The New AIDS Denialism How criminal courts' dismissal of modern science perpetuates HIV stigma, discrimination and criminalisation

Conflict of interest None

What is HIV criminalisation? Prosecution for: Not disclosing HIV+ status before sex Perceived exposure Transmission Acknowledge intersectionalities

We know people living with HIV are used to having their bodies policed travel apply for residence mandatory testing related to employment access health care health insurance or life insurance                                                                                                              

HIV-specific laws 100 jurisdictions in 73 countries From October 2015 to June 2018 Two new HIV-specific criminal laws were enacted (Bahrain & El Salvador) and two were proposed (Chile and Nepal) Nine applied their HIV-specific criminal laws for the first time: Honduras, Kenya, Kazakhstan, Kyrgyzstan, Nigeria, Paraguay, Somalia, Tajikistan and Uzbekistan

Issues associated with HIV-specific laws Stigmatising Often don’t reflect current science Intention/risk may be irrelevant, e.g. obligation to disclose Often ‘misnamed’, implying intent Usually attribute ‘intent’ when there is none ……. an intention to have sex is not the same as an intention/ desire to transmit HIV

Use of non-HIV specific laws Many countries use more general criminal laws From October 2015 to June 2018 Nine jurisdictions applied general criminal laws for the first time: Chile, Iceland, Ireland, Israel, Malawi, Nigeria (Zamfara state), Suriname and United Kingdom (Northern Ireland) Consequences can be harsher, including longer sentences and sex offender registration

At least 115 jurisdictions in 76 countries

The majority of reported cases: October ‘15 – June’18 US (143) - Florida (26), Ohio (18) and Tennessee (18) Belarus (128) Russia (126) Ukraine (29) Canada (22) Zimbabwe (15) Highest per capita: Belarus (8.5 per 1000) Czech Republic (3.3 per 1000)

What else does the data show? Demographics don’t reflect the epidemic Marginalised populations are over-represented … those already under scrutiny Issue of mass arrests What data doesn’t show How prosecutions perpetuates stigma through media coverage Large number of cases initiated by ex-partners

“As long as there are laws to prosecute people who deliberately infect others”

Prosecutions Worldwide … Old News Most cases involve an HIV positive person having sex without disclosing their HIV status and some involve spitting or biting. Many cases involve: Possible or perceived exposure only (no transmission) No or negligible risk, e.g. spitting, undetectable viral load or condom used during sex

Recent cases Incarceration and sex offender registration for consensual sex with lvl Denial of an appeal against a 30-year sentence for consensual sex with a condom & lvl

What are people prosecuted for? Interim Results - Interim Results - Interim Results - Interim Results N = 193 104 Vaginal Sex 43 Anal Sex 9 Oral Sex 16 Biting 17 Spitting 4 Other – Scratching, Bleeding, Urine

Low viral load (treatment not mentioned) Interim Results - Interim Results - Interim Results - Interim Results N = 193 4 Condom used 16 On treatment 6 Low viral load (treatment not mentioned) 8 (9) Oral Sex Biting 16 (17) Spitting Other – Scratching, Bleeding, Urine

Consequences Interim Results - Interim Results - Interim Results - Interim Results More than half jailed – up to 30 years People held without bail – then found not guilty Possibly 2 or 3 during that period involved intention to transmit … although press and courts frequently referred to ‘intention’ in other cases Intention to have sex is not the same as intention to transmit HIV

Expert Consensus Statement on the Science of HIV in the Context of Criminal Law Global panel of leading scientists support of IAPAC, IAS and UNAIDS consultation with HIV JUSTICE WORLDWIDE Aimed at expert witnesses, but helpful for police, prosecutors, lawyers, judges, lawmakers & advocates Available Wednesday 25 July at 3.15pm (JIAS)

HIV-related prosecutions reinforce a narrative of incredulity that a person didn’t disclose their HIV status before sex subvert public health strategy undermine the human rights of people living with HIV, particularly those already marginalised or criminalised

Science won’t fix HIV criminalisation but it will reduce prosecutions Science won’t fix HIV criminalisation but it will reduce prosecutions * We must ensure those not on treatment are not further marginalised

You are the litmus test.