The Australasian HIV&AIDS Conference hosted by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) last week unanimously adopted a statement condemning laws in South Australia, the Northern Territory and Western Australia that force people who spit on police or emergency service workers to undergo blood tests for HIV and other blood-borne viruses.
ASHM CEO Levinia Crooks outlines concerns that laws are a knee-jerk response that undermines Australia’s best practice policy framework and risk greater ignorance, fear and stigmatisation for people lviing with blood-borne viruses.
Levinia Crooks writes
Delegates at Australia’s leading HIV conference last week expressed their profound disappointment in recently-enacted laws in three states that will force people who spit on police or emergency service workers to undergo blood tests for HIV and other blood-borne viruses (BBVs). The laws, ostensibly designed to protect police from disease, are not based on science and represent a backwards step in Australia’s response to HIV.
There’s no question that intentionally spitting on a police officer is inexcusable. Spitting is a vile and degrading form of assault and quite rightly a serious criminal offence, especially when the target is a police officer. These laws don’t change that. They do however come at an extreme and unjustifiable cost – they remove the right to privacy and the right to give informed consent before being subject to medical procedures. Moreover, this unjustified intervention is based on a serious misapprehension about the science regarding the risk of disease transmission.
The laws don’t only apply to those who deliberately spit at or bite police (mandatory tests can be ordered whenever the officer suspects there may have been a transmission of saliva). Even the involuntary expulsion of small quantities of saliva while speaking could qualify. And they don’t only apply to people in custody or charged with a crime – any person suspected of a crime can be forced to undergo testing.
The risk of HIV or hepatitis C transmission via spitting is so low that it is impossible to quantify. There is a small risk of transmission of viral hepatitis A or B, but these diseases are vaccine-preventable and the vaccine is recommended or mandated by police services in Australia.
Mandatory HIV and other BBV testing is not only completely unsupported by science, it also risks perpetuating fundamental misconceptions about HIV transmission and serves to further stigmatise an entire group of people living with a disease. While the fears of police and others who come in contact with bodily fluids are undoubtedly genuine and deeply held, they are not based on science. Forcing people to submit to blood tests will not eliminate those fears – education and support will.
The 2016 Australasian HIV and AIDS Conference – a group consisting of Australia’s most eminent HIV experts – last week unanimously adopted a resolution condemning the legislation.
“This conference expresses its profound disappointment in the governments of South Australia, Western Australia and the Northern Territory for enacting anti scientific and counterproductive laws mandating HIV testing for people accused of spitting on law enforcement personnel, in the face of overwhelming evidence that such laws are neither effective nor necessary,” read the resolution.
“We call on all governments to establish evidence-based protocols that protect the wellbeing of police and emergency workers and the rights of people living with HIV,” it concluded.
Why were spitting laws introduced?
The rationale for these mandatory testing laws has been variously stated as ‘protecting’ the police, and helping to address officers’ anxieties while they wait for their own test results. The problem is that for HIV and other BBVs, these new forced-testing laws represent a knee-jerk response that undermines Australia’s best practice policy framework for addressing BBV risks to public health in a way that responds to actual risk; and does nothing to educate the public or police about BBV transmission and exposure risk, or allay unfounded fear and stigmatisation of people living with BBVs in the community.
And we can already see the impact they’re having.
Just a few months ago a case of a man spitting at a police officer made headlines, with the police officer so distressed by HIV comments that he was reportedly ‘unable to hold his infant daughter for fear of passing on a communicable disease’ while he waited for his test results to come through. The reader was left with the impression that HIV transmission from spitting was perfectly plausible.
Let’s be clear: the spitting attack on that officer was indefensible. But there is no scientific justification for invading the privacy of people by forcing them to undergo blood tests when there is no risk to the officer. Doing so perpetuates myths about how these diseases are spread, increases the stigma surrounding HIV and hepatitis, and wrongly characterises vulnerable people as a threat to public and workplace health. Laws dealing with disease should be founded on rigorous scientific evidence, a key reason we recently published a consensus statement on HIV and the criminal law.
We all want our police and emergency services personnel to be safe. They face challenging and dangerous situations daily, and it is perfectly understandable that an officer who has come in contact with bodily fluids will want workplace polices that minimise the risk of contracting an infectious disease as a result of potential exposure.
But let’s make sure they are founded on evidence, not fear.
Levinia Crooks is ASHM Chief Executive Office and Adjunct Associate Professor at the Public Health and Human Biosciences, La Trobe University and at the Centre for Social Research in Health, University of New South Wales.