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J Int AIDS Soc. 2018 Jul;21(7):e25161. doi: 10.1002/jia2.25161.

Expert consensus statement on the science of HIV in the context of criminal law.

Author information

1
Pasteur Institute, Paris, France.
2
Mailman School of Public Health, Columbia University, New York, NY, USA.
3
Centre for the AIDS Program of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
4
Weill Medical College, Cornell University, New York, NY, USA.
5
Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
6
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
7
Department of Epidemiology, Center for AIDS Research and Center for Public Health and Human Rights, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
8
Infectious Diseases Unit, Juan A. Fernandez Hospital Buenos Aires, CABA, Argentina.
9
Buenos Aires University Medical School, Buenos Aires, Argentina.
10
Fundación Huésped, Buenos Aires, Argentina.
11
Infectious Diseases, Geneva University Hospital, Geneva, Switzerland.
12
Instituto Nacional de Infectologia Evandro Chagas-Fiocruz, Fiocruz, Rio de Janeiro, Brazil.
13
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
14
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
15
YRGCARE Medical Centre, Voluntary Health Services, Chennai, India.
16
Women's College Research Institute, Toronto, Canada.
17
Women's College Hospital, Toronto, Canada.
18
Department of Medicine, University of Toronto, Toronto, Canada.
19
Infectious Diseases Unit, Ibn Rochd Universtiy Hospital, Casablanca, Morocco.
20
Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Dakar, Senegal.
21
Faculty of Medicine, University of British Columbia, Vancouver, Canada.
22
BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
23
International Association of Providers of AIDS Care, Kampala, Uganda.
24
Russian Peoples' Friendship University (RUDN- University), Moscow, Russian Federation.
25
Central Research Institute of Epidemiology, Federal Service on Customers' Rights Protection and Human Well-being Surveillance, Moscow, Russian Federation.
26
KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium.
27
Center for Global Health and Tropical Medicine, Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
28
International Association of Providers of AIDS Care, Washington, DC, USA.
29
UNAIDS, Geneva, Switzerland.
30
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.

Abstract

INTRODUCTION:

Globally, prosecutions for non-disclosure, exposure or transmission of HIV frequently relate to sexual activity, biting, or spitting. This includes instances in which no harm was intended, HIV transmission did not occur, and HIV transmission was extremely unlikely or not possible. This suggests prosecutions are not always guided by the best available scientific and medical evidence.

DISCUSSION:

Twenty scientists from regions across the world developed this Expert Consensus Statement to address the use of HIV science by the criminal justice system. A detailed analysis of the best available scientific and medical research data on HIV transmission, treatment effectiveness and forensic phylogenetic evidence was performed and described so it may be better understood in criminal law contexts. Description of the possibility of HIV transmission was limited to acts most often at issue in criminal cases. The possibility of HIV transmission during a single, specific act was positioned along a continuum of risk, noting that the possibility of HIV transmission varies according to a range of intersecting factors including viral load, condom use, and other risk reduction practices. Current evidence suggests the possibility of HIV transmission during a single episode of sex, biting or spitting ranges from no possibility to low possibility. Further research considered the positive health impact of modern antiretroviral therapies that have improved the life expectancy of most people living with HIV to a point similar to their HIV-negative counterparts, transforming HIV infection into a chronic, manageable health condition. Lastly, consideration of the use of scientific evidence in court found that phylogenetic analysis alone cannot prove beyond reasonable doubt that one person infected another although it can be used to exonerate a defendant.

CONCLUSIONS:

The application of up-to-date scientific evidence in criminal cases has the potential to limit unjust prosecutions and convictions. The authors recommend that caution be exercised when considering prosecution, and encourage governments and those working in legal and judicial systems to pay close attention to the significant advances in HIV science that have occurred over the last three decades to ensure current scientific knowledge informs application of the law in cases related to HIV.

KEYWORDS:

criminal law; criminalization; human rights; law and policy; policy; prosecution; risk factors

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