscients de leur VIH, qui sont présumés ne pas avoir divulgué leur statut sérologique avant d’avoir des rapports sexuels (non-divulgation du VIH), ou qui sont perçus comme ayant potentiellement exposé autrui au VIH (exposition au VIH), ou perçus comme ayant transmis le VIH (transmission du VIH).

Dans de nombreux pays, une personne vivant avec le VIH reconnue coupable d’autres “crimes”, notamment, mais pas exclusivement, pour le travail du sexe, ou une personne qui crache ou qui mord un membre des forces de l’ordre au moment de son arrestation ou pendant son incarcération, fait souvent face à des condamnations plus sévères, même lorsque l’exposition ou la transmission du VIH n’était pas possible, ou qu’elle représentait au plus, un risque très petit.

Quelle est l’étendue de la pénalisation du VIH?

En mars 2023, 91 pays (114 juridictions) disposent d’une forme de droit pénal spécifique au VIH, et on sait que 41 autres pays (61 juridictions) ont appliqué des dispositions pénales générales pour poursuivre des personnes vivant avec le VIH pour non-divulgation présumée du VIH, exposition perçue ou potentielle au VIH, et/ou transmission non intentionnelle.

Quelles sont les conséquences de la pénalisation du VIH sur la riposte au VIH?

La pénalisation du VIH compromet les objectifs de santé publique à bien des égards.

Les poursuites, et l’attraction médiatique qui s’ensuit, isole et dramatise le VIH de façon fortement stigmatisante, en présentant le diagnostic de VIH comme une catastrophe et les personnes séropositives comme une menace inhérente pour la société. Suggérer des poursuites pénales comme une première réponse ou une réponse adaptée en cas d’exposition perçue ou éventuelle au VIH n’est pas une approche appropriée. Ce type de stigmatisation rend encore plus difficile la divulgation du VIH aux partenaires intimes. Certaines données suggèrent que la pénalisation du VIH pourrait dissuader les individus à faire le test de dépistage, particulièrement parmi les communautés les plus vulnérables à l’infection au VIH. Encourager le dépistage du VIH est un élément essentiel pour une riposte efficace: un diagnostic positif est la première étape vers l’accès au traitement antirétroviral bénéfique à la santé, et un résultat négatif, la première étape vers l’accès à la prophylaxie pré-exposition, deux outils essentiels de la prévention du VIH.

La pénalisation du VIH peut également nuire à la relation thérapeutique entre une personne vivant avec le VIH et le personnel de santé, et ainsi réduire la capacité des soignants à offrir un soutien et des conseils francs sur les stratégies de réduction des risques. En effet, certains prestataires de santé ont été obligés de témoigner devant les tribunaux au sujet de leurs échanges avec leurs patients.

La pénalisation du VIH porte également atteinte à la recherche dans les domaines de la prévention, du traitement et des soins du VIH en raison de la crainte des chercheurs et des participants de voir des données normalement tenues confidentielles saisies par les forces de l’ordre et utilisées dans une affaire criminelle.  Elle renforce également les inquiétudes quant à l’utilisation de nouvelles technologies pour suivre l’évolution de l’épidémie, comme par exemple la surveillance moléculaire du VIH.

Quel est l’impact de la pénalisation du VIH sur les droits de l’homme?

La pénalisation du VIH porte atteinte aux droits des personnes vivant avec le VIH, dont beaucoup appartiennent aussi à des communautés marginalisées ou criminalisées. Des menaces de dénonciation à la police pour non-divulgation du VIH ont été utilisées comme forme d’abus ou de représailles à l’encontre de partenaires séropositifs présents ou passés. La pénalisation du VIH expose les personnes vivant avec le VIH – et plus particulièrement les femmes (mais pas uniquement) – à des risques accrus de violence et de maltraitance et ignore le fait que certaines personnes ne sont pas en mesure de divulguer leur statut sans danger ou de demander à leur partenaire d’utiliser un préservatif.

Les déclarations stigmatisantes des forces de l’ordre ou des agences de santé publique, et la couverture médiatique, y compris la publication des noms complets et de photos de personnes poursuivies– même s’il ne s’agit que d’allégations – peuvent avoir des conséquences dramatiques pour les personnes vivant avec le VIH dont le statut sérologique est ainsi révélé publiquement et qui sont présentés comme des criminels. De telles révélations peuvent entrainer une perte d’emploi, de logement, l’ostracisme social ou même à la violence physique. Les enquêtes et les poursuites ont souvent un impact disproportionné sur les minorités raciales et sexuelles, les migrants et les femmes. Les accusés disposant de peu de ressources n’ont pas forcément accès à une représentation juridique adéquate.

Dans certains cas, les infractions les plus graves du droit pénal d’un pays (par exemple voies de fait graves, agression sexuelle et tentative de meurtre) sont utilisées pour poursuivre la non-divulgation du VIH alléguée avant des relations sexuelles consensuelles. Les sanctions sont souvent disproportionnées par rapport au préjudice causé, comme de longues peines d’emprisonnement et / ou l’enregistrement en tant que délinquant sexuel. Les personnes qui n’ont pas la nationalité de leur pays de résidence risquent aussi d’être expulsées s’ils sont reconnus coupable, ce qui peut signifier, pour certains, la fin de leur traitement ou et de l’accès aux soins.

Uganda: Controversial proposals on HIV transmission and the death penalty rejected

The following is an extract from an article on the inaugural consideration of the Sexual Offences Bill, 2024, a comprehensive piece of legislation aimed at reforming laws around sexual violence and exploitation

The proposal to include the deliberate transmission of HIV to minors as an aggravating factor in cases of sexual violence was debated during the inaugural consideration of the Sexual Offences Bill by the Joint Committee of Legal and Gender Affairs.

Anna Adeke, the Member of Parliament for Soroti District Woman Representative, who had tabled the Sexual Offences Bill had suggested that spreading HIV to a minor during a sexual assault should elevate the crime to aggravated rape, carrying heavier penalties.

However, Fox Odoi, the MP for West Budama North East, and several other MPs rejected this idea, arguing that it could further stigmatize people living with HIV and be difficult to prove.

“There are many people living with HIV who are not aware of their status, and others who are on ARV treatment but still test positive,” Odoi explained.

“The Director of Public Prosecutions (DPP) herself has expressed concerns about the difficulty of prosecuting these cases, as proving knowledge of an HIV-positive status is virtually impossible.”

The debate also extended to the issue of the death penalty for rapists. Adeke had proposed that the death penalty be imposed on individuals convicted of rape, particularly in cases where the victim is a minor. Odoi, a staunch opponent of the death penalty, questioned the fairness and necessity of such a harsh punishment.

“Why are we introducing the death penalty for rape when other more egregious crimes like mass murder and genocide do not carry such a penalty?” Odoi asked.

He further criticised the proposal, stating, “In principle, I don’t support the death penalty for any offense. I thought we had moved away from this position as a country.”

While Adeke expressed disappointment over the rejection of her proposals, she acknowledged the challenges in achieving consensus on the Bill.

The Joint Committee of Legal and Gender Affairs is expected to continue its review of the Sexual Offences Bill, 2024, with further consultations and amendments.

The Bill, which aims to tackle issues of sexual violence, exploitation, and human trafficking, has sparked heated debates on the appropriate legal framework for addressing these sensitive issues.

As MPs grapple with the complexities of regulating sex work, preventing the spread of HIV, and ensuring justice for sexual violence victims, the discussions on the Bill are likely to remain contentious.

The Committee will be under pressure to strike a balance between protecting vulnerable groups and adopting practical policies that reflect the realities of Ugandan society.

 

Australia: Migration policies for People with HIV perpetuate criminalisation and expose them to harm

David Carter Delivers Keynote at the Australasian HIV&AIDS Conference

Health+Law’s research lead David Carter, delivered a keynote address at the recent ASHM HIV Conference in Sydney, exploring the controversial past and present of HIV criminalisation in Australia. His urgent, provocative address challenged us to consider how current legal and policy processes in migration law recreate conditions of criminalisation, producing serious health and other harms for people living with HIV. 

Talking to Health+Law researchers in an interview about legal issues, Sergio*, a man in his thirties originally from South America and living with HIV, described the experience of migration to Australia:

I didn’t have to face any court, but I [did] have to prove that I wasn’t a bad person just because I have HIV […] I [had] to prove myself to someone else, who probably is not living with HIV, that I was not a bad person, and I was a good citizen and I deserve to be here.

The migration process is a complex one – and this complexity is amplified for people living with HIV.  Sergio’s reflections express a particularly grim aspect of this process for migrants, especially those living with HIV.

Indeed, as Scientia Associate Professor David Carter, Health+Law’s research lead, argued in an invited keynote at the 2024 Australasian HIV&AIDS Conference hosted by ASHM Health in September this year, the experience of people living with HIV seeking to migrate to Australia is part of Australia’s long history of the criminalisation of HIV.  Speaking to delegates from Australia, New Zealand, Asia and the Pacific at Sydney’s International Convention Centre on Gadigal Country, David reminded the audience that criminalisation is a policy approach, that doesn’t just use the criminal law. To show this he set out five stages of criminalisation that are also evident in the migration process for those living with HIV.

First, as he explained, criminalisation characterises specific behaviour as harmful or carrying a risk of harm to the community. In this case the harm presented is, to quote Australian migration law, that a person’s HIV care represents a ‘significant cost to the Australian community or prejudice [to] the access of Australian citizens or permanent residents to health care or community services’.

Second, criminalisation creates a suspect population, made up of people thought to warrant suspicion because they come to be associated with the potential harm.

Third and fourth, this suspect population attracts surveillance from the state, with a hierarchy created within the suspect population whereby some members are subject to further and intensified surveillance.

Fifth, and finally, some members of this suspect population are subjected ‘to the most severe forms of the state’s coercive and punitive authority’, including investigation, more intensive supervision, detention or arrest, and in some cases, criminal or civil proceedings.

The criminalisation of HIV has a long and storied history, going back to the very early days of the AIDS crisis. Vocal members of HIV-affected communities, legal and human rights advocates and many others have argued strongly against criminalisation, viewing it as draconian and as an approach to public (health) policy with very negative consequences for HIV epidemics.

In Australia, arguments against HIV-specific criminal offences have been broadly successful, and yet the ‘temptation’ to criminalise – as the very first Australian National HIV Strategy described it – continues to emerge in some policy responses to HIV and other communicable diseases.

In 1987, when the authors of the first national HIV strategy were writing, they were warning against measures including compulsory universal HIV testing, the closure of gay venues, criminal penalties for HIV transmission, and limitations on the movement of HIV positive people, including forced quarantine. Today, HIV criminalisation is operating in Australian migration policy and law.

‘This contemporary criminalisation of HIV begins’, David argued, ‘like all criminalisation, with the characterisation of behaviour in terms of harm and risk of harm’. He continued, arguing that:

This characterisation of migrating while HIV positive as harmful establishes, and in-turn enlivens, the suspect population management and criminalising processes of our medical border […] This criminalising logic establishes an adversarial relationship between the person living with HIV and the state, and between them and members of the Australian community, whose access to health care it is alleged may be prejudiced by providing care for a person living with HIV who wishes to migrate.

Among the many negative effects of this process is that it can discourage migrants living with HIV from engaging in testing, treatment and HIV care. Interviews conducted by Health+Law as part of our national legal needs (LeNS) study confirm that this is happening. They show that many migrants living with HIV in jurisdictions across Australia experienced an alienating and hostile environment: a ‘threat environment so elevated’, as David described it in his keynote, that they frequently described withdrawing from HIV care and community life as a coping mechanism.

Unfolding the history of ‘unjust and unhelpful’ HIV criminalisation in Australia, David outlined how the current legal and policy conditions that prospective migrants living with HIV face in Australia today work to recreate conditions of criminalisation and expose both individuals and the community to multiple health harms.

You can read more about David’s keynote in The Medical Republic’s coverage of the conference.

Uzbekistan: Successful advocacy is reshaping HIV legislation and profession bans

“‘A woman came to us, she asked for help with the legal process’” – Interview with Evgenia Korotkova

Translated from Russian with Google translate. Scroll down for the original article. 

Do you want to know how an activist living with HIV went from a public defender in cases under Article 113 of the Criminal Code to a community expert who, after speaking at a feminist forum, is influencing the humanisation of legislation on people living with HIV in Uzbekistan?

Read about it in Svetlana Moroz’s interview with Yevgeniya Korotkova on the significant reduction of the list of prohibited professions for people living with HIV in Uzbekistan.

S.M.: Zhenya, let’s start from the beginning. In 2020, a woman who faced criminal prosecution for working as a hairdresser came to your organisation for help. Tell us about this woman, why did she come to you specifically?

E.K.: I remember very well when we first started to focus on the issue of HIV criminalisation under Article 113 of the Criminal Code. At that time, we were actively collecting cases of people who had been prosecuted under this article. At some point we came across an article on the website of the Ministry of Internal Affairs. It said that an orphaned teenager living with HIV had sexual relations with a teenage girl and she became pregnant. The main message of the article was directed at parents – they should keep an eye on their children and have preventive conversations with them.

However, the article was full of stigmatising, incorrect and distorted information. Amidst the outrage, we decided to write a post on our organisation’s page, where I gave my comments. This post also included an appeal to people living with HIV who were affected by Part 4 of Article 113 of the Criminal Code of the Republic of Uzbekistan. We informed that they could contact us for legal assistance and counselling.

The response to the post did not take long. One of the first to appeal was a woman who worked as a hairdresser. She told us that her case had already been taken to court and at the time of the investigation she didn’t even have money for a lawyer. We started looking for ways to help and were able to find money to pay for a lawyer. The lawyer took on her case and filed a request to review the materials.

In the process of discussions with the woman, we came to the conclusion that I would participate in the court as a public defender from our organisation. It was the first such experience for me. We did not know that we even had the opportunity to represent someone’s interests in this way. So we prepared a motion in which we indicated that in addition to the lawyer, the interests of the woman would be represented by a public defender – that is me.

This case was a serious test for me. We discovered a new form of assistance that we had not even realised existed before.Now we know that the involvement of a public defender can be key in such cases and really helps people.

S.M.: How did this case get to court? Who sued this woman? How did they find out about her HIV status?

E.K.: How exactly this case ended up in court, we learnt only during the trial. It turned out that a police officer came to the woman’s workplace with some list. He showed her that she was on the list and said that it included people who violated the law. In particular, it was about those who were HIV-positive and worked in a hairdresser’s shop, which was allegedly against the law.

In fact, it meant the transfer of health data to law enforcement agencies without the consent of the patient. And at the trial they did not even tried to hide this fact. During the trial, the prosecutor who was in charge of the case directly stated that the information about her HIV status had been obtained from the AIDS Centre.

S.M.: How was the trial? What was the verdict?

E.K.: The trial was held in closed mode, because the case concerned doctor-patient confidentiality and confidentiality of the diagnosis. We were very lucky that we managed to attract doctors who supported our side and defended the woman.She was strictly following the ARV regimen, so she had an undetectable viral load. In court, a doctor acted as an expert who clearly explained that under such conditions, infection was impossible. He also emphasised that there were no casualties at the time of trial.

Even the investigator pointed out in the case file that the woman did not use scissors or razors in her work – only a haircutting machine. She did not use cutting or stabbing objects that could theoretically create a threat of infection. It is important to note that the witnesses who were called from her work did not testify negatively. They confirmed that the woman performed her duties professionally and without impropriety.

In my arguments, I relied on this evidence to argue that our defendant could not have transmitted HIV infection while working as a hairdresser. During the hearing, the judge asked me, ‘As a public defender, would you, yourself,  have gone to this woman to cut your hair?’ I explained that HIV transmission would have required a number of unlikely conditions: she would have had to be off therapy, and she would have cut herself and me badly. Only then could there be a theoretical threat of infection. But even then, the probability of transmission would be extremely low.

I would like to note separately that the Makhali committee gave our defendant serious support. They filed many petitions in her defence, despite knowing her HIV status. The women’s committee also got involved in the process and filed additional motions in favour of our client.

However, the woman was still given a suspended sentence of two and a half years. This decision was taken because of the existence of Article 113, under which she was tried. The court took into account that she had a minor child, and this influenced the mitigation of the sentence.

I still remember how the judge, while announcing the verdict, emphasised the importance of our advocacy work. He said that our organisation should work on changing the list of prohibited professions because it contradicts modern legislation. These words were the starting point for a great advocacy process that took us three years. This case not only showed us the need to protect people in specific situations, but also gave a start to changes at the systemic level.

S.M.: How does this woman live now? How does she feel?

E.K.: You can imagine, she worked in her favourite profession for more than 30 years. It was a terrible blow for her – to lose the job on which she had built her whole life. Given that she had a minor child and was a single mother and the sole breadwinner in the family, all the responsibility fell on her shoulders. After the trial, it was very difficult for her to find a suitable job. She did everything she could: she cleaned houses, worked as a governess, tried a lot of professions.

It was not easy for her to recover from the trial. She underwent a long psychological rehabilitation, and we, on our part, also supported her by providing the services of a psychologist. This period was very difficult for her. When the legislation was finally changed, I was the first to send her the amended document. But unfortunately, she never returned to the profession. Instead, she started her own small business, determined to start her life with a clean slate.

We continued and still maintain a relationship with her. After the trial, she took part in the Judges’ Forum where she spoke openly and told her story. She shared how an unfair piece of legislation had affected her life and it was an act of courage and hope for change. She was motivated by the desire to help others who are HIV-positive so that they would no longer have to face the hardships and humiliation that she went through.

We realised that this case was not only about criminal law issues, but also touched on socio-economic rights. It showed how much stigma and restrictive laws can affect a person’s life, depriving them of a source of income and the ability to work in a profession. Nevertheless, her story has become an important part of our advocacy work and has helped draw attention to the need for change in the law.

S.M.: We have another milestone in this story – in 2022, Uzbekistan, the third country in Central Asia (after Tajikistan and Kyrgyzstan) to receive, among other things, a recommendation to decriminalise HIV transmission from the UN CEDAW committee. Your country received this recommendation, largely due to your participation and our joint shadow report from the community. Can we assume that the recommendations received have influenced the advocacy process in the context of HIV decriminalisation, namely the revision of the list of prohibited professions?

E.K.: I had only three minutes to address the CEDAW Committee and I remember very well how we prepared my oral statement. Every second mattered. It seems to me that all our efforts were interconnected, especially considering how seriously the state takes the recommendations of international structures. In recent years, the country has really seen progress in supporting women.

From 2019, laws have started to be adopted to ensure equal rights for men and women and to combat discrimination and violence against women. I see that the country is emphasising women’s economic independence and expanding our educational and professional opportunities. Special attention is being paid to women’s access to leadership positions, which opens up new perspectives for us.

I believe that the final recommendations of the CEDAW Committee may have played a role in the state’s attention to the list of prohibited professions. This list has long been in need of revision, as it restricted women’s rights and hindered their professional development. The work in this direction is ongoing, and I hope that our efforts will help more women to avoid such restrictions and achieve justice.

S.M.: So, the year is 2024. Something has happened that probably you and we ourselves did not expect – the list of prohibited professions for people living with HIV in Uzbekistan has been changed (reduced) by the order of the Minister of Health. How did this become possible?

E.K.: According to the new order, HIV-positive people can now work as dentists, as long as they are not involved in surgical interventions. This move was a significant change, especially for us, as we had a case where a man working as a dental technician was prosecuted just because of his HIV status.

In November 2023, there was a big feminist forum where I gave a speech that was well received. One of the newspapers wrote about me as a leader living with HIV. After this publication, the presidential administration became interested in my story. I was invited to a meeting to discuss the most pressing issues facing women and people living with HIV.

At the meeting, I tried to use this opportunity to draw attention to the list of prohibited professions. I explained that this piece of legislation is not only of no public benefit, but also destroys people’s lives by restricting their ability to work in their profession. My arguments resonated. I had the impression that I was able to convince them that this order had long ago lost its relevance.

In the course of the discussion, it became clear that the officials with whom I spoke had a progressive approach and were ready to support the initiative to review and amend the list of prohibited professions. Their readiness for dialogue and understanding of the importance of the issue inspired me and gave me hope for further positive changes.

S.M.: Do I understand correctly that officials of the Ministry of Health had no resistance to this initiative? Before that, doctors used to hand over data on people with HIV to the police. I can’t forget the case when a woman (nurse) was simply summoned to the district department in the middle of the working day, checked the list of her contacts in the phone book, asked who she was sleeping with, threatened with an article, etc. – such ‘preventive’ humiliating methods.

E.K.: After the adoption of the new, shortened list of prohibited professions, we started to conduct trainings for medical workers. In the process, we encountered some resistance – among the participants there were epidemiologists who did not support the changes. They argued that the risk of HIV transmission still existed despite the new data and international standards. Such statements rather demonstrated their lack of awareness of the issue. Later, their colleagues, doctors with more experience, even advised them to refrain from making such statements in order not to mislead other participants.

Particularly important for us was the participation of the chief epidemiologist of the Republican AIDS Centre in these trainings. He presented information about the changes in the list of professions in the most professional and accessible way possible, which helped to reduce mistrust and resistance among health workers. His presentations played an important role in disseminating correct knowledge.

We also held meetings with the staff of the Ministry of Internal Affairs, in particular with representatives of the moral department, which supervised cases related to Article 113 of the Criminal Code. They were the ones who had previously initiated cases against HIV-positive hairdressers, leading to their criminal prosecution. These discussions were important for us because they allowed us to convey to law enforcement officials that the old norms no longer meet modern realities and only contribute to the stigmatisation of people living with HIV.

S.M.: We know that you worked on the bill that has already been submitted from your NGO Ishonch va Haet to the parliament. You have also received a response, thankfully. How do you assess the prospect of amending the Criminal Code with regard to Article 113?

E.K.: I am an optimist and I am sure that the changes will definitely happen, it is only a matter of time. It is already evident that people involved in legislative reforms realise that some laws are outdated and need to be revised. It is good to see that the country is actively aiming to update the legislative systems and bring them in line with modern realities.

I believe that our voice will be heard. Especially since these changes are being called for not only by civil society, but also by the scientific and medical community, as well as international organisations. These are not just recommendations invented in a narrow circle of activists/v – they are a global agenda, reflecting progress and the realisation that HIV infection is now a chronic disease that can be lived with thanks to affordable and effective treatment.

Importantly, positive developments are already taking place in the country. Progressive initiatives on gender equality, protection of the rights of women and people living with HIV demonstrate the state’s commitment to improving the quality of life of its citizens. These changes give me confidence that the reform will also affect the legislative acts that still restrict people in their rights and freedom of choice of profession.

I believe in my state and its rational approach. I see that there is a dialogue going on and it is bearing fruit. We are moving towards change, and I am convinced that it will be positive for everyone.

S.M.: One last question. Looking back at your path from a public defender to a community expert who submits a draft of legislative changes to the parliament, tell us how you came to this? Who/what is behind it?

E.K.: Behind all our efforts there are always people – people who need help and support. I myself am a woman living with HIV, and although I have not experienced criminalisation directly, I have had many examples of stigma and discrimination in my life. One of the people I defended in court is now an employee of our organisation. It is stories like these that give me the strength and inspiration to keep going.

Deep down, I dream of a perfect world. No one can stop me from at least trying to make it so. My main motivation has always been to ensure that people living with HIV no longer face discrimination and stigma, that their rights are respected and not violated just because of their diagnosis.

I am convinced that the state should work in the interests of those who live in it. And today we really have good prospects.We see the existence of political will and civil society, which is actively involved in promoting change and has real weight.This is a favourable time for change.

The state is showing a desire to hear us and understand our problems. Moreover, we are not just talking about problems, we are helping to find solutions, and this process becomes an additional motivation for me. When we are listened to and really heard, it is inspiring. It means that our efforts matter and lead to change.

Order of the Minister of Health of the Republic of Uzbekistan

On approval of the List of types of professional activities prohibited for persons infected with the human immunodeficiency virus

[Registered by the Ministry of Justice of the Republic of Uzbekistan on May 07, 2014. Registration № 2581]

Order of the Minister of Health of the Republic of Uzbekistan

On approval of the List of types of professional activities prohibited for persons infected with the human immunodeficiency virus

[Registered by the Ministry of Justice of the Republic of Uzbekistan on February 19, 2024. Registration № 3497]

Types of professional activities prohibited for persons infected with the human immunodeficiency virus

List:

1. Professions related to the procurement and processing of blood and its components.

2. Professions related to the production of blood and its components, sperm and breast milk.

3. Professions related to blood transfusion.

4. Professions related to the following medical procedures: injections; dialysis; venesection;, catheterization.

5. Professions related to cosmetic and plastic surgery.

6. Professions related to dental procedures.

7. Professions related to childbirth.

8. Professions related to abortions and other gynecological operations.

9. Professions related to hair and shaving, piercing, manicure, pedicure and tattooing.

Types of professional activities prohibited for persons infected with the human immunodeficiency virus

List:

1. Professions related to the procurement, processing and transfusion of human blood and/or its components.

2. Professions related to all types of surgery.

3. Professions related to childbirth.

4. Professions related to the following medical procedures: dialysis; venesection; catheterization.


«К нам пришла женщина, она просила помощи с судебным процессом»

Интервью с Евгенией Коротковой

Хотите узнать, как активистка, живущая с ВИЧ, прошла путь от общественной защитницы по делам по 113-й статье Уголовного Кодекса до экспертки сообщества, которая после выступления на феминистском форуме влияет на гуманизацию законодательства в отношении людей, живущих с ВИЧ, в Узбекистане?

Читайте об этом в интервью Светланы Мороз с Евгенией Коротковой, посвященном существенному сокращению списка запрещенных профессий для людей, живучих с ВИЧ, в Узбекистане.

С.М.: Женя, давай начнем с начала. В 2020 году к вам в организацию за помощью обратилась женщина, которая столкнулась с уголовным преследованием за то, что она работала парикмахером. Расскажи про эту женщину, почему она пришла именно к вам?

Е.К.: Я хорошо помню, как мы только начали уделять внимание проблеме криминализации ВИЧ в рамках статьи 113 Уголовного кодекса. Мы тогда активно собирали кейсы людей, которые были привлечены по этой статье. В какой-то момент наткнулись на статью на сайте МВД. В ней говорилось о том, что подросток-сирота, живущий с ВИЧ, вступил в половую связь с подростком девочкой, и она забеременела. Основной посыл статьи был направлен на родителей — мол, следите за детьми и проводите с ними профилактические беседы.

Однако статья была переполнена стигматизирующей, некорректной и искаженной информацией. На фоне возмущения мы решили написать пост на странице нашей организации, где я дала свои комментарии. В этом посте также было обращение к людям, живущим с ВИЧ, которые пострадали по части 4-й статьи 113 УК РУз. Мы сообщали, что они могут обратиться к нам за юридической помощью и консультациями.

Реакция на пост не заставила себя долго ждать. Одной из первых обратилась женщина, работавшая парикмахером. Она рассказала, что ее дело уже передано в суд, а на момент расследования у нее даже не было средств на адвоката. Мы начали искать возможности помочь и смогли найти деньги на оплату адвокатских услуг. Адвокатка взялась за ее дело и подал запрос на ознакомление с материалами.

В процессе обсуждений с этой женщиной мы пришли к выводу, что я буду участвовать в суде как общественная защитница от нашей организации. Это был для меня первый такой опыт. Мы не знали, что у нас вообще есть возможность представлять чьи-то интересы таким образом. И мы подготовили ходатайство, в котором указали, что помимо адвоката интересы женщины будет представлять общественная защитница — то есть я.

Этот случай стал для меня серьезным испытанием. Мы открыли для себя новую форму помощи, о существовании которой раньше даже не догадывались. Теперь мы знаем, что участие общественного(ой) защитника/цы может оказаться ключевым в подобных делах и реально помогает людям.

С.М.: Как это дело попало в суд? Кто подал в суд на эту женщину? Как они узнали о ее ВИЧ статусе?

Е.К.: То, как именно это дело оказалось в суде, мы узнали только в ходе судебного процесса. Оказалось, что к женщине на работу пришел сотрудник милиции с каким-то списком. Он показал ей, что она числится в этом списке, и заявил, что туда включены люди, нарушающие закон. В частности, речь шла о тех, кто имеет ВИЧ-положительный статус и работает в парикмахерской, что якобы противоречит закону.

Фактически это означало передачу данных о состоянии здоровья правоохранительным органам без согласия пациентки. И на суде этот факт даже не пытались скрыть. В ходе разбирательства прокурор, который вел дело, прямо заявил, что сведения о ее ВИЧ-статусе были получены из Центра СПИДа.

С.М.: Как проходил суд? Какой был приговор?

Е.К.: Судебное разбирательство проходило в закрытом режиме, поскольку дело касалось врачебной тайны и конфиденциальности диагноза. Нам очень повезло, что удалось привлечь врачей, которые поддержали нашу сторону и встали на защиту женщины. Она строго следовала режиму приёма АРВ-терапии, благодаря чему у нее была неопределяемая вирусная нагрузка. В суде в качестве эксперта выступил врач, который ясно объяснил, что при таких условиях инфицирование было невозможно. Он также подчеркнул, что на момент разбирательства не было ни одного пострадавшего.

Даже следователь указал в материалах дела, что женщина не пользовалась в работе ножницами или бритвами — только машинкой для стрижки. Она не применяла режущие и колющие предметы, которые могли бы теоретически создать угрозу заражения. Важно отметить, что свидетели, которых вызывали с ее работы, не давали негативных показаний. Они подтверждали, что женщина выполняла свои обязанности профессионально и без нарушений.

В своих прениях я опиралась на эти доказательства, утверждая, что наша подзащитная не могла передать ВИЧ-инфекцию, работая парикмахером. Во время заседания судья задал мне вопрос: «Вы, как общественная защитница, сами бы пошли стричься к этой женщине?» Я объяснила, что для передачи ВИЧ потребовался бы целый ряд маловероятных условий: она должна была бы не принимать терапию, при этом и себя, и меня сильно порезать. Только в таком случае могла бы возникнуть теоретическая угроза заражения. Но даже тогда вероятность передачи была бы крайне низкой.

Отдельно хочу отметить, что махалинский комитет оказал нашей подзащитной серьезную поддержку. Они подали множество ходатайств в ее защиту, несмотря на знание ее ВИЧ-статуса. К этому процессу также подключился комитет женщин, который внес дополнительные ходатайства в пользу нашей клиентки.

Однако женщине все же назначили условный срок — два с половиной года. Это решение было принято из-за существования статьи 113, по которой ее судили. Суд учел, что у нее есть несовершеннолетний ребенок, и это повлияло на смягчение приговора.

До сих пор помню, как судья, оглашая приговор, подчеркнул важность нашего адвокационного направления. Он сказал, что наша организация должна работать над изменением списка запрещенных профессий, потому что он противоречит современному законодательству. Эти слова стали отправной точкой для большого адвокационного процесса, который занял у нас три года. Это дело не просто показало нам необходимость защиты людей в конкретных ситуациях, но и дало старт изменениям на системном уровне.

С.М.: Как сейчас живет эта женщина? Как она себя чувствует?

Е.К.: Представляешь, она проработала в своей любимой профессии более 30 лет. Для нее это было страшным ударом — лишиться работы, на которой она строила всю свою жизнь. Учитывая, что у нее был несовершеннолетний ребенок, а она — мать-одиночка и единственная кормилица в семье, вся ответственность легла на ее плечи. После суда ей было очень тяжело найти подходящую работу. Она бралась за все, что могла: убирала дома, работала гувернанткой, перепробовала массу профессий.

Восстановиться после судебного процесса ей было нелегко. Она проходила длительную психологическую реабилитацию, и мы со своей стороны также оказывали ей поддержку, предоставив услуги психолога. Этот период был очень непростым для нее. Когда наконец изменили законодательство, я первой отправила ей документ с поправками. Но, к сожалению, она так и не вернулась в профессию. Вместо этого она открыла свой маленький бизнес, решив начать жизнь с чистого листа.

Мы продолжали и до сих пор поддерживаем с ней отношения. После суда она приняла участие в Форуме судей, где выступила с открытым лицом и рассказала свою историю. Она поделилась тем, как несправедливая законодательная норма отразилась на ее жизни, и это стало для нее своего рода актом мужества и надеждой на перемены. Её мотивацией было желание помочь другим людям с ВИЧ-положительным статусом, чтобы они больше не сталкивались с теми трудностями и унижениями, через которые прошла она.

Мы понимали, что этот случай касался не только вопросов уголовного права, но и затрагивал социально-экономические права. Он показал, как сильно стигматизация и ограничительные законы могут повлиять на жизнь человека, лишив его источника дохода и возможности работать по профессии. Тем не менее, ее история стала важной частью нашей адвокационной работы и помогла привлечь внимание к необходимости изменений в законодательстве.

С.М.: У нас есть еще одна веха в этой истории — в 2022 году, Узбекистан, третья страна в ЦА (после Таджикистана и Кыргызстана), которая среди прочего получила рекомендацию декриминализировать передачу ВИЧ от комитета ООН CEDAW. Твоя страна получила эту рекомендацию, во многом, благодаря твоему участию и нашему совместному теневому отчету от сообщества. Можем ли мы считать, что полученные рекомендации повлияли на адвокационные процесс в контексте декриминализации ВИЧ, а именно пересмотр списка запрещенных профессий?

Е.К.: У меня было всего три минуты на выступление перед членами Комитета CEDAW, и я прекрасно помню, как мы готовили мое устное заявление. Каждая секунда имела значение. Мне кажется, что все наши усилия были взаимосвязаны, особенно с учетом того, насколько серьезно государство относится к рекомендациям международных структур. В последние годы в стране действительно заметен прогресс в вопросах поддержки женщин.

С 2019 года начали приниматься законы, направленные на обеспечение равноправия мужчин и женщин и борьбу с дискриминацией и насилием в отношении женщин. Я вижу, что в стране делается акцент на экономическую независимость женщин и расширение наших возможностей в образовании и профессиональной деятельности. Особое внимание уделяется доступу женщин к руководящим должностям, что открывает новые перспективы для нас.

Я верю, что заключительные рекомендации Комитета CEDAW могли сыграть свою роль в том, что государство обратило внимание на перечень запрещенных профессий. Этот список давно нуждался в пересмотре, так как он ограничивал права женщин и препятствовал их профессиональному развитию. Работа в этом направлении продолжается, и я надеюсь, что наши усилия помогут еще большему числу женщин избежать подобных ограничений и добиться справедливости.

С.М.: Итак, 2024 год. Случилось то, что, наверное, вы и мы сами не ожидали – приказом министра здравоохранения изменен (сокращен) список запрещенных профессий для людей, живущих с ВИЧ, в Узбекистане. Как это стало возможным?

Е.К.: Согласно новому приказу, ВИЧ-положительные люди теперь могут работать стоматологами, если они не занимаются хирургическими вмешательствами. Этот шаг стал значимым изменением, особенно для нас, поскольку у нас был случай, когда мужчину, работающего зубным техником, привлекли к уголовной ответственности только из-за его ВИЧ-статуса.

В ноябре 2023 года прошел большой феминистский форум, на котором я выступила с речью, вызвавшей широкий отклик. В одной из газет обо мне написали как о лидерке, живущей с ВИЧ. После этой публикации моей историей заинтересовались в администрации президента. Меня пригласили на встречу, чтобы обсудить наиболее острые проблемы, с которыми сталкиваются женщины и люди, живущие с ВИЧ.

На встрече я постаралась использовать этот шанс, чтобы привлечь внимание к списку запрещенных профессий. Я объяснила, что этот законодательный акт не только не приносит общественной пользы, но и разрушает жизни людей, ограничивая их возможности работать по профессии. Мои доводы нашли отклик. У меня сложилось впечатление, что я смогла убедить их в том, что этот приказ давно утратил свою актуальность.

В процессе обсуждения стало очевидно, что чиновники, с которыми я общалась, проявили прогрессивный подход и готовы поддержать инициативу по пересмотру и изменению списка запрещенных профессий. Их готовность к диалогу и понимание важности вопроса вдохновили меня и дали надежду на дальнейшие позитивные изменения.

С.М.: Я правильно понимаю, что у чиновников Минздрава не было сопротивления этой инициативе? До этого врачи передавали милиции данные о людях с ВИЧ. Не могу забыть случай, когда женщину (медсестру) просто посредине рабочего дня вызвали в райотдел, проверяли список ее контактов в телефонной книге, спрашивали с кем она спит, угрожали статьей, и т.д. — такие «профилактические» унизительные методы.

Е.К.: После принятия нового, сокращенного списка запрещенных профессий мы начали проводить тренинги для медицинских работников. В процессе мы столкнулись с определенным сопротивлением — среди участников встречались эпидемиологи, которые не поддерживали изменения. Они утверждали, что риск передачи ВИЧ все равно существует, несмотря на новые данные и международные стандарты. Такие заявления, скорее, демонстрировали их недостаточную осведомленность в вопросе. Позже их коллеги, врачи с большим опытом, даже советовали им воздержаться от таких высказываний, чтобы не вводить в заблуждение других участников.

Особенно важным для нас стало участие главного эпидемиолога Республиканского центра СПИД в этих тренингах. Он представил информацию об изменениях списка профессий максимально профессионально и доступно, что помогло снизить уровень недоверия и сопротивления среди медработников. Его выступления сыграли важную роль в распространении правильных знаний.

Мы также проводили встречи с сотрудниками МВД, в частности с представителями нравственного отдела, который курировал дела, связанные со статьей 113 УК. Именно они ранее инициировали дела против ВИЧ-положительных парикмахеров, приводя к их уголовному преследованию. Эти обсуждения были для нас важны, поскольку позволили донести до сотрудников правоохранительных органов, что старые нормы больше не отвечают современным реалиям и только способствуют стигматизации людей, живущих с ВИЧ.

С.М.: Мы знаем, что ты работала над законопроектом, который уже подан от вашей неправительственной организации «Ишонч ва Хает» в парламент. Вы еще ответ получили, с благодарностью. Как ты оцениваешь перспективу внесения изменений в УК в отношении 113-й статьи?

Е.К.: Я — оптимистка и уверена, что изменения непременно произойдут, это лишь вопрос времени. Уже сейчас видно, что люди, занимающиеся реформами в области законодательства, осознают, что некоторые законы устарели и требуют пересмотра. Приятно видеть, что страна активно нацелена на обновление законодательных систем и приведение их в соответствие с современными реалиями.

Я верю, что наш голос будет услышан. Тем более, что к этим изменениям призывает не только гражданское общество, но и научное и медицинское сообщество, а также международные организации. Это не просто рекомендации, придуманные в узком кругу активисток/в — это глобальная повестка, отражающая прогресс и понимание того, что ВИЧ-инфекция сегодня является хроническим заболеванием, с которым можно жить благодаря доступному и эффективному лечению.

Важно, что в стране уже происходят позитивные сдвиги. Прогрессивные инициативы в области гендерного равенства, защиты прав женщин и людей, живущих с ВИЧ, демонстрируют стремление государства к улучшению качества жизни своих граждан. Эти перемены дают мне уверенность, что реформа затронет и законодательные акты, которые до сих пор ограничивают людей в их правах и свободе выбора профессии.

Я верю в свое государство и его рациональный подход. Вижу, что идет диалог, и он приносит плоды. Мы движемся в сторону перемен, и я убеждена, что они будут положительными для всех.

С.М.: Последний вопрос. Оглядываясь на твой путь от общественной защитницы до экспертки сообщества, которая подает в парламент проект законодательных изменений, расскажи, как ты к такому пришла? Кто/что за этим стоит?

Е.К.: За всеми нашими усилиями всегда стоят люди — люди, которые нуждаются в помощи и поддержке. Я сама женщина, живущая с ВИЧ, и, хотя напрямую не сталкивалась с криминализацией, в моей жизни было немало примеров стигмы и дискриминации. Один из тех, кого я защищала в суде, теперь стал сотрудником нашей организации. И такие истории дают мне силы и вдохновение двигаться дальше.

В глубине души я мечтаю об идеальном мире. Никто не может запретить мне хотя бы пытаться сделать его таким. Моя главная мотивация всегда была в том, чтобы люди, живущие с ВИЧ, больше не сталкивались с дискриминацией и стигмой, чтобы их права уважались и не нарушались только из-за их диагноза.

Я убеждена, что государство должно работать в интересах тех, кто в нем живет. И сегодня у нас действительно есть хорошие перспективы. Мы видим наличие политической воли и гражданского общества, которое активно участвует в продвижении изменений и имеет реальный вес. Это благоприятное время для перемен.

Государство проявляет желание услышать нас и понять наши проблемы. Более того, мы не просто говорим о проблемах, мы помогаем находить решения, и этот процесс становится для меня дополнительной мотивацией. Когда нас слушают и действительно слышат — это вдохновляет. Это значит, что наши усилия имеют значение и ведут к изменениям.

Приказ Министра здравоохранения Республики Узбекистан

Об утверждении Перечня видов профессиональной деятельности, запрещенных для лиц, зараженных вирусом иммунодефицита человека

[Зарегистрирован Министерством юстиции Республики Узбекистан 07 мая 2014 года. Регистрационный № 2581]

Приказ Министра здравоохранения Республики Узбекистан

Об утверждении Перечня видов профессиональной деятельности, запрещенных для лиц, зараженных вирусом иммунодефицита человека

[Зарегистрирован Министерством юстиции Республики Узбекистан 19 февраля 2024 года. Регистрационный № 3497]

Виды профессиональной деятельности, запрещенные лицам, инфицированным вирусом иммунодефицита человека

СПИСОК

1. Профессии, связанные с заготовкой и переработкой крови и ее компонентов.

2. Профессии, связанные с получением крови и ее компонентов, спермы и грудного молока.

3. Профессии, связанные с переливанием крови.

4. Профессии, связанные со следующими медицинскими процедурами: инъекции; диализ; венесекция; катетеризация.

5. Профессии, связанные с косметическими и пластическими операциями.

6. Профессии, связанные со стоматологическими процедурами.

7. Профессии, связанные с родами.

8. Профессии, связанные с абортами и другими гинекологическими операциями.

9. Профессии, связанные с прической и бритьем, пирсингом, маникюром, педикюром и татуировкой.

Виды профессиональной деятельности, запрещенные лицам, инфицированным вирусом иммунодефицита человека

СПИСОК

1. Профессии, связанные с заготовкой, переработкой и переливанием крови человека и (или) ее компонентов.

2. Профессии, связанные со всеми видами хирургии.

3. Профессии, связанные с родами.

4. Профессии, связанные со следующими медицинскими процедурами: диализ; венесекция; катетеризация.

 

 

 

US: New report shows that most of Indiana’s HIV criminal laws have yet to account for decades of advances in HIV science

Indiana has six HIV criminalization laws. Most criminalize conduct that cannot transmit HIV

Indiana has six laws that criminalize people living with HIV (PLWH), spanning both the public health and criminal codes. A new report by the Williams Institute at UCLA School of Law evaluates whether these laws reflect current understandings of HIV science and criminalize conduct that poses negligible or no risk of transmitting HIV.

Results show that most of Indiana’s HIV criminal laws have yet to account for decades of advances in HIV science, and none are currently written with enough specificity to prevent criminalizing behaviors that have little to no risk of transmitting HIV.

In Indiana, HIV criminal laws make potential HIV exposure a crime under specific circumstances, such as sexual activity, blood or semen donation, or battery using bodily fluids, such as spitting. All of the laws were enacted between 1988 and 2002 before effective HIV treatment options were widely available and it was established that treating PLWH could prevent the transmission of HIV.

“Scientifically outdated laws work against public health goals regarding HIV testing, prevention, and treatment,” said lead author Nathan Cisneros, HIV Criminalization Project Director at the Williams Institute. “The criminalization of HIV could undermine Indiana’s efforts to end the HIV epidemic and reach the communities most impacted, including people of color, women, and LGBTQ people.”

Key Findings

  • None of Indiana’s laws require actual HIV transmission or the intent to transmit HIV. The laws also criminalize conduct that cannot transmit HIV, such as spitting.
  • Two laws criminalizing the donation of blood, plasma, or semen penalize conduct that does not transmit HIV. All bodily fluid donations are tested for HIV, and positive units are destroyed.
  • Two laws impose enhanced penalties for PLWH who knowingly expose another person to their bodily fluids or waste in an aggressive or malicious manner—conduct that poses no HIV transmission risk. HIV cannot be transmitted externally through contact with body fluids or waste.
  • Two laws that criminalize a person’s failure to disclose their HIV status have been partially modernized in recent years to reflect advances in HIV science. They limit criminal conduct to high-risk forms of sexual contact and needle sharing.
    • Nevertheless, these laws fail to clarify which sexual activities are considered low or no risk and whether a person who has an undetectable viral load—and therefore cannot transmit HIV through sex—is safe from prosecution.

In recent years, public health and medical experts, including the Indiana State Medical Association, have agreed that to effectively end the HIV epidemic, it is essential to update the state’s HIV criminal laws in line with current scientific understanding of HIV. A key aspect of Indiana’s plan to significantly reduce the number of new transmissions by 2030 involves prioritizing the modernization of these laws.

This report is part of a series by the Williams Institute examining HIV criminalization in Indiana.

Read the current report

US: Advocating for HIV decriminalisation and health equity at Indiana’s first HIV advocacy summit

HIV advocates, organizations talk legislative solutions at first advocacy summit

By Abigail Ruhman

Community health centers and Ryan White HIV AIDS Program centers play an important role in expanding services and care for vulnerable populations, including HIV prevention and wellness. The Damien Center – Indiana’s oldest and largest HIV service organization – hosted its first HIV advocacy summit Wednesday to develop strategies for the upcoming legislative session.

Carrie Foote, a professor of sociology at Indiana University-Indianapolis, has been living with HIV since 1988 and leads HIV Modernization Movement-Indiana. She said Indiana has several laws that lead to the inappropriate arrest or prosecution of people living with HIV — which wastes state resources and has no public health benefit.

“We can end the epidemic,” Foote said. “We can end it, so anything that’s a barrier to doing that — and these laws are — we want to get rid of and improve.”

Foote said these laws lead to stigma around HIV that act as a barrier to testing and care — which gets in the way of preventing new transmissions and optimizing wellness for people living with HIV.

There are six laws that criminalize HIV in Indiana — which include both public health and criminal codes.

Two relate to the donation, sale or transfer of semen for artificial insemination, blood or plasma when someone “knowingly” has HIV. Another two focus on alleged non-disclosure of someone’s HIV status. When the laws were originally written, they said people living with HIV have a “duty to inform” sexual and needle sharing partners of their states prior to “high-risk activity.”

“The disclosure law used to be called ‘Duty to Warn,’” Foote said. “We came with a warning label before we had sex. So first, I need to warn you that I have HIV. That’s the language. How stigmatizing is that?”

Advocates were able to work with lawmakers to revise the language to be less stigmatizing, but the disclosure law still exists in Indiana code.

The last two enhance punishments for battery or malicious mischief by bodily fluid or waste for people living with HIV. For example, Foote said for someone who doesn’t live with HIV, spitting on someone is considered a misdemeanor.

“For anybody living with viral hepatitis or HIV, it gets enhanced to a felony crime solely because of their HIV status, even though those diseases are not transmitted that way,” Foote said.

Foote said legislative reform around the issue focuses on efforts to repeal HIV specific criminal laws and remove enhanced penalties based solely on a person’s HIV status. Advocates also want to modernize or reform laws to reflect the current science of HIV transmission and HIV as a chronic manageable condition, as well as narrow the law to situations that involve the “intent to transmit” or a “substantial risk of transmission.”

Foote is collaborating with the University of California-Los Angeles School of Law’s Williams Institute to analyze the enforcement of HIV criminalization in Indiana. She said not all of the HIV criminalization laws have been used, but many have led to arrests.

“People also are being convicted under these laws, so that right there tells you that change needs to occur because we have these people being prosecuted in ways that are unfair and don’t reflect advances in modern science,” Foote said.

Foote said in addition to creating harmful stigma, HIV criminalization disproportionately affects Black people, sexual minorities and people who inject drugs, which makes health inequities worse.

The Damien Center event also focused on different challenges these community centers face when trying to provide services and how threats to a federal program can make care more complicated.

The 340B drug pricing program was created in partnership with pharmaceutical companies — which agreed to provide “significant” discounts to eligible health care providers in order to participate in the Medicaid program.

Community health centers, also known as federally qualified health centers, are designed to increase access to primary care by reducing barriers such as cost, lack of insurance and distance. Ryan White centers are a part of the federal program designed to increase access to care for HIV.

Colleen Meiman, the national policy advisor for state and regional associations of Community Health Centers, said the program allows these centers to stretch federal resources to reach more patients and provide comprehensive services to vulnerable populations.

“340B is about so much more than pharmaceuticals,” Meiman said. “340B is essential to the financial sustainability of many, many, probably the majority of health centers.”

She also said the 340B program is facing several threats at the federal level, but some states have been able to pass legislation to protect the program.

Damien Center President and CEO Alan Witchery said the event was meant to identify issues that advocates and organizations want to address moving forward.

“There really isn’t an opportunity for nonprofits to come together and think about just doing this kind of advocacy,” Witchery said.

Witchery said he wants there to be a continued conversation around lobbying, advocacy and education efforts for these organizations to promote their causes together as a group around the state.

Australia: Criminalisation fuels healthcare disparities for migrants living with HIV

HIV in Australia: shades of injustice remain

Elimination is the goal, but migrants living with the virus experience a criminalised environment that thwarts access to care.

Health Minister Mark Butler painted a largely rosy picture of the progress towards elimination of HIV in Australia today, speaking on the second morning of the ASHM HIV/AIDS Conference in Sydney.

A legal academic, however, said people with HIV in Australia were still living under a pall of criminalisation, none more so than migrants.

Mr Butler praised the Australian response to the epidemic, especially in NSW, which was most affected in the early days.

“Since HIV was first detected more than 40 years ago in Australia, Australia’s response has been one to be proud of,” he said.

“When you go back to those early years, AIDS was highly feared here as it was around the world. There was huge stigma, misinformation, homophobia and such loss and so much grief for communities.

“But Australia’s response early on was characterised by partnership and collaboration: governments, people living with HIV, communities affected by HIV, non-government organisations, health professionals and academics all came together and worked together.”

He said HIV notifications were declining in Australia, at one of the fastest rates in the world – “but as you have all heard, I’m sure, transmission has also gone up in 2023, reminding us there is always more work to be done”.

“Eliminating transmission of HIV here in Australia is ambitious, but I am absolutely assured it is now achievable,” he said today, citing inner Sydney – once the epicentre of the epidemic – as a place that had effectively achieved elimination.

Mr Butler set up the HIV Taskforce last year with a goal to “virtually” eliminate transmission by 2030. The Ninth National HIV Strategy covers from last year to 2030, continuing the work of the Eighth – whose goal was virtual elimination by 2022.

He said transmission rates had grown “among temporary residents who are here in Australia on work or study visas”.

“So we will provide subsidised access to PrEP to make healthcare more equitable for people who don’t have access to Medicare … We will make sure that at-risk populations can get free HIV self-testing kits through an expansion of the national HIV self-test mailout program [run by the National Association of People with HIV Australia (NAPWHA)] as well as HIV self-testing vending machine programs,” said Mr Butler.

For David Carter, Scientia Associate Professor at the faculty of Law & Justice at UNSW, the necessary changes for people on visas won’t be found in any vending machine but in immigration policy.

Professor Carter, who leads the Health+Law Research Partnership for social justice for people living with HIV or hepatitis B, walked through the history of “unjust and unhelpful” HIV criminalisation in Australia – a public policy environment that includes but is not limited to action by law enforcement and courts. It begins with the creation of a “suspect population”.

He quoted the very first National HIV Strategy in 1987, which warned of the “temptation” of criminalisation measures, including “universal or selective testing, closure of gay venues, criminal penalties for transmission, compulsory notification of HIV infection and restrictions on freedoms of infected people through limitations on employment, quarantine or compulsory detention”, and noted these would jeopardise health measures to prevent transmission.

A working party in 1992 concluded that “even in the face of decisions by individuals that generate harm, it was the wrong decision to restrict the free choice of individuals in modern society, as draconian measures would merely alienate people at risk of infection and deter them presenting for counselling, testing and treatment”.

While pressure to enforce such measures may have been largely resisted, and the situation for Australians has greatly improved, migrants living with HIV are still experiencing an alienating and hostile environment, said Professor Carter.

Characterising them as posing potential harm to Australians “establishes an adversarial relationship between the person living with HIV and the state” and compromises health care by promoting defensive behaviour.

He and his team have interviewed migrants in Australia living with HIV over the past two years, for whom “criminalisation is indeed very active, and it is producing serious, negative health and other impacts of individuals or communities and respects”.

He quoted one interviewee, “Sergio”, who told the team: “I don’t have to face any court, but I did have to prove that I wasn’t a bad person just because I have HIV.”

Others spoke of experience going through the migration process as being “subject to an unending interrogation”.

“Laurence” told his interviewer: “It’s like a tattoo on your mind. The government will treat you different for every single step of your life from here on out.”

“Manish”, who was on a temporary visa, avoided getting tested for 10 months after beginning to suspect he had HIV, for fear of having his visa revoked. His health deteriorated during this time.

“The elevated threat levels produced by the interaction of migration law and public health law … significantly harmed Manish’s health, caused psychological distress and steered him towards coping responses that denied him the testing and treatment, access to medical care and other supports that he deserves and that we all collectively affirm are essential and are his right,” said Professor Carter.

“Manish said to us: ‘I feel like if I had reassurance that nothing’s going to happen to me if I tested positive for this, I would not have been afraid to go and get a test for HIV’.”

Others described feelings of “hopelessness and depression, because there is no hope for us to stay permanently while living with HIV” (in fact there are pathways for permanent migration despite living with HIV). These people would go for weeks without medication in a form of self-sabotage “because they just don’t have hope for their future anymore”.

For these and other people like them, the Australian environment “is just a set of undifferentiated threats to autonomy, wellbeing and safety, to which they are forced to respond with adaptation, distancing and adopting a posture of self-defence”.

Professor Carter concluded that “it may be different today [from the 90s], but it is not over, and it won’t be over here or elsewhere until the stigma of HIV, unconventional sexuality and drug use are gone”.

The HIV/AIDS Conference is running in Sydney this week back-to-back with the 25th IUSTI World Congress.

Tajikistan: Rising HIV cases among migrants highlight urgent need for testing and repeal of HIV criminalisation law

Every third person with HIV in Tajikistan is a labour migrant

Translated with Deepl.com. For article in Russian, please scroll down. 

There are more and more people living with HIV among migrants

In Tajikistan, every third person with HIV is a labour migrant. Over the past five years, 5,463 cases of HIV infection have been detected, according to data from the Republican Centre for HIV/AIDS Prevention and Control. Of these, migrants account for 22 per cent of those infected. While in 2019 migrants accounted for only 17 per cent of those infected, by 2023 that figure had risen to 32.5 per cent.
Balajon Davlatov, a specialist of the dispensary department of the Republican HIV Centre, strongly recommends to take a free test at one of the HIV prevention and control centres in Tajikistan immediately after arrival.

“Every migrant, after returning home, should be tested for HIV infection if they have doubts about it,” Davlatov said.
More than 300 migrants are already on the Republican HIV Centre’s dispensary register, he said. Their identities and test results are not disclosed to third parties.
“Any information about each person should be confidential. It is possible to get express tests, which within 15 minutes by analysing saliva report the patient’s HIV status – completely anonymously,” he says.
Such tests are available free of charge at one of the 67 government HIV prevention and control centres in all regions of Tajikistan.
In addition to testing through blood at AIDS centres, self-testing using near-blood fluid is now available. Self-test kits are available in Dushanbe, Rudaki, Khujand and B.Gafurov through online ordering at hivtest.tj.

The ordering process involves filling out a simple form with a few questions. This platform helps people confidentially find out their HIV status and provides up-to-date information on protection and prevention methods.
Those who test positive for HIV can learn more about their result and get a follow-up confirmatory test at the AIDS Centre.

We had a case with a woman who tested positive for HIV,” says Balajon Davlatov, “after treatment with antiretrovirals, she gave birth to two HIV-negative children. Now she lives in Russia, and we send her the necessary medication and counselling.
This proves that HIV-infected people can give birth to healthy children and live a full life.

It is an offence to infect another person with HIV

However, a positive HIV status can carry certain risks, which are not only related to the state of health. If a person knows that he or she is HIV-positive but hides it from his or her sexual partner, he or she can be fined from 720 to 1440 somoni under Article 120 of the Code of Administrative Offences (CAO).

Evasion of treatment for HIV or other infectious diseases is also punishable by a fine of 1,440 to 2,160 somoni. This liability is stipulated in Article 119 of the Code of Administrative Offences.

If a person deliberately infects another person with HIV, he or she may be punished with restriction of freedom for up to 3 years or imprisonment for up to 2 years. If, knowing his/her HIV status, he/she infects another person, he/she may face 2 to 5 years in prison. The term of imprisonment can be longer, from 5 to 10 years, if more than one person was infected or if the victim was a minor. This punishment is already stipulated in article 125 of the Criminal Code, which characterises these actions not as an offence but as a criminal offence.

Therefore, it is very important to periodically take tests and check your status, especially if you are in a risk group.


Среди мигрантов всё больше людей, живущих с ВИЧ

В Таджикистане каждый третий человек с ВИЧ – это трудовой мигрант. За последние 5 лет выявлено 5463 случая заражения ВИЧ инфекцией, говорят данные Республиканского центра по профилактике и борьбе с ВИЧ/СПИД. Из них 22% инфицированных приходится на мигрантов. Если в 2019 году мигранты составляли всего 17% зараженных, то к 2023 году эта цифра увеличилась до 32,5%.
Баладжон Давлатов, специалист диспансерного отделения Республиканского центра ВИЧ, настоятельно рекомендует сразу после прибытия пройти бесплатный тест в одном из центров по профилактике и борьбе с ВИЧ-инфекцией в Таджикистане.

«Каждый мигрант после возвращения на родину должен пройти обследования на факт заражения ВИЧ, если у него есть сомнения по этому поводу», – говорит Давлатов.
По его словам, уже более 300 мигрантов находятся на диспансерном учете республиканского центра ВИЧ. Их личность и результаты теста не разглашаются третьим лицам.
«Любая информация о каждом лице должна быть конфиденциальной. Можно получить экспресс-тесты, которые в течение 15 минут путем анализа слюны сообщают о ВИЧ-статусе пациента – полностью анонимно», – говорит он.
Такие тесты можно получить бесплатно в одном из 67 государственных центров по профилактике и борьбе со ВИЧ во всех регионах Таджикистана.
В дополнение к тестированию через кровь в Центрах СПИД, сегодня доступно самотестирование с использованием околодесновой жидкости. Наборы для самотестирования можно получить в городах Душанбе, Рудаки, Худжанд и Б.Гафуров через онлайн-заказ на сайте hivtest.tj.
Процесс заказа включает заполнение простой формы с несколькими вопросами. Эта платформа помогает людям на конфиденциальной основе узнать свой ВИЧ-статус и предоставляет актуальную информацию о методах защиты и профилактики.
Те, у кого тест на ВИЧ оказался положительным, могут узнать о своем результате подробнее и пройти повторное подтверждающее тестирование в Центре СПИД.

«У нас был случай с женщиной с положительным ВИЧ статусом, – рассказывает Баладжон Давлатов, – после лечение антиретровирусными препаратами она родила двоих детей с отрицательным ВИЧ-статусом. Сейчас она живёт в России, и мы отправляем ей нужные медикаменты и даём консультации».
Это доказывает, что ВИЧ инфицированные люди могут рожать здоровых детей и полноценно жить.

Заражение ВИЧ другого человека – это преступление

Однако положительный ВИЧ-статус может нести определенные риски, которые связаны не только с состоянием здоровья. Если человек знает, что у него положительный ВИЧ-статус, но скрывает это от своего сексуального партнера, то в рамках статьи 120 Кодекса об административных правонарушениях (КоАП) РТ ему могут выписать штраф от 720 до 1440 сомони.

За уклонение от лечения от ВИЧ или других инфекционных заболеваний тоже выписывается штраф от 1440 до 2160 сомони. Эта ответственность предусмотрена статьей 119 КоАП.
Если человек умышленно заражает другого ВИЧ, он может быть наказан ограничением свободы до 3 лет или лишением свободы до 2 лет. Если, зная о своем ВИЧ-статусе, он заразил другого человека, ему может грозить от 2 до 5 лет тюрьмы. Срок лишения свободы может быть больше – от 5 до 10 лет, если было заражено более одного человека или жертвой стало несовершеннолетнее лицо. Это наказание предусматривается уже в статье 125 Уголовного кодекса РТ, что характеризует эти действия не как правонарушение, а как уголовное преступление.
Поэтому очень важно периодически сдавать анализы и проверять свой статус, особенно, если человек находится в группе риска.

US: Legislative study in Oklahoma could lead to repeal of STI and HIV criminalisation laws

Interim study will examine Oklahoma laws that criminalize spreading STIs, HIV

An interim legislative study will evaluate the criminalization of sexually transmitted infections and HIV in Oklahoma.

State Sens. Julia Kirt and Carri Hicks, both Democrats representing Oklahoma City, are co-sponsors of the study with the goal of educating and correcting misinformation on sexually transmitted infections (STI) and HIV. The study could also lead to renewed legislation to repeal several laws that criminalize intentionally spreading transmitted diseases.

Advocates say a public health response is more appropriate than a criminal sentence. Oklahoma’s laws currently carry a felony charge and two to five years in prison if a person is found to have intentionally or recklessly spread HIV, smallpox, syphilis or gonorrhea.

Kirt said her district covers an area with some of the most active testing facilities for HIV and sexually transmitted diseases (STD), and her constituents are concerned because the laws that criminalize intentional spreading also bring with them several stigmas that tend to stop people from getting tested.

“If adding a crime for those is what helps get people better, we wouldn’t have such problems,” she said.

Freedom Oklahoma Executive Director Nicole McAfee said she agreed with Kirt and said the study has been several years in the making.

Freedom Oklahoma, a local advocacy organization, started the conversation with local and national partners in public health, direct service providers and others involved with public health criminalization to look at Oklahoma’s laws that establish criminal penalties for intentionally tansmitting diseases such as HIV.

McAfee said Oklahoma needs “a sex education one-on-one and some of that real public health discussion so that we can better talk about sexually transmitted infections in ways that are a public health response and not a criminalization or sort of moralistic response.”

Some lawmakers, including Rep. Toni Hasenbeck, R-Elgin, say the reasons for criminalization relate to domestic violence. House Bill 3098, introduced this year, would have added several more diseases that could be criminalized. The bill passed the House to the Senate Public Safety Committee but did not advance further. It was sponsored by Sen. Jessica Garvin, R-Duncan.

In a written statement to The Oklahoman, Hasenbeck said she wants to pursue the legislation in the future and follow the study closely.

“Throughout my years of working on legislation addressing domestic abuse, I’ve heard countless stories from Oklahomans who were deliberately infected with diseases by a sexual partner,” she said. “These diseases sometimes cause severe, long-lasting consequences, like liver disease and infertility. Beyond the physical health implications, there’s the profound emotional distress of discovering that a trusted partner has knowingly and willfully inflicted harm.”

McAfee said that when Hasenbeck’s bill was discussed, it was clear that a stigma against people with STIs and HIV still existed. She said topics like testing status, dirty versus clean language, and intentionality were difficult “to dig into when there’s inadequate sex education and sexual health resources for many people.”

“I think we can all agree that we’ve learned a lot about sexual health since 1910, and maybe the responses that we had and came up with at that point in time should not be the same ones that we utilize today,” she said.

As of 2023, 34 states have laws that criminalize HIV exposure, but 13 states have “modernized” or repealed these laws, according to the Centers for Disease Control and Prevention.

Not the first time decriminalization has been proposed

Last year, Rep. Mauree Turner, D-Oklahoma City, introduced House Bill 2343 that would have repealed two 1910 laws that criminalized public exposure with a contagious disease and intentionally spreading smallpox, syphilis and gonorrhea, as well as a 1988 law that criminalized the intentional spreading of HIV/AIDS. The bill died in the House Criminal Justice and Corrections Committee.

McAfee said the conversation showed how little a lot of legislators know about HIV, especially in the modern sense.

“We heard a lot of misinformation repeated as fact from folks,” she said.

Old stigmas surface in modern politics

McAfee said the highest number of STI and HIV cases are often in rural areas where access to health services can be farther away and that Oklahoma ranks in the top seven states for rural transmission. She said people in smaller communities who receive services from providers at clinics who might be people they encounter on a regular basis might not want to risk having everyone know their health status.

“It’s really disappointing that all of these decades later when we know so much more, when there is a lot more prevention and treatment accessible, that we still have legislators whose knowledge of HIV/AIDS is rooted in sort of mid-’80s stigma and misinformation,” she said, adding that some “are governing from that basic fear or this desire to sort of impose morality on your folks, in particular, instead of realizing that this is a public health conversation.”

Kirt and McAfee said they want people to be more educated on the science and health aspects of STIs and HIV, reduce the stigma attached to the problems and encourage more testing.

Kirt said she would be interested in introducing legislation in the next session to address the laws. No date for holding the interim study has yet been set.

“We have to look at true bipartisan approaches to really solve problems instead of kind of short-term, short-sighted ways of approaching problems,” Kirt said.