{"id":1229,"date":"2016-11-28T16:58:23","date_gmt":"2016-11-28T16:58:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=1229"},"modified":"2016-11-28T16:58:23","modified_gmt":"2016-11-28T16:58:23","slug":"criminalizing-hiv-transmission-is-imprisonment-ever-the-right-response","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2016\/11\/28\/criminalizing-hiv-transmission-is-imprisonment-ever-the-right-response\/","title":{"rendered":"Criminalizing HIV transmission: Is imprisonment ever the right response?"},"content":{"rendered":"

This month sees the publication of a ‘Consensual Statement’<\/a> \u00a0by Australian medical professionals on \u2018Sexual Transmission and the Law\u2019.\u00a0 This draws on a similar Canadian ‘Consensus Statement’<\/a> \u00a0issued in 2014.<\/p>\n

The involvement of the law in this area remains a highly controversial matter.\u00a0 It is easy to assume that UNAIDS policies underlining the public health disbenefits of “overly broad criminalization”<\/a> largely concern those African nations which have recently adopted draconian legal previsions in response to the HIV crisis (Kpanake & Mullet\/STIs<\/a>; Stackpole-Moore\/STIs<\/a>).\u00a0 Yet we should not forget that prosecution and imprisonment for transmission of HIV continues to occur in first-world countries as well (e.g. 16 custodial sentences in England over the period 2001-2012 (Phillips & Sukthankar\/STIs<\/a>)).\u00a0 National jurisdictions differ in respect to whether, in order to be subject to prosecution, the transmission must be intentional or reckless.<\/p>\n

Many in sexual health, I suspect,\u00a0would\u00a0reject the\u00a0idea of involving the criminal law\u00a0in\u00a0such cases.\u00a0 Stackpole-Moore\/STIs,<\/a> for example,\u00a0argues that its use \u201cin order to guide normative behaviour\u201d\u00a0is irreconcilable\u00a0with the concern to avoid internalized stigma among at risk populations.\u00a0 According to S, employing criminal sanctions in this area involves promoting just the kind of social stigma that health policy makers have found so counter-productive in fighting the epidemic.\u00a0 However,\u00a0this side-steps the\u00a0question whether there might ever be a\u00a0moral<\/em> argument for legal sanctions regardless of their impact on behaviour.\u00a0\u00a0Phillips & Sukthankar\/STIs<\/a>, in their theoretical examination of traditional justifications for sentencing to imprisonment,\u00a0recognize the possibility that \u2018retributive justice\u2019 could provide some genuine\u00a0justification for imprisonment for HIV transmission.\u00a0 This might explain why those\u00a0African legislators\u00a0responsible for passing\u00a0the\u00a0recent severe previsions, tend, when asked about their motivations,\u00a0to revert to the argument of retribution\u00a0– even\u00a0where that is not the ‘official’ justification\u00a0(Stackpole-Moore\/STIs<\/a> and Kpanake & Mullet\/STIs<\/a>).<\/p>\n

To come at last to the recent Australian and Canadian statements \u2013 these discourage, even if they don\u2019t quite\u00a0exclude, the involvement of the law.\u00a0\u00a0However, they do so not<\/em> on the grounds of\u00a0a principled\u00a0rejection of\u00a0all justifications for criminalization (such as advocated by Stackpole-Moore\/STIs<\/a>), but on the grounds of the changing reality, and changing perceptions, of HIV.\u00a0 They specify the risk of per sex-act transmission \u2013 in the case of penal-vaginal transmission, rated low (0.4%-1.4%) \u2013 and point to the effectiveness and tolerability of treatment.\u00a0\u00a0If HIV is no longer a \u2018death-sentence\u2019, then transmitting HIV to a partner can hardly be considered \u2018killing\u2019.\u00a0 Still more conclusively, perhaps, they point to the inadequacy of phylogenetic analysis as forensic evidence, which, they argue, \u201csimply cannot determine beyond reasonable doubt that the reference samples are linked\u201d.<\/p>\n

Yet it should be remembered\u00a0that the first two of these three considerations (unlike the claims of retributive justice) are context-dependent.\u00a0 Whether or not\u00a0HIV\u00a0amounts to\u00a0a\u00a0‘death sentence’ may depend on where you live.\u00a0 Were the same kind of arguments to be applied in the case of the African countries discussed by S and K&M, they would need to take account of the very\u00a0different\u00a0health realities obtaining in those countries.<\/p>\n","protected":false},"excerpt":{"rendered":"

This month sees the publication of a ‘Consensual Statement’ \u00a0by Australian medical professionals on \u2018Sexual Transmission and the Law\u2019.\u00a0 This draws on a similar Canadian ‘Consensus Statement’ \u00a0issued in 2014. The involvement of the law in this area remains a highly controversial matter.\u00a0 It is easy to assume that UNAIDS policies underlining the public health […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[264,2789,16491],"tags":[275],"class_list":["post-1229","post","type-post","status-publish","format-standard","hentry","category-health-policy","category-hiv-the-law","category-phylogenetic-analysis","tag-human-rights"],"yoast_head":"\nCriminalizing HIV transmission: Is imprisonment ever the right response? - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2016\/11\/28\/criminalizing-hiv-transmission-is-imprisonment-ever-the-right-response\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Criminalizing HIV transmission: Is imprisonment ever the right response? - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"This month sees the publication of a ‘Consensual Statement’ \u00a0by Australian medical professionals on \u2018Sexual Transmission and the Law\u2019.\u00a0 This draws on a similar Canadian ‘Consensus Statement’ \u00a0issued in 2014. 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