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.

‘Health Tourism’ Mischief

posted: 08/06/2010

Sunday Times deputy editor Isabel Oakeshott has written an ignorant and mischief-making scare story about people from abroad using NHS money. People with HIV were included among those the NHS ‘counter-fraud unit’ listed as responsible.
 

The story calls it health tourism. The Department of Health has published no evidence that people with HIV come here as tourists deliberately to get HIV treatment. The only evidence there is (a snapshot survey by George House Trust and Terrence Higgins Trust) shows people do not know they have HIV when they travel here (to seek asylum, to start a university course, or to work, or visit family …. ).
 

Legal rights ignored
Most people from abroad who do have HIV treatment have every legal right to this. The few who are chargeable under the legal rules usually only find out they have HIV months or years after arrival, and their HIV diagnosis is always a big shock.

The NHS charging rules worsen public health in the UK by discouraging people from taking (always free) HIV tests. Untested and untreated people with HIV are likely to be much more infectious and lead to more HIV infections in the UK. Testing and HIV treatment can make people with HIV almost uninfectious, and that can save the NHS a lot more money than not treating everyone who needs this. HIV is the only sexually transmitted infection that can be left untreated because of these charging rules.
 

The Times report says that in eight-months last year, hospitals reported £24m in “bad debts”, 'most linked to patients from abroad'. The article suggests hospitals recover some of the cash later, but not much. The report says ‘According to the NHS’s counter-fraud unit, health tourism has a particularly heavy impact on maternity services, HIV care and cancer and heart units’.
 

Wrong about pregnant women, cancer, serious heart disease, HIV rights
The newspaper report is mischievous and malicious. The law and official guidance to NHS hospitals tells hospitals they must provide ‘immediately necessary’ or ‘urgent’ treatment.

Who would or could refuse a pregnant woman emergency care, or someone with life-threatening heart conditions, cancer, HIV?
 

Accident and Emergency – wrong again
It claims, without quoting any evidence, that “thousands of foreigners have been diagnosed in their own countries who cannot afford treatment there simply turn up at accident and emergency units in British hospitals and demand to be seen”.

Again this completely ignores the law and official NHS guidance – anyone needing accident and emergency care is always entitled to it without any charge. We get and would expect this if we are abroad and need emergency care.
“6.7 Some NHS services provided in NHS trusts are free to everyone regardless of the status of the patient. This Regulation says what these services are. The current list includes: a. treatment given in an accident and emergency department or casualty department......”
 

Doctors opposed
It correctly reports that most doctors dislike the charging system because medical ethics and the Hippocratic oath mean it is unethical to turn away patients who need urgent medical help.
 

Blame the Irish and Welsh – wrong
It also falsely blames people from the Irish Republic. Irish Citizens have always had the right to come and go freely and live here and use UK services. Brits can do the same in Ireland.

It seeks to create divisions within the UK by blaming people living in Wales for using NHS services in England, although the Welsh pay UK taxes just like everyone else. The Welsh are not foreign or migrants.
 

The Department of Health is already reviewing its policy on foreign patients.
 

Times article

Malawi, HIV and Jailing Gay Men

posted: 24/05/2010

UPDATED 2 June - see at end

The Stop AIDS Campaign says that it is with grave dismay that they learnt of the imprisonment of Steven Monjeza and Tiwonge Chimbalanga (the Malawian gay couple jailed for 14 years with hard labour). They join with numerous southern African organisations in condemning the decision and the impact it will have on the individuals and the principle of universal human rights.

The denial of human rights of all kinds has a very negative effect on the response to HIV. Men who have sex with men are at risk of HIV transmission in all regions of the world, including Africa. The more marginalised they become, the higher the risk, and this decision – which runs contrary to stated government policy on HIV and the rights enshrined in the constitution of Malawi – will drive them further away from the information and services essential to an effective HIV response. Stigma and discrimination have potent consequences – countless thousands have died from HIV as a result of silence and fear.
 

A commitment to human rights is essential to securing equitable and fair development. It must be an intrinsic part of the effort to end the spread of HIV. The eyes of the world are now on the government of Malawi. We have written to the Malawi high commission calling on them to demonstrate its government's commitment to universal human rights and an effective, inclusive Aids response by releasing the men and moving to repeal laws which deny human rights. We also call on them to take action to combat homophobia in Malawi and to lead an honest and open dialogue on the impact of discrimination against key populations, such as men who have sex with men, drug users and sex workers, on the African Aids response.
 

Alan Smith
Chair, Stop Aids Campaign
 

Source - letter to the Guardian 
 

Malawi already knows what to do

It was just over one year ago that the Malawian president's secretary for nutrition and HIV told Malawi's HIV conference that a key need is to follow a human rights approach to HIV that includes gay men. 

Recognizing the rights of Malawi's gay population is essential if the spread of HIV is to be checked, the president's secretary for nutrition and HIV said. "There is a need to incorporate a human rights approach in the delivery of HIV and AIDS services to such risk groups like men who have sexual intercourse with men," Mary Shawa said at the opening of a two-day AIDS conference in Lilongwe.

1 in 4 gay Malawian men have HIV

While prevention campaigns are credited with lowering Malawi's overall HIV prevalence from 14% to 12%, the Center for the Development of People, which serves the gay community, estimates that 25% of Malawi's gay men are HIV-positive.

2 June UPDATE

Malawi Pardons Couple

Although the Malawian President has pardoned the gay couple who were jailed for the 14 years maximum with hard labour, they have now been separated and forced to live apart. And the human rights and HIV prevention problems for men who have sex with men in Malawi remain unaffected by the President’s decision.
 

A gay couple sentenced to serve 14 years in jail in Malawi were pardoned after their country's president met Ban Ki-moon, the UN secretary general. Steven Monjeza, 26, and Tiwonge Chimbalanga, 20, were tried and found guilty of sodomy and indecency earlier this month in a move that sparked international condemnation.
 

But after talking with Ban, Malawi's president, Bingu wa Mutharika, announced the pair would be freed.
"These boys committed a crime against our culture, our religion and our laws," he said after the meeting, at State House. "However, as the head of state, I hereby pardon them and therefore ask for their immediate release with no conditions. I have done this on humanitarian grounds, but this does not mean that I support this." He added: "We don't condone marriages of this nature. It's unheard of in Malawi and it's illegal."
 

Ban praised the decision, but said: "It is unfortunate that laws criminalise people based on sexuality. Laws that criminalise sexuality should be repealed."
 

He is due to address Malawi's national assembly later and is expected to ask legislators to look at this.
Joseph Amon from Human Rights Watch said the president was responding to the international outcry following the couple's conviction and sentence.
 

"I hope that other leaders of African countries with anti-gay laws see that this is just not acceptable in the international community," he said.
 

Source
 

Action Against HIV Hate

posted: 21/05/2010

People with HIV now have the same protection as other victims of disability hate crime. The Crown Prosecution Service has updated its official guidance on disability hate crime, and has now added HIV. This official guidance is used by prosecutors and police.
 

Disability hate crime means anything from HIV abuse in the street, to a burglary where someone spray paints HIV abuse on your kitchen wall. Any crime where HIV hate plays some part is a HIV hate crime. Sentences are then increased for the HIV-hate part of the main crime – which is the one that's prosecuted : insulting behaviour, harassment, burglary etc.
 

Unprotected?
Until HIV was added to this official guidance, it was unclear whether the legal definition of disability used for hate crime cases included everyone with HIV. It looked like many people with HIV were unprotected from disability hate crime.

There seemed to be a loophole in disability protection for people with HIV. When disability hate crime was made illegal, this was at a time when some people with HIV were not treated by the law as ‘disabled’ and therefore had no legal protection. Later disability law was extended to cover everyone with HIV from the moment of diagnosis. But the CPS guidance ignored this law change.
 

Evidence for change
George House Trust and other HIV organisations champion the fair treatment and protection of all people with HIV and NAT has led the national campaign since 2008. Working with the Equality and Human Rights Commission, NAT told the CPS that their disability hate crime guidance excluded people living with HIV and provided the evidence to back it up.

A serious case of assault in Manchester, where the HIV hate was ignored in the sentencing by the court was one example of the problems.
 

The reality of HIV stigma means it is vitally important that people living with HIV receive the same protection as other disabled people. The CPS revised their guidance, making it clear that people living with HIV are included within the definition of disability.
 

Deborah Jack, Chief Executive of NAT, commented: “The publication of this revised guidance brings to an end the legal disadvantage faced by people living with HIV who are victims of hate crime. By issuing this statement, the CPS has sent out a clear message that HIV-related hate crime will not be tolerated.”
 

Nadine Tilbury, Senior Legal Advisor for the CPS, said: “The assistance of the NAT in providing data and expertise during our review of our legal guidelines on prosecuting cases of disability hate crime was invaluable. We welcome all such help from organisations and individuals and, where it makes a clear case for change or clarification, we will act on it. Crimes against people living with HIV which are motivated by hostility towards their status have no place in our society and we will prosecute those responsible robustly and, where there is sufficient evidence to do so, we will apply to the court for more severe sentences.”

What the change means
If a person is a victim of crime because of their HIV status, this can now be considered an aggravating factor by the courts, leading to enhanced sentences for the perpetrators of such crimes.

NAT will now be working with organisations that support people living with HIV to ensure they are aware of this recent development and can support people living with HIV that are victims of hate crime.
 

People living in NW England are encouraged to contact our services team for advice and support.

Clinics Guide to Law and HIV

posted: 23/04/2010

Have your say about the draft guidance for HIV clinics from BHIVA / BASHH about HIV transmission, the law and the work of the clinical team, 2010. The deadline for your comments is Friday 21 May 2010.

There have been prosecutions for reckless transmission of HIV in the UK since 2001 (Scotland) and 2003 (England & Wales). The prospect of prosecutions raises complex questions among medical practitioners about their ethical and legal responsibilities related to HIV transmission, particularly around disclosure of information on HIV status.
 

Although established generic ethical and professional principles continue to apply, certain features of the HIV epidemic have required special consideration.
 

An underlying principle in the provision of clinical care for people with HIV is the need for a secure and confidential environment in which extremely sensitive matters can be frankly and fully discussed. The importance of ensuring that full trust is maintained by people with HIV in their clinical services is fundamental, not only for the health of people living with HIV but also for people who may wish to seek information or testing and thus for the wider public health.
 

This guidance document sets out these responsibilities, and how these relate to the roles and responsibilities of health care professionals when caring for individuals infected with HIV.
 

Roles and responsibilities of Health Care Professionals

• Health care professionals have a central role to advise and support patients and to maintain confidentiality according to professional guidance and the law.
• For HIV positive individuals, advice must include the routes of HIV transmission, how to prevent transmission, with information about safer sexual practices and the use of condoms.
• Discussion of sexual health needs must take place regularly according to relevant BASHH guidelines to enable the giving of appropriate advice.
• There is individual and public interest in maintaining confidentiality; this may be outweighed in order to prevent serious harm to others.
• It is important when considering breaching confidentiality to weigh up all potential harms as there may be situations where disclosure of HIV status to protect a sexual partner results in considerable harm to an individual e.g. domestic violence.
• In situations where a health care professional believes that an HIV positive individual continues to put close contacts at risk their duties and subsequent action depend upon the type of contact (see figure one).
• No information should be released to the police unless there is verified consent from the patient or there is a court order in place.
• It is up to an individual patient to make a decision about complaining to the police and health care workers should remain impartial during discussions with patients.
• Those involved (complainant and defendant) in cases of reckless transmission are likely to need specialist legal advice and support and referral to THT direct would be appropriate.
• Sources of further information are listed in appendix two.

Vulnerable Groups

There are special considerations with regards cases of alleged reckless transmission in those under 18, or anyone with learning difficulties, discussed in section 5.
 

You can download the document and then submit any comments using this online form. 
 

Please make your comments here by Friday 21 May