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Reproductive Health Matters
An international journal on sexual and reproductive health and rights
Volume 17, 2009 - Issue 34: Criminalisation of HIV, sexuality and reproduction
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Original Articles

Protecting HIV-positive women's human rights: recommendations for the United States National HIV/AIDS Strategy

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Pages 127-134 | Published online: 03 Dec 2009
 

Abstract

To bring the United States in line with prevailing human rights standards, its National HIV/AIDS Strategy will need to explicitly commit to a human rights framework when developing programmes and policies that serve the unaddressed needs of women. This paper focuses on two aspects of the institutionalized mistreatment of people with HIV: 1) the criminalization of their consensual sexual conduct; and 2) the elimination of informed and documented consensual participation in their diagnosis through reliance on mandatory and opt-out testing policies. More than half of US states have HIV-specific laws criminalizing the consensual sexual activity of people with HIV, regardless of whether transmission occurs. Many of these laws hinge prosecution on the failure of HIV-positive people to disclose their HIV status to a sexual partner. The Obama Administration should explore administrative and legislative incentives to eliminate these laws and prosecutions, and target a portion of prevention funding for anti-stigma training. Testing policies should be reconsidered to remove opt-out and/or mandatory HIV testing as a condition for receipt of federal funding; incentives should encourage states to adopt local policies mandating counseling; and voluntary HIV testing should be offered regardless of the provider's undocumented perception of an individual's risk.

Résumé

Pour se mettre en conformité avec les normes des droits de l'homme, les États-Unis devront faire adhérer explicitement leur stratégie nationale de lutte contre le sida à un cadre des droits de l'homme lors de la préparation de programmes et politiques répondant aux besoins des femmes. Cet article porte sur deux aspects de la maltraitance institutionnalisée des personnes avec le VIH: 1) la criminalisation de leur conduite sexuelle consensuelle; et 2) l'élimination de leur participation volontaire éclairée et informée au diagnostic par des politiques de dépistage obligatoire ou à consentement explicite. Aux USA, plus de la moitié des états possèdent des lois spécifiques au VIH qui criminalisent l'activité sexuelle consensuelle des personnes avec le VIH, qu'il y ait ou non transmission du virus. Beaucoup de ces lois fondent les poursuites sur la non-révélation de la séropositivité au partenaire sexuel. Le gouvernement Obama devrait envisager des incitations administratives et législatives pour éliminer ces lois et poursuites, et réserver une partie des fonds de prévention à la formation contre la stigmatisation. Il faut revoir les politiques de dépistage pour ne plus subordonner le financement fédéral au dépistage obligatoire et/ou à consentement présumé; les états doivent être encouragés à adopter des politiques locales obligeant le conseil; et le prestataire proposera le dépistage volontaire du VIH quelle que soit l'idée intuitive qu'il se fait du risque couru par un individu.

Resumen

Para lograr que Estados Unidos siga la línea de las normas imperantes respecto a los derechos humanos, su Estrategia Nacional del SIDA deberá comprometerse explícitamente a un marco conceptual de derechos humanos al crear programas y políticas que atiendan las necesidades insatisfechas de las mujeres. Este artículo se centra en dos aspectos del maltrato institucionalizado de las personas con VIH: 1) la penalización de su conducta sexual consensual; y 2) la eliminación de participación consensual informada y documentada en su diagnóstico mediante la dependencia de políticas referentes a pruebas obligatorias u optativas. Más de la mitad de los estados de EE.UU. tienen leyes específicas al VIH, que penalizan la actividad sexual consensual de las personas con VIH, independientemente de que ocurra transmisión. De acuerdo con muchas de estas leyes, la acusación se basa en el hecho de que las personas VIH-positivas no divulguen su estado de VIH a su pareja sexual. El Gobierno de Obama debería explorar los incentivos administrativos y legislativos para eliminar estas leyes y acusaciones, y designar una porción de los fondos de prevención para la capacitación contra el estigma. Se debe reconsiderar las políticas y eliminar las pruebas optativas y/u obligatorias de VIH como condición para recibir fondos federales; los incentivos deberían motivar a los estados a adoptar políticas locales que exijan consejería; y se deben ofrecer pruebas voluntarias de VIH independientemente de la percepción indocumentada del prestador de servicios en cuanto al riesgo de una persona.

Acknowledgments

Terry McGovern, Ford Foundation HIV/Human Rights Program Officer, held the Women, Human Rights & HIV/AIDS convening in New York, NY, April 2009, where the resulting publication was initially conceived. This article is an edited and expanded excerpt from a larger document entitled Critical Issues for Women and HIV: Health Policy and the Development of a National AIDS Strategy, July 2009, that covers topics of meaningful involvement, discrimination and human rights violations, disparities in southern and rural United States, health care reform and access, the integration of reproductive health and HIV/AIDS care, and prevention for women living with and affected by HIV/AIDS. The organizations that contributed to the original document were the African Friends Services Committee, New York, NY; AIDS Alabama, Birmingham, AL; Alliance of AIDS Services, Raleigh, NC; Center for HIV Law & Policy, New York, NY; Community HIV/AIDS Mobilization Project, New York, NY; Center for Health and Gender Equity, Washington, DC; HIV Law Project, New York, NY; International Community of Women Living with HIV, Washington, DC; National AIDS Fund, Washington, DC; National Women and AIDS Collective, a project of the Ms. Foundation, New York, NY; Sisterlove, Inc, Atlanta, GA; US Positive Women's Network, Oakland, CA; The Women's Collective, Washington, DC; Women Organized to Respond to Life-threatening Disease, Oakland, CA.

Notes

* Stop press: The 22-year-old travel ban was lifted by President Obama as of 2 November 2009 because it was “rooted in fear rather than fact”. From: Washington Post, 30 October 2009.

† The US Department of Justice released guidelines in July 2009, clarifying the rights of persons with HIV/AIDS to obtain occupational training and state licensing.

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