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924 new HIV cases reported in April 2018; 98% from unsafe sex

With up to 31 new HIV infections happening every day, the total number of Filipinos who tested HIV-positive reached 924 in April 2018. 96% of the newly diagnosed were male, and sexual contact remains the main mode of transmission (98%).

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Still in a bad situation.

With up to 31 new HIV infections happening every day, the total number of Filipinos who tested HIV-positive reached 924 in April 2018, the month covered by the most recent report released by the HIV/AIDS & ART Registry of the Philippines (HARP). Of that number, 179 (19%) already had clinical manifestations of advanced HIV infection (WHO clinical stage 3 or 4) at the time of diagnosis, meaning late diagnosis of their HIV status.

Broken according to sex, 96% (885) of the newly diagnosed were male, with the median age of the newly infected 28 years old (range: 2 – 70 years old). Half (50%, 462) were 25-34 years old and 30% (277) were 15-24 years old at the time of testing.

REGIONAL FOCUS

About one third (30%, 282) of the newly infected were from the National Capital Region (NCR). Region 4A (18%, 164 cases), Region 3 (13%, 117), Region 7 (8%, 71), Region 11 (5%, 50) and Region 6 (5%, 44) rounded off the top six regions with the most number of newly diagnosed cases for the month, together accounting for 79% of the total.

MODES OF TRANSMISSION

Sexual contact remains the main mode of transmission (98%, 905). Among this, eighty-six percent were among males who have sex with males (MSM).

Other mode of transmission were needle sharing among injecting drug users (1%, 13) and vertical transmission/mother-to-child transmission (<1%, 1).

There were five cases that had no data on mode of transmission. Among the newly diagnosed females for April, four were pregnant at the time of diagnosis.

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SPECIAL POPULATIONS

In April 2018, 277 (30%) cases were among youth 15-24 years old; 97% were male. Almost all (99%, 273) were infected through sexual contact (29 male-female sex, 168 male-male sex, 76 sex with both males and females) and two were infected through sharing of needles. Two cases had no data on mode of transmission.

There were 47 newly diagnosed adolescents 10-19 years old in April 2018. Almost all (98%) were infected through sexual contact (eight male-female sex, 31 male-male sex, seven had sex with both males and females) and one had no data on mode of transmission.

There was one newly diagnosed child less than 10 years old and was infected through mother-to-child transmission.

TRANSACTIONAL SEX

In April 2018, 11% (106) of the newly diagnosed engaged in transactional sex. Ninety-nine percent (105) were male and were 18 to 54 years old (median: 27 years). More than half of the males (59%, 62) reported paying for sex only, 29% (30) reported accepting payment for sex only and 12% (13) engaged in both. There was one newly diagnosed female who engaged in transactional sex aged 26 years old and was reported accepting payment only.

The first case of HIV infection in the Philippines was reported in 1984. Since then, there have been 54,332 confirmed HIV cases reported to the HARP.

AIDS-RELATED DEATHS

In April 2018, there were 66 deaths among people with HIV. All were male. Eleven (17%) were 15-24 years old, 27 (41%) cases were from 25-34 years old, 27 (41%) cases were from 35-49 years old age group and one (1%) case was aged 50 years or older. Almost all (98%) of the cases were reported to have acquired the infection through sexual contact (10 through male-female sex, 38 through male-male sex, and 17 through sex with both males and females); while there was one case that had no data on the mode of transmission.

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From the Editor

On beauty pageants and messed up priorities in dealing with HIV in Phl…

After encountering a young PLHIV who has to prostitute himself just to access ARVs, Michael David Tan finds it infuriating that the Department of Health saw it fit to allocate lots of money to HOLD A BEAUTY PAGEANT. For him, from the get-go, this approach needs to be closely looked at.

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Photo by Valentin Salja from Unsplash.com

I am chatting with a person whose HIV rapid test only recently showed he’s reactive. He was told by this satellite clinic in Mandaluyong City that he can actually proceed to get the meds; though only if:

  1. He pays his PhilHealth; and
  2. He pays for all his lab tests.

The problem is, this young person – who did not even finish schooling – is unemployed.

So he is chatting with me now to “manghiram ng P100 (borrow a hundred pesos) so I can go to a client who will give me P1,000; which I can then use to pay for my lab tests.”

Yes, he is resorting to selling himself. To access life-saving medicine that is supposedly – and ERRONEOUSLY claimed to be – “free”.

It is cases like this young person’s that make it infuriating that the Department of Health saw it fit to allocate lots of money to… HOLD A BEAUTY PAGEANT.

In a pageant-obsessed country like the Philippines, at least superficially, this seems like an “intelligent” move.

But from the get-go, this approach needs to be closely looked at.

  1. The pageant is supposed to create “HIV advocates”. BUT only those who fit specific qualifications can enter – e.g. age limit, height limit, vital stats requirement of participants (with the candidates even told to ‘model’ in swimwear as part of the screening process). So now – with this ‘move’ – what is being insinuated is that you need to be young and beautiful first before you can be an HIV ‘advocate’…
  2. We are supposed to dismantle this lookist society; to recognize people’s worth NOT based solely on how they look like. Pageants – by their very nature – promote the status quo (of lookism) by giving “positions of power” only to those who “fit” socially-constructed standards of beauty and attractiveness.
  3. The country has a lot of REAL advocates who do for free what should be DOH’s job – e.g. community-based HIV screeners who go from barangay to barangay without any payment. There are those doing community-based HIV screening (CBS) who are RUNNING OUT OF RAPID TEST KITS, so they are now unable to serve; unable to be advocates. Seriously now, if there’s money for a beauty pageant, surely there’s money that can be given to those already working on the ground, or even to buy life-saving paraphernalia used in battling HIV in the Philippines.
  4. One of the supporters of this beauty pageant told me that Pia Wurtzbach’s effort to bring the spotlight to HIV is a good example of the “relevance” of a beauty pageant like this, as it could “create another Pia”. In a marketing standpoint, this is not a well-thought response; mainly because if you wanted to “create” someone to be like Pia to promote HIV awareness in the Philippines, then… JUST HIRE PIA HERSELF!
    Besides, as a friend aptly said: You can’t just “create” a Pia. She “works” because she’s unique.
  5. If you need a crown, a title and the prize money before you start advocating for HIV-related issues in the Philippines, then you’e not really an “advocate” and what you’re doing is not “advocacy”.

PLASTIC CROWNS
There remain many life-threatening and urgent issues concerning HIV in the Philippines. And if you try bringing these issues up (e.g. to government people, or NGOs), you’d more likely be told “there’s no money”. But apparently there is. Just not for the urgent ones…
Photo by Pro Church Media from Unsplash.com

The fact is, numerous HIV-related issues continue to plague the country.

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We get 31 new cases every day now.

A growing number of those getting infected are getting younger and younger (e.g. in July, 28% were from the 15-24 age bracket).

The ARVs in treatment hubs are OLD – e.g. many have expired, and the Philippines still uses meds already discontinued in Western countries. Don’t get me started with the shortage that the DoH continues to deny is happening.

We still don’t have widely-distributed pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

Newly-diagnosed PLHIVs – like that young person at the start of this article – are still unable to pay for their baseline tests; and so they can’t proceed to the next steps, which is to start their ARV therapy.

There are treatment hubs that do not have viral load machines, so that PLHIVs do not know their VL years and years after they tested HIV-positive. And this is even if they have been paying the same PhilHealth amount that should give them that VL test.

There are accredited hubs that do not even offer CD4 test. This is accepted as “normal”, and again, this is even if the PLHIVs in these hubs still pay the same PhilHealth amount that should grant them the CD4 test.

There remains lack of updated knowledge even among existing service providers – e.g. try asking them about U=U, and you’re more likely to encounter internalized stigma and discrimination, largely because… this is not even openly discussed in the Philippines, including by DoH.

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There are no Filipino Sign Language interpreters who can assist Deaf Filipinos to get tested for HIV; and – if they test HIV-positive – access treatment, care and support.

I can go on and on and on…

But just try bringing these issues up (e.g. to government people, or NGOs) and you’d more likely be told “there’s no money”.

Well… apparently there is; just not for these…

As it is – and yes, I recognize this – I’ve already been repeatedly told that I’m too… negative.

I’m not sure I’m being “negative”; instead, I am being more “realistic”.

And the thing is, as long there are PLHIVs like that young person who has to prostitute himself just so he can pay to access life-saving meds and services, we all should be…

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POZ

Alternative PrEP forms needed for better uptake

Low uptake of daily oral PrEP since US Food and Drug Administration approval and low medication adherence among users have stimulated the investigation of other modalities for delivery, such as injectable PrEP and on-demand PrEP.

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Pre-exposure prophylaxis (PrEP) is widely accepted as an effective strategy to prevent HIV. However, low uptake of daily oral PrEP since US Food and Drug Administration approval and low medication adherence among users have stimulated the investigation of other modalities for delivery, such as injectable PrEP and on-demand PrEP.

A study – titled “Acceptability of Injectable and On-Demand Pre-Exposure Prophylaxis Among an Online Sample of Young Men Who Have Sex with Men in California”, written by Matthew R. Beymer, Jennifer L. Gildner, Ian W. Holloway and Raphael J. Landovitz – attempted to determine the demographic and behavioral predictors of willingness to try alternative PrEP delivery mechanisms among young men who have sex with men (YMSM) who stated that they were unwilling to try daily oral PrEP.

The study particularly recruited 265 YMSM in California through geosocial networking applications; and then analyzed a subsample who stated that they were either ambivalent about trying or unwilling to try daily oral PrEP. The researchers used chi-square and Fisher’s exact tests to determine characteristics associated with willingness to try injectable PrEP, willingness to try on-demand PrEP, and willingness to try either alternative form.

The study found that for individuals who stated that they would not be willing to try daily oral PrEP, ∼85% were willing to try on-demand and/or injectable PrEP. Individuals who reported some college or more reported greater willingness to try injectable PrEP (adjusted odds ratio [aOR]: 2.92; 95% confidence interval [CI]: 1.32–6.46), on-demand PrEP (aOR: 2.28; 95% CI: 1.06–4.90), or either method (aOR: 5.54; 95% CI: 1.78–17.22).

Confusion about PrEP still common, according to study

According to the researchers, “future research should determine how to enhance uptake of emerging forms of PrEP among the individuals most at risk for HIV.”

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It is worth noting that – while other countries are already discussing alternative PrEP forms – countries like the Philippines continue to have limited access to PrEP. With this, it remains a (sadly) very elitist approach to deal with HIV, with only those who have contacts to pilot project implementers able to access the same.

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From the Editor

3 Terms you need to know in HIV advocacy in the Philippines

HIV advocacy in the Philippines has evolved – and in many ways, devolved – to highlight erroneous practices. Here are at least three terms in use locally that highlight how BROKEN HIV advocacy is in the Philippines.

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Photo by Samantha Sophia from Unsplash.com

I was in Northern Mindanao when I first heard of a term used to refer to a service “provider” who – in a word (and there really is no going around this) – ALLEGEDLY “molested” masseurs who had to be tested for HIV as required by their line of work.

When interviewed, some of these masseurs alleged that a certain medical practitioner who – during testing – would “dulaan ang among itlog ug utin (fondle our testicles and our penises).” And then – as if to show them who’s the boss – “mu-ngisi pa jud siya, unya mu-schedule sa uban sa amo-a ug booking (this person would smirk at us, and would even schedule trysts with some of us).”

That was the first time I heard of a term that is apparently used to refer to people like this person: “advoKATI”, a play on “advocacy” and “makati (literally, itchy; and contextually, a slut)”, because they supposedly use advocacy as a cover for their itch/desire to pick up or sleep around.

Through the years, other terms being used related to HIV advocacy also came to my attention. And here are at least three of them; all of them highlighting how BROKEN HIV advocacy is in the Philippines.

***

1. advoKATI
n. Refers to a person who uses the advocacy as a front to get sexual partners.

The medical practitioner mentioned above is an example; though – by no means – is his case unique. Other examples include: giving (donated) vacc in exchange for sex with a PLHIV; providing after-testing services only to good-looking newly-diagnosed persons with HIV, while the not-so-good-looking are left to fend for themselves; and “counselors” using the confused state of mind of newly-diagnosed PLHIVs to sleep with them.

2. advoCASHy
n. Profiting from HIV advocacy; or people who profit from the same.

Let’s get this straight: Profiting from HIV is not exactly new; nor is this exclusive to the Philippines.

Globally – and perhaps even more apparent – is the profiteering done by pharma companies that produce the life-saving ARVs for PLHIVs. There is also the issue with accessing “good” drugs by developed countries (e.g. PrEP) versus “dumping” of those not already used by the developed countries in the poorer countries (e.g. phase out of Nevirapine and Efavirenz).

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Perhaps Peter Mugyenyi said it best when he tackled in “Genocide by Denial: How Profiteering from HIV/AIDS Killed Millions” the “incredible self-indulgence of the pharmaceutical companies and the cold-heartedness of the rich world that turned a blind eye until it was far too late, and then responded too slowly with too little.”

Now not just the big “bodies”, but even the other players in responding to HIV are mimicking this. And yes, this includes HIV “advocacy” in the Philippines, which is emulating this, too.

Here, we continue hearing that “there is no money in advocacy”, much more for those affected by HIV. This is supposedly why it’s difficult accessing existing treatment, care and support (TCS) – because, as always stressed – “there just isn’t enough money to go around”.

And then you hear about HIV “advocates” who can afford to buy numerous stuff (from a number of cars to a number of properties to luxury items to high-end gadgets to getting cosmetic surgery, and so on) from their “small” salary as NGO workers.

Or “advocates” who have drivers. WITH UNIFORM.

Or “advocates” who can tour the world using only their “meager” earnings from their “small” salary.

This is NOT to begrudge people their salaries.

BUT when you couple these with:

  • Inability of newly-diagnosed PLHIVs to go to treatment hubs because they don’t have money to pay for their fare.
  • Complaints from PLHIVs about inability to access to treatment because they can’t pay PhilHealth.
  • Non-access to other meds for opportunistic infections (or the need to beg the likes of DSWD or PCSO to fund these meds).

I am starting to sound like a “sirang plaka (broken record)”, repeatedly writing about issues I’ve already written about.

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BUT there’s this disconnect that is too painful to just ignore.

All because there are “advocates” who see HIV as a cash cow.

3. advoKATKAT
v. The use of HIV advocacy for social climbing. “Katkat” is a Bisayan word meaning “to climb”. This is often related to advoCASHy as it emphasizes only the glam in “helping” even sans the actual helping.

There are NGOs paying PR firms to promote HIV “advocacy”. Ask them how many people got tested because of the “campaigns”, and they’d tell you: Our indicator is the number of Facebook likes. “Likes” derived from the money paid to celebs, bars, photographers/videographers, alcohol consumed, et cetera. Partying in the guise of advocating.

There’s an “award” for people who “helped” HIV advocacy in the Philippines – even if grassroots HIV workers question the “winners” (e.g. who these people are, how they were chosen, what they’ve really done for the HIV community). What’s seemingly important is the hype created; particularly since celebs “joined” the “cause”. More photo ops mean more exposure means more (possible) funds.

There’s the funding of a photo campaign because the one disbursing the fund are “models” in the campaign, themselves.

There’s a well-funded beauty pageant even if we have (often denied) ARV shortage (not to mention hubs that still do not offer all tests included in the OHAT package, from CD4 count to viral load count).

As already noted in the past, there’s this focus on the glam/social climbing (e.g. get celebs to promote testing), perhaps forgetting that real advocacy goes beyond that.

Too much focus on the glitzy fibs, less emphasis on the grimy truth

And so here we are now, with 31 new HIV cases reported every month in the Philippines. Ten years ago, we only had one case EVERY DAY.

We are fucked. But we’re not only fucked because of lack of sex education, non-promotion of condom use, antiquated practices (e.g. we have yet to teach U=U in the country, or make PrEP and PEP widely accessible), and so on.

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We’re also in deep shit because the people who should be serving us want us to be there so they can benefit from it.

This is the new(er) world of “advocacy”…

It’s called advoCASHy to promote advoKATI and advoKATKAT.

***

Back in Northern Mindanao, I asked those who alleged to have been victimized if they complained – officially.

I was told: “Na, kinsa ra ba mi (Yeah, right! Who do we think we are)? Kolboy kontra sa medical practitioner, paminawun ba mi (Sex workers versus a medical practitioner, who would listen to us)?”

Despite recognizing power structures and all that, I admit I still initially found the “excuse” inexcusable. Lodging a complaint against an abusive service “provider” seems like a good first step to remedy this situation. Letting things as they are only allows the erroneous system to continue.

And then – much later – the person they alleged did them harm formed a new NGO, and this NGO was funded by a bigger NGO based in Metro Manila. I mentioned the allegations to one of the heads of the Metro Manila-based NGO, hoping – perhaps – for them to closely look at the allegations since, and after all, they were “enabling” the person involved by funding this person.

Let me get this straight: These are all allegations, of course, and they need to be investigated to be validated/invalidated. Everyone involved ought to be heard – from those who accused, and the accused. But that they exist at all should already be cause for concern.

Alas, the allegations were ignored.

So this “provider” continues to be coddled – and enabled – so long as this person’s NGO churns out reports that the bigger NGO can use to get even more big bucks.

All too apparent, people choose to turn the blind eye so long as money keeps flowing in…

No wonder HIV advocacy is in the Philippines remains broken…

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NEWSMAKERS

Address causes that put young people at risk of HIV – Pia Wurtzbach

Pia Alonzo Wurtzbach urged decision makers to address the causes that put young people at risk of HIV.

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UNAIDS Goodwill Ambassador for Asia and the Pacific Pia Alonzo Wurtzbach urged decision makers to address the causes that put young people at risk of HIV, speaking at the International Youth Day Conference organized by the United Nations Youth Association of the Philippines in collaboration with the United Nations Association of the Philippines.

“We live in a world where adolescents and young people, especially from key populations, are still left behind. We cannot fail to address their needs. I challenge the indifference and I call for action now,” said Wurtzbach.

Every day, approximately 230 young people are newly infected with HIV in Asia and the Pacific. In 2017, almost half a million young people between the ages of 15 to 24 years were living with HIV in the region.  In the Philippines, young people account for 69% of new HIV infections and data indicates that there is a growing HIV epidemic among young men having sex with men. Young key populations (including gay men and other men who have sex with men, bisexual people, transgender people, sex workers and people who use drugs) are at a high risk of HIV acquisition due to rights violations, discrimination, exclusion, criminalization and violence.

This year’s theme for International Youth Day was Safe Spaces for Youth, highlighting the need of young people for safe spaces to come together, hang out and participate in decision making processes. This includes in healthcare settings, which should be places of safety, free from stigma, discrimination and violence. This is not always the case in Asia and the Pacific, where policies and attitudes remain barriers to youth-friendly HIV and sexual and reproductive health services. In the region, available data indicates that more than half of the countries requires parental consent for HIV testing for adolescents younger than 16 years old.

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‘‘We need a critical change to respond to the dynamic shift of the HIV epidemic among young key populations, not only in the Philippines, but in Asia and the Pacific,” stressed Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific. “We need the innovation and creativity of young people in designing HIV interventions that work for them and, at the same time, support their leadership in challenging structural barriers in accessing health services, including parental consent requirements for adolescents and the lack of comprehensive sexuality education,” he added.

Wurtzbach encouraged people to advocate for young people’s participation in the AIDS response as leaders and agents of change and build strategic partnerships to end the AIDS epidemic.

“We have miles to go to end AIDS in the Philippines and we need to equip young people with the right information and enable them to access services that are safe and responsive to their needs,” Wurtzbach concluded.

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POZ

993 new HIV cases in Phl in June; 77 AIDS-related deaths reported

There were 77 reported deaths due to any cause among people with HIV last June in the Philippines, more than double the 30 deaths in May. 19% were 15-24 years old, and 51% were 25-34 years old. Also, 90% of the cases acquired HIV from sex.

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The HIV situation remains bad in the Philippines.

There were 77 reported deaths due to any cause among people with HIV last June in the Philippines. This is according to the HIV/AIDS & ART Registry of the Philippines (HARP), which reported that – among those who passed away – 72 were males and five were females.

This is more than double the May figure, when 30 deaths were reported.

For June’s 77 deaths, 15 (19%) were 15-24 years old, 39 (51%) cases were from 25-34 years old, 16 (21%) cases were from 35-49 years old age group, and seven (9%) case were 50 years and older. Ninety percent of the cases were reported to have acquired the infection through sexual contact (12 through male-female sex, 36 through male-to-male sex, and 21 through sex with both males and females), and 10% (8) of the cases were infected through sharing of needles.

The number of deaths may actually be higher because of under-reporting.

But to date, the HIV situation in the country continues to be bad, with 31 new HIV cases reported every day.

In June 2018, there were 993 new HIV cases reported to HARP. This is higher than the number reported in May, with the newly infected reaching 950. In April, it was “only” 924.

Among the new HIV cases, 18% (174 of the total) had clinical manifestations of advanced HIV infection (WHO clinical stage 3 or 4) at the time of diagnosis. Ninety-four percent (934) of the newly diagnosed were male. The median age was 27 years old (range: 3-73 years old). More than half (52%, 512) were 25-34 years old and 29% (287) were 15-24 years old at the time of testing.

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As noted – and worth highlighting – is the age of those getting infected with HIV in the Philippines, with the affected populations getting younger.

In June 2018, 287 (29%) cases were among youth 15-24 years old; 95% were male. Almost all (99%, 285) were infected through sexual contact (23 male-female sex, 187 male-male sex, 75 sex with both males & females). Two cases had no data on mode of transmission.

There were 31 newly diagnosed adolescents 10-19 years old in June 2018. All were infected through sexual contact (5 male-female sex, 20 male-male sex, and six had sex with both males and females). There were two newly diagnosed child less than 10 years old and was infected through vertical/mother-to-child transmission.

One third (33%, 324) of the new HIV cases were from the National Capital Region (NCR). Region 4A (17%, 167 cases), Region 3 (12%, 123), Region 6 (7%, 66), Region 12 (6%, 58) and Region 7 (6%, 55) round off the top six regions with the most number of newly diagnosed cases for June, together accounting for 80% of the total.

Also, sexual contact remains the predominant mode of transmission (98%, 977). Among this, 88% were from males who have sex with males (MSM).

Other modes of transmission were needle sharing among injecting drug users (1%, 7) and vertical (formerly mother-to-child) transmission (<1%, 2).

There were seven cases that had no data on mode of transmission.

Among the newly diagnosed females for June, four were pregnant at the time of diagnosis, three of the cases were from NCR and one case from Region 7.

READ:  What you need to know about HIV and AIDS

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POZ

Let science inform application of law in criminal cases related to HIV, according to experts

Prosecutions of people living with HIV for acts that pose no risk of HIV exposure or transmission prompt scientists to issue a statement urging the criminal justice system to use science when considering prosecution of HIV non-disclosure, exposure or transmission.

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A group of 20 leading HIV scientists from around the world have issued a scientific consensus statement urging governments and people working in the legal and justice systems to pay close attention to the significant advances in HIV science to ensure that science informs the application of criminal law in cases related to HIV.

“Science has greatly advanced in recent years which has been critical in allowing countries to make evidence informed decisions in their HIV programming,” said Michel Sidibé, executive director of UNAIDS. “With all the new scientific advances now available we need to continue to use science as evidence to deliver justice. No one should face criminalization because of a lack of information or understanding by the justice system about the risks of HIV transmission.”

The expert group of scientists, convened by UNAIDS, the International Association of Providers of Care (IAPAC) and the International AIDS Society, warn that an overly broad and inappropriate application of criminal law against people living with HIV remains a serious concern across the globe. Around 73 countries have laws that criminalize HIV non-disclosure, exposure or transmission, and 39 countries have applied other criminal law provisions in similar cases.

“Many of these laws do not take into account measures that reduce HIV transmissibility, including condom use, and were enacted well before the preventive benefit of antiretroviral therapy or pre-exposure prophylaxis was fully characterized,” said José M. Zuniga, IAPAC President and Chief Executive Officer. “Most people living with HIV who know their status take steps to prevent transmitting HIV to others. Laws that specifically criminalize HIV non-disclosure, exposure, or transmission thus primarily exacerbate HIV-related stigma and decrease HIV service uptake.”

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Most prosecutions have occurred based on perceived risk of HIV transmission through sexual activity. Some have also occurred for biting, spitting or even scratching. Prosecutions, and convictions, have often been influenced by a lack of knowledge or appreciation of scientific evidence regarding the possibility of transmission of the virus. In many instances, they have been influenced by deep-rooted stigma and fear associated with HIV, which still exists despite the huge advances in HIV treatment and prevention.

“We support this globally relevant expert consensus statement, for which we have been long-time advocates,” said HIV Justice Network’s Senior Policy Analyst Sally Cameron, on behalf of the Steering Committee of HIV Justice Worldwide, a global civil society coalition campaigning to end unjust prosecutions. “HIV criminalization is a growing global phenomenon that unfairly targets people living with HIV through criminal prosecutions and harsh penalties. This welcome statement makes the case that our current understanding of HIV science, alongside key human rights and legal principles, does not support this miscarriage of justice.”

The peer-reviewed consensus statement, endorsed by 70 additional scientists from around the world, was released today in the Journal of the International AIDS Society. It describes scientific evidence on the possibility of HIV transmission under various circumstances, the long-term impact of HIV infection and the means of proving HIV transmission so that it is better understood in criminal law contexts.

Based on a detailed analysis of the best available scientific evidence on HIV transmission and treatment effectiveness, the statement notes that there is no possibility of HIV transmission through saliva as a result of biting or spitting, even where saliva contains small quantities of blood. There is no to negligible possibility of HIV transmission where a condom is used correctly during sex, or where a partner living with HIV has an undetectable viral load.

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In addition, effective antiretroviral therapy, low viral load, the use of pre-exposure prophylaxis (antiretroviral drugs taken by an HIV-negative person before a possible exposure), or post-exposure prophylaxis (antiretroviral medicines taken after a possible exposure) all significantly reduce the possibility of HIV transmission.

International guidance on HIV in the context of the criminal law recommends that “proof of causation, in relation to HIV transmission, should always be based on evidence derived from a number of relevant sources, including medical records, rigorous scientific methods and sexual history” (Ending overly broad criminalization of HIV non-disclosure, exposure and transmission: critical scientific, medical and legal considerations).

The experts recommend strongly that more caution be exercised when considering criminal prosecution, including careful appraisal of current scientific evidence on HIV risk and harms. The consensus statement is expected to help policymakers, prosecutors and courts be guided by the best available science and thereby avoid the misuse of the criminal law, as is currently happening in many countries worldwide.

Read the full Expert Consensus Statement on the Science of HIV in the Context of Criminal Law.

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