Police HIV Investigations

posted: 19/08/2010

The key guides for the police investigation of claims of HIV transmission are now available freely on the web. George House Trust helped NAT's work with the Association of Chief Police Officers on these guides.

The police realised that they were reinventing the wheel every time they began a new investigation and that some investigations could be done very much better.

These new guides mean police should now always investigate allegations of criminal HIV transmission in a way which is:
• consistent with Crown Prosecution Service prosecution policy for HIV prosecutions
• well informed about HIV, from both a clinical and a social point of view
• respects human rights and confidentiality
• timely and does not prolong investigations.
 

It's all on POLKA

The complete Guidance is available to all police officers in England, Wales and Northern Ireland via the Police Online Knowledge Area (POLKA) hosted by the National Police Improvement Agency.

Key papers available to all 

NAT now have on their website the key documents so that people with HIV, and organisations supporting people with HIV, know what the police should be doing and best police practice.

• Police Investigation flowchart: This flowchart sets out the whole investigation process
• HIV Key facts: This tells the police key information on HIV, including basic biological and clinical facts, information on PEP, HIV testing, HIV treatments and discrimination issues
• Accused under 18?: This alerts the police how to take special care where the accused is under 18
• Communication Strategy: This guides police about publicity during and after investigations, confidentiality and media relations
• Evidential Flowchart: This key document sets out the evidential steps that must be covered in any investigation, to help avoid unnecessary intrusion and ensure the appropriate evidence is collected. They can't move on to the next invetigation stage until they have collected the necessary evidence. 
• Initial contact with STI / GUM clinics: This advises police to use STI / GUM clinics to contact any new people of interest to them rather than by the police making contact and shocking unprepared people with the news that they may have HIV
• NAT is preparing a simple Q&A on police investigations for people with HIV, which will soon be available on the same NAT webpage.

Hepatitis investigations too

Similar guidance for investigating possible cases of Hepatitis B and Hepatitis C transmission is also available. Contact NAT for these.

Police HIV investigation guidelines

These guidelines are a response to the Policing Transmission report.

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1 in 6 Gay Men Recently Infected

posted: 26/07/2010

One in six gay men having a HIV positive test in the UK became HIV positive within the past six months. This is the first result from a new system tracking trends in recent HIV infections in the UK.
 

The Health Protection Agency devised a formula (an algorithm) and method for tracking recent HIV infections. Knowing how many people were recently infected is helpful for working out what is actually happening in the UK HIV epidemic.

The number of recent infections matters because people who are recently infected are far more infectious than at any other time.
 

Tracking recent infections
The new formula and tracking method, called either the Recent Infection Testing Algorithm (RITA) or Serological Testing Algorithm for Recent HIV Seroconversion (STARHS), measures the amounts of certain antibody markers. These amounts change depending on how long ago the HIV infection took place. Amounts below a certain level mean the infection was recent (approximately within the last six months).
 

The RITA / STARHS method is not exact enough to tell an individual when they became HIV positive, because we all vary in how our immune system responds to HIV, but the method is good enough to give rough timings, which is all we need to track what is happening with the epidemic.
The work on this tracking system began in 2008, when the Health Protection Agency rolled-out STARHS as part of the routine public health monitoring of all newly diagnosed HIV infections in the country.
 

Results
The data presented the International AIDS 2010 conference in Vienna that has just ended, came from samples of 2099 people, who broadly represent, demographically and geographically, people newly diagnosed in the UK. The samples were collected between February 2009 and May 2010.
 

Gay and bi men results

Amongst gay and bisexual men, 16.1% of diagnoses were judged to be recent – within the past six months – one in six. There wasn’t any difference between gay and bi men of different ages.
 

Heterosexual results

Among heterosexuals, 6.2% men and 6.8% women were recently infected. This is just one in sixteen heterosexuals being infected within six months of their positive test.
 

There appears to be a trend for recent infections to be more commonly identified in younger heterosexual women (probably due to antenatal testing), but the age variations were not statistically significant. Curiously, in women aged 50 or over, there was a relatively high proportion of recent infections, but this is based on a small number of cases and could be due to chance. But it fits with another recent report from the HPA at the Vienna International AIDS Conference - many long-term heterosexual relationships break up when people are in their 50s, and women, no longer needing contraception, may neglect to consider the need for safer sex - condoms - to protect against STIs such as HIV.

Recently infected heterosexuals were largely people born in the UK. Heterosexual people born in Africa tend to have infection diagnosed later, the majority becoming HIV positive before migration to the UK.
 

Source

Reference: Lattimore S et al. Surveillance of recently acquired HIV infections among newly diagnosed individuals in the UK. Eighteenth International AIDS Conference, Vienna, abstract FRAX01001, 2010.
 

HIV and the Criminal Law

posted: 22/07/2010

A new book, HIV and the Criminal Law, has just appeared online from NAM/aidsmap. It will also be published on paper in the autumn.

HIV & the Criminal Law is about criminalisation of HIV transmission and exposure and the effects this has on individuals and society. It is written for people living with HIV, advisers, policy and lawmakers, people in the criminal justice system, and journalists.

George House Trust's policy expert Chris Morley helped with the production of the book by commenting and making suggestions on some of the chapters.

Here's the book's contents which available to read in full here

• Preface By The Hon. Michael Kirby AC CMG and Edwin Cameron, Justice of the Constitutional Court of South Africa
• Introduction - How this resource addresses the criminalisation of HIV exposure and transmission
• Fundamentals - An overview of the global HIV pandemic, and the role of human rights and the law in the international response to HIV
• Laws - A history of the criminalisation of HIV exposure and transmission, and a brief explanation of the kinds of laws used to do this
• Harm - Considers the actual and perceived impact of HIV on wellbeing, how these inform legislation and the legal construction of HIV-related harm
• Responsibility - Looks at two areas of responsiblity for HIV prevention: responsibility for HIV-related sexual risk-taking and responsibility to disclose a known HIV-positive status to a sexual partner
• Risk - An examination of prosecuted behaviours, using scientific evidence to determine actual risk, and how this evidence has been applied in jurisdictions worldwide
• Proof - Foreseeability, intent, causality and consent are key elements in establishing criminal culpability. The challenges and practice in proving these in HIV exposure and transmission cases
• Impact - An assessment of the impact of criminalisation and HIV – on individuals, communities, countries and the course of the global HIV epidemic
• Details: international resource and individual country data - a summary of laws, prosecutions and responses to criminalisation of HIV exposure or transmission internationally, and key sources of more information.

Ordering paper copies of the book

If you want to buy a paper copy when this appears in the autumn please email NAM

Laws Should Not Worsen HIV

posted: 02/07/2010

The ‘Vienna Declaration’  sounds like a half-forgotten piece of school history, but it is brand new and all about ending laws and policy across the world that cause HIV harm. The UN has at the same time set up a brand new Global Commission on HIV and the Law  to deal with some of the toughest issues in HIV. Laws and policies across the world are making the HIV epidemic worse and causing harm to many people. Anti-gay, anti-sex-worker, anti-drug, anti-HIV sex and transmission laws and policies are all the UN Commission’s new battle-ground.
 

If you agree that the law should not criminalise drug users because this makes the HIV epidemic far worse and causes more harm than good, you are invited to sign the Vienna Declaration. The Vienna Declaration is a call from the international scientific community to countries across the world (including the UK) to face the facts and recognise that the so-called 'War on Drugs' isn't working, and causes far more harm than good, particularly in the fight against HIV.

It asks the UN and countries to update drug policy and laws to end this HIV harm, discrimination against people's human rights, and to remove the legal and other barriers to effective HIV prevention, treatment and care.
You can read and sign the Vienna Declaration here  and facebook and twitter it from there
 

Why is the Declaration from Vienna? Well, the International AIDS Conference opens in Vienna in Austria later this month.

This conference is the largest HIV conference, and is held every two years, and is the one where big HIV news on treatments and almost everything else is revealed. 

New - Global Commission on HIV and the Law
The Global Commission on HIV and the Law was set up last month – the secretary general of the UN said “I urge all countries to remove punitive laws, policies and practices that hamper the AIDS response … . Successful AIDS responses do not punish people; they protect them … . We must ensure that AIDS responses are based on evidence, not ideology, and reach those most in need and most affected.”

The Commission has a challenging job – its job is to produce practical steps, based on evidence and that support human rights, that will reduce HIV transmission caused by laws and policies. So it will focus its efforts on ending laws that criminalise HIV transmission and exposure, illicit drug use, sex work, and same sex relationships. Global Commission on HIV and the Law
 

HIV and the Law is part of the Law on Trial  season at Birkbeck College this weekend, and Matthew Weait, a long-time ally of George House Trust and who works at Birkbeck as a senior law lecturer, writes about how the law should not worsen HIV discrimination and stigma, and if laws do this they do not deserve our support.

Gay HIV Prosecution Dropped

posted: 20/05/2010

More than 15 months after complaints were first made to the police, a Doncaster (South Yorkshire) gay man had the two cases of reckless HIV transmission against him dropped as his trial began. He was charged with reckless Grievous Bodily Harm for allegedly transmitting HIV to two men.
 

Another fine mess by police and prosecutors

The case was dropped due to lack of evidence – the police had failed to investigate the previous sexual partners of the two men who went to the police. Any of those previous partners could have had HIV and infected the two men, instead of the accused.

And the Crown Prosecution Service again ignored their own policy and procedures in approving the prosecution, despite failing to rule out all the previous partners of the complainants.

The two men who complained to the police both believed that they had been infected by the accused during separate dates. To prove the defendant was the cause (source) of the two men’s HIV infections, the prosecution must prove beyond reasonable doubt that only the accused could have infected them.

No phylogenetic analysis

Edwin J Bernard, who runs the excellent Criminal HIV Transmission blog has spoken with the man’s expert HIV defence lawyer, Khurram Arif. The trial was meant to begin on Tuesday at Doncaster Crown Court. The defence lawyer had prepared a scientific report examining the likelihood that only the accused could have infected both complainants. The report highlighted that the complainants' previous sexual partners may also have infected them and that phylogenetic analysis could not rule this out.

In court on the first day, the prosecution consulted with its own scientific expert and conceded that since both complainants had previous sexual partners and the police did not investigate nor eliminate them as possible sources of infection, there was no case to answer. This is what the CPS guidelines clearly tell them to do before prosecutions are authorised. The Crown Prosecution Service has ignored a key part of its policy once again. 

The same thing happened to the man prosecuted in 2008 in Manchester, and in several other cases elsewhere. 

HIV Legal Experts Successes
This is one of several cases defended by Mr Arif, where the Crown Prosecution Service ignored expert guidance and witnesses. The CPS embarrasses itself by dropping HIV cases very late in the day. As Mr Arif told Edwin: "The prosecution, when making such allegations, have to prove that they have closed all the doors to the possible sources of infection. Again, in this case, they did not."

The case highlights that in England & Wales, people accused of such 'crimes' should never plead guilty and should immediately contact an HIV organisation for advice in order to be put in touch with an expert defence lawyer, such as Mr Arif, who advises and represents his legal aid customers through Christian Khan Solicitors and any paying private customers through GSC Solicitors.

Complainants' sexual histories are investigated in detail
People thinking of going to the police with a HIV infection complaint need to realise there is only a very small chance that any complaint will result in a conviction. In the investigation process their own sexual history will have to be investigated in detail since their last negative HIV test. All those previous sexual partners must be traced and all of them ruled out as a source for the HIV. If the complainant has never had a HIV test before, that means investigating every partner since they became sexually active. Only then might a prosecution succeed.
 

Source Criminal HIV Transmission blog