Groundhog Day
Each time I sit down to write my editorial, it feels like Groundhog Day: another
month, another prosecution of someone for reckless transmission of HIV. What
was once thought of as ‘exceptional’, with the Stephen Kelly case
in 2001, is fast becoming commonplace in courts up and down the land. There
have now been six prosecutions in the UK and more are in the legal pipeline.
This time Cardiff Crown Court felt compelled to sentence a 20-year-old woman
to two years’ youth custody for recklessly infecting her ex-boyfriend.
But, when all the legal dust has settled, few are bothering to ask about the
long-term impact on the lives of people living with HIV, including those recently
infected by sexual partners.
Early findings from the UKC criminalisation survey (www.ukcoalition.org)
suggest that far from encouraging disclosure, these convictions are beginning
to generate a state of fear among some HIV positive people. Rather than encouraging
more people to disclose their HIV status to new sexual partners, substantial
numbers will keep this information to themselves, driving the problem further
underground.
Of the 200 respondents so far, the vast majority (77 per cent) think the convictions
will increase the stigma and isolation of people living with HIV. This figure
rises to 86 per cent of respondents who said they were HIV positive. Almost
half (45 per cent) think the recent convictions would make them less frank
when talking about sex to health professionals and HIV organisations.
So, if the Crown Prosecution Service (CPS) hoped these prosecutions would
terrify people into disclosure, they were wrong. Around 45 per cent stated
the prosecutions would not alter their disclosure decisions with new sexual
partners while 20 per cent said they would be less likely to disclose. If
that 20 per cent includes people previously confident about disclosure, the
implications for prevention are huge. As if to underline the point, a third
of respondents thought the convictions would definitely increase onward transmission
rates.
On whether there should be prosecutions, around 45 per cent of HIV positive
respondents felt the CPS should prosecute cases of intentional (deliberate)
transmission only, while 37 per cent thought there should be no prosecutions
at all. Meanwhile, prosecutions across Europe are increasing. A new report
shows there have been at least 130 convictions for transmitting or exposing
another person to HIV infection. Sweden has been most active in policing the
bedroom, jailing at least 30 people for the offence – a terrifying rate
of one per 120 people living with HIV. We suspect many Swedes are deterred
from testing in a country which isolated an HIV positive man for a year-and-a-half
to ‘prevent the spread of HIV’.
Last month the CPS wrote to PN to say it would consult widely, including people
living with HIV, to inform prosecution policy. But it’s hard to take
their assurances seriously when prosecutions are becoming a monthly occurrence.
Health ministers have yet to be drawn into public debate over criminalisation
but a strong intervention from them during the CPS consultation could be crucial.
It’s clear they cannot support anything that stops people coming forward
for testing. Meanwhile, Department of Health officials have assured PN that
behind the scenes they are talking to the Home Office and the CPS. UKC are
among several HIV organisations who have been invited to take part in the
CPS consultation in the autumn. Whether that process will prove to be anything
other than a sham is yet to be seen.
Amanda Elliot, Managing editor
