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Hiv Disclosure And Public Health


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Hiv Disclosure And Public Health

  1. 1. Kate Bukowski NZAF Policy Analyst HIV and the Law in New Zealand from a Public Health Perspective Public Health Association Conference 3 September 2009
  2. 2. Overview <ul><li>History of New Zealand HIV prosecutions </li></ul><ul><li>People living with HIV’s rights and legal obligations </li></ul><ul><li>Criminal law and public health harm reduction </li></ul><ul><li>Public Health Bill </li></ul><ul><li>How to work with the rare cases of people with HIV who place others at risk </li></ul>
  3. 3. <ul><li>Crimes Act (1961) </li></ul><ul><ul><ul><li>s156: Duty of persons in charge of dangerous things </li></ul></ul></ul><ul><ul><ul><li>s145: Wounding with intent </li></ul></ul></ul><ul><ul><ul><li>s188(2): Criminal nuisance </li></ul></ul></ul><ul><li>Health Act (1956) </li></ul>Legislation
  4. 4. <ul><li>Cases that will be discussed in this presentation: </li></ul><ul><li>R v Mwai (1995) </li></ul><ul><li>Police v Truscott (1999) </li></ul><ul><li>Police v Dalley (2005) </li></ul>HIV Criminal Prosecutions
  5. 5. <ul><li>R v Dalley (2005) – a significant alignment of criminal law with Public Health principles: </li></ul><ul><ul><ul><ul><ul><li>Condom use not disclosure of HIV status were deemed reasonable to discharge duty of care. </li></ul></ul></ul></ul></ul>Public Health and Criminal Law
  6. 7. <ul><li>A successful outcome because: </li></ul><ul><ul><ul><li>Good relationship with Police first </li></ul></ul></ul><ul><ul><ul><li>Provide the same information on the science of </li></ul></ul></ul><ul><ul><ul><li>HIV risk to prosecution and defense </li></ul></ul></ul><ul><ul><ul><li>Ensure accused party is supported </li></ul></ul></ul>Lessons learnt from R v Dalley lubricant was a reasonable precaution to discharge the duty of care in a criminal nuisance prosecution under section 145 of the Crimes Act (1961). However this was for vaginal intercourse which has a lower risk of transmission than anal intercourse. However there is a case before the courts at the moment concerning an individual who allegedly intended to transmit HIV to others. It is important to remember that cases like this are rare. The majority of people with HIV take precautions to protect others from being infected with HIV.
  7. 8. NZAF’s “HIV transmission and the law”
  8. 9. <ul><ul><ul><li>NZAF supports HIV becoming notifiable. </li></ul></ul></ul><ul><ul><ul><ul><li>Only if an anonymous code. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In order to ‘future proof’ the current reporting system. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Various improvements and clarity for Medical Officers of Health. </li></ul></ul></ul></ul>Public Health Bill
  9. 10. The Discussion Document on Proposed Guidelines <ul><li>NZAF is chairing the National HIV and AIDS Forum working group on the discussion document “Guidelines for the Management of People with HIV who Place Others at Risk”. </li></ul>
  10. 11. Our mission/koromakinga Ki te arai i te tuku o te HIV me te whakapai ake i hauora me te oranga o nga tangata e ora ana me te HIV me te AIDS. To prevent the transmission of HIV and to support people affected by HIV and AIDS to maximise their health and wellbeing.
  11. 12. References <ul><li>Cameron, S., Power, L., Le Mesurier, R., & Azad, Y. (2009) The Criminalisation of HIV Transmission: International Unpublished chapter. </li></ul><ul><li>Goldstein, D., Patton, C., & Worth, H (2005) “Reckless Vectors: the infecting ‘other’ in HIV/AIDS law”. Sexuality Research and Social Policy: Journal of NSRC 2:2 (1-2) </li></ul><ul><li>MacDonald, A., & Worth, H. (2005) “Mad, and Bad: HIV Infection, Mental Illness, Intellectual Disability, and the Law”. Sexuality Research and Social Policy: Journal of NSRC 2:2 (51-62) </li></ul><ul><li>Stein, T.S. (2005) “Editorial. Criminalization, Cultural Studies, and Other New Territory for SRSP”. Sexuality Research and Social Policy: Journal of NSRC 2:2 (1-2) </li></ul><ul><li>UNAIDS (1996) HIV and Human Rights International GuidelinesDownloaded on 18 August 2009 from: </li></ul><ul><li>WHO (1986) Ottawa Charter </li></ul><ul><li>WHO (2006) WHO Technical Consultation in collaboration with the European AIDS Treatment Group and AIDS Action Europe on the criminalization of HIV and other sexually transmitted infections. Copenhagen 16 October 2006 </li></ul>