Friday, September 1, 2017

Whatsapp Group Discussion On Health Seeking Practices Veers Toward HIV Criminalization

It was a light moment that started with an Instagram picture of two men one sitting on top of the other.

The one down was reclined, resting on the elbows and shirtless in submission after a seemingly long wrestling match. The other on top was in jerseys, all sweaty, sitting on on top of the other's loins and using his weight to hold the other down.

It turned out that the man they were holding down was struggling forcefully with the health workers not to receive a mandatory Tetanus shot.

The anxiety of injections was mentioned and so were the positions of the men. Jokes ping ponged and insinuations suffused with sexual innuendoes were exchanged too.

The the moderator steered the discussion to health seeking practices such planning to visit a dental clinic, mental health units or scheduling a full medical check up.

It turned out that most only go to clinics when they are ill. Other than that they saw no utilitarian advantage of regular check ups.

And then, one other moderator asked something to do with HIV criminalization.

"I have just read something on HIV criminalization. Would you agree that a person who is living (the term used was infected) with HIV, knows it is deadly but who has unprotected sex with others is intentionally spreading HIV? Should such a person be condemned by law? Which law would it be? How would it read in simple language?"

The first answer:

"Yes, if the person does it intentionally to spread HIV and he knows it, he is guilty of the offense, I am not sure of the law but murder charges should be brought against such a person."

This same thought was followed by 25 others out of 35 who belonged to this Whatsapp group.

We should realize that many in this group already show that HIV criminalization has a  male/masculine skewed bias.

Members threw around the word guilty as if they were the very courts of law. 

Remember it is courts of law that pronounce the guilty or not guilty verdict. But, at this Whatsapp group we had constituted ourselves into a court. 

"The person is criminal but HIV is not. We should not criminalize HIV but the person that spreads it," went on one who had just joined the foray.

"HIV intended infection is punishable by law and is well stipulated in the Constitutions of many African countries," added another.

The moderator probed further for language and said that the crime should be HIV Voluntary Transmission. So, the law broken should be HIV Voluntary Transmission Law. That way, they agreed, it is specifically dealing with malicious act of spreading as well as neglect by professions from taking caution.

"What if both are sexually consenting and agree to have unprotected sex?"

This sparked more contributions on responsibility by both partners. But, it was made clear that the burden of protective conduct was placed on the one living with HIV.

"Responsible conduct is what binds all of us. It is like contamination containment. People with TB, wear face masks; food industry workers wash their hands every time they come out of a bathroom or washroom. So, one with HIV has to disclose to a sexual partner and ensure precautions are taken not to spread such as: carrying condoms, lubrication and other protective consumables."


"If one is exposed, then one should run to nearest clinic to be given PEP dose. If one is at risk, then one should enroll on PrEP and life goes on."


We say it so smoothly and we forget the human emotions. We don't factor in financial clout; family connections; adjustment feasibility to all best care options; and ability to fix a multitude of vulnerabilities (The four F's). The four F's being the HIV care grids. If the four F's are not applicable one is likely to be excluded from accessing or benefiting from optimal care.  


This discussion had very good input and veered into different scenarios around which we do not see much counselling literature. It appears as if Criminalization laws are affirming sexual intercourse between consenting married couples in a heterosexual normativity. Anything outside of this has been stigmatized and draped in demagoguery.
 








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