US: State public health officials condemn 'stigmatising, harmful' HIV-specific laws

This weekend, the National Alliance of State and Territorial AIDS Directors (NASTAD) released a statement that signifies an extremely important development in the Positive Justice Project's campaign to repeal HIV-specific criminal laws in the United States.

NASTAD is a highly-respected organisation of public health officials that administer state and territorial HIV prevention and care programmes throughout the US.

Its motto is: 'Bridging Science, Policy, and Public Health'.

The message of their statement is simple: repeal these laws because

HIV criminalization undercuts our most basic HIV prevention and sexual health messages, and breeds ignorance, fear and discrimination against people living with HIV.

In order to work towards the goal of repealing laws that create HIV-specific crimes or increased penalties for persons who are HIV-positive and convicted of criminal offences, NASTAD will

advocate at the national level to raise awareness of this urgent issue. Realizing the vision of the NHAS is predicated on a strong foundation of public health science and practice void of stigma and discrimination. Instead of applying criminal law to HIV transmission, state and local governments should expand programs to reduce HIV transmission while protecting the human rights of people living with HIV.

Further, NASTAD encourages its members to:

Support the maintenance of confidentiality of HIV test and medical records in order to encourage and support individuals to be tested, learn their status and enter services if positive;

Identify and share best practices related to successes in repeal of policies and/or laws and statutes in jurisdictions that are not grounded in public health science; Promote public education and understanding of the stigmatizing impact and negative public health consequences of criminalization statutes and prosecutions;

Provide unequivocal public health leadership on the relative risks of transmission and the dangers of a punitive response to HIV exposure on the epidemic.

Todd Heywood of the Michigan Messenger reports that US HIV advocates - including the National Association of People with AIDS (NAPWA) and the Positive Justice Project's Senior Advisor, Sean Strub – have warmly welcomed NASTAD's statement.  Read his report at the Michigan Messenger here.

The full text of the statement, below, can also be downloaded as a pdf.

NATIONAL HIV/AIDS STRATEGY IMPERATIVE: FIGHTING STIGMA AND DISCRIMINATION BY REPEALING HIV-SPECIFIC CRIMINAL STATUTES

The National Alliance of State and Territorial AIDS Directors (NASTAD), the organization which represents the public health officials that administer state and territorial HIV/AIDS and adult viral hepatitis prevention and care programs nationwide is gravely concerned about the corrosive impact of sustained stigma and discrimination on state, federal and local efforts to combat HIV/AIDS in the United States. The National HIV/AIDS Strategy (NHAS) provides an unprecedented strategic blueprint for reducing HIV/AIDS incidence through the scale-up of interdisciplinary, impactful prevention approaches. NASTAD acknowledges that the NHAS is not a magic bullet; however, the NHAS’ central vision of the U.S. becoming “a place where new HIV infections are rare” cannot be realized until the nation aggressively responds to the core of the matter: pervasive and unmitigated stigma and discrimination against people living HIV/AIDS that diminishes our best efforts to combat one of the greatest public health challenges of our time.

As a member of the Positive Justice Project, a coordinated national effort to address “HIV criminalization” statutes – laws that create HIV-specific crimes or which increase penalties for persons who are HIV positive and convicted of criminal offenses – NASTAD supports efforts to examine and support level-headed, proven public health approaches that end punitive laws that single out HIV over other STDs and that impose penalties for alleged nondisclosure, exposure and transmission that are severely disproportionate to any actual resulting harm. Steps identified to reach this goal in the Federal Implementation Plan include step 3.3, Promote public health approaches to HIV prevention and care which states that “state legislatures should consider reviewing HIV-specific criminal statutes to ensure that they are consistent with current knowledge of HIV transmission and support public health approaches to screening for, preventing and treating HIV.” In addition, step 3.4, Strengthen enforcement of civil rights laws requires an examination and report by the Department of Justice on HIV-specific sentencing laws and implications for people living with HIV.

HIV criminalization has often resulted in egregious human rights violations, including harsh sentencing for behaviors that pose little to no risk of HIV transmission. Thirty- four states (34) and two (2) U.S. territories explicitly criminalize HIV exposure through sex, shared needles or, in some states, exposure to “bodily fluids” that can include saliva. Examples include:

A man with HIV in Arkansas was sentenced to 12 years (and must register as a sex offender after release) when he failed to disclose his status with his girlfriend and another woman – both women tested negative;

A man with HIV in Iowa, who had an undetectable viral load, was sentenced to 25 years after a one-time sexual encounter during which he used a condom;

A woman with HIV in Georgia, who was sentenced to eight years imprisonment   for failing to disclose her viral status, despite it having been published on the front page of the local newspaper and two witnesses who testified her sexual partner was aware of her HIV positive status.

In none of the cases cited was HIV transmitted. In fact, most prosecutions are not for transmission, but for the failure to disclose one’s HIV status prior to intimate contact, which in most cases comes down to competing stories about verbal consent that are nearly impossible to prove.

HIV criminalization undercuts our most basic HIV prevention and sexual health messages, and breeds ignorance, fear and discrimination against people living with HIV. NASTAD members commit to examining existing public health policies related to HIV criminalization that may exacerbate stigma and discrimination and lessen the likelihood that individuals will learn their HIV status. NASTAD members will also continue to emphasize the importance of providing comprehensive prevention and care services for HIV positive individuals to help reduce the risk of transmission to others. In conjunction with new and existing partners, our members also pledge to:

Support the maintenance of confidentiality of HIV test and medical records in order to encourage and support individuals to be tested, learn their status and enter services if positive;

Identify and share best practices related to successes in repeal of policies and/or laws and statutes in jurisdictions that are not grounded in public health science; Promote public education and understanding of the stigmatizing impact and negative public health consequences of criminalization statutes and prosecutions;

Provide unequivocal public health leadership on the relative risks of transmission and the dangers of a punitive response to HIV exposure on the epidemic.

NASTAD will continue to advocate at the national level to raise awareness of this urgent issue. Realizing the vision of the NHAS is predicated on a strong foundation of public health science and practice void of stigma and discrimination. Instead of applying criminal law to HIV transmission, state and local governments should expand programs to reduce HIV transmission while protecting the human rights of people living with HIV.

Approved by NASTAD’s Executive Committee: February 2011

Sweden: Underreported: The Link Between Julian Assange and Sweden’s Repressive HIV Law

"The arrest of Wikileaks founder Julian Assange has focused a spotlight on Sweden’s supposedly liberal, human rights-based sex conduct laws," writes Julie Turkewitz on the Housing Works blog. (Housing Works is an AIDS advocacy organisation in New York.)

Julie and I have been corresponding since December 9th, when she emailed me with a query about Swedish laws that criminalise sexual contact without a condom.  I also have been intrigued and perplexed by the Assange case and had been meaning to contact my esteemed colleague, Andreas Berglöf from HIV Sweden, who I thought may know about this arcane law.


Andreas confirmed what I already thought to be true: "There is no law in Sweden that prohibits unprotected sex. Unless you have an infection or disease that is included in The Swedish Communicable Disease Act, like HIV and other STI's. Then one also has a duty to inform about this."


I then suggested that Julie contact a smart Swedish journalist, Victor Bernhardtz, who had interviewed me in the summer.  He highlighted the more recent report that one of the complainants in the Assanage alleges he had sex with her whilst she was asleep (which is, therefore, non-consensual) rather than the allegations of non-condom use.

"What is illegal is to engage in sexual acticity without consent, which is the case when the other person is asleep," he said in a brief email.  "Everything points to that the charges against Assange are indeed quite valid."

Of note, my estimate in the article of the forced isolation of more than 100 people with HIV came via the Global Criminalisation Scan, which was informed by Andreas.  Following the 2005 European Court of Human Rights ruling (Enhorn vs. Sweden) Sweden changed its policy which is why Andreas now estimates that, on average, one person with HIV is now isolated per year.

With her permission, Julie's entire article on the Housing Works blog is below.

The arrest of Wikileaks founder Julian Assange has focused a spotlight on Sweden’s supposedly liberal, human rights-based sex conduct laws, which allow for a rape conviction even when a perpetrator uses a low level of coercion.

The extradition case against Assange began when two Swedish women contacted authorities to compel him to take an STD test. As reported by Reuters, Assange may have tried to have sex with the women without a condom.

What STD are the women worried about? That hasn’t been made public. But if, as part of an STD test, Assange were to test positive for HIV, the legal consequences could be dire. When it comes to the virus, Sweden’s policies are far from “liberal” or “rights-based.” The country is home to some scarily repressive HIV criminalization laws, which have allowed for the forced isolation of at least 100 HIV-positive people.

“Sweden and its Nordic neighbors are pretty draconian in the way they use their laws to control the lives of people living with HIV and AIDS,” said Edwin Bernard, editor of HIV and the Criminal Law, an extensive summary of laws, prosecutions and responses to criminalization of HIV. “Sweden is by far the worst, though.”

According to the National AIDS Manual, the Scandinavian nation has prosecuted more people living with HIV per capita for exposure or transmission than any other country in the world.

Punishment under the Communicable Disease Act
Despite recent arguments from UN Special Rapporteur Anand Grover that HIV criminalization fuels stigma, discourages testing and undermines public health goals, Sweden continues to persecute HIV-positive people under its Communicable Disease Act.

The law mandates the “obligation to inform sexual partners about infection carrier status.” In practice, those convicted of violating the act are often subject to extensive punishment.

Perhaps most strikingly, the act allows for the compulsory isolation of an HIV-positive person if officials decide that he or she is “not ready to undergo the measures to prevent” transmission. The law places no limits on how long such cumulative isolation may continue. Detentions happen about once a year, according to Andreas Berglöf, organization manager at HIV-Sweden, but “just having the legal possibility is awful, we think.”

The National AIDS Manual offers a higher estimate, saying that at least 100 people have been isolated under this measure.

HIV-Sweden, an umbrella organization that works to protect HIV-positive persons, has documented at least 50 prosecutions and 38 convictions for nondisclosure since 1992, a fairly high number, considering there are just over 5,000 people in Sweden living with HIV.

Incarceration for nondisclosure can last up two to years, and up to 10 years if transmission occurs. The average sentence is five to 10 years. Damages of around 700,000 krona—or about $100,000—are not unusual if transmission occurs, according to a 2009 report from HIV-Sweden. And not surprisingly, foreign nationals are disproportionately affected by the policies.

The European Court of Human Rights has lashed out against Sweden’s repressive policies, saying in 2005 that Sweden had violated the right to liberty and security of an HIV-positive man forcibly detained for up to seven years.

No word on when or if Assange will head to Sweden to answer questions about alleged sexual misconduct—or if he’ll take STD tests. But with these laws on the books, who would?

US: CDC finally admits criminalisation is problematic

A campaign by the HIV Prevention Justice Alliance for the US Centres for Disease Control and Prevention (CDC) to confront criminalisation in the United States is finally bearing fruit.

The HIV Prevention Justice Alliance is network of organisations advocating for effective and just HIV prevention policies for the United States, coordinated by Community HIV/AIDS Mobilization Project (CHAMP) in collaboration with AIDS Foundation of Chicago, and SisterLove.

Their campaign began in 2008. The Alliance was extremely concerned that prosecutions for HIV-associated spitting and biting were doing a lot of harm.

CDC has long maintained that contact with saliva, tears, or sweat does not expose others to an appreciable risk of HIV transmission. The continued perpetuation of false information by the justice system and the media on how the virus is transmitted underscores the need for more effective HIV communication and education strategies at the highest levels that are accessible to the general public. In light of an unabated and growing HIV epidemic among certain segments of the U.S. population, we believe that it is incumbent upon the CDC to aggressively respond and provide the public with the most accurate information to reduce HIV vulnerability.

A December 2008 letter from the CDC had previously pledged to do all of what they now promise to do (see below), but when no action was taken, the Alliance sent another letter in January 2010 to the CDC's Kevin Fenton – Director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention – "to urge CDC to take action on the steps it had identified to address the criminalization of HIV."

In a letter signed by Fenton, the CDC has now agreed to:

• Update and expand the "Rumors, Myths, and Hoaxes" section of the CDC website by April 30th 2010.
• Update and expand CDC's factsheet and question and answer sets (Q&As) regarding HIV transmission to better address myths and misconceptions about HIV transmission by April 30th 2010.
• Develop internal talking points to ensure CDC staff is equipped to deliver consistent, scientifically accurate information when they receive inquiries around issues of criminalization and/or myths and misconceptions about HIV transmission by April 30th 2010.
• Survey health departments, beginining May 2010 to determine whether they have collaborative relationships with criminal justice personnel and, if so, how these relationships affect HIV prevention efforts in communities.
• Use information obtained from the surveys to develop a communications package to provide to state and local health departments with the tools and messages they need to facilitate interactions with their criminal justice counterparts by August 30, 2010.

The letter concludes: "While these activities represent a concrete beginning, we realize there is much to be done to address the need for a public health, rather than punitive perspective to drive how people living with HIV/AIDS are approached in the United States. We all must continue to be forward thinking in this endeavor, and collectively we will make a broader impact. We at CDC appreciate the work organizations such as yours do in the communities affected by this disease."

I'd like to congratulate all those involved in persuading the CDC to take its first tiny steps towards making a stand against the draconian treatment of people living with HIV in the United States. Their response is focused on the most egregious criminal prosecutions, and there is, indeed, "much to be done to address the need for a public health, rather than punitive perspective to drive how people living with HIV/AIDS are approached in the United States."

For example, the CDC could also publically state that non-disclosure laws do more harm than good for public health, and also support the idea (which they already are exploring on a population level) that on an individual level people on successful antiretroviral treatment are as as unlikely to expose their sexual partners to HIV as those who wear condoms.

Click on the image of Mr Fenton's pledge to read the entire letter.

Australia: New publication examines criminalisation; works as advocacy tool

NAPWA monograph:
click on image to download
There have been some very important policy developments in Australia recently that I've been waiting to post about until I'd finished reading the entire (Australian) National Association of People Living With HIV/AIDS (NAPWA) monograph, The Criminalisation of HIV Transmission in Australia: Legality, Morality and Reality, to which I contributed a chapter (as a co-author).

I've now read all eleven chapters and I have to say that the monograph is essential reading for anyone interested in the issue of criminalisation. It has provided me with a great deal of insight and food-for-thought as I write my book (an international overview of the issues) for NAM.

As the Honourable Michael Kirby writes in the preface

"NAPWA has collected knowledgeable and informed commentators who have a great awareness of the epidemic in Australia. Without exception, the chapters are thoughtful, balanced and informative. I hope that they will be read in Australia. Indeed, I hope that they will be available overseas to bring enlightenment that is the first step in an effective response to the epidemic."

You can see video of MP Kay Hull speaking at the launch, held last month in Canberra, here.

The monograph is already working its magic as an advocacy tool. Last week, the Sydney Star Observer reports that HIV organisations in Victoria – where more than half of all Australian prosecutions have taken place – are leading the call to clarify exactly when the public health department will involve the police to deal with people who are not disclosing their HIV status and having unprotected sex.

Contents: click on image to enlarge


One of the chapters in the monograph examines such discrepancies in new state and national guidance on the management of people living with HIV who engage in risky sexual behaviour. The National Guidelines for the Management of People with HIV Who Place Others at Risk were produced in 2008 following the fallout from the Michael Neal and Stuart
McDonald cases. The guidelines recommend that public health authorities refer people who persistently ignore warnings to disclose and/or practise safer sex to the police as a last resort, but aren't very clear on how this happens in practice.

Victorian AIDS Council executive director Mike Kennedy said although there were guidelines, a recent meeting of AIDS Council heads showed other states were similarly unclear about exactly what circumstances trigger a referral to police. “I’m not aware of any Australian state that has any clear guideline to say how this will happen, so that’s the missing bit from the reviews that were done around the country,” Kennedy said. “Our view is that [protocols] ought to be governed by a set of agreed procedures, not just rely on goodwill and a set of relationships between people in the Health Department and people in the police service because those people change.”

The NAPWA monograph also includes an enlightening chapter on the impact of prosecutions on people living with HIV, concern echoed in this comment in the SSO article from People Living With HIV/AIDS Victoria president Paul Kidd.

[Kidd] said the uncertainty of where criminal charges would be pursued was creating concern among some HIV positive people. “They’re fearful that in the normal course of their sexual lives they could put themselves in a situation where they inadvertently attract the attention of the police,” Kidd said. “We’re not talking about people who are deliberately spreading HIV or behaving in a negligent fashion. We’re talking about ordinary gay men and other people who are HIV positive who live in an environment where unprotected sex is a part of [their] lives.

I'm also reproducing an editorial by Robert Mitchell, NAPWA's president, below, to give you an idea how NAPWA hopes this monograph will lead to a change in the way Australia deals with criminal prosecutions.

HIV affects us all and, positive or negative, gay or straight, we all have a responsibility to do what we can do prevent HIV transmission. People living with HIV have long accepted the critical role they play in preventing HIV infections, as part of a model of shared responsibility. But the recent increases in criminal prosecutions of HIV exposure and transmission in Australia have caused considerable concern and led some to ask: is that model of shared responsibility breaking down?

In response, last year NAPWA commissioned a collection of papers to examine these issues. We wanted to show how these cases have been prosecuted quite inconsistently across the country, and how they have been represented in the public domain by media coverage. We are launching the resulting monograph, The Criminalisation of HIV Transmission in Australia: Legality, Morality and Reality, this week.

A number of authors with different viewpoints have contributed to the monograph, including academics, legal experts and voices from within the HIV-positive and HIV-affected communities. The end result is a collection of papers that provide rigorous analysis of the current environment in Australia, and other parts of the world, with regards to prosecution of HIV transmission.

This set of materials and commentaries will be the basis for further work on these issues by NAPWA and its member organisations. Our intention is to start a dialogue across the HIV sector and with the broader public health and legal sectors, to examine the issues raised and the impact of criminal prosecutions on the HIV-positive community in Australia today.

While few would argue that an HIV-positive person who deliberately and maliciously sets out to infect another person with HIV has committed an act of violence that should be subject to criminal sanction, very few of the prosecutions in Australia have been in this category. Almost all have been for the ‘knowing and reckless’ category of HIV transmission, where the accused had no intention of transmitting HIV.

The use of criminal law against a person on the basis of HIV status in these circumstances is considered by many to be discriminatory, as it treats the HIV-positive partner as perpetrator and the HIV-negative partner as victim. This shifts the burden of prevention onto people with HIV, and undermines established principles of shared responsibility and safe, consenting, sexual practice.

The blame and persecution directed towards HIV positive people is unacceptable and NAPWA is calling for a review of criminal laws to redress this imbalance. Laws requiring mandatory disclosure by positive people, and laws that treat HIV as inherently more serious than other infections with similar medical impacts, are areas we think need fixing. We need a nationally consistent legal framework that supports public health policy and population health outcomes, and protects the human rights of people with HIV.

NAPWA hopes this work will spark interest and support from across the community to work towards resolving these differences and contradictions. We are working towards a nationally consistent, fair and just legal framework that reinforces rather than degrades the model of shared responsibility and treats HIV as a health issue first and a legal issue only as a last resort.

New Zealand: 'HIV predator' is named; seventh complainant adds further charges

The man dubbed the 'HIV predator' had his name and face splashed all over New Zealand's media today in what has become the biggest criminal HIV transmission case in NZ history. There are now seven complainants (six men, one woman) of whom five are alleging that the man was source of their HIV infection.

As well as his name and several photos, today's report on GayNZ.com includes many of the details left out of their earlier reporting, including his online dating profile nicknames and the name of the street he lived on in Auckland. They also highlight that HIV testing centres are anticipating a rise in HIV testing today and over the weekend as people recognise the man. But surely this is as much a 'fishing expedition' as a public health warning.

Today's story on TVNZ.com includes a quote from Bruce Kilmister, chief executive of NZ's PLHIV organisation, Body Positive

[Kilmister] said the alleged charges significantly changed a lot of people's lives. "Everybody who has had an association with him in the past should come forward for a test. But it's also a timely reminder that everybody has a responsibility to keep themselves safe and follow safe sex practice. HIV positive people have an added responsibility not to transmit the virus, and the best way they can do that is to have safe sex."

To put the case into perspective, according to data from New Zealand's Ministry of Health (AIDS New Zealand Issue 63 – March 2009 ) only 184 people were newly diagnosed with HIV in 2008 – of whom 91 were acquired via sex between men, but only 70% of these were acquired in New Zealand, most of whom lived in Auckland – and this was the highest number ever recorded. Since there are now five gay men (aged between 17 and 31) who claim the accused man infected them, this 'cluster' alone would represent around 8% of new diagnoses.

Adding to the panic is the 19 year-old female complainant (who has not tested positive). Between 1999-2008 there were only 52 women diagnosed with HIV that was heterosexually acquired in New Zealand. The TVNZ article continues

The fact a woman had allegedly been affected raised concerns the virus may have spread into the heterosexual community. "The reality is that most women think of the pill as the beginning and end of safe sex. It needs to be a message that goes right across the broad spectrum," [said Kilmister.]

If this man is the source of five (or possibly more) infections, this certainly is a public health concern, and the criminal justice system involvement is, indeed, a result of the failure of public health. The call for new and better public health laws in New Zealand are understandable, and certainly would be better than the current system which required media and CJS intervention.

However, last year the NZ Ministry of Health published a study examining HIV prevalence in New Zealand, both diagnosed and undiagnosed (AIDS New Zealand Issue 62 - November 2008) which found a prevalence of 4.4% amongst men who have sex with men attending sexual health clinics, of whom only half were diagnosed. Undiagnosed people can't disclose – and cannot be publically (or even privately) named and shamed as a way to warn others about specifically avoiding them. Undiagnosed people may also be having as much – or more – 'promiscuous' sex as the so-called 'HIV predator'.

Earlier in the week, TVNZ ran an in-depth look at the case and interviewed Michael Stevens, the man who orginally brought the allegations to GayNZ.com and Simon Harger-Forde, director of HIV prevention at New Zealand AIDS Foundation. It makes for uncomfortable viewing by making patient confidentiality appear to be something bad, and conflating two issues (non-disclosure resulting in HIV exposure or transmisison being a criminally liable act and the lack of an effective public health response) without any examination of the issue of shared responsibility for sexual health. Only at the very end does Mr Harger-Forde say that laws don't protect anyone, and that everyone should be using condoms.



Finally, an interesting blog posting from a feminist commentator, which highlights other concerns - that this case will end up leading to further stigmatisation of gay men and people living with HIV in New Zealand, and concludes:

Safe sex is crucial, of course, but it's also crucial that the ... case doesn't become an exercise in victim-blaming, with homophobic overtones. And it's also important that [his] behaviour doesn't prompt a backlash against HIV positive people, who have the same needs for affection, companionship and intimacy as the rest of us.

New Zealand: Article examines implications of 'HIV predator' case

After all the hysterical media reporting surrounding the current 'HIV predator' case comes a thoughtful analysis of the situation from the New Zealand Herald. The article also usefully includes a summary of the most important criminal HIV transmission cases over the years.

I include the first few paragraphs below. Click here to read the full article.

HIV-positive: The case for disclosure
By Chris Barton
Saturday Jun 06, 2009

Many questions arise from the case of the 40-year-old HIV-positive man charged with wilfully infecting three other men with HIV and attempting to infect a fourth.

Not just why the man, now in custody with name suppression, allegedly did what he did. Or why it took so long for the police to stop him. Or why our laws are so out of date that doctors and other health professionals are uncertain about what to do when they come across such reckless behaviour. Or why HIV is not a notifiable condition.

Puzzling as all that sounds, the greater mystery here is why did the man's sexual partners participate the way they did? Why, after decades of messages honed from the reality of the Aids epidemic 25 years on, did they not practise safe sex?

Past cases include:

1994 Kenyan musician Peter Mwai sentenced to seven years jail for having unprotected sex with five women and infecting two with HIV. Deported in June 1998 having served four years in jail here, Mwai died in Uganda in September 1998.

1999 David Purvis, a 31-year-old Pakuranga invalid beneficiary, sentenced to four months jail for committing a criminal nuisance by having unprotected sex with another man who did not contract HIV. Pleaded guilty.

2001 Former male prostitute Christopher Truscott held in "secure" care (he has escaped many times) in Christchurch after being prosecuted in 1999 for having unprotected sex with four men. Intellectually impaired, Truscott seemed unable to comprehend the implications of his HIV infection.

2004 Zimbabwean Shingirayi Nyarirangwe, 25, was sentenced to three years jail after pleading guilty in the Auckland District Court to four charges of criminal nuisance and three of assault relating to unprotected sex with several women.

2005 Justin Dalley found guilty of criminal nuisance by failing to inform a woman he was HIV positive - sentenced in Wellington to 300 hours' community work, six months' supervision and told him to pay $1000 reparation to the woman to cover her counselling costs and expenses. The woman did not contract HIV. Soon after, Dalley was acquitted on a second, similar charge because on that occasion he did wear a condom - possibly setting a legal precedent that by wearing a condom an HIV positive man is taking "reasonable precautions" against infection and need not disclose his HIV status.

Current A New Zealander originally from the Democratic Republic of Congo awaiting trial on charges that he had unprotected sex with a woman and infected her with the virus. It is possible he also infected other women.

US: Young, recently diagnosed gay man in Washington State arrested for HIV exposure

A 22 year-old gay man from Spokane, Washington, who was diagnosed HIV-positive in August 2008 has been arrested and charged under Washington's HIV exposure and transmission law following a complaint from a bisexual married man whom he met on the internet for casual sex.

The case highlights the great divide between criminal HIV laws and accepted practice amongst men who have sex with men. In particular, the Washingon State Appeals Court upheld in 1999 that if someone who knows their HIV status has unprotected sex with someone else without first disclosing then this is considered to be "acting with intent to inflict harm".

Yet, the details of the case, which have been revealed in a series of stories published by local papers and TV in and around Spokane, suggest that the man had no intention of inflicting harm.

In yet another US trial by media, he was interviewed following his arraignment, by local TV station KXLY, during which he admits his (moral, rather than legal) guilt.

In a jail house interview Thursday afternoon [he] says he willingly had unprotected sex with men he met in online, on chat lines and in People's Park without telling them he had HIV. "I can't count but I think there's a few that didn't know," [he] said...The 22-year-old contracted the virus from a former boyfriend and has known he's HIV-positive since August but he continued to have unprotected sex and admits he only told about half the men he has the virus. "I wanted to apologize to everybody I've come into contact with and haven't told," he said.

[...He] said he had "no idea" why he was having unprotected sex, but claims that Spokane's gay community isn't as concerned as it used to be about the virus. "Nowadays if somebody has HIV they don't care, they don't care about asking," he said. [He] is now sorry he wasn't more careful with the married man that went to police. "I want to apologize to him and his family for putting him at risk, his wife at risk. Their lives are pretty much ruined from this point on if it comes back positive on them."

The story doesn't stop there, however. Citing police concerns that the man had sex with around 70 men since his diagnosis, Spokane's public health department is launching an outreach campaign, including ads on craigslist and manhunt, and posters in public cruising areas, encouraging people to undergo HIV testing.

"We understand there may have been a number of anonymous sex partners that could have been exposed to HIV and because of this we are doing some extra outreach efforts," said Lisa St. John with the Spokane Regional Health District. This type of outreach is something the health district has never done before. They want people to know they're not affiliated with any kind of police investigation.

Last week, according to a story from the Seattle Post-Intelligencer that number is now up to 80. Public health officials appear to be incredulous that a gay man with HIV could have so many sex partners (they obviously live very sheltered lives).

"Since I've been here we've not had an investigation of this magnitude," said district spokeswoman Julie Graham, who's been with the district for at least five years. According to court documents, [the accused man] signed health district paperwork last year warning him it was a crime to expose people to the virus without telling them. But [his] friends told police that he routinely meets anonymous men on the Internet and that he often visited a local park to have sex.

[...]

The health district has a process for discouraging risky sexual behavior, which can include issuing a cease-and-desist order, which if violated, can land the client in the court system. "On a rare occasion that we find out that someone has intentionally put others at risk, we would take the actions first to keep that from happening," Graham said. "This is our first time where we have had our records subpoenaed by police as a first step."

The person making the most sense was the accused man's father, who apparently only discovered his son's HIV status a few months ago. Both parents are supporting their son, and their response has been heroically pragmatic.

“I just feel that unsafe sex by anybody is real dumb in this place and time in the world,” [his father] said. “I blame both equally.”

Unfortunately, Washington State laws don't blame both equally. The man has now pleaded not guilty, and a trial is set for July 20th.

US: North Carolina man gets suspended sentence, named and shamed on TV, for HIV exposure

When does privacy include televising someone's name, address, the place and nature of their work, and showing their face?

That's the question I am sure you will ask yourself when you watch how two local TV stations in Raleigh, North Carolina, report on the "sensitive" issue of an apparently HIV-positive 23 year-old man who appeared in court under North Carolina's public health laws, for allegedly having unprotected sex without disclosure.

I was alerted to the case on August 22nd when the outcome of the man's hearing was published on two local TV websites.

Then, I found a link to a story from a week earlier, which was all about how the man's attorney, Evonne Hopkins, had argued before District Court Judge James Fullwood that the hearing should be done in a closed court because it was "a sensitive matter and that exposing medical information might violate medical privacy laws."

Even the prosecutor, Wake County Assistant District Attorney Boz Zellinger, conceded that, "We recognize the sensitivity of this issue."

And yet, how do I know all of this? Because it was all shown on the local TV news, including the face and name of the 23 year-old, and a close-up shot of his charge sheet that lasts a good five seconds, showing not just his full name and job alias, but also his address!



(Click on image for a link to the video of the news report which includes showing the 23 year-old's face, name, and address, which I have blurred in this still)

In the end, the man agreed to a plea bargain which results in him being able to keep his job - he received a 45 day suspected sentence and three years' probation.

But I wonder if he really will be able to keep his job now that he has been named and shamed on local TV?

Attorney wants closed court for client's health-law case
Aug. 15, 2008
WRAL.com

The case of a Raleigh man charged with a public health violation was continued Friday after his attorney said she does not want the matter heard in open court.

Joshua Waldon Weaver, 23, was arrested in April on charges stemming from North Carolina General Statute 130A-144 (f), which requires all people to comply with measures controlling communicable diseases, and North Carolina Administrative Code 10-41 A.02020 (1)(a)(e), which addresses control measures regarding HIV.

According to an arrest warrant, the alleged offenses ranged from Aug. 1, 2006, to the present. Weaver is out of jail on a $50,000 bond.

Weaver's attorney, Evonne Hopkins, tried to have a judge close proceedings Friday morning when Weaver was in court for what was to have been a plea deal with prosecutors. She said it is a sensitive matter and that exposing medical information might violate medical privacy laws.

"The Americans With Disabilities Act, HIPAA – I'm concerned about State Bar consequences. I am highly alarmed," Hopkins said. She referred to the Health Insurance Portability and Accountability Act, a federal law that guards patients' privacy.

After several hours of delays and arguments, District Court Judge James Fullwood agreed to continue the case until next Friday.

"We recognize the sensitivity of this issue," Wake County Assistant District Attorney Boz Zellinger said. "We're not out to get anyone."

According to court documents, the Wake County Public Health Department reported Weaver to the district attorney's office.

Although she said she could not talk specifically about Weaver's case, director Gibby Harris said that, in general, the agency has a responsibility to monitor people with communicable diseases to make sure they don't spread them.

"Our intent is to change behavior," Harris said.

When a person is diagnosed with a communicable disease, such as HIV, health officials ask the person to supply a list of people they have had contact with so those people can be notified.

Harris said the patient is initially given an isolation/no-contact order not to spread the disease.

If they fail to comply, they are first warned, Harris said. Criminal charges are a last resort.

"If we see someone who just can't comply for one reason or another or just will not comply, then we do have the option of prosecuting that individual," Harris said.

Overall, there were 229 documented cases of HIV in Wake County last year, down 31 from 2006. Three-quarters of the patients were men.

Raleigh man pleads guilty to public-health violation
Aug. 22, 2008
WRAL.com

A Raleigh man received a 45-day suspended jail sentence Friday after pleading guilty to charges that he failed to use a condom and notify sexual partners that he has HIV.

Joshua Waldon Weaver, 23, a DJ in Raleigh and Wilmington, was also sentenced to 30 months of supervised probation and ordered to pay a $300 fine, plus court costs.

Weaver was arrested in April on charges brought under North Carolina Administrative Code 10-41 A.02020 (1)(a)(e), which addresses control measures regarding HIV, and North Carolina General Statute 130A-144 (f), which requires all people to comply with measures controlling communicable diseases.

The offenses, which ranged from Aug. 1, 2006, to April 2008, are misdemeanors in North Carolina.

"The defendant's repeated violations of those are what brought him here today," Wake County Assistant District Attorney Boz Zellinger said Friday.

As part of his probation, Weaver must pay a $300 fine, plus court costs, and comply with the public health laws under which he was charged. He must also undergo a mental health and substance abuse assessment and stay away from nightclubs unless he is working.

Zellinger said that if Weaver violates his probation, he could be quarantined for up to two years.

Last Friday, District Judge James Fullwood continued the case after Weaver's attorney, Evonne Hopkins, tried to have court proceedings closed, saying the case is a sensitive matter and that exposing medical information might violate medical privacy laws.

Although she would not speak about the specifics in Weaver's case, Gibby Harris, director of the Wake County Public Health Department, said patients diagnosed with a communicable disease, such as HIV, must agree to a no-contact order so that the disease will not spread.

Criminal charges are a last resort, she said, if patients don't comply.

"Part of the issue, I do believe, is that people have started to believe that HIV is a chronic disease. It used to be that it was a death sentence," she said. "We're having difficulty educating our younger community about this."

Zellinger said he hopes the case will be a wake-up call for others.

"When you think about it, somebody's lives have been changed irreparably by this defendant's actions," he said. "Having a cavalier attitude about following public health laws can't really be tolerated because other people are put in harm's way."

Man pleads guilty to endangering public health
Friday, August 22, 2008
WTVD.com

RALEIGH (WTVD) -- A Wake County man takes plea agreement for allegedly endangering public health by exposing others to HIV.

A Wake County man takes plea agreement for allegedly endangering public health by exposing others to HIV.

Joshua Weaver plead guilty to health code violation Friday in court for alleged multiple violations between August 2006 to April 2006.

"The fact that this happened over and over again is what caused this to come to court today," said Boz Zellinger with the District Attorney's Office.

The 23-year-old disc jockey faced charges of violating the state's public health control law by exposing partners to an incurable, sexually transmitted disease. No one will name his specific offense citing medical privacy laws.

A judge sentenced Weaver to 30 months probation and a 45 day suspended jail sentence.

The judge also ordered Weaver to refrain from having sex unless he uses a condom and must tell past and future partners of any infection.

He will be allowed to keep his jobs as a DJ in the Triangle and at a gay and lesbian club in Wilmington, but he must stay away from clubs if he is not working.

Wake County Prosecutors charged Weaver with failure to use protection during sexual intercourse, in violation of the state's control measures for HIV. They also accused him of not notifying his sexual partners that he is HIV-positive.

North Carolinians diagnosed with HIV are obligated under the law to limit others' exposure to the virus that can lead to AIDS. Carriers are required to sign an agreement that orders them to practice safe sex and be honest with partners about their status.

"They have to avoid having sex with people without letting them know that they're HIV positive and without using condoms," Wake County Public Health Gibby Harris said.

The penalty for violating the law holds a maximum of up to two years in prison. Wake County health officials say they haven't brought a case like this to court in more than 15 years.

Australia: Man suing SA for not preventing Stuart McDonald from 'infecting him with HIV' complains over costs

A man from Melbourne who is suing the South Australian Government for 'allowing' Stuart McDonald to 'infect him with HIV' is now publicising his problems with the costs of the complaint.

His lawyer has now gone public with the fact that he is being charged AUS$35,000 to get copies of more than 2000 documents relating to the case.

Two of the eight men that Mr McDonald is alleged to have infected with HIV are now suing the SA Government for not having controlled his behaviour.

Meanwhile, Stuart McDonald's trial is due to take place in August.

(click here for a page refresh with all of my blog postings on the Stuart McDonald case)

Full story, below, comes from Adeleide Now.

Victims charged $35,000 in HIV case
Andrew Dowell, Court Reporter
July 05, 2008

THE State Government is demanding victims of alleged HIV sex predator Stuart McDonald pay up to $35,000 to access crucial information about him.

Lawyers for a man suing the state over his alleged HIV infection accused the Government of threatening victims with "financial ruin" to stop them pursuing compensation claims.

They said demands of $35,000 just to inspect documents were "outrageous".

The Victorian man and another alleged victim have launched District Court claims.

They argue authorities failed to properly supervise McDonald when he was subject to a Health Department control order. McDonald, 42, is alleged to have "deliberately and recklessly" infected eight men with the HIV virus between January, 2005, and mid-2006.

One claimant's lawyer, Leo Redden, wrote to the Crown Solicitor's office seeking access to documents from the Health Department and a Sexually Transmitted Diseases clinic relating to McDonald's control order.

A letter from the Crown Solicitor's office said there were "approximately 2000 documents potentially within the scope of your request."

"This would amount to some 170 hours' work. The cost, therefore is likely to be in excess of $35,000," it said. "Could you please confirm your client is aware of this and is agreeable to pay the relevant costs."

In a strongly worded reply, Mr Redden accused the state of using threats against his client.

"The suggestion that (my client) and others could each be liable to the State of South Australia for an amount of $35,000 is outrageous and appears to be nothing more than an in terrorem threat, designed to dissuade our clients from pursuing their legal entitlements," he wrote.

"It is aimed at allowing a powerful litigant such . . . to threaten financial ruin to members of the public."

The alleged victim, 31, who lives in Melbourne, claims to have been infected by McDonald after they met on an internet dating site. Prosecutors have alleged McDonald infected eight victims after meeting them through the Gaydar website – at the same time he was subject to the Government control order.

Fiji: Updated: Moral, legal panic after one man linked to two women's HIV infections

Update: 28th April. There have been fewer than 260 HIV diagnoses in Fiji since records began (I originally quoted a source claiming fewer than 30), so it must come as something of a shock for Fijians to have to come to terms with the fact that an HIV-positive man is not disclosing his status before having unprotected sex.

The hunt is now on for a 33 year-old Fijian man who allegedly transmitted HIV to two women. The Fiji Times has published four stories since Friday covering the issue.

Update: 28th April. In fact, Fiji now seems to be hunting down six HIV-positive individuals.

Interestingly, according to one of the articles, reckless or intentional HIV transmission (or exposure) is not a crime in Fiji, although the transmission of HIV via shared needles is.

Police spokesman Corporal Josaia Weicavu said wilfully passing on the HIV virus had not been criminalized.

Police can only advise women in Labasa to be careful when engaging in sexual activity after health and police authorities mounted a search in recent weeks for a 33-year-old man of Labasa.

Consequently, Reverend Sekove Veisa, head of a Methodist church circuit, has "called for lawmakers to criminalise the wilful spread of the disease by anyone."

Highlights of the four news stories from The Fiji Times are below, followed by a brief report from the Australian Broadcasting Corporation on the missing six.

Hunt for HIV man
SERAFINA SILAITOGA
Saturday, April 19, 2008

HEALTH authorities are on the hunt for a HIV positive patient who they believe is engaged in promiscuous sex and deliberately spreading the disease.

Acting general manager community health North Doctor Pablo Romanik confirmed the search for the 33-year-old Fijian man started early this month after two women who were admitted to the Labasa Hospital tested positive for HIV (human immunodeficiency virus).

Dr Romanik said what worried them was that the patient did not have a stable address and efforts to find him the past three weeks were unsuccessful.

"We are looking for this man to counsel him. The reason for our search is because he is the same man identified by his two ex-girlfriends who were admitted and tested HIV positive," he said. "All we want to do is counsel him and help him. The fact that he does not have a stable address is of great concern because he could continue to have other partners and spread the disease."

Dr Romanik said the second woman was admitted in January this year after health officials carried out a blood test on her which tested HIV positive.

He said they interviewed the woman who then told them about her partner who is a known HIV positive patient.

"That's when we found out, and strongly believe, that she contracted the disease from him because he is a known patient who was tested positive in 2004 when he came to donate some blood to the hospital," Dr Romanik said.

"The first case involved his other girlfriend who was also admitted last year and tested HIV positive. She also identified the same man as her boyfriend."

Stop, HIV lover told

Sunday, April 20, 2008

THE head of a Methodist Church circuit has pleaded with a HIV patient being hunted by health authorities to stop infecting women.

And Reverend Sekove Veisa, who leads the Macuata circuit, called for lawmakers to criminalise the wilful spread of the disease by anyone.

[...]

Mr Veisa said the fact that the HIV positive man was deliberately infecting women was hard to fathom.

He said the church had a program that dealt with such issues as HIV and urged the man not to destroy lives.

Police assistant spokesman Corporal Josaia Weicavu said he had to clarify whether wilfully spreading the disease was a criminal offence.

Isolate HIV suspect
AMELIA VUNILEBA
Sunday, April 20, 2008
Update: 4:47PM

HEALTH authorities have the power to isolate people that have contracted HIV, police said today.

Police spokesman Corporal Josaia Weicavu said wilfully passing on the HIV virus had not been criminalized.

Police can only advise women in Labasa to be careful when engaging in sexual activity after health and police authorities mounted a search in recent weeks for a 33-year-old man of Labasa.

Acting general manager community health North Doctor Pablo Romanik said the search for the man started early this month after two women who were admitted at the Labasa Hospital tested positive for HIV.

The ministry has identified 28 HIV positive cases since 1995.

Of this, there is one case under the age of 20, 15 cases between the ages of 20 to 29, three cases between the ages of 30 to 39, seven between 40 and 49 and two cases over the age of 50.

Out of this, 40 per cent are males and 60 per cent females. Fijians top the list at 84 per cent, Indo-Fijians at 8 per cent and 8 per cent for other races.

No laws on HIV

Monday, April 21, 2008

WHILE there are no laws to charge people living with HIV and wilfully spreading the virus, the Ministry of Health has powers to isolate these people.

Police assistant spokesman Corporal Josaia Weicavu said the act of knowingly passing on the HIV virus was not a criminal offence yet.

"It's not criminalised yet, however, the Ministry of Health has powers to isolate these people who have HIV," said Cpl Weicavu.

He said people could be charged if they were caught passing on the virus through needle injections. However, this did not apply to transmission of the virus through sex.

Attempts were made to get comments from interim Health Minister Jiko Luveni.

[...]

Ministry of Health permanent secretary, Doctor Lepani Waqatakirewa, said health officials could search for HIV positive patients for counselling.

Fiji seeks missing HIV patients
Updated April 28, 2008 04:25:33

Fiji health officials are trying to find six people with HIV in the country's northern division.

The Division's acting Chief Medical Officer for Community Health told Fijilive there are 15 known AIDS cases on record in the north, but that health officials only have addresses for nine of those individuals.

The youngest known HIV patient in the North is a 20-year-old student in Labasa.

Fiji has reported 259 HIV cases since 1989, with more than 15 reported cases last year alone.

Australia: New Victoria public health policy clarifies when 'risky' HIV-positive individuals should be reported to the police

I spoke too soon in my posting yesterday regarding reassurances from Victoria's chief health office, Dr John Carnie, on a new policy from the public health department about reporting HIV-positive individuals who did not disclose or use condoms to the police.

A report in today's The Age quotes Dr Carnie as saying:

anyone who had intentionally infected someone else, had committed crimes such as rape, or had shown they were unwilling to change their behaviour after being ordered to do so by the department, would be reported to the police.

Full story from The Age below.

Police to be told about reckless HIV acts

Julia Medew
February 26, 2008

HIV-POSITIVE people who ignore warnings not to have unprotected sex will be reported to police under new Department of Human Services guidelines.

Victoria's Chief Health Officer, Dr John Carnie, said that, under the system, anyone who had intentionally infected someone else, had committed crimes such as rape, or had shown they were unwilling to change their behaviour after being ordered to do so by the department, would be reported to the police.

Under the previous system, Dr Carnie said there were no guidelines to indicate when a case required police attention.

"This system makes it much more explicit," he said.

On the department's website, the previous guidelines for the management of people living with HIV who put others at risk says the police will only become involved if someone outside the department makes a complaint to them.

When the department receives allegations that an HIV-positive person is not disclosing their status and having unprotected sex, trained staff contact the person to remind them of their legal obligations to disclose their status or practise safe sex.

If they do not change their behaviour and the department receives more allegations, the person can be served with a legally binding public health order restricting their behaviour. The orders can impose restrictions on people's movements or ban them from a gay beat or sex-on-premises venue.

If the Chief Health Officer believes the person poses an urgent risk to public health, he can detain the person under the Health Act in a secure facility.

Dr Carnie exercised this power in December when he placed an HIV-positive person in an undisclosed secure location. The person, who has the right to appeal to the Supreme Court, is still there.

Dr Carnie, who replaced Dr Robert Hall after he was sacked by the government last year, has ruled out genotyping new HIV infections — developing a genetic profile of the virus in patients — to track who or what is driving up infections in Victoria.

Former health minister Bronwyn Pike sacked Dr Hall last April after a string of communication failures over his management of HIV cases and a fatal outbreak of gastroenteritis at a nursing home.

HIV infections recently reached their highest level in Victoria in 20 years. The department was notified of 334 cases in 2006, 17% higher than the 285 in 2005 and the highest since 1987.

Australia: Review critical of Victoria's public health response to 'risky' HIV-positive individuals

A review of the Victorian Health Department's management of 'risky' HIV-positive people has been published. The Age puts its own negative spin on the story, but somewhat reassuring is the response from Dr John Carnie, Victoria's chief health officer.

He said cases warranting police intervention were rare and that the review reinforced education and counselling to change people's behaviour rather than criminal prosecution.

The full story, from The Age, is reproduced below.

'Reckless' HIV patients not reported
Julia Medew
The Age
February 23, 2008

HEALTH authorities failed to refer to police HIV-positive people who ignored warnings not to have unprotected sex, a report has found.

A review of the Department of Human Services' management of "risky" HIV-positive people has also revealed authorities lost track of people they were monitoring and did not take action against some who breached public health orders restricting their behaviour.

The review, of 15 cases before the department last year, urges an overhaul of procedures.

The review was ordered by former health minister Bronwyn Pike last year after she sacked Victoria's chief health officer Dr Robert Hall for his management of HIV-positive people who exposed others to the virus.

The review found that while swift and decisive action was taken against some people, there were "occasions where the evidence demanded action but none was forthcoming".

Most of the cases under review involve either recent migrants or gay men.

The examination, carried out by former Western Australian police commissioner Bob Falconer, and former health bureaucrat Dr John Scott, said: "The reviewers believe . . . that involvement of police without the client being referred to police has not always happened when it should have, and this is by no means a recent issue.

"The authors have found the system is in need of significant overhaul and improvement."

It is understood that more than one of the cases reviewed included examples of criminal behaviour that should have been referred to the police.

The report said people who had been served with public health warnings controlling their behaviour were often "uncontactable for a period of time" and that a number of clients who breached behavioural rules were not properly controlled.

The review also found:

■There was no dedicated facility to isolate HIV-positive people who posed a risk to public health under the Health Act.

■Internal procedures for managing cases left a perception that decisions about people's cases were made in an "ad hoc" fashion.

■Legal advice for "contentious" decisions resulted in "significant delays in action being taken" against people.

■Access to interpreters was minimal.

Victorian chief health officer Dr John Carnie yesterday said changes had been implemented to ensure the department returned to "world's best practice". He said the department had been working with Victoria Police to create a shared understanding of each agency's role in managing cases of concern. He said cases warranting police intervention were rare and that the review reinforced education and counselling to change people's behaviour rather than criminal prosecution.

A Canadian expert who reviewed the report said the department's new protocols were in line with world best practice.

Health Minister Daniel Andrews said the Government was committed to implementing the review's recommendations.

Australia: Western Australia proposes new public health laws to detain HIV-positive people who 'put others at risk'

A proposed change to Public Health law in the State of Western Australia would allow people with HIV to be detained and forced to undergo medical treatment.

WA's Public Health executive director, Tarun Weeramanthri, used recent concerns over a sex worker who was named and shamed by health officials in the Australian Capital Territory, to argue that these changes were a good thing.

Ironically, Health Consumers Council executive director, Michelle Kosky, is also for the changes. She believes that the new law would provide HIV-positive individuals with more rights, because for the first time, it allowed people detained under these laws to be able to appeal to the State Administrative Tribunal.

Full story from The Sunday Times (of Australia) below:

Disease carriers may be detained without charge
By Anthony Decegle
February 24, 2008 01:00am
Article from: The Sunday Times


PEOPLE carrying dangerous diseases and sexually transmitted infections, such as HIV, could be detained without charge and forced to undergo medical treatment under legal changes.

A new public health Bill is set to replace the existing law, which is nearly 100 years old, and give the The Western Australian Health Department powers to deal swiftly with individuals who it suspects pose a threat to the community.

Those affected could be banned from venues such as nightclubs, public baths or bars and have to submit to supervision or face the threat of a $50,000 fine. They could also be forced to take antibiotics.

If passed, the new law would replace the WA Health Act 1911 which, according to State Government literature, has "significant limitations in regard to its application to people who knowingly expose others to the risk of HIV infection".

Public Health executive director Tarun Weeramanthri said the deliberate spreading of sexual diseases was a real threat.

The Health Department was forced to put out an urgent warning earlier this month after a 41-year-old male sex worker infected with HIV was charged by police in the Australian Capital Territory.

The sex worker previously lived in WA.

"It is believed that the man may have had unsafe sex with clients in the ACT and other jurisdictions, including WA," Communicable Disease Control director Gary Dowse said.

"It is believed some of the people contacted may have been WA residents and it is possible that other persons in WA may have had contact with the man in the past."

Dr Weeramanthri said the Public Health Bill clarified the terms for dealing with people who had infectious diseases.

"The old act gives certain powers, but doesn't say exactly under what circumstances you may apply them," he said.

"This Bill clarifies the range of circumstances in which someone might act."

Dr Weeramanthri said the Bill was based on a principle of precaution; officials could act on suspicions faster.

"If you think there is a serious risk in the intermediate to long term, even though you may not have all of the evidence right now, it's ethical and prudent to act on the risk," he said.

"You can't just use the lack of definitive evidence as an excuse for not acting. You use common sense."

Public Health Association national president Mike Daube said the Bill would modernise public health legislation.

"It ensures that the health of the community is properly protected," he said. "This is much better than trying to work off legislation that was written long before HIV was even dreamed of."

The Health Department refused to reveal the number of people with an STD infection who were being monitored.

Health Consumers Council executive director Michelle Kosky said the new Bill would provide people with more rights. For the first time, these individuals would be able to appeal to the State Administrative Tribunal.

Australia: Canberra public health officials name (and shame) HIV-positive male sex worker

Public health officials in Canberra have taken the unusual step of holding a press conference to announce that a male sex worker who was charged with "knowingly" transmitting an (unnamed) sexually transmitted infection earlier this month is HIV-positive.

It is unclear from the reports whether the 41 year-old man is, in fact, charged with criminal HIV exposure or transmission; rather, the Canberra health department is appealing for former clients to come forward, even though they already have a list of 250 phone numbers obtained from the man, which they said they would be calling after the press conference.

"It is a very unusual step to take to mention the diagnosis of this kind in the interest of privacy but we will be calling people this afternoon and discussing this diagnosis with them so we know that it will be in the public domain today so therefore I'll share that with you," ACT Chief Health Officer Charles Guest told the press conference.

Of the two news reports online so far, ABC News online's also includes a photo of the man.

To me, this kind of 'contact tracing' – where an HIV-positive individual is named and his picture publicised – seems more like a 'fishing expedition' than an ethical public health measure.

These are the reports from The Herald Sun and ABC News online.

Sex worker exposes 250 to HIV

HEALTH officials are trying to contact 250 people who may have been exposed to HIV by a sex worker.

Hector Scott, 41, of Kingston appeared in ACT Magistrates Court earlier this month charged with knowingly infecting someone with a sexually transmitted disease and failing to register as a sex worker.

At the time, the details of the disease were not known.

ACT Chief Health Officer Charles Guest said today Mr Scott had Human Immunodeficiency Virus (HIV).

"It is a very unusual step to take to mention the diagnosis of this kind in the interest of privacy but we will be calling people this afternoon and discussing this diagnosis with them so we know that it will be in the public domain today so therefore I'll share that with you," Dr Guest said at a press conference.

"HIV positive since 1999"

The health department first became aware of Mr Scott's actions on December 20 last year when notified by another jurisdiction. The department alerted police within 24 hours.

But Mr Scott was not issued with a public health order - to stop working as a prostitute - until January 4, when he was arrested.

Dr Guest said there was evidence Mr Scott had been HIV positive for some years, possibly since 1999.

During 2007 he advertised himself as a prostitute in Canberra media using the names "Adam" and "Josh" but was unregistered as a sex worker.

Could be less

"Bear in mind please 250 is just the number of phone numbers and he may have been phoning family friends, businesses - there are all sorts of other reasons," Dr Guest said.

"That may be a very inflated figure of the number of people that he had sex with or unprotected sex with."

Dr Guest would not say how the contacts were obtained and said many of the phone numbers being used were mobiles so it was unclear whether all of the potential victims were from the ACT.

"We will be exploring that nature of their contact very delicately with them - we have skilled counsellors and clinicians involved in this process," he said.

Counselling

The people contacted will be invited to be counselled and tested for sexually-transmitted infections.

Dr Guest said the whole situation was just a reminder of the importance of safe sex.

"There is a general message here about safe sex and entering into casual sexual relationships - assume that safe sex, protection, use of condoms is essential."

Mr Scott is due to reappear in the ACT Magistrates Court for a mention on February 7.

Charged sex worker has HIV: ACT Health

ACT Health has confirmed Canberra sex worker Hector Scott has HIV.

The 41-year-old from Kingston faced court earlier this month charged with knowingly transmitting a sexually transmitted disease and failing to register as a sex worker.

It is believed Scott may have contracted the disease in 1999.

Authorities have a list of 250 phone numbers of people who may have been in contact with the sex worker, but they say not all are at risk.

ACT Chief Health Officer Doctor Charles Guest says counsellors have started calling people on the list after receiving very few calls to a helpline it set up.

"The extraordinary effort that we're taking to communicate with people who may have been in contact with the sex worker has led us now to start calling people and advising them to be tested and explaining what the consequences of the testing would be," he said.

ACT Health has notified other states and territory authorities to help track down Scott's interstate clients.

New Zealand police have also joined the investigation after Scott spent a week there over Christmas.

Anyone who may have had contact with the man, who advertised under the names Adam and Josh, is urged to call the hotline on xxx xxxx xxx.

Scott is due back in court next month.

Australia: SA goverment sued for 'allowing' Stuart McDonald to infect him with HIV

Man sues in HIV case
ABC News

The South Australian Government is being sued for allegedly failing to prevent a man from being infected with HIV.

The young man alleges he was deliberately infected by Stuart McDonald, 39, who has been charged with endangering the life of several men he had sex with.

McDonald's movements are restricted by home detention conditions.

The alleged victim's lawyer, Peter Humphries, argues the SA Health Department should have better managed McDonald.

Mr Humphries says his client had unprotected sex with McDonald in October 2005.

"That was at a time, as far as we understand it, at least two reports had been made to the Health Department of McDonald's practice of engaging in sexual activity without protection, knowingly full well he was carrying the HIV virus," he said.

Mr Humphries says his client, aged in his 20s, is angry that his life has potentially been cut short.

"I think it's probably fair to say the main one's anger, that he's been put in this position needlessly," he said.

"Had McDonald been put under some sort of control orders, given his complete lack of interest in exercising self control, then this whole thing would have been avoided."

Australia: Editorial argues epidemiological information should be used to prosecute 'reckless' individuals

An editorial in The Age argues that Australia's HIV Epidemiology Project should be used to track down individuals who are 'reckless' so that they can be prosecuted.

This is not only unethical, it is also not scientifically possible given the uncertainties inherent in phylogenetic analysis – the scientific method used when assessing the relationship between HIV genotypes.

A suitable case for treatment. Unsuitable for restriction.
Editorial, The Age
May 14, 2007

The battle against HIV/AIDS in Australia is being waged on shifting territory. In one area there is solid ground: the promise of scientific vigilance to find factors contributing to the rise in infection rates, particularly in Victoria. Elsewhere is a darker, more treacherous landscape: the threat of politically initiated assessments of HIV-positive visitors to Australia and the possibility they could be banned altogether. Both initiatives originate from the Federal Government.

As The Age reports today, the Government's Health Protection Committee has chosen a team of Victorian scientists to analyse HIV infections over the past three years to determine who or what is responsible for the rise in national infection rates from 656 cases in 2000 to 930 in 2005, an increase of 41 per cent; in this state HIV infection is at its highest level for 20 years: in 2006, 334 cases of HIV were reported to the Department of Human Services, an increase of 17 per cent on the previous year. As part of its investigation, the HIV Epidemiology Project will examine whether genotyping HIV infections - developing a genetic profile of the virus in patients - could help identify groups of individuals transmitting the virus. Three men, including a Melbourne man, Michael John Neal, are before Australian courts on charges of recklessly or deliberately infecting others with HIV.

Although civil-rights groups representing people living with HIV and AIDS have raised ethical concerns over genotyping - previously used only in criminal cases or to determine a virus' resistance to drugs - the Health Minister, Tony Abbott, who approved the project last month, has said the research is aimed at gathering information on risk groups and not tracking down individuals. This has been supported by the head of the Infectious Disease and Epidemiology Unit at Monash University, Dr Karin Leder, who says risk groups are the focus of the first phase of the project, with any future investigation of individuals dependent on the data received. If, however, this leads to the identification of HIV-positive individuals who, through indiscriminate recklessness are endangering the lives of others, then surely public safety must take precedence over rights to privacy.

The HIV Epidemiology Project should be welcomed. At the very least, it represents a national approach to what is really a national problem, as well as a significant step towards proper research into a condition that knows no boundaries. Any sensible measure that can lead to a reduction in the HIV infection rate cannot be discounted, especially when news of the project comes at the same time as Government funding of almost $10 million over four years for a national HIV-prevention program, including a new media campaign. The project should also, by default, begin to restore confidence in a health system beleaguered by last month's breakdown in bureaucratic communication at Victoria's Department of Human Services; this led to the sacking of the state's chief health officer, Dr Robert Hall, by his minister, Bronwyn Pike, over alleged non-disclosure of three HIV-positive people under police investigation.

A far more sensitive issue, one that stigmatises rather than helps HIV sufferers, is the intention of the Prime Minister, John Howard, to restrict or perhaps ban such infected people from entering the country. Mr Howard has written to his immigration and health ministers seeking advice on the public-health implications of letting HIV-positive people into Australia. This follows Mr Howard's response last month, when asked about allowing in HIV-positive immigrants, "My initial reaction is no". Mr Howard also said there could be "humanitarian considerations".

Some countries, including the United States, Russia and the United Arab Emirates, have absolute bans on HIV sufferers; others, such as Britain and France, are more tolerant. It is difficult to see how Australia could benefit from becoming an HIV exclusion zone without being seen to be unnecessarily discriminatory or alarmist. It would be better for the Government to concentrate on the more effective methods of control through scientific research and public awareness.