A few years ago, I was consulted about the case of a person who was allegedly trying to sexually transmit HIV. This happened because it was found to be living with the virus, after medical prescriptions were found in his drawer, which contained the remedies for the treatment cocktail. The delegate responsible for investigating the complaint, until then, tended to accept the opening of the process.
Criminalizing someone for being infected with HIV is still a serious problem in several countries around the world, including Brazil. At least 92 countries have specific or sufficiently vague laws that allow a person living with the virus to be held liable for having sex. The situation becomes even more serious as the majority of people living with HIV belong to more socially vulnerable population groups.
In consensual sex, does a person living with HIV necessarily need to disclose their HIV status to their partner? The answer is no”. In support of this position, here are some considerations.
Regarding the prevention of sexually transmitted infections, having a consensual sexual relationship brings responsibilities to everyone who takes part in it.
Treatment with the antiretroviral cocktail is highly effective in controlling the spread of HIV, allowing people to keep HIV undetectable in their blood. As a consequence, stop transmitting HIV sexually. In several, extensive and repeated studies, the results are striking: people who make up couples whose sexual partner lives with HIV and has an undetectable virus did not become infected, even with unprotected sex with a male or female condom. As a result, a person who is living with HIV and is undetectable is a safer sexual partner in unprotected sex than someone who does not know if they have the virus. Hence the concept of “undetectable = non-transmitter”.
The recommendation is shared by the Joint United Nations Program on HIV/AIDS (UNAIDS), which also suggests that countries respect the confidentiality of people living with the virus, helping to combat prejudice and favoring access to health services. Continuing to criminalize people just because they are living with HIV takes the opposite path.
Comparing HIV to other agents of sexually transmitted infections, it is noted that these can also lead to potentially serious consequences. For example, syphilis, in its tertiary form, can compromise organs and systems, including neurological functions. Gonorrhea can lead to infertility. HPV can lead to genital cancer, especially in women. In these circumstances, there is not the same movement of attribution of guilt for having occurred transmission by sex.
After a few days, the case presented at the beginning of the text was clarified by the delegate: the accused was undergoing treatment regularly and had an undetectable viral load, while the accused, in bad faith, sought an opportunity for extortion.
Instead of criminalizing people living with HIV, it is necessary to strengthen health services to promote the prevention of sexually transmitted infections, facilitate access to tests for sexually transmitted agents and ensure treatment with antiretroviral cocktail drugs for those living with the HIV. Here, it is worth discussing a campaign that better clarifies the concept “undetectable = non-transmitter” to society.
The time has passed to resolve this public health problem and, also, human rights.
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