One of the highlights of last month’s 22nd International AIDS Conference in Amsterdam (AIDS 2018) was the release of the “Expert consensus statement on the science of HIV in the context of criminal law”. In this statement, 20 eminent world scientists — including two leading Canadian researchers — provided their conclusive opinion on the low-to-no possibility of a person living with HIV transmitting the virus in various situations, including via sexual acts. Published in the peer-reviewed Journal of the International AIDS Society, the statement describes the current evidence on HIV transmission, treatment effectiveness and forensics so that HIV-related science may be better understood in criminal law contexts. You can learn more about the evidence in the statement from the short summary and a Frequently Asked Questions document, both available here.
People living with HIV in Canada have been charged with some of the most serious offences in the Criminal Code, even in cases of consensual sex where there was negligible or no risk of HIV transmission, no actual transmission and no intent to transmit.
The Undetectable=Untransmittable (“U=U”) campaign is based on scientific research, including the ground-breaking PARTNER study, establishing that when a person living with HIV on treatment maintains an undetectable viral load for at least six months, the risk of transmitting the virus through sex is effectively non-existent. As advocates for persons living with HIV await action from federal, provincial and territorial governments to address the overly-broad criminalization of HIV non-disclosure, how might the U=U campaign and the results of the PARTNER study impact ongoing prosecutions under the current state of the law?
Lack of access to HIV treatment and care among other complex factors contributes to these alarming rates: in many rural or remote areas, HIV-specific services are simply not available, or the small size of the community creates concerns around confidentiality for those accessing care. Indigenous people in Canada — many of whom are surviving a legacy of colonization and the intergenerational effects of residential schools — continue to experience systemic discrimination and extremely high rates of incarceration. In this context, the criminalization of HIV non-disclosure may be perceived as yet another form of institutionalized violence and discrimination, amplifying the negative impact of the HIV epidemic on Indigenous communities.
It’s been a long and winding campaign trail and like most of the country, we’re waiting in anticipation to see what this new government will do.
In the lead up to the election, Action Canada for Sexual Health and Rights produced a series of policy briefs that outlined actions the Government of Canada could take on a range of sexual and reproductive rights-related issues. We’ve already seen movement on some of the proposals, but as a whole these briefs still offer a road map to the changes the country needs to make to meet its sexual and reproductive rights obligations.
In Canada and in much of the Western world, thanks to the advent of combination antiretroviral therapy, there has been a clear improvement in health status and increased life expectancy of people living with HIV approaching that of the general population. However, despite these medical advances, negative public perception about HIV has yet to catch up to the reality that most clinicians encounter. The reality for the most part is of healthy and conscientious patients looking to improve their quality of life.
The CATIE Blog hosts the views and opinions of people and organizations working and volunteering in Canada’s response to HIV and hepatitis C.