Decriminalizing Behaviors and the Global AIDS Epidemic

Maria de Bruyn

More than 10 panels and roundtables at the International AIDS conference argued for decriminalization of sex work, drug use and sexual identity. 

Rewire is publishing a series of articles and opinion pieces on global AIDS and HIV in conjunction with the International AIDS Conference in Vienna, which ended this weekend.  We welcome vigorous policy debates on these and other issues.

The International AIDS Conference’s theme of “Rights here, Right now” was clearly in evidence throughout the five days of the international meeting. An exuberant march through the streets of Vienna, a large human rights networking zone, multiple sessions on various aspects of human rights and numerous poster presentations addressed topics such as rights of sex workers and people with different sexual orientations, monitoring human rights violations, and combating stigma and discrimination. The subject receiving the highest level of attention, however, concerned the law: criminalization of behaviors and groups of people in the context of HIV/AIDS.

More than 10 panels and round tables in the official program and satellite/side sessions argued for decriminalization of sex work, drug use, sexuality outside the heterosexual sphere and transmission of HIV. Several points reiterated during these sessions were especially noteworthy because they can also be applied to another area of reproductive health that is prohibited and criminalized in many countries: women’s access to contraception/emergency contraception and safe legal abortion.

A number of speakers, including Johanna Kehler of the South African AIDS Legal Network, Anand Grover, UN Special Rapporteur on the right to health, Manfred Nowak, UN Special Rapporteur against Torture and Michel Sidibé, Executive Director of UNAIDS, emphasized that there is no evidence to show that criminalization of sex work, drug use and sexual behavior has any efficacy in changing behaviors or practices. On the contrary, people are driven underground and become afraid to access – or are prevented from accessing – protective health services. The same is, of course, true for women who wish to terminate unwanted pregnancies where legal abortion is inaccessible. Research by the Guttmacher Institute and World Health Organization have shown that the prevalence of abortion is not lower where abortion is criminalized; the difference is that women who have legal abortions undergo safe procedures while women who have only the option of clandestine, backstreet or self-induced abortions suffer high rates of morbidity and mortality.

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During a panel discussion on law reform and how this can either compromise or protect people’s rights, Kehler commented on the fact that discriminatory laws in some countries are not enforced, which implies that it might be better to leave things well enough alone. She noted, however, that decriminalization has symbolic value; moreover, it can help protect people from mistreatment and harassment by law enforcement personnel (e.g., police who may not arrest sex workers but then use threats of jail to demand sex). Again, the same is true for women who are desperate to deal with unwanted pregnancies: enabling them to use emergency contraception and to terminate pregnancies safely can help lower the associated stigma and protect them from clandestine providers who demand large sums of money and who use unsafe methods which endanger their health and lives.

Morten Kjaerum, of the European Union Agency for Fundamental Rights, noted the importance of getting gatekeepers to become defenders of human rights when he spoke about the role of prison medical staff in ensuring that prisoners can obtain needed medical care. Similarly, health-care workers can be important advocates for women’s access to safe services for pregnancy termination and should be considered human rights defenders in this regard. Anand Grover argued that criminalization of HIV transmission, sex work and drug use dehumanizes the people involved and contributes to the spread of HIV and hepatitis C, requiring a pragmatic rather than moralistic approach to harm reduction. At the risk of being repetitious, it can be stated that such an approach is also needed to reduce maternal mortality and morbidity due to unsafe abortions.

The series of sessions on decriminalization culminated on the fourth day of the conference with a round table entitled: “Leaders against Criminalization of Sex Work, Sodomy, Drug Use/Possession and HIV”. The participants included Michel Sidibé, Gill Greer (Executive Director of IPPF), Festus Mogae (former President of Botswana and a member of the new Global Commission on HIV and the Law), Tim Barnett (World AIDS Campaign) and Stephen Lewis. Sidibé noted that the resources used to enforce criminalization could be better spent on HIV prevention – similarly, the costs to health systems and countries of providing safe, early pregnancy terminations are much lower than those needed for post-abortion care to deal with the serious consequences of unsafe abortions.

Gill Greer criticized the criminalization of behaviors that only some people in societies find unacceptable; she noted that this moreover does not address the complex issues involved in areas such as drug use. This session ended with a rousing call for everyone to support decriminalization. Could we expect a panel of world leaders to do the same for decriminalization of contraception and abortion at the next international conference that deals with reproductive health and/or HIV/AIDS?

News Politics

Anti-Choice Democrats: ‘Open The Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

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Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.