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1he addlLlonal prevenLlon effecL of anLlreLrovlral Lherapy (A81) has Lhe poLenLlal Lo beneflclally lmpacL Lhe
Plv epldemlc as well as Lhe llves of people llvlng wlLh and aL rlsk of, Plv, ln many ways. Crlmlnal [usLlce acLors
and law- and pollcymakers are sLlll comlng Lo Lerms wlLh Lhls game changlng" sclenLlflc advancemenL. 1helr
reacLlons have Lhe poLenLlal Lo elLher lmprove or harmboLh Lhe Plv response as well as Lhe human rlghLs of
people llvlng wlLh Plv.
A desk revlewof crlmlnal proceedlngs, pollcy documenLs and newspaper reporLs archlved on Lhe Plv !usLlce
neLwork webslLe (www.hlv[usLlce.neL) was underLaken Lo beLLer undersLand Lhe crlmlnal lawlmpllcaLlons of
lncreased knowledge and awareness of Lhe addlLlonal prevenLlon beneflL of A81 as Lhey relaLe Lo Plv non-
dlsclosure, exposure and/or Lransmlsslon laws, prosecuLlons and pollcy.
1he lmpacL of vlral load on lnfecLlousness has resulLed ln a number of [urlsdlcLlons revlslng or revlslLlng Lhelr
crlmlnal laws or prosecuLorlal pollcles relaLlng Lo Plv non-dlsclosure, exposure and/or Lransmlsslon. 1he
neLherlands was Lhe flrsL counLry Lo conslder lowvlral load as a facLor ln Plv rlsk ln 2003, resulLlng ln Lhe
essenLlal decrlmlnallsaLlon of all buL lnLenLlonal exposure or Lransmlsslon.
lollowlng Lhe 'Swlss sLaLemenL'
publlshed ln !anuary 2008
a growlng number of courLs, governmenL mlnlsLrles and prosecuLorlal auLhorlLles
have accepLed A81's lmpacL on reduclng Lhe rlsk of boLh Plv exposure and Lransmlsslon. 1hese lnclude: Ceneva
CourL of !usLlce, SwlLzerland (2009), AusLrlan MlnlsLry of !usLlce (2010), ManlLoba CourL of Appeal, Canada
(2010), uenmark MlnlsLry of !usLlce (2011), Crown rosecuLlon Culdance for Lngland and Wales (2011), Crown
Cfflce and rocuraLor llscal Servlce Culdance for ScoLland (2012), Lhe CourL of Appeal for Skne and 8leklnge,
Sweden and Swedlsh MlnlsLry of PealLh and Soclal Affalrs (2013), and Lhe Supreme CourL of lowa (2014).
+$/) ")$("
uesplLe Lhese encouraglng developmenLs, Lhe norweglan LawCommlsslon
as well as Lhe Supreme CourL of
were noL convlnced regardlng Lhe proLecLlve effecL of A81, Lhe former conLlnulng Lo recognlse ooly
cooJoms and Lhe laLLer rullng LhaL only cooJoms ooJ lowvltol looJ LogeLher could negaLe Lhe legal obllgaLlon Lo
dlsclose prlor Lo sex. 1hese declslons are noL ln llne wlLh 2013 unAluS guldance, whlch noLes: Where crlmlnal
llablllLy ls exLended Lo cases LhaL do noL lnvolve acLual Lransmlsslon of Plv, such llablllLy should be llmlLed Lo
acLs lnvolvlng a slgnlflcanL rlsk" of Plv Lransmlsslon. 1he deLermlnaLlon of wheLher Lhe rlsk of Plv Lransmlsslon
froma parLlcular acL ls slgnlflcanL should be lnformed by Lhe besL avallable sclenLlflc and medlcal evldence."

SclenLlsLs and cllnlclans musL, Lherefore, work closely wlLh advocaLes ln [urlsdlcLlons where Lhe prevenLlon
lmpacL of A81 ls noL currenLly legally recognlsed. lL ls vlLally lmporLanL LhaL crlmlnal [usLlce sysLemacLors and
law- and pollcymakers are educaLed so LhaL laws and pollcles relaLed Lo Plv non-dlsclosure, exposure and
Lransmlsslon are applled raLlonally and falrly, and ln a way LhaL does noL harmpubllc healLh.
)0$ +$)0$',.+%"
1he neLherlands was Lhe flrsL counLry Lo conslder
vlral load as a facLor ln Plv rlsk. ln 2003, a Supreme
CourL rullng - whlch closely examlned sclenLlflc
evldence of sexual Lransmlsslon rlsk and found LhaL
Lhe per-acL rlsk of unproLecLed sex, especlally when
vlral load ls low, does noL creaLe a 'conslderable
chance' of Lransmlsslon - subsLanLlally narrowed
Lhe scope of Lhe law. As a resulL, only lnLenLlonal
Plv exposure or Lransmlsslon ls a crlme.
ln 2009, Lhe Ceneva CourL of !usLlce quashed an
Plv exposure convlcLlon afLer accepLlng LesLlmony
fromrofessor 8ernard Plrschel, one of auLhors
of Lhe 'Swlss sLaLemenL'. lL was Ceneva's uepuLy
ubllc rosecuLor, ?ves 8erLossa, who had called
for Lhe appeal afLer hearlng abouL Lhe 'Swlss
sLaLemenL'. 8erLossa Lold Swlss newspaper, Le
1emps: Cn ne condamne pas les gens pour des
rlsques hypoLheLlques" (Cne shouldn'L convlcL
people for hypoLheLlcal rlsks").
Cf noLe, rofessor
Plrschel ls on record as saylng one of Lhe prlmary
purposes of Lhe 'Swlss sLaLemenL' was Lo prevenL
furLher prosecuLlons under ArLlcle 231 of Lhe Swlss
Crlmlnal Code. 1here have been no furLher reporLs
of prosecuLlons for Plv exposure slnce Lhe rullng.
ArLlcle 231 wlll be repealed ln !anuary 2016, when
Lhe Lpldemlcs AcL 2013 wlll come lnLo effecL.
1he changes mean LhaL a prosecuLlon wlll only
Lake place lf Lhere ls a mallclous (and sclenLlflcally
posslble) aLLempL Lo lnfecL someone wlLh Plv or
anoLher serlous communlcable dlsease.
ln 2010, Lhe AusLrlan MlnlsLry of !usLlce provlded
a flrmoplnlon LhaL sex wlLhouL a condom
ls noL a crlme lf Lhe person wlLh Plv has an
undeLecLable vlral load glven LhaL such persons
are noL lnfecLlous."
Powever, Lhe oplnlon was noL
blndlng on Lhe courLs and Lhere have slnce been
prosecuLlons for exLremely lowrlsk acLs, lncludlng
unproLecLed oral sex wlLhouL e[aculaLlon.
ln 2011, uenmark's MlnlsLer of !usLlce suspended
a law used Lo prosecuLe Plv exposure and/or
Lransmlsslon once he became aware of boLh Lhe
lmprovemenLs ln llfe expecLancy and reducLlon
ln lnfecLlousness as a resulL of A81.
ln AugusL
2012, a uanlsh courL acqulLLed a person llvlng
wlLh Plv who had prevlously been found gullLy
under Lhe suspended law. A governmenL worklng
group conLlnues Lo conslder wheLher or noL Lo
revlse Lhe law or Lo compleLely abollsh any crlmlnal
law relaLlng Lo Plv non-dlsclosure, exposure or
1he lmpacL of A81 on Lransmlsslon rlsk was
lncorporaLed lnLo Lhe 2011 revlslon of Lhe Crown
rosecuLlon Culdance for Lngland and Wales
lncluded ln Lhe 2012 Crown Cfflce and rocuraLor
llscal Servlce Culdance for ScoLland.
ln effecL,
boLh seLs of guldance clarlfy LhaL charges wlll noL
be flled lf Lhe accused ls on LreaLmenL wlLh an
undeLecLable vlral load and was counselled by a
healLhcare provlder LhaL Lhls meanL Lhere was a
low rlsk of Lransmlsslon. Powever, Lhere have been
no LesL cases Lo daLe.
ln 2013, a CourL of Appeal acqulLLed an Plv
exposure case ln Sweden, followlng a sLaLemenL by
Lhe naLlonal 8oard of PealLh and Welfare (parL of
Lhe Swedlsh MlnlsLry of PealLh and Soclal Affalrs)
LhaL hlghllghLed Lhe prevenLlon beneflL of A81. 1he
rullng reflecLed a ma[or shlfL ln prosecLlon pollcy.
1he crlLerla Lo noL be legally bound Lo dlsclose
are very slmllar Lo Lhose seL ouL ln !anuary 2008
by Lhe Swlss lederal AluS Commlsslon's 'Swlss
sLaLemenL'. 1he MlnlsLer for Soclal Affalrs ls
currenLly conslderlng a revlew of Swedlsh law and
pollcy as lL relaLes Lo Plv non-dlsclosure, exposure
and Lransmlsslon.
!*1.6 #+!)$%").)$"
ln 2014, Lhe Supreme CourL of lowa seL aslde Lhe
'Plv exposure' convlcLlon of nlck 8hoades, who
was lnlLlally senLenced Lo 23 years ln prlson, wlLh
requlred reglsLraLlon as a sex offender, afLer havlng
a one-Llme sexual encounLer wlLh anoLher man
comprlslng anal sex wlLh a condomand oral sex
wlLhouL whllsL hls vlral load was undeLecLable.
ln reverslng Lhe convlcLlon, Lhe CourL recognlsed
LhaL sexual Plv exposure rlsks should noL be
based on ouLdaLed bellefs and musL be speclflc
Lo Lhe lndlvldual acLs and slLuaLlon, sLaLlng LhaL
we are unable Lo Lake [udlclal noLlce LhaL an
lnfecLed lndlvldual can LransmlL Plv, regardless
of an lnfecLed lndlvldual's vlral load, when LhaL
lndlvldual engages ln proLecLed anal or unproLecLed
oral sex wlLh an unlnfecLed person".
1he rullng
came Lwo weeks afLer lowa's Covernor repealed
Lhe Plv-speclflc lawunder whlch Mr 8hoades was
convlcLed, replaclng lL wlLh an lnfecLlous dlsease law
LhaL lncludes a more nuanced undersLandlng of Plv-
relaLed rlsks, buL whlch requlres boLh subsLanLlal
good falLh compllance wlLh a LreaLmenL reglmen
prescrlbed by Lhe person's healLh care provlder"
and use of a prophylacLlc devlce".

1 van kouwen Wand 8rulnenberg k. 5opteme coott of tbe NetbetlooJs, ctlmlool ulvlsloo. nlv 1toosmlssloo. ctlmloollsotloo. !. Crlm. L. 70: 483-489, 2006.
2 vernazza eL al. les petsoooes stoposltlves oe soofftoot Joocooe ootte M51 et solvoot oo ttoltmeot ootltttovltol efflcoce oe ttoosmetteot pos le vln pot vole sexoelle. 8ulleLln des medeclns
sulsses 89 (3), 2008.
3 Notwoy. looq owolteJ low commlssloo tepott Jlsoppolots. Plv !usLlce neLwork, CcLober 22, 2012. Avallable aL: hLLp://www.hlv[usLlce.neL/news/norway-long-awalLed-law-commlsslon-
4 coooJo. 5opteme coott mokes boJ low wotse. Plv !usLlce neLwork, CcLober 3, 2012. Avallable aL: hLLp://www.hlv[usLlce.neL/news/canada-supreme-courL-makes-bad-law-worse
3 unAluS. oJloq ovetly-btooJ ctlmloollsotloo of nlv ooo-Jlsclosote, exposote ooJ ttoosmlssloo. ctltlcol scleotlflc, meJlcol ooJ leqol cooslJetotloos. Ceneva, May 2013. Avallable aL: hLLp://www.
6 van kouwen Wand 8rulnenberg k. op. clt.
7 CuoLed ln 8ernard L!. 5wlss coott occepts tbot ctlmlool nlv exposote ls ooly bypotbetlcol oo soccessfol tteotmeot, poosbes coovlctloo., lebruary 23, 2009. Avallable aL: hLLp://
8 5wltzetlooJ. New low oo plJemlcs ooly ctlmloollsloq loteotloool ttoosmlssloo posseJ lo lowet boose. Plv !usLlce neLwork, March 9, 2012. Avallable aL: hLLp://www.hlv[usLlce.neL/news/
9 lAS, Cn+, lCW. 5totemeot oo Aosttloo lows lmpoctloq leople llvloq wltb nlv/Alu5 (llnlv). !uly 2010. Avallable aL: hLLp://!olnL_SLaLemenL_AusLrlan_
10 Aosttlo. nlv-posltlve moo ocpoltteJ fot otol sex wltboot ejocolotloo (upJote). Plv !usLlce neLwork, uecember 18, 2012. Avallable aL: hLLp://www.hlv[usLlce.neL/news/ausLrla-Lrlal-of-hlv-
11 ueomotk. Iostlce Mlolstet sospeoJs nlv-speclflc ctlmlool low, sets op wotkloq qtoop. Plv !usLlce neLwork, lebruary 12, 2011. Avallable aL: hLLp://www.hlv[usLlce.neL/news/denmark-[usLlce-
12 Crown rosecuLlon Servlce. ltosecotloo lollcy ooJ ColJooce. loteotloool ot keckless 5exool 1toosmlssloo of lofectloo. LasL updaLed !uly 13, 2011. Avallable aL: hLLp://
13 5cotlooJ. New qolJooce oo ptosecotloos clotlfles low, tecoqolses tteotmeots lmpoct oo lofectloosoess. Plv !usLlce neLwork, May 2, 2012. Avallable aL: hLLp://www.hlv[usLlce.neL/news/
14 Sweden: CourL of Appeal acqulLs 'Plv exposure' case, recognlses naLlonal 8oard of PealLh and Welfare endorsemenL of 'Swlss sLaLemenL', MlnlsLer for Soclal Affalrs wlll conslder revlewlng
appllcaLlon of law. Plv !usLlce neLwork, CcLober 29, 2013. Avallable aL: hLLp://www.hlv[usLlce.neL/news/sweden-courL-of-appeal-acqulLs-hlv-exposure-case-recognlses-naLlonal-board-of-
13 8hoades v. SLaLe of lowa (lowa Supreme CourL !une 13, 2014) Avallable aL: hLLp://
16 lowa SenaLe llle 2297, LnacLed 31 May 2014. Avallable aL: hLLp://
20Lh lnLernaLlonal AluS Conference, Melbourne, 2014.
AbsLracL 1uL308

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