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HIV prison laws inflame stigma, offer no protection

Media Release
11 May 2020

Proposed laws to forcibly test prisoners for HIV have no basis in science, perpetuate stigma, and should be referred to a parliamentary committee, according to the WA AIDS Council and National Association for People with HIV Australia.

Under laws set to be introduced to the WA Parliament on Tuesday, a prisoner who assaults a prison officer will be immediately tested for HIV. The laws overlook the following critical facts:

  • HIV is not transmitted through saliva, a key myth perpetuated to justify this and similar legislation.
  • In the unlikely event a prison officer was exposed to HIV, they should take post-exposure prophylaxis, a medicine which can prevent transmission within 72 hours of exposure.
  • The Government’s press release falsely claims prison officers who have been assaulted have to wait three months before they themselves can be tested for HIV. This is false. Modern HIV tests detect exposure within six days.
  • Falsely equating HIV with criminality inflames stigma and discourages people from seeking tests for HIV.
  • A vaccine exists for hepatitis B and there is a cure for hepatitis C.

WAAC President, Asanka Gunasekera said:

“HIV thrives on stigma and misinformation. These laws inflame that problem and hinder our prevention efforts. Marginalised communities such as gay and bisexual men, people who inject drugs, and sex workers will be less likely to seek a test for HIV when they see it associated with criminality.

“Part of the case for these laws rests on the discomfort prison officers face when they are spat upon. However, HIV is not transmitted through saliva, destroying one of the key arguments for introducing this legislation.

“The Government has also argued a prison officer may face an anxious three month wait to know if they have contracted HIV. The truth is that modern tests pick up the presence of HIV within six days of exposure. Rapid tests provide highly accurate results within fifteen minutes.

NAPWHA President Scott Harlum said:

“Frontline workers including prison officers need to know they’re being sold a lie and offered nothing but dangerous false reassurance by these proposed laws and any government promoting them.

“There is no mystery in how best to respond to a genuine potential exposure to HIV, such as a needlestick injury, and that does not include any time wasted or misdirected attention on anybody but the person potentially exposed.

“In cases where someone faces genuine potential exposure to HIV, such as a needlestick injury, post-exposure prophylaxis medicine is highly effective at preventing HIV transmission if taken as soon as possible and within 72 hours. Additionally, all frontline workers should be protected against hepatitis B through vaccination.

“These laws fail to solve any problem, and only hinder the HIV prevention effort. Likewise, there is no evidence mandatory testing of prisoners will do anything other than further marginalise those living with HIV and other blood borne viruses. Amplifying anxiety and misplaced fear around HIV is simply the wrong thing to do.”

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Anxiety about HIV criminalisation among people living with HIV in Australia

Data from HIV Futures – a national periodic survey of health and wellbeing of people living with HIV conducted by the Australian Research Centre in Sex, Health and Society of La Trobe University was used to examine the relationship between criminal laws and quality of life for people living with HIV. The paper concluded that laws criminalising the transmission of HIV have a negative impact on the health and wellbeing of people living with HIV in Australia.

“HIV Futures involves over 800 people living with HIV across Australia focusing on a range of issues related to health and wellbeing,” explains co-author Dr Jennifer Power, elaborating that in this paper we [the co-authors] found an association between greater levels of worry about HIV criminalisation and poorer mental health.

HIV activist, lawyer, and paper co-author Paul Kidd continues, “In the study, we found that people who reported higher levels of anxiety about criminalisation also reported lower levels of resilience and a greater sense of vulnerability to HIV-related stigma”.

Although the vast majority of people with HIV understand and comply with laws about disclosure and taking reasonable precautions, a third of HIV Futures respondents said they were worried about disclosing their status to partners due to the risk of criminalisation. Almost a quarter of respondents were concerned about disclosure to service providers for the same reason.

“That suggests a level of fear and anxiety about unjust prosecution and profound negative impacts. Importantly, anxiety about criminalisation was higher among groups that are already marginalised, including people from culturally and linguistically diverse communities and those experiencing financial hardship.”

NAPWHA co-author, Dr John Rule continues, “We’ve always understood that criminalisation of HIV and recourse to the legal system leads to problematic outcomes that are not based in known, successful public health approaches.”

There are a number of things we can do to respond to these findings. Improving awareness of the criminal law among people with HIV and ensuring people are aware of the requirements in their Australian State or Territory could help allay concerns. Improving peer support, especially for people newly diagnosed or those from more marginalised communities is equally as important. But ultimately, fears and anxieties about HIV criminalisation will only be eliminated when we end the criminalisation of un-intentional transmission and exposure. That needs to be the end goal.

Dr Jennifer Power, the leader of the study reminds us, “It is important that we use findings from studies such as HIV Futures to reflect on the ways existing policy and service delivery affects the 30,000 Australians who are living with HIV. The paper on criminalisation demonstrates that research can be used to point towards policy changes and responses.”

Currently the HIV Futures 10 Survey is open until March 2022.
Participants can enroll and respond to a series of questions about their health and quality of life.

Further viewing: Paul Kidd — HIV and the Law

Presentation Synopsis

In this address at the Art of Art in May 2018, Paul Kidd explores: What is the role of the criminal law in relation to HIV medicine? Medical practitioners and other health care workers provide testing, diagnosis, counsel and care – but the use of the criminal law to prosecute people with HIV means health professionals may also find themselves entangled in a criminal investigation. What should we tell patients about their rights and responsibilities when it comes to HIV transmission or exposure? Taking medical and legal notions of consent as its starting point, this presentation will explore the complex and problematic impacts of HIV criminalisation on medical practice and the lives of people living with HIV, discuss the unrealised potential for the criminal law to be a healing process, and provide some guidance for practitioners who need to balance their roles as health providers with the legalities of HIV transmission and exposure.

Biography

Paul Kidd is an activist, writer and commentator with a particular interest in LGBTI law reform and legal issues affecting people living with blood-borne viruses. He was the founding chair of the Victorian HIV Legal Working Group, is a past President of Living Positive Victoria, has served on the boards of the Victorian AIDS Council, Hepatitis Victoria and the Equality Project, and is a member of the Victorian Government LGBTI Justice Working Group. He holds an honours degree in law from La Trobe Law School.

Further viewing: Aaron Cogle — HIV Criminalisation

Video:  In this address at the 2021 Virtual Australasian HIV&AIDS Conference, Aaron Cogle (NAPWHA CEO) presents on HIV criminalisation in a symposia entitled ‘Regulating Sex.’ 

Further viewing: Guide to the Legal issues within Victoria (by Living Positive Victoria)

Video:  Watch the video recording of the Living Positive Victoria online launch in August 2021 of a guide to disclosing your HIV status, featuring inspiring and compelling stories of disclosure from members of their community.

Highlights from AIDS2022

Montréal, Canada and virtually  |  29 July — 2 August

The 24th International AIDS Conference #AIDS2022 was held in Montreal, Canada, and virtually. Convened by IAS – the International AIDS Society, the annual event unites scientists, policy makers and activists to galvanize the scientific response, build global solidarity and enhance human dignity for all those living with and affected by HIV. NAPWHA has compiled a selective list of program highlights that may be of interest for our communities below. Also access NAM aidsmap: The official scientific media partner for the conference.

U=U Global Summit

Professor Sharon Lewin address as she takes the reins as President of the IAS

Except:  I look forward to IAS 2023, the 12th IAS Conference on HIV Science, taking place next year in Australia. I had the honour of serving as Local Co-Chair at AIDS 2014 in Melbourne, a memory cast in shadow by the 280 lives that were lost on flight MH17; many were IAS Members, including former IAS President Joep Lange.

It felt impossible to hold a productive meeting after such a tragedy, just as the challenges of today can feel insurmountable. But the secret of success of the HIV movement has always been how we come together – diverse communities, diverse disciplines, from all corners of the world.

Together, harnessing the strength, passion and talent of this movement, we will end this epidemic once and for all.”

HIV Cure Research: Rapportage by Jillian Lau

At AIDS2022, Infectious Diseases doctor, Jillian Lau, who has been involved in HIV cure clinical research at Alfred Health (Monash University) based in Melbourne, and completing a PhD in this field, reported back about HIV cure research being presented through the @HIVCureAU Twitter handle.

HIV Criminalisation and HIV Law: Rapportage by Paul Kidd

At AIDS2022, research and action on HIV criminalisation and HIV law were well represented, summarised in this twitter thread by @PaulKidd.

The Silver Zone: a Networking Zone for Older Adults Living with HIV

Globally, the face of HIV is an ageing one. Although in supportive systems people are living longer with access to effective treatments, many older adults living with HIV and HIV Long-Term Survivors are coping with the lasting impact of untreated HIV, age-related comorbidities and loss. In the era of COVID-19 and “working to end the HIV epidemic”, many feel isolated and uncertain about the future.

The Silver Zone in the AIDS2022 Global Village is a place for older people living with HIV to re-engage with the HIV community and follow the science on HIV and ageing; to feel included and celebrated.

Bi+ People Living with HIV: Positive Networking Zone

Women’s Networking Zone

Breast/chestfeeding guidance and advocacy

PozQoL (Quality of life among people with HIV) and AusQoL (the Australian Accord)

Panel discussion on Person-centered Care

‘Key Populations’

Long-acting ARV Treatment

Video:  What’s new in long-acting formulations of HIV medications for prevention and treatment? CATIE (Canada’s source for HIV and Hepatitis C information) spoke to Professor Chloe Orkin at Queen Mary University of London at this year’s International AIDS Conference who covers the new data on long-acting treatment, and their thoughts on the drug pipeline and on equity of access.

Could long-acting injectable cabotegravir and rilpivirine be self-administered? New formulations and alternative injection sites might allow administration of this long-acting treatment. Liz Highleyman reports back results from two studies which were presented to the 24th International AIDS Conference (AIDS 2022), which was held in Montreal, Canada.

HIV/AIDS in the Asia-Pacific