Forum: Not fair to lay responsibility for disease prevention solely on persons with HIV

We refer to the article “Jail for transgender streetwalker with HIV who did not tell 3 men before sex acts” (Nov 21). The article reported that a transgender sex worker was sentenced to three years and three months’ jail for failing to disclose his HIV status to three sexual partners.

It is neither effective nor equitable to lay the responsibility for disease prevention solely on persons living with HIV. Sexual health should be a shared responsibility between partners, regardless of their HIV status. This includes adopting HIV-prevention strategies, like the proper use of condoms and HIV pre-exposure prophylaxis.

These practices are highly effective in preventing HIV and are especially important when you are unsure of your partner’s sexual history.

From a public health perspective, there is no evidence that criminalising the non-disclosure of one’s HIV status can stop the spread of the virus in the community. On the contrary, according to the Joint United Nations Programme on HIV/Aids (Unaids) and the US Centres for Disease Control and Prevention, punitive laws are more likely to prevent access to HIV services. Such laws disproportionately impact vulnerable communities and increase stigma against persons living with HIV, and they also discourage people from seeking HIV testing and treatment.

Importantly, criminal legislation already exists outside the Infectious Diseases Act to penalise cases of deception and grievous harm. Therefore, a law governing HIV disclosure alone is not necessary and is counterproductive to public health efforts. 

We must continue to address social and legal barriers that stigmatise persons living with HIV and make people fearful of testing and treatment. In fact, Unaids has called for the removal of punitive laws that criminalise HIV non-disclosure, same-sex relationships, sex work, and drug use, to create more supportive legal and policy environments to end the HIV epidemic.

As we commemorate World Aids Day on Dec 1, we should renew our commitment to ending HIV by combating stigma and focusing our efforts on improving access to HIV education, prevention and treatment for everyone.

Roy Chan (Professor)
Action for Aids Singapore

Rayner Tan (Dr)
Project X

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