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HIV Criminalization Called Ineffective and Unjust

— Expert consensus: laws put public more at risk

Ƶ MedicalToday

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AMSTERDAM – In a new consensus paper, worldwide scientists and physicians who treat HIV said here that laws on the books of at least 68 countries that criminalize HIV infection only contribute to making the epidemic worse.

"Simply put, HIV criminalization laws are ineffective, unwarranted, and discriminatory. In many cases, these misconceived laws exacerbate the spread of HIV by driving people living with and at risk of infection into hiding and away from treatment services," said Linda-Gail Bekker, MBChB, of the University of Cape Town and president of the International AIDS Society.

"Expert Consensus Statement on the Science of HIV in the Context of Criminal Law" was released here at the International AIDS Conference, with Bekker as lead author.

The document, published simultaneously in the , states that science has disproven many of the tenets of laws that criminalize HIV-related activities.

Among its main points:

  • There is no possibility of HIV transmission via contact with the saliva of an HIV-positive person, including through kissing, biting, or spitting
  • Risk of transmission from a single act of unprotected sex is very low, and there is no possibility of HIV transmission during vaginal or anal sex when the HIV-positive partner has an undetectable viral load
  • It is not possible to establish proof of HIV transmission from one individual to another, even with the most advanced scientific tools

Said Bekker: "There are justifications [offered] for these laws, but almost all these justifications have one thing in common: They misstate the scientific facts regarding how HIV is and is not transmitted."

In an , the journal's editor-in-chief, Kenneth Mayer, MD, of Harvard Medical School in Boston, and Henry de Vries, MD, PhD, of the Public Health Service of Amsterdam in The Netherlands, said that limited understanding of current HIV science reinforces stigma and can lead to miscarriages of justice while undermining efforts to address the HIV epidemic.

"Specific laws focusing on HIV criminalization, and misuse of other laws despite the evidence against the likelihood of HIV transmission, reflect the perpetuation of ignorance, irrational fear, and stigmatization. We therefore hope that governmental authorities will view this Expert Consensus Statement as a resource to better understand the actual rather than the perceived risks posed by exposures to individuals living with HIV, and to create societies that encourage engagement and not fear."

The Expert Consensus Statement, which has been translated into French, Russian, and Spanish, encourages governments and legal and judicial systems to pay close attention to the significant advances in HIV science. The statement serves as the gold standard of current scientific knowledge on HIV to inform any application of the criminal law in cases related to HIV, Bekker said.

At a press conference at the meeting, she along with other academic, professional, and society leaders decried the laws, many of which come with Draconian penalties. Edwin Bernard, global coordinator of the HIV Justice Network, said that in the latest audit, the group found the following:

  • 100 jurisdictions in 73 countries currently have HIV-specific laws
  • At least 115 jurisdictions in 76 countries had ever unjustly applied HIV-specific or general laws
  • Although not all countries with these laws have applied them as yet, 39 other countries have used other laws to unjustly prosecute persons with HIV

"The majority of the cases occurred in the United States, Belarus, Russia, Ukraine, Canada, and Zimbabwe," Bernard said. "The U.S. cases are concentrated in the states of Florida, Ohio, and Tennessee."

Also addressing the press conference by phone was Kerry Thomas, who serves as a board member of the , an organization aimed at combating criminalization of HIV. Thomas is serving a 30-year sentence in Idaho for failing to disclose his HIV status to a female sexual partner. Even though he used condoms, had an undetectable viral load, and did not transmit HIV to that partner, he was convicted under Idaho laws of not telling his partner he had HIV. He has served 10 years of his sentence and will not be free until 2036.

"My hope is that the consensus statement will lead prosecutors and judges to take all the science of transmission of HIV into account," Thomas said. During his incarceration, he has learned "that while I cannot change what I have done in the past, I can certainly change what I do next."

Disclosures

All the authors as well as the editorial writers reported having no relevant relationships with industry.

Primary Source

Journal of the International AIDS Society

Bekker L-G, et al "Expert Consensus Statement on the Science of HIV in the Context of Criminal Law" JIAS 2018; DOI: 10.1002/jia2.25161.

Secondary Source

Journal of the International AIDS Society

Mayer K, de Vries H "Addressing HIV criminalization: Science confronts ignorance and bias" JIAS 2018; DOI: 10.1002/jia2.25164.