Behind Bars: Persistence and Patience are Virtues

This interview with Amery Brown, the former Director of the National AIDS Coordinating Committee working in Trinidad and Tobago, is part of the Behind Bars series by Kevin Osborne and the International Planned Parenthood Federation.

“We have to make all our decisions based on evidence as opposed to emotion or knee-jerk reactions.

One or two sensational stories and emotive reactions should not be guiding government policy, and wherever they occur, legislative initiatives to criminalize HIV

transmission are not based on effective policy.

To those who are working toward sound legislation to benefit persons living with HIV and those at risk, I would encourage persistence and patience. There is no magic bullet and you cannot expect overnight change.”

“There is broad recognition within Trinidad and Tobago and in the Caribbean region that the law as it stands may not be serving us well in terms of an effective response to HIV. Bearing in mind that we are part of a Commonwealth System and some of what existed formerly in the United Kingdom has remained in our countries—we share a unique historical context. 

There has been a fairly strong regional response to HIV and the law, and a recent legislation review has looked at issues of human rights, issues related to criminalization and looking at issues that some countries have with regard to HIV, sodomy and sex work. 

The national consultations were very rewarding because there was some demonstration that the local population has matured to some extent in terms of the openness to change and progress with regard to some of the traditionally challenging issues. 

The emerging strength of a number of advocacy groups has assisted additional sectors to recognize that the ‘traditional’ approaches to HIV policy and law have in some respects left some of our citizens at continued or increased risk.

“There is often a very strong impetus for quick change or rapid action but I don’t know if that is always realistic or even desirable, and we must always bear in mind the possibility of a backlash from more conservative elements, but let’s say a country that has made positive changes and the government has not reaped any political whirlwind or collapsed because of a bold legislative decision, some of that change and those benefits should be shared across borders, utilizing key Commonwealth organizations and other agencies.

That dialogue is important specifically among politicians and parliamentarians who sometimes are not sufficiently included in multi-sectoral fora that could lead to change.

Many of the parliamentarians would have grown up with certain attitudes, constantly reinforced, and it is important to develop opinion leaders who can become beacons among their peers, as well as in the national context. The key qualities that I would encourage are persistence and patience.

“There are very good reasons why HIV transmission should not be a criminal offence. It’s certainly not a cut and dried issue. 

It has proven very difficult to prove or demonstrate willful transmission to the issue of attribution or causality—which person had HIV first—resulting in much controversy in some cases that have been pursued internationally.

Such laws have the danger of further stigmatizing key populations and persons living with HIV — being seen overall as potential perpetrators as opposed to very often the primary victims of social injustice and crime. 

We have made a transition to seeing people living with HIV as part of the response and as the solution, but having laws or provisions like this would shift the concept back to persons living with HIV being perceived as the ‘problem’. 

It is the stigma, it is the ignorance and it is the discrimination that contribute more to the transmission and propagation of HIV, than the sporadic cases of someone who has escaped the type of support that now exists and might be having unprotected sex and be willfully exposing others to the virus.

“We have to make all our decisions based on evidence as opposed to emotions or knee-jerk reactions. One or two sensational stories and emotive reactions should not be guiding government policy—it must be much more evidence-based. So from a medical background the thing is to first do no harm. If what you are proposing as part of a solution has been proven or has the potential to do harm: is that really something you would want to do as a country?

“People living with HIV should be encouraged to voluntarily disclose their status. Certainly the health services emphasize voluntary disclosure, sometimes with support, as opposed to coerced or enforced disclosure. 

Bearing in mind that sexual contacts and sexual relationships occupy a very wide spectrum—those very complex and diverse human interactions. The law is not a useful instrument to enforce disclosure. Instead in Trinidad and Tobago we would continue to review our counseling protocols and those associated with diagnosis to ensure that disclosure support is part of how we interact with clients—as opposed to bringing in a law that would criminalize non-disclosure. 

“The law exists for a reason and that’s why we have laws against all sorts of things. But with regard to the desire to control certain types of human behaviour—especially sexual or intimate behaviour between women and men, men and men, or women and women—the law really is a very blunt instrument and it can be misused very often.

“We have seen countries making the wrong decisions in regard to HIV and AIDS.

I am very confident that in my part of the world societies are maturing to a point where it is easier to make improvements in the law and harder to make the wrong types of decisions.”

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