US: Charges of HIV exposure for spitting, despite absence of risks, prove that Georgia needs to modernise its HIV laws

HIV-positive man’s arrest for spitting called ‘plain and simple discrimination’

A 31-year-old man in Rome, Ga., was charged with exposing police officers to HIV after allegedly spitting on them, which HIV activists said highlights why the state needs to fix its HIV laws.

Authorities said JS was swearing at people and making obscene gestures near the intersection of Maple Road and Park Road on Aug. 25, according to the Marietta Daily Journal. S allegedly spat on officers after being apprehended by the Floyd County Police Department.

S was charged with criminal trespass, two misdemeanor counts of disorderly conduct, three misdemeanor counts of willful obstruction of police officers and three felony counts of assault on police officers by someone with HIV, according to the Floyd County Sheriff’s Office. He is being held without bond in the Floyd County Jail.

HIV cannot be transmitted by spitting, according to the Centers for Disease Control & Prevention. S’s arrest highlights why Georgia needs to modernize its HIV laws, according to Nina Martinez of the Georgia HIV Justice Coalition.

“In 2019, it’s not breaking news that saliva does not transmit HIV,” she told Project Q Atlanta. “And yet, the punishment for a person living with HIV who spits on a police officer is potentially 20 times greater than that for someone not living with HIV who commits the same offense. This is state-sanctioned discrimination, plain and simple.”

Malcolm Reid, another member of the Georgia HIV Justice Coalition, agreed with Martinez.

“Although we don’t know much about this specific case, we do know that there is no chance of HIV transmission through spit,” he said. “This proves once again that the laws in Georgia need to catch up to science. HIV is not a crime.”

Georgia is one of some three-dozen states that criminalize a lack of HIV disclosure. Activists and lawmakers have tried for years to modernize state law by decriminalizing HIV. 

A Republican lawmaker introduced an HIV decriminalization bill on the final day of this year’s legislative session. It will be back in the 2020 session in January.

An Athens man was arrested in July after allegedly having sex with a woman without informing her he had HIV. He was charged with reckless conduct by a person with HIV. He remains in Athens-Clarke County Jail nearly two months later on a $3,000 bond, according to the Clarke County Sheriff’s Office.

A gay Atlanta man was arrested for HIV exposure in South Carolina in 2015. He claimed he disclosed his status before having sex with the alleged victim. The charges were later dropped.

The Global Network of People Living with HIV (GNP+) and the HIV Justice Network (HJN) condemn dismissal of appeal in Singapore HIV criminalisation case

The Global Network of People Living with HIV (GNP+) and the HIV Justice Network (HJN) condemn dismissal of appeal in Singapore HIV criminalisation case

The Global Network of People Living with HIV (GNP+) and the HIV Justice Network (HJN) condemn the dismissal of the appeal by a Singaporean man living with HIV who was convicted to two years’ imprisonment for not disclosing his status to his sexual partner and for not communicating the risk of HIV transmission to his sexual partner. We are particularly concerned that the judgement has emphasised the lack of explaining the risk of HIV transmission as the main reason for dismissing the appeal.

“HIV prevention is a shared responsibility and therefore not the sole responsibility of people living with HIV. If more people are sensitised to the rights of people living with HIV, including their sexual rights, and were aware of the mechanisms of HIV transmission there would be far less stigma and discrimination towards people living with HIV. Furthermore, HIV criminalisation creates a bad public health environment where people living with HIV have fears in disclosing their status, which lead to delay in engaging in care and treatment,” said Rico Gustav, Executive Director of GNP+.

According to the Infectious Diseases Act in 2016 of Singapore, Section 23 (1) a person who knows that he has HIV Infection shall not engage in any sexual activity with another person unless, before the sexual activity takes place — (a) he has informed that other person of the risk of contracting HIV Infection from him; and (b) that other person has voluntarily agreed to accept that risk.

“HIV is the only disease singled out as a transmittable disease in the Infectious Diseases Act,” said Edwin Bernard, Global Co-ordinator of the HIV Justice Network. “Not only does this perpetuate stigma, it also creates a false sense of security, suggesting that only people with diagnosed HIV can transmit HIV, when many new infections come from those who are undiagnosed. Ironically, a law such as this one that places such an onerous burden on people with diagnosed HIV, is only likely to make HIV testing, and open and honest discussions around HIV, less likely.”

Furthermore, the facts of the case reported in the judgement suggest that there was no effective HIV risk during any sexual activity, regardless of whether or not disclosure – and acceptance of risk – was established beyond reasonable doubt. Condoms were used early in the relationship, and subsequently when condoms were not used, the unjustly convicted man had a very low viral load.

As expressed in the Expert Consensus Statement on the Science of HIV in the context of criminal law, HIV criminalisation laws and prosecutions have not always been guided by the best available scientific and medical evidence, have not evolved to reflect advancements in knowledge of HIV and its treatment, and can be influenced by persistent societal stigma and fear associated with HIV. HIV continues to be singled out, with prosecutions occurring in cases where no harm was intended; where HIV transmission did not occur, was not possible or was extremely unlikely; and where transmission was neither alleged nor proven.

GNP+ and HJN not only strongly condemn this legislation and the dismissal of appeal of this case, but all kinds of HIV criminalisation, which often entails legislation that is applied in a manner inconsistent with contemporary medical and scientific evidence and includes overstating both the risk of HIV transmission and also the potential for harm to a person’s health and wellbeing. Such limited understanding of current HIV science reinforces stigma and may lead to human rights violation and undermines efforts to address the HIV epidemic.

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France: Highest Court confirms that people living with HIV with an undetectable viral load can never be prosecuted as the risk of transmission is nul

Source TETU, Published 20/03/2019 – Google translation, for article in French please scroll down.

Can a person living with HIV be prosecuted if she is under treatment? The Court of Cassation (French Highest Court) delivers a landmark decision.

In a decision handed down on 5 March, the Court of Cassation ruled that it was impossible to prosecute an HIV-positive man on treatment who had sex without a condom and without informing his partner of his HIV status.

That’s a first. In a decision handed down on 5 March, the Court of Cassation recognised the preventive nature of HIV treatment. Thus, any person whose viral load is undetectable, who has sex without a condom with another person without the latter being aware of the HIV status of his or her partner, cannot be prosecuted.

In this case, a woman who had sex with a man who was HIV-positive and undergoing treatment sued the man on the grounds that he had not previously informed her of his HIV status. The partner was not infected. However, the man was prosecuted on the grounds of “administration of a harmful substance”, i.e. alleged exposure to the virus.

Non-harmful bodily fluids

The investigating judge did not give rise to prosecution. A decision from which the civil party has appealed. But the woman was once again dismissed. According to the Court of Appeal, it has been proven that the “HIV viral load” was “constantly undetectable since 3 September 2001”. The man was “strictly and permanently compliant with the treatment, so that his HIV status was only potential but not current”.

And the judges of the Court of Appeal ruled: “The carrier’s bodily fluids cannot be considered harmful on the date of the alleged acts”.

A significant reminder from the judges, who stated that it takes “a detectable viral load in an infected person for him/her to infect any partner”.

A purely mathematical margin of error

Moreover, the judges of the Court of Appeal acknowledged that there was indeed a margin of error, but that it was purely mathematical. Thus, they conceive of the idea of the “non-zero risk” of HIV transmission by a person undergoing treatment. A risk they call “very small” since it is about one in 10,000. And according to them, this margin of error does not make it possible to condemn the carrier of the virus.

The civil party has appealed to the Supreme Court. The High Court dismissed the appeal, aligning itself with the judges of first instance.


Peut-on poursuivre une personne séropositive sous traitement ? La Cour de cassation rend un arrêt historique

Dans un arrêt rendu le 5 mars dernier, la Cour de cassation a affirmé qu’il était impossible de poursuivre un homme séropositif sous traitement, ayant eu des relations sexuelles sans préservatif et sans informer sa partenaire de son statut sérologique.

C’est une première. La Cour de cassation a reconnu, dans un arrêt rendu le 5 mars dernier, le caractère préventif du traitement contre le VIH. Ainsi, ne saurait être poursuivie toute personne dont la charge virale est indétectable, qui aurait des relations sexuelles sans préservatif avec une autre personne sans que celle-ci ne soit au courant du statut sérologique de sa/son partenaire.

Dans cette affaire, une femme ayant eu des relations sexuelles avec un homme, porteur du VIH et sous traitement, a engagé des poursuites contre ce dernier au motif qu’il ne l’avait pas prévenue au préalable de son statut sérologique. Sa partenaire n’a pas été contaminée. Pourtant, l’homme était poursuivi au motif « d’administration d’une substance nuisible », c’est-à-dire à une prétendue exposition au virus.

Des fluides corporels non nuisibles

Le juge d’instruction n’a pas donné lieu aux poursuites. Une décision de laquelle la partie civile a fait appel. Mais la femme s’est fait une nouvelle fois débouter. Selon la Cour d’appel, il a été prouvé que « la charge virale de VIH » était « constamment indétectable depuis le 3 septembre 2001 ». L’homme a fait « compliance stricte et permanente au traitement, de sorte que la séropositivité n’était plus que potentielle mais non actuelle ».

Et les juges de la Cour d’appel de statuer : « Les fluides corporels du porteur ne sauraient être tenus pour nuisibles à la date des agissements qui lui sont reprochés ».

Un rappel non négligeable des juges, qui affirment qu’il faut « une charge virale détectable chez une personne infectée pour qu’elle puisse contaminer quelque partenaire ».

Une marge d’erreur purement mathématique

Par ailleurs, les juges de la Cour d’appel ont reconnu qu’il existait bel et bien une marge d’erreur, mais qu’elle était purement mathématique. Ainsi, ils conçoivent l’idée du « risque non nul » de la transmission du VIH par une personne sous traitement. Un risque qu’ils qualifient d’ »infime » puisqu’il est d’environ un sur 10.000. Et selon eux, cette marge d’erreur ne permet pas de condamner le porteur du virus.

La partie civile s’est pourvue en cassation. La haute juridiction a rejeté le pourvoi, s’alignant sur les juges de première instance.

 

Canada: Review undertaken as part of government’s examination of HIV nondisclosure laws confirms risk of sexual transmission when viral load is suppressed is virtually zero

Risk of sexual transmission of human immunodeficiency virus with antiretroviral therapy, suppressed viral load and condom use: a systematic review

Abstract

Background: The Public Health Agency of Canada reviewed sexual transmission of HIV between serodiscordant partners to support examination of the criminal justice system response to HIV nondisclosure by the Department of Justice of Canada. We sought to determine HIV transmission risk when an HIV-positive partner takes antiretroviral therapy, has a suppressed viral load or uses condoms.

Methods: We conducted an overview and systematic review update by searching MEDLINE and other databases (Jan. 1, 2007, to Mar. 13, 2017; and Nov. 1, 2012, to Apr. 27, 2017, respectively). We considered reviews and studies about absolute risk of sexual transmission of HIV between serodiscordant partners to be eligible for inclusion. We used A Measurement Tool to Assess Systematic Reviews (AMSTAR) for review quality, Quality in Prognosis Studies (QUIPS) instrument for study risk of bias and then the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence across studies. We calculated HIV incidence per 100 person-years with 95% confidence intervals (CIs). We assigned risk categories according to potential for and evidence of HIV transmission.

Results: We identified 12 reviews. We selected 1 review to estimate risk of HIV transmission for condom use without antiretroviral therapy (1.14 transmissions/100 person-years, 95% CI 0.56–2.04; low risk). We identified 11 studies with 23 transmissions over 10 511 person-years with antiretroviral therapy (0.22 transmissions/ 100 person-years, 95% CI 0.14–0.33; low risk). We found no transmissions with antiretroviral therapy and a viral load of less than 200 copies/mL across consecutive measurements 4 to 6 months apart (0.00 transmissions/100 person-years, 95% CI 0.00–0.28; negligible risk regardless of condom use).

For full study see: http://www.cmaj.ca/content/190/46/E1350

Bringing Science to Justice: End HIV Criminalisation Now

News Release

Networks of people living with HIV and human rights and legal organisations worldwide welcome the Expert Consensus Statement on the Science of HIV in the Context of Criminal Law

Amsterdam, July 25, 2018 — Today, 20 of the world’s leading HIV scientists released a ground-breaking Expert Consensus Statement providing their conclusive opinion on the low-to-no possibility of a person living with HIV transmitting the virus in various situations, including the per-act transmission likelihood, or lack thereof, for different sexual acts. This Statement was further endorsed by the International AIDS Society (IAS), the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and 70 additional experts from 46 countries around the world.

The Expert Consensus Statement was written to both assist scientific experts considering individual criminal cases, and also to urge governments and criminal justice system actors to ensure that any application of the criminal law in cases related to HIV is informed by scientific evidence rather than stigma and fear. The Statement was published in the peer-reviewed Journal of the International AIDS Society (JIAS) and launched at a critical moment during the 22nd International AIDS Conference, now underway.

“As long-time activists who have been clamouring for a common, expert understanding of the current science around HIV, we are delighted with the content and widespread support for this Statement,” said Edwin J Bernard, Global Co-ordinator of the HIV Justice Network, secretariat to the HIV JUSTICE WORLDWIDE campaign. “Eminent, award-winning scientists from all regions of the world have come together to provide a clarion call for HIV justice, providing us with an important new advocacy tool for an HIV criminalisation-free world.”

The Statement provides the first globally-relevant expert opinion regarding individual HIV transmission dynamics (i.e., the ‘possibility’ of transmission), long-term impact of chronic HIV infection (i.e., the ‘harm’ of HIV), and the application of phylogenetic analysis (i.e., whether or not this can be used as definitive ‘proof’ of who infected whom). Based on a detailed analysis of scientific and medical research, it describes the possibility of HIV transmission related to a specific act during sexual activity, biting or spitting as ranging from low to no possibility. It also clearly states that HIV is a chronic, manageable health condition in the context of access to treatment, and that while phylogenetic results can exonerate a defendant when the results exclude them as the source of a complainant’s HIV infection, they cannot conclusively prove that one person infected another.

“Around the world, we are seeing prosecutions against people living with HIV who had no intent to cause harm. Many did not transmit HIV and indeed posed no actual risk of transmission,” said Cécile Kazatchkine, Senior Policy Analyst with the Canadian HIV/AIDS Legal Network, a member and key partner organisation of the HIV JUSTICE WORLDWIDE campaign. “These prosecutions are unjust, and today’s Expert Consensus Statement confirms that the law is going much too far.”

Countless people living with HIV around the world are currently languishing in prisons having been found guilty of HIV-related ‘crimes’ that, according the Expert Consensus Statement, do not align with current science. One of those is Sero Project Board Member, Kerry Thomas from Idaho, who says: “I practiced all the things I knew to be essential to protect my sexual partner: working closely with my doctor, having an undetectable viral load, and using condoms.  But in terms of the law, all that mattered was whether or not I disclosed. I am now serving a 30-year sentence.”

FINAL_KERRY_NOT-A-CRIME-POSTERWhile today’s Statement is extremely important, it is also crucial to recognise that we cannot end HIV criminalisation through science alone. Due to the numerous human rights and public health concerns associated with HIV criminalisation, UNAIDS, the Global Commission on HIV and the Law, the UN Committee on the Elimination of Discrimination against Women, and the UN Special Rapporteur on the Right to Health, among others, have all urged governments worldwide to limit the use of the criminal law to cases of intentional HIV transmission. (These are extremely rare cases wherein a person knows their HIV-positive status, acts with the intention to transmit HIV, and does in fact transmit the virus.)

We must also never lose sight of the intersectional ways that — due to factors such as race, gender, economic or legal residency status, among others — access to HIV treatment and/or viral load testing, and ability to negotiate condom use are more limited for some people than others. These are also the same people who are less likely to encounter fair treatment in court, within the medical system, or in the media.

“Instead of protecting women, HIV criminalisation places women living with HIV at increased risk of violence, abuse and prosecution,” says Michaela Clayton, Executive Director of the AIDS and Rights Alliance for Southern Africa (ARASA). “The scientific community has spoken, and now the criminal justice system, law and policymakers must also consider the impact of prosecutions on the human rights of people living with HIV, including women living with HIV, to prevent miscarriages of justice and positively impact the HIV response.”

HIV criminalisation is a pervasive illustration of systemic discrimination against people living with HIV who continue to be stigmatised and discriminated against on the basis of their status. We applaud this Statement and hope it will help end HIV criminalisation by challenging all-too-common mis-conceptions about the consequences of living with the virus, and how it is and is not transmitted. It is indeed time to bring science to HIV justice.

To read the full Expert Consensus Statement, which is also available in French, Spanish and Russian in the Supplementary Materials, please visit the Journal of the International AIDS Society at https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25161

VIsit the HIV JUSTICE WORLDWIDE website to read a short summary of the Expert Consensus statement here: http://www.hivjusticeworldwide.org/en/expert-statement/

To understand more about the context of the Expert Consensus Statement go to: http://www.hivjusticeworldwide.org/en/expert-statement-faq/

HIV JUSTICE WORLDWIDE is a growing, global movement to shape the discourse on HIV criminalisation as well as share information and resources, network, build capacity, mobilise advocacy, and cultivate a community of transparency and collaboration. It is run by a Steering Committee of ten partners AIDS Action Europe, AIDS-Free World, AIDS and Rights Alliance for Southern Africa (ARASA), Canadian HIV/AIDS Legal Network, Global Network of People Living with HIV (GNP+), HIV Justice Network, International Community of Women Living with HIV (ICW), Southern Africa Litigation Centre (SALC), Sero Project, and Positive Women’s Network – USA (PWN-USA) and currently comprises more than 80 member organisations internationally.

UK: Avon & Somerset police withdraw untrue claims that HIV could be contracted through spitting

Police finally change false HIV claims after being accused of ‘preying on people’s prejudices’ 

Avon and Somerset Police falsely claimed that HIV could be transferred through saliva

Bristol’s police force has finally changed untrue claims it made about HIV, eight months after it was accused of “preying on people’s prejudices.”

Avon and Somerset Police announced last November that it would be rolling out controversial spit hoods to be used on suspects to protect officers.

But during the announcement, the force made untrue claims that HIV could be contracted through spitting, causing outrage amongst campaign groups.

The force did apologise for “any offence caused” to anyone living with HIV, but then repeated the claim that Human Immunodeficiency Virus (HIV) can be transferred through spit.

Now eight months after police made the claim, Avon and Somerset Constabulary has now confirmed that HIV will not be used as a reason to introduce spit guards after national guidance was changed.

Assistant Chief Constable Steve Cullen said: “I’d like to thank both charities and our communities for the advice and feedback they gave us following our announcement last year.

“We apologised unreservedly at the time if we caused any offence to people living with HIV.

“It has never been our intention to reinforce stigma. Every day we work to reduce stigma and discrimination experienced by communities and individuals who are victims of hate crime in all its guises.”

In January, 2018 Bristol Live reported that Avon and Somerset Police said the false claims about the transfer of HIV were taken from national guidlines.

The Bristol wing of the HIV advocacy group ACTup! Launched a petition calling for the force to retract the statement.

A spokesperson for the group said officers deserve not to be spat at while working and the group is not calling for the recall of spit hoods but raised issues with the “poorly researched” press announcement.

ACC Cullen added: “Our aim has never been to focus attention on people living with health conditions, but to target people who use spit as a weapon.

“We assured our communities we would seek to ensure that we learn from this and would share our learnings across the police service, providing clarity and direction.

“We also invited Brigstowe to help support our training for officers and staff

“I’m delighted that this has now been done.”

The National Police Chiefs Council, which issues guidance to police forces across the UK, said in January the advice on spit guards has not changed since it published a report in March 2017, but specific guidance on HIV was sent to police forces after feedback was received by Avon and Somerset.

The police chiefs’ council guidance on spit guards released in March last year said the national picture for blood-borne viruses like HIV affecting officers was “unclear “.

HIV is found in many bodily fluids of a sufferer including semen, vaginal and anal fluids, blood and breast milk.

The disease is most commonly contracted through unprotected sex and the sharing of needles. NHS England states HIV cannot be contracted through saliva.

Spit hoods made of mesh are shaped like a plastic bag and are put over the heads of suspects who had threatened to spit, have attempted to spit or have spat before.

 

UK: New research confirms HIV cannot be transmitting through spitting and risks from biting are negligible

HIV cannot be transmitted by spitting, and risk from biting is negligible, says detailed case review

Use of spit hoods not justified to protect emergency workers from HIV

Michael Carter
Published: 08 May 2018
 

There is no risk of transmitting HIV through spitting, and the risk from biting is negligible, according to research published in HIV Medicine.

An international team of investigators conducted a meta-analysis and systematic review of reports of HIV transmission attributable to spitting or biting. No cases of transmission due to spitting were identified and there were only four highly probable cases of HIV being transmitted by a bite.

The study was motived by the use of spit hoods by police forces in the UK because of the perceived risk of the transmission of HIV and other blood-borne viruses from spitting. The researchers’ findings endorse the position of the National AIDS Trust and Hepatitis C Trust that neither HIV nor hepatitis C virus can be transmitted by spitting, and that the use of spit hoods by police forces to protect offices against these viruses cannot be justified.

“We undertook a systematic literature review of HIV transmission related to biting or spitting to ensure that decisions about future policy and practice pertaining to biting and spitting incidents are informed by current medical evidence,” explain the study’s authors.

They identified published studies and conference presentations reporting on transmission of HIV via spitting or biting. Inclusion criteria were: discussion of transmission by biting or spitting; outcome described by documented HIV antibody test. Two reviewers independently identified studies that were included in the full analysis.

There were no cohort or case-control studies. The investigators therefore assessed the plausibility of HIV being transmitted to a spitting or biting incident according to baseline HIV status, nature of the injury, temporal relationship between the incident and HIV test, and where, available, phylogenetic analysis.

The plausibility of transmission being related to an incident was categorised as high, medium or low.

A total of 742 studies and case reports were reviewed by the authors.

There were no reported cases of HIV transmission attributable to spitting.

A total of 13 studies reported on HIV transmission and biting. The studies consisted of eleven case reports and two case series relating to HIV transmission, or its absence, after a biting incident.

None of the possible cases of HIV transmission due to biting were in the UK or involved emergency workers. The reports included information on 23 individuals, of whom nine (39%) seroconverted for HIV. Six of these cases involved family members, three involved fights resulting in serious wounds, and two were the result of untrained first-aiders placing fingers in the mouth of an individual experiencing a seizure.

“Of the 742 records reviewed, there was no published cases of HIV transmission attributable to spitting, which supports the conclusion that being spat on by an HIV-positive individual carries no possibility of transmitting HIV,” write the authors. “Despite biting incidents being commonly reported occurrences, there were only a handful of case reports of HIV transmission secondary to a bite, suggesting that the overall risk of HIV transmission from being bitten by an HIV-positive person is negligible.”

There were only four highly plausible cases of HIV transmission resulting from a bite. In each case, the person with HIV had advanced disease and was not on combination antiretroviral therapy and was therefore likely to have had a high viral load. The bite caused a deep wound and the HIV-positive person had blood in their mouth.

“Two cases occurred in the context of a seizure whereby an untrained first-aid responder was bitten while trying to protect the seizing person’s airway,” note the researchers. “It is therefore important that both emergency workers and first-aid responders are trained in safe seizure management including non-invasive airway protection and use universal precautions.”

The investigators emphasise that they found no cases of an emergency worker or police officer being infected with HIV because of a bite. They point out that bite injuries are a common reason for attending accident and emergency departments: a review of A&E admissions over a four-year period at a hospital in the United Kingdom found that one person was admitted with a bite wound every three days, on average.

“Current UK guidance on indications for PEP [post-exposure prophylaxis, emergency HIV therapy after a high-risk exposure to HIV] state that ‘PEP is not recommended following a human bite from an HIV-positive individual unless in extreme circumstances and after discussion with a specialist,’” conclude the authors. “Necessary conditions for transmission of HIV from a human bite appear to be the presence of untreated HIV infection, severe trauma (involving puncture of the skins), and usually the presence of blood in the mouth of the biter. In the absence of these conditions, PEP is not indicated, as there is no risk of transmission.”

Reference

Cresswell FV et al. A systematic review of risk of HIV transmission through biting or spitting: implications for policy. HIV Med, online edition. DOI: 10.1111/hiv.12625 (2018).

Published in aidsmap on May 8, 2018

Canada: Recent case in British Columbia demonstrates the "cycle of fear, stigma and misinformation surrounding HIV"

Misinformation is the real culprit in British Columbia HIV case

Police and media left out key details of HIV non-disclosure charges – 

The case of Brian Carlisle shows that when it comes to HIV, what you don’t know can hurt you.

Last summer, Mission RCMP reported that Carlisle, a 47-year-old marijuana activist, had been charged with three counts of aggravated sexual assault for not disclosing to his sexual partners that he has HIV. The RCMP posted Carlisle’s name and photo, asking for any other partners who might have been exposed to come forward.

At the time, the RCMP said that while they would not normally publish private medical information, “the public interest clearly outweighs the invasion of Mr Carlisle’s privacy.”

Xtra does not usually publish the names of people charged with HIV non-disclosure, but Carlisle has given permission to Xtra to publish his name and HIV status.

In the following months, three charges of aggravated sexual assault against Carlisle swelled into 12.

But the RCMP failed to mention a crucial fact: Carlisle couldn’t transmit the virus to anyone.

After studying thousands of couples over decades of research, HIV scientists around the world have reached the consensus that people with HIV who regularly take medication and achieve a suppressed viral load cannot transmit the virus through sexual contact. Like most HIV patients in British Columbia, Carlisle’s viral load was suppressed, so none of the women he had sex with were in any danger of contracting the virus.

Months after publicly disclosing his HIV status, Crown prosecutors stayed all charges against Carlisle. But it became stunningly clear that not only had the police not fully informed the public that Carlisle was uninfectious, they also hadn’t properly informed Carlisle’s alleged victims.

One woman who had sex with Carlisle told the CBC anonymously about going through PTSD, anxiety and depression, losing her job and going bankrupt because she thought she might have HIV.

Not only did the woman mistakenly think she could have contracted HIV, she also said she thought she still might become infected. Nine months after charges were laid against Carlisle, she told the CBC she still had to “wait one more year to know if I have HIV or not,” and that she was still taking HIV tests every three months to ensure the virus did not appear. She said she still avoids sexual relationships out of fear of having to disclose that she might have HIV.

This understanding of how HIV testing works is catastrophically wrong. Modern HIV testing technology, like that used by the BC Centre for Disease Control, catches 99 percent of new HIV infections only six weeks after a new infection. If even that window is too large, new technologies like RNA amplification, also used in BC, can cut the time down to only two weeks.

Even if Carlisle’s viral load had been high enough to transmit the virus, which it was not, the women he had sex with could have been given a clear bill of health only days after the RCMP knocked on their doors.

The CBC, however, did not correct the woman’s misinformation, and reported as fact that the women involved would have to undergo annual testing to make sure they do not have HIV.

Mission RCMP would not confirm at what point they discovered that Carlisle’s viral load was suppressed, or when they informed the women involved, because they say the investigation into Carlisle is still open. It’s also not clear who told the women they might be infected, or that they required yearly HIV testing.

Regardless what you think of Carlisle’s choice not to inform his sexual partners that he had HIV, and regardless whether you care about the publication of his name and HIV positive status, much of the psychological harm suffered by the women in Carlisle’s case was for nothing. Accurate medical information might have saved them months or years of anxiety, fear and isolation.

Carlisle’s case is an example of what many HIV experts say is a cycle of fear, stigma and misinformation surrounding HIV, propelled by police and prosecutors’ use of the criminal law against people who are HIV positive. Criminal prosecutions, experts say, make people less likely to seek medical help or get tested, and can increase the likelihood of new infections. One study found thathalf of the targets of HIV non-disclosure prosecutions are Black men, and nearly 40 per cent are men with male partners.

Media reports in other high profile Canadian HIV cases have also skimmed over the medical science, adding to public confusion around HIV safety.  

In December, a federal government report recommended that prosecutors should move away from the “blunt instrument” of the criminal law to handle HIV non-disclosure cases, and the government of Ontario announced it would stop prosecuting cases involving people with low viral loads. BC’s attorney general said in December he would also reconsider the province’s policy, but recent updates to the Crown counsel policy manual do not rule out prosecuting people whose viral load makes the virus intransmissible.

Regardless of the law, the least that the police and journalists can do is be honest and accurate about the actual risks involved in HIV cases. Carlisle’s case shows just how devastating ignorance can be.

Published in Xtra on May 5, 2018

 

 

UK: Avon and Somerset police statement over risk of HIV from spitting allegedly based on National Police guidelines

Police say false HIV claims over spitting were taken from national guidelines

Avon and Somerset Police still have not retracted their statement despite pressure from campaigners

The police force for Bristol and the surrounding areas say false claims made about the transfer of HIV were taken from national guidelines.

Avon and Somerset Police announced last year it would be introducing the use of spit guards in 2018 to remove the risk of officers catching diseases like the human immunodeficiency virus or hepatitis.

However, campaign groups were quick to point out HIV cannot be passed on through saliva and accused the force of “praying on people’s prejudices.”

The force did apologise for “any offence caused” to people living with HIV or Hepatitis B or C but still has not retracted the statements despite calls from campaigners to do so.

In January 24, a Freedom of Information request revealed no Avon and Somerset Police officers had caught an infection disease after being spat at since 2012/13.

When asked by the Bristol Post if the force would retract the statements about HIV, a spokesman said on January 25: “The information we used previously in the roll-out of spit guards was based on National Police Chiefs Council (NPCC) guidance.

“Following feedback from the public and consultation with local charities, Assistant Chief Constable Stephen Cullen asked the NPCC to seek medical opinion. As a result of ACC Cullen’s representations the NPCC has altered its guidance to forces.”

The Bristol wing of the HIV advocacy group ACTup! Launched a petition calling for the force to retract the statement.

A spokesperson for the group said officers deserve not to be spat at while working and the group is not calling for the recall of spit hoods but raised issues with the “poorly researched” press announcement.

On November 17 Avon and Somerset Police announced it would be introducing the use of ‘spit hoods’ across the force area from next year. The hoods made of mesh are shaped like a plastic bag and are put over the heads of suspects who had threatened to spit, have attempted to spit or have spat before.

The National Police Chiefs Council, which issues guidance to police forces across the UK, said the advice on spit guards has not changed since it published a report in March 2017, but specific guidance on HIV was sent to police forces after feedback was received by Avon and Somerset.

A spokesperson said: “Our position paper on this was published back in March last year and our overall position on this has not changed. However, after receiving feedback from colleagues in Avon and Somerset we wrote to forces to give specific guidance on HIV and spit guards – entirely in line with our position.”

The police chief’s council guidance on spit guards released in March last year says the national picture for blood-borne viruses like HIV affecting officers is “unclear “.

It adds: “There are annually a very significant number of officers who are receiving precautionary treatment to prevent blood-borne viruses initial following spitting and biting incidents. Some of this treatment is intrusive, debilitating and can have a significant impact on officers’ personal lives.”

The conclusion reads: “The NPCC position is that the risk of transfer of blood-borne viruses through spitting or biting is very low, however the impact of infection would be extremely high.”

HIV is found in many bodily fluids of a sufferer including semen, vaginal and anal fluids, blood and breast milk.

The disease is most commonly contracted through unprotected sex and the sharing of needles. NHS England states HIV cannot be contracted through saliva.

Published in the Bristol Post on Jan 30, 2018

UK: Police accused of fear mongering by playing up the risks of HIV and hepatitis C transmission through spitting

Police accused of exaggerating risks of HIV to introduce spit guards

Force plans to issue guards to officers from January, saying people infected with blood-borne viruses use spitting as a weapon

A police force has been accused of fear mongering and stigmatising sufferers of hepatitis C and HIV by playing up the risks of transmission of blood-borne viruses as a reason to introduce spit guards.

Avon and Somerset police announced their plan to issue spit guards to all operational officers from January next year. “Each day we face being spat at, putting us at risk of HIV, hepatitis and tuberculosis and the degrading assault can have a lasting psychological impact,” said Assistant Chief Constable Stephen Cullen.

Spit guards are tight mesh hoods that officers can pull over the heads of suspects resisting detention to stop them from spitting or biting. They are used by 25 forces but have been criticised by human rights groups.

Avon and Somerset’s announcement came with an account by an officer, named John, who said people infected with blood-borne viruses use spitting as a “weapon”. He described an incident in which he arrested a drunk woman who had hepatitis C after she attacked a paramedic.

“She was continually spitting, spit that was bloody. It was disgusting; she was trying to infect us,” he said, recounting how officers donned riot gear to protect themselves as they stripped the detainee for her safety. “After the shift we all went home to our kids wondering what we were taking home.”

Rachel Halford, the deputy chief executive of the Hepatitis C Trust, said she agreed that police should be protected from health risks, but rejected the force’s implication that the virus could be transmitted through spitting.

“Hepatitis C is a blood-borne virus and is therefore only transmitted through blood-to-blood contact. The virus cannot be transmitted via spit,” she said.

“Stigma and misinformation about hepatitis C and other blood-borne viruses is a key challenge faced by patients, who are already disproportionately from the most marginalised and disadvantaged groups in society. Many patients report feeling ‘dirty’ and experiencing social exclusion due to misinformation about transmission risks.”

Kat Smithson, the director of policy and campaigns at NAT (National Aids Trust), said Avon and Somerset’s claims about HIV and hepatitis C were wrong and stigmatised people with the conditions.

“HIV is irrelevant to the debate about spit hoods because spitting simply is not an HIV transmission route,” she said. “In the history of the epidemic, there has never been a case of HIV being passed on through spitting, even when the spit contains blood.”

According to Avon and Somerset police, the restraints will be used only when a person threatens to spit, has attempted to spit or has already spat, and only when officers’ body-worn cameras are switched on.

Despite those safeguards, Deborah Coles, the director of Inquest, raised concerns over their introduction to another police force. “There should be no doubt spit hoods are a use of force and have the potential to cause acute trauma and injury,” she said.

“We know from our work that mental health concerns or other difficulties often sit behind agitated behaviour. Our fear is spit hoods will become the default response and used against vulnerable detainees.

“We had hoped that after the restraint death of James Herbert, Avon and Somerset police would have prioritised safer, more humane policing methods with a focus on de-escalation and detainee welfare.”

Avon and Somerset’s police federation backed the decision, which the force said was in support of the national federation’s proposed assault on emergency workers (offences) bill.

Vince Howard, the chairman of Avon and Somerset police federation, said: “This option affords those officers, who are increasingly subject to this abhorrent act, the opportunity to protect themselves from the risks of serious communicable diseases.”

Data for spitting incidents reported on the Welfare Information Form shows there have been 79 spitting incidents out of 487 recorded assaults since April, which a force spokesman said was a sharp increase on previous reports.