20th International AIDS Conference, Melbourne, July 2014 Doing HIV Justice: How Clinicians and Advocates Can Work Together to Ensure Up-To-Date Scientific.

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20th International AIDS Conference, Melbourne, July 2014 Doing HIV Justice: How Clinicians and Advocates Can Work Together to Ensure Up-To-Date Scientific and Medical Evidence Informs the Application of Criminal Law to Cases of HIV Exposure or Transmission Introduction and global overview Edwin J Bernard Co-ordinator, HIV Justice Network

20th International AIDS Conference, Melbourne, July 2014 P 20, HIV AND THE LAW: RIGHTS, RISKS & HEALTH, JULY

20th International AIDS Conference, Melbourne, July 2014 Where we know HIV non-disclosure, potential exposure / transmission is a crime

20th International AIDS Conference, Melbourne, July 2014 Global law enforcement hotspots

20th International AIDS Conference, Melbourne, July 2014

Why we are concerned? Human rights, justice and public health Prosecutions for acts that represent no risk, or insignificant risk, of HIV transmission Prosecutions against individuals who use condoms, have low viral load or use or other prevention strategies Excessive penalties for people found guilty Failure to apply standard requirements for criminal liability to people charged (intent, causation and proof) Selective prosecution of people from marginalised communities Media coverage that fuels public misunderstanding about HIV and increases HIV-related stigma

20th International AIDS Conference, Melbourne, July Only the people most responsible for “spreading HIV” are arrested and prosecuted. 2. If you have sex just once with someone who has HIV you are incredibly lucky if you aren't infected. 3. Having unprotected sex with someone with HIV is like playing Russian Roulette. 4. People with HIV are potential lethal weapons. 5. HIV = AIDS = death sentence. Top 10 ‘HIV Criminalisation’ Myths

20th International AIDS Conference, Melbourne, July It is the easiest thing in the world to tell someone you have HIV and people with HIV who don't tell their sexual partner(s) they have the virus are selfish, evil monsters. 7. Scientific tests can easily tell who infected whom 8. Scientific tests can easily tell when someone was infected. 9. The criminal law can protect you from HIV. 10. Police care about public health and healthcare workers are agents of law enforcement. Top 10 ‘HIV Criminalisation’ Myths

20th International AIDS Conference, Melbourne, July 2014 UNAIDS guidance note Restrict the use, if any, of criminal law in the context of addressing HIV. Where it is used, criminal justice principles should be upheld. Best scientific evidence should guide any use of criminal law. Criminal law should not undermine public health efforts Treat like harms alike, with proportionate penalties Condoms or low viral load = no significant risk; use shows no intent to harm Non-disclosure alone is not proof of malicious intent Limitations of phylogenetic analysis / RITA

20th International AIDS Conference, Melbourne, July 2014 Encouraging policy developments (1) Netherlands: ‘Detention or Prevention’ (2004) led to very limited role of criminal law via Supreme Court rulings on HIV risk (2005-7) England & Wales: Prosecutorial guidance (2008) and police guidance (2010) developed, informed by science, to limit overbroad application of law. Denmark: Government acknowledges reduced HIV risk/harm, suspends HIV-specific law (2011); currently undecided on new or no law. Switzerland: ‘Swiss statement’ on viral load/risk leads to acquittal in Geneva (2008). Law on Epidemics revised in 2012 so only intentional communicable disease transmission a crime (2016)

20th International AIDS Conference, Melbourne, July 2014 Encouraging policy developments (2) Scotland: Prosecutorial guidelines highlights HIV risk reduction ART (2012) Sweden: ‘Swedish statement’ on sexual HIV risks (2013) impacted two cases resulting in major policy shift, Government review pending. United States: Iowa became the first US state to ‘modernise’ its draconian HIV-specific criminal law in May 2014 based on scientific, legal and public health principles. Iowa Supreme Court recognises science. Canada: Criminal law and public health workshop (2013); Practical guide for HIV nurses (2013); ‘Canadian consensus statement’ on HIV sexual risks (2014)

20th International AIDS Conference, Melbourne, July 2014 Where clinicians/nurses/scientists can impact HIV criminalisation