“REMAINING ignorant of your HIV status is not a human right,” Professor Lucy Allais, director of the Wits Centre for Ethics, said today at a discussion on HIV testing and human rights.
Allais was speaking at the 5th South African AIDS Conference about whether- in theory in a country with a high HIV prevalence – it would be a human rights violation for the government to require every individual to know their HIV status.
Since April last year the government has dramatically scaled up voluntary HIV counselling and testing (HCT) and through its national HCT campaign 12 million people have found out their HIV status.
“A policy of ‘mandatory knowledge‘, in which the individual is required to find out their HIV status and demonstrate he or she has this knowledge, would not be a human rights violation,” Allais stated.
A mandatory knowledge policy would not require the individual to disclose their status, nor the health professional to break confidentiality nor demand ‘mandatory testing’ (where the health professional demands an HIV test),” she said.
HIV testing is not risky, nor invasive, nor painful and the only plausible harm to the individual was the psychological impact of finding out he or she had HIV, she said.
But not knowing one’s status can be harmful, while finding out one’s status has proven benefits.
“Knowing one’s status has benefit for the individual, his or her partner and for public health,” Allais suggested, “but most people do not realise these benefits since they do not know their status or start treatment until late (in the disease).”
If a state infringes on an individuals’ fundamental freedoms then it is are violating that person’s rights, said Allais, but a “mandatory knowledge” policy would not violate the right to privacy (HIV results would remain confidential),
Putting rights in a broader context than that of health, she explained that HIV testing would not violate the right to autonomy nor to bodily integrity.
“We would argue that mandatory knowledge is not at odds with informed consent since it does not require testing without consent.”
One of the delegates expressed relief that Allais’ view was theoretical and not practical.
But Allais is raising an important issue and maybe it’s time to debate this in real time in the real world.
Human trafficking is a gross human rights violation but the scale of this problem, particularly during the World Cup, is often exaggerated researchers state in a report released this month.
No emperical evidence exists to prove that trafficking escalates during big sporting events, say Marlise Richter and Tamlyn Monson from Wits University’s Forced Migration Studies Programme.
“Germany’s experiences during the 2006 Soccer World Cup contradict claims that trafficking volumes will rise during the 2010 Event in South Africa,” they say.
Research conducted after the 2006 World Cup exposed five cases of human trafficking, nothing like the 40 000 cases that were predicted.
Most reports on human trafficking – moving people against their will so that they may be exploited – are based on claims and estimates, they say.
They warn that undue emphasis on human trafficking can detract attention from other human rights violations and labour exploitation, and be to the detriment of policy development in areas like cross-border migration and sex work.
Sex work and human trafficking demand different responses since they are different phenomena, the researchers say – supporting the call to combat human trafficking but also to decriminalise sex work.
The ministry is presently being sued in the Windhoek High Court for the alleged forced sterilisation of six women in state medical facilities.
Human rights groups claim that 40 out of 230 women they interviewed early in 2008 claimed they were sterilised without consent -and that a further 15 women have come forward after they alerted in the ministry about this.
The Legal Assistance Centre is claiming damages for the women on two grounds:
the alleged sterilisations without their consent by medical practitioners employed at state hospitals, or alternatively on the grounds of breach of duty of care that medical professionals owed each of the plaintiffs; and
*the sterilisation constituted a wrongful and unlawful practice of discrimination against each of the women due to their HIV-positive status, and is thus in breach of their basic human rights
Acting for the LAC, senior counsel Dave Smuts, told the court that “one common thread” between all the cases were that the women were living with HIV and the outdated notion was that women with the virus should not have children.
Dr Matti Kimberg, a gynaecologist and obstetrician, is providing expert evidence on the invasive nature and consequences of the procedures on the plaintiffs, he said.
The alleged forced sterilisation procedures constitute a profound invasion of his clients’ rights to dignity and personality, Smuts said.
The first plaintiff said the nurse only informed her when she was being taken to theatre for a C-section that “the doctor will remove her uterus “because all HIV-positive people must have it removed”.
The woman was given a forms to sign. The plaintiff’s lawyers will argue that the women did not understand the procedure or were coerced, and that the “informed consent” process was not followed correctly.
The hearing is expected to continue in the High Court.
HIV activists need better protection the International AIDS Society declared today, calling for the release of Maxim Popov, who has been imprisoned for seven years in Uzbekistan for his HIV prevention work.
This week 9 activists were detained in Tanzania, after handing over a memorandum calling on political leaders to fund universal prevention and treatment for HIV/AIDS, and then deported.
Popov is in prison for promoting effective, evidence-based ways to prevent HIV, the IAS stated.
“Popov, 28, is the author of ‘HIV and AIDS Today,’ a brochure that discusses the use of condoms in HIV prevention, the need for sterile needles for injecting drug users, and education on HIV prevention within same-sex relations,” said IAS executive director Robin Gorna.
“In his training workshops with school teachers, Popov, used a text-book ‘Healthy Lifestyles, The Guidance for Teachers, published in Kyrgyzstan and Kazakhstan with support of USAID and UNDP, which advises using condoms to protect oneself from HIV.
“The Uzbek government said that the book constituted an ‘assault on minors without violence’ and ordered the book incinerated and barred from circulation. Izis, the AIDS NGO founded by Popov, with support from a wide array of donors including USAID and DfID, has shut down since his jailing.
“Imprisoning Maxim Popov is not only a violation of human rights, but it has hurt public health efforts in Uzbekistan,” said Gorna. “In most countries around the world the work done by Maxim Popov would be drawing praise and support.”
Uzbekistan has one of the world’s fastest-rising HIV infection rates, the UNAIDS reports.
About 16,000 cases of HIV were reported in 2009 – more than an eleven-fold increase from 1,400 cases in 2001.
IAS president Julio Montaner said: “I urge all influential political and public health leaders to join IAS in calling for Maxim Popov’s release from prison.”
Homosexuality is a crime in Uzbekistan and the Popov verdict obtained by Eurasia.net, shows he was also convicted of distributing copies of a UNAIDS publication, “HIV and Men who have Sex with Men in Asia and the Pacific”, according to a report on the International Lesbian, Gay, Bisexual, Trans and Intersex Association website.
In Germany, it’s a criminal act to have sex with people without telling them you are HIV positive.
Now singer Nadja Benaissa, from that country’s popular girl band No Angels, has been charged with “causing bodily harm for failing to inform sexual partners” that she was HIV positive.
One of the three people involved in this case has since become infected with virus.
Prosecutors from Darmstadt, a town near Frankfurt, said: “She was well aware that any unprotected sexual contact can lead to the virus being passed on.”
Benaissa was arrested last year April before a performance in Frankfurt, on the “suspicion of sleeping with the men” between 2004 and 2006.
She faces up to 10 years in jail if found guilty of this offence.
Of course it’s immoral and unethical to knowingly put another person at risk, but in this case Benaissa is being held soley responsible for this new HIV infection.
What about the responsibility of her adult sexual partners: why didn’t they use condoms to protect themselves in an era when HIV is common?
Criminalising the sexual behaviour of consenting adults with or without HIV will worsen the stigma around this virus.
In South Africa, all sexual partners need to think about HIV and the risks of infection. A Cape Town survey of 24 HIV-positive men and 58 HIV-positive women found that most sex – 80% of 5000 sex acts – involved no condoms at all.
“More than half of the unprotected sex events were with HIV -negative partners or partners with unknown HIV status,” said the researchers, who were led by Dr Susan Kiene and Dr Leickness Simbayi.
Another study of HIV risk among 15- to 24-year-old females and their older male partners, or “sugar daddies”, found both parties wrongly believed the other to be at low risk for HIV .
It’s time for every sexually active person to be responsible for himself or herself.