MS KAREN Tan of the Ministry of Health in her letter, 'HIV law aims to deter irresponsible sex conduct' (ST, Oct 11), admitted that 'public education and prevention must be the mainstay but legislation by itself is inadequate to tackle the problem of HIV/Aids'. It is always not easy to coax people to change their social behaviour but legislation is still the last bastion to drive home the message that the HIV/Aids epidemic can be contained. As early as 2003, the governor of California had been lobbying for the promulgation of HIV laws in his state and a year later California's HIV/Aids laws were accepted by the legislature. Under the Health and Safety Code, the following provisions are enacted: a) All licensed physicians and surgeons or other persons engaged in the prenatal care of a pregnant woman or attending the woman at the time of delivery are to inform the woman of the intent to perform a test for HIV infection; the routine nature of the test; the purpose, risks and benefits of the test; the risks of perinatal transmission of HIV and that treatments are known to decrease the risks of perinatal transmission. b) A three-year sentence enhancement is mandatory for a conviction of rape (including statutory and spousal rape), or unlawful sodomy or oral copulation, if the defendant knew that he was HIV positive at the time of the commission of the offence. c) At the request of the crime victim, the court may order HIV testing of any person charged with a crime. Before issuing a search warrant for the defendant's blood, the court must find that there is a probable cause to believe that blood, semen or other bodily fluids have been transferred from the defendant to the victim and that there is probable cause to believe the defendant committed the alleged offence. A victim may also request HIV testing of the accused in the case of certain alleged sex crimes that are the subject of a police report. d) Any person who exposes another to HIV by engaging in unprotected sexual activity is guilty of a felony when the infected person: i) knows he is infected ii) has not disclosed his HIV-positive status iii) acts with the intent to infect the other person with HIV. The felony charge is punishable in the state prison for a period not exceeding eight years. What are the principles that should guide legal policy on HIV? The law must be used to establish a protective and supportive framework for people affected by the epidemic and not a punitive one. Informed ethical debate can guide the direction of the evolution of the law in this area. The law can be used as an instrument to bring about change in personal behaviour and only by having an informed group of lawyers will the legal and human rights issues associated with the epidemic be properly tackled. The people who remain vulnerable to HIV are those who are denied the means of protecting themselves against the disease because of economic need, for example, or powerlessness to control the basis upon which their sexual relationships take place. Many factors come into play here such as poverty, inadequate health care and health education and cultural values that compel certain practices that expose women to the risk of HIV transmission. Women are often not free to make their own decisions about their sexual relationships or to insist upon measures, such as the use of condoms or fidelity on the part of their partner, that would reduce the risk of exposure to HIV. The HIV policy debate is usually characterised as an inevitable conflict between public health and individual rights. Policies that infringe individual rights such as forcible HIV testing are defended on the basis of an overriding need to protect public health. On a practical level, HIV laws are not easy to enforce. However, there is some evidence that such laws can assist in encouraging condom use, if only because it makes it easier for prostitutes to nsist upon condom use by their clients. The legislation can be an instrument to bring about a marked behavioural change in this way. Law is a product of social and cultural values within a community. It can also be instrumental in defining, reinforcing and actively promoting certain values and practices. By either condoning or outlawing certain forms of behaviour or expressions of cultural values, the law can be a very powerful instrument for shaping and reinforcing these values. The law can and ought to play a proactive role not merely in mediating rights and obligations as between individuals but also in seeking to change underlying values and patterns of social interaction that create vulnerability to the threat of HIV infection. Heng Cho Choon |
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