2011 HIV awareness campaign in Prague.
A public health department in the Czech Republic has launched criminal investigations against 30 HIV-positive men whom it alleges had unprotected sex in violation of the country’s laws that make it a crime to expose someone else to HIV.
There are no complainants in the case, nor any evidence anyone has contracted HIV from the 30 men under investigation. The sole evidence against the men is that they contracted other sexually transmitted infections (STI) — like gonorrhea or syphilis — after testing HIV-positive, which the health department contends is proof they had condomless sex in violation of the law.
“There’s absolutely no evidence, there are no victims,” said Jakub Tomšej, a lawyer with the Czech AIDS Help Society, which has provided counseling to some of the men under investigation. “We believe the only consequence [of this kind of investigation] is that HIV-positive people who get another STI will simply avoid doctors.”
Tomšej said he had spoken to nine men directly, and all said they had contracted the other infections through sex with another person who was also diagnosed as HIV-positive or despite wearing condoms, which are not 100 percent effective against conditions like syphilis.
The department has not appeared to have factored in whether the men were on effective treatment, which can reduce their viral load so much that they are not at risk of transmitting the disease, Tomšej said.
Many other European countries prosecute people for HIV exposure, according to Edwin Bernard, the U.K.-based head of the HIV Justice Network, which campaigns against HIV criminalization, but usually prosecutions only happen when a sexual partner goes to the police to file a complaint. There are also comparable laws on the books in 33 U.S. states.
The United Nations AIDS agency has called on states to reign in laws criminalizing HIV exposure, warning that they can drive people away from medical services proven to control the disease. States should strictly “limit any application of criminal law to truly blameworthy cases” in which someone intentionally transmitted the illness, the agency recommends.
The Czech investigations not only go well beyond that guidance, said Jaime Todd-Gher, who leads a project on sexual and reproductive rights for Amnesty International, it also goes well beyond even other far-reaching HIV transmission investigations.
“I’ve never heard of a public health witch hunt [against] people living with HIV and violating medical privacy to do it,” Todd-Gher told BuzzFeed News.
The head of the public health department, Zdeňka Jágrová, responded to the Czech AIDS Help Society’s criticism of the investigation in a statement posted on the agency’s website on Friday, saying, “This campaign [questioning] our practices is clearly intended to assert the alleged rights of a minority at the expense of the rights of the majority, i.e. in particular the right to health, irrespective of who and how threatens the health.”
She also refuted the notion that the investigation was “an attack on the gay community,” saying that “no HIV-positive woman in Prague was diagnosed with a sexually transmitted disease” in the period covered by the investigations and so all those investigated happened to be gay men. She alleged this was a ploy by the organization to get support for insurance coverage for Truvada — medication that prevents HIV transmission — which she describes as a “relatively expensive drugs that promiscuous people would use before having unprotected sex.”
“A public health authority is obliged to protect the public health of the population and must act in the same manner as in case of other infectious diseases,” she wrote. “We consider attempts to create a privileged group that would be excluded from generally defined responsibilities very dangerous.”
While many European countries have grown less aggressive in these kinds prosecutions — thanks in part to growing scientific consensus that people on effective treatment are not infectious — prosecutions in the Czech Republic (along with neighboring Austria) stand out, said the HIV Justice Network’s Bernard.
The new investigations come as a case is heading to the Czech Republic’s top court challenging a six year prison sentence for a man who had sexual contact with six partners without disclosing his HIV status, but none of whom contracted HIV. Some of the initial local media reports about the new investigation from late January also linked it to an unrelated case of a man accused of knowingly infecting at least 16 people, including a 16-year-old boy.
Bernard, who helped publicize the new investigations in English by writing a widely-shared post about it on his network’s website, said that the collaboration between a public health agency and law enforcement in this new investigation is alarming because it threatens much of the progress that has been made in Europe in reforming HIV policy. He worries that other public health authorities in the Czech Republic and neighboring countries where politics are tilting rightward — like Hungary or even Germany — might copy the Prague approach if it’s not widely condemned.
“I worry that if we don’t nip this in the bud, there will be copycat countries in the region or elsewhere,” he said. Prague is brewing the “perfect storm of a moral panic.”