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Friday, 17 April 2009

Germany: Complexities of scientific evidence discussed in Spiegel magazine article

The plight of Nadja Benaissa, the No Angels singer arrested last week in Frankfurt for alleged criminal HIV exposure and transmission has already resulted in more international media attention on the issues around criminalisation than any other case I'm aware of.

Although the recent murder trial of Johnson Aziga in Canada led to a great of press and soul-searching within its own borders, Ms Benaissa's celebrity has resulted in coverage far beyond Germany.

Today, Time magazine in the United States, ran a nicely balanced article summarising the case, and including the first quote I've seen from No Angels manager, Khalid Schroeder.

...manager, Khalid Schroeder says Benaissa's arrest is the result of "a witch-hunt against Nadja. She is being prejudged. The investigation is still continuing and there are no hard facts yet. This is unfair. We want her to be released as soon as possible."
It also quotes yet another spokesperson from Deutsche AIDS-Hilfe, who eloquently sums up their objections to her arrest and to criminalisation in general.
AIDS groups have criticised the authorities' handling of the arrest and have warned against a rush to criminalise the transmission of HIV. "Based on the information that we have about the detention of Nadja Benaissa, we think she should be released," says Carolin Vierneisel, a spokeswoman for the AIDS organisation Deutsche AIDS-Hilfe. "When it comes to consensual sex, whether protected or unprotected, we talk about shared responsibility," she says. "The criminalisation of HIV transmission, as shown in this case, doesn't support HIV prevention efforts. On the contrary, it fosters the stigmatisation of HIV positive people."

Meanwhile, Germany's answer to Time, Der Spiegel, today published an English-language article that examines the difficulties the Darmstadt prosecutor faces in proving that Ms Benaissa actually infected the male complainant. This is the first time I've ever seen the discussion of the unreliability of phylogenetic analysis in a mainstream magazine article.
Investigators in the case have since ordered an immunological report to clarify if the 26-year-old singer actually infected her former partner with HIV.

Experts like Norbert Brockmeyer, a spokesman for HIV/AIDS, a network of experts funded by the German government, is doubtful if such a report can be of much value.

"The absolute proof that person A infected person B cannot be provided by medical means after a number of years," Brockmeyer, a professor of dermatology and allergology, told SPIEGEL ONLINE. He explains that the virus would have mutated too much in each of the bodies -- particularly if those infected have undergone medical treatment.

Of course, that isn't the whole story (and it's a virological, not an immunological report, this is required). Even if there are stored blood samples available from 2004 - when the alleged transmission occurred - it is still impossible to tell from a virological analysis the timing and direction of transmission. And to rule out that someone with a similar virus (and there will be many, many people with similar viruses) didn't infect the male complainaint, they would need to test all of the man's previous sexual partners between his first HIV-negative test and first HIV-positive test (assuming he'd previously taken a test) and include those samples in the analysis. In the English courts, this limitation alone has resulted in charges being dropped in three recent cases.



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