Panel--Criminalization of HIV non-disclosure: new development and community responses.

This article provides summaries of the six presentations made during the panel. Stéphanie Claviaz-Loranger gives an overview of the recent developments in Canadian law since R v. Cuerrier. Barry Adam discusses views of people living with HIV/AIDS (PHAs) with respect to the criminalization of HIV transmission and exposure. Shannon Thomas Ryan discusses the racialized nature of criminalization. Eric Mykhalovskiy explains the available policy options for Ontario concerning criminalization, and calls on the Ministry of the Attorney General to establish a consultation process to inform the development of policy and practice memoranda. Glenn Betteridge discusses the development and work of the Ontario Prosecutorial Guidelines Campaign. Finally, Lisa Power presents the experience of England and Wales with regard to HIV criminalization.

The impact of incarceration upon adherence to HIV treatment among HIV-positive injection drug users: a qualitative study.

INTRODUCTION: HIV-positive injection drug users (IDU) often do not derive the full benefits of highly active antiretroviral therapy (HAART). Among IDU, recent incarceration has been associated with discontinuation of HAART for non-clinical reasons. We sought to qualitatively evaluate experiences with HAART among HIV-positive IDU who had been recently incarcerated within provincial prisons in British Columbia in order to identify factors influencing adherence to treatment. METHODS: Twelve in-depth qualitative interviews were conducted with males recruited from a cohort study (ACCESS) involving over 450 HIV-positive IDU. All participants had been incarcerated after initiating HAART. Audio-recorded interviews were conducted to examine experiences of taking HAART in prison, with particular attention to adherence and experiences of treatment discontinuation. FINDINGS: Participant accounts described situations where adherence to HIV treatment was compromised in custody. A small number of participants reported treatment interruptions that lasted over a week when they were unable to obtain HIV medications through institutional healthcare. Short-term interruptions in treatment were said to be common during intake into the correctional system and at the point of release from custody. High levels of HIV discrimination motivate prisoners to hide the fact that they are HIV-positive by making efforts to take medications discreetly, which may result in missed doses. CONCLUSIONS: The current study identified contextual factors within correctional environments that hinder individuals' ability to adhere to HAART. These findings also indicate that improved health services and coordination with community care providers are needed to enhance the quality of HIV treatment within correctional environments.

Draft evaluation suggests pilot safer tattooing program had potential to reduce disease transmission.

As reported in the last issue of the Review, effective 30 September 2006 the Canadian federal government terminated the pilot safer tattooing initiative which had been operating in six prisons.1 A draft of the evaluation report, obtained under access to information laws, detailed positive outcomes, constraints and enhancements to address implementation issues and cost-effectiveness of the initiative.

Public health agency says prison needle exchanges reduce risk, do not threaten safety or security.

In April 2006, the Public Health Agency of Canada (PHAC) provided a report to the Correctional Service of Canada (CSC) regarding the potential risks and benefits of introducing needle exchange programs in Canadian federal prisons (PNEPs). The PHAC report concludes that while definitive data concerning the impact of PNEPs on the transmission of blood-borne pathogens among prisoners does not exist, such programs have resulted in a decrease in behaviours which risk transmission and have not threatened prison safety or security.

Ontario passes new mandatory blood testing law: a preliminary review.

In December 2006, the Mandatory Blood Testing Act, 2006 passed third reading in the Legislative Assembly of Ontario. When this new Act comes into force, it will replace the existing administrative system for forced blood testing, currently operating under Ontario's public health law. Responsibility for forced blood testing will shift from the Minister of Health and Long-Term Care to the Minister of Community Safety and Corrections.

Federal Court of Appeal examines for first time refugee protection on the basis inadequate health care.

On 10 November 2006, in a precedent-setting case, the Federal Court of Appeal dismissed an application by a Mexican national to remain in Canada as a "person in need of protection" under the Immigration and Refugee Protection Act (IRPA). The principal issue before the Court was whether the IRPA excludes from protection people who face a risk to life if returned to their home country, where the risk arises from the fact the government does not provide affordable medical treatment.

Subcommittee fails to recommend legal reforms needed to promote human rights of sex workers.

In December 2006, the House of Commons Subcommittee on Solicitation Laws released its longawaited report on the criminal laws related to prostitution in Canada, entitled The Challenge of Change: A Study of Canada's Criminal Prostitution Laws. The Subcommittee's report fails to call for amendments to the Criminal Code provisions which have been demonstrated to increase the health and safety threats faced by sex workers. The Canadian HIV/AIDS Legal Network and two sex worker organizations, Stella and Maggie's, jointly published an analysis of the report.

HIV-positive woman suing police, man who allegedly infected her and his family.

By statement of claim dated 18 April 2005, a Windsor woman is suing a man she alleges infected her with HIV. She is also suing the Windsor Police Service and the man's family.

Medical marijuana users continue to experience legal barriers.

Four recent developments highlight that people continue to face significant legal and administrative barriers to using marijuana for medical purposes--despite the existence of the Marihuana Medical Access Regulations (MMAR), enacted by the federal government, as a result of court rulings, to enable people who require marijuana for medical purposes to exercise their constitutional right to such medicine.

Vancouver safe injection facility: more positive results.

Two recently published articles report on the positive impact of Insite on drug use among people who inject drugs.

CEE/CA: Report calls for decriminalization of sex work.

In December 2005, the Central and Eastern European Harm Reduction Network (CEEHRN) released a report calling for the decriminalization of sex work in the 27 countries of Central and Eastern Europe and Central Asia (CEE/CA). The report brings together a wealth of published and original information concerning sex work, laws regulating sex work, epidemiological data regarding HIV and other sexually transmitted infections (STIs), services available to sex workers, and human rights abuses faced by sex workers.

Federal prison guards call for power to test prisoners for HIV.

The union representing federal prison guards is lobbying the government to amend the Corrections and Conditional Release Act (CCRA) to permit prison staff to apply for orders to test prisoners for HIV and the hepatitis B and C viruses. This article summarizes the union's proposal and the Legal Network's response.

Medical marijuana: CAS releases report, government cuts research funding.

In June 2006, the Canadian AIDS Society (CAS) released a comprehensive report with recommendations to overcome barriers to the use of cannabis for medical purposes faced by people living with HIV/AIDS in Canada. On 25 September 2006, as part of package of spending cuts, the federal government announced plans to eliminate its marijuana medical research program.

B.C. court gives go-ahead to non-profit needle exchange and drop-in.

In a 15 February 2006 decision, the Supreme Court of British Columbia effectively ordered the City of surrey to licence the surrey HIV/AIDS Centre Society as a medical office. As a result, the Society did not have to submit to city council a community impact statement and study in order to obtain a new licence to operate.

Another prisoner dies of HIV in a CSC institution--medical parole not considered until too late.

In a 20 July 2006 report, a Québec Coroner criticized Correctional Service Canada's (CSC) handling of a prisoner who died of HIV-related complication while imprisoned. The Coroner recommended that CSC change the way it handles cases of medical parole.

U.S.: HIV-positive prospective employee can sue Foreign Service for discrimination.

On 27 June 2006, the U.S. Federal Court of Appeals overturned a lower court ruling and permitted an HIV positive man to sue the Secretary of State for alleged discrimination in hiring. He was denied a position as a foreign service officer, which required travel and work at overseas posts, because of his HIV status.

Prisoners who inject drugs: public health and human rights imperatives.

This article examines the human rights and public health implications of injection drug use in prisons with a specific focus on HIV and hepatitis C (HCV) viruses. The authors argue that prisoners who inject drugs have a right to access harm reduction measures--those that reduce the harmful consequences of drug use without necessarily reducing drug consumption. Moreover, states that fulfill their obligation to provide prisoners with harm reduction measures such as access to bleach, substitution therapy, and sterile injection equipment implement sound public health policy with a positive impact for a population particularly vulnerable to HIV and HCV. Ultimately, this approach benefits not only prisoners but also prison staff and the public, and does not entail lessening of the safety and security of prisons.

Legal Network launches Plan of Action on HIV/AIDS-related stigma and discrimination.

On 26 January 2005, the Canadian HIV/AIDS Legal Network launched A Plan of Action for Canada to reduce HIV/AIDS-related stigma and discrimination. The kick-off included a national press conference on Parliament Hill, and local press conferences by six community-based organizations across Canada.

Alberta review panel recommendations threaten privacy of personal health information.

In a report released in October 2004, the Alberta Select Special Health Information Act Review Committee has recommended increasing the situations under which custodians of health information can release such information. If these recommendations become law, people living with HIV/AIDS would have less control over the disclosure of their health information, including their HIV status.

New Brunswick: new sex education curriculum stirs debate.

Controversy has surrounded the sex education component of the New Brunswick Department of Education's new health curriculum for grades six, seven, and eight.