History of the Government`s Response to HIV in the Sex Indusfry

History of the Government`s Response to HIV in the Sex Indusfry

,?
Response
Historyof the Government's
to HIVin
the SexIndusfry
HIV ond SexWork- lst Nqtionql Confere/?ce
Melbourne, 2nd, 3rd April 1996
Geoffrey Fysh, Austrqlion Fdderotion of AIDSOrgonisqfions
publicheclthpolicyhosreflectedo desireto protectthe
Historicolly
generolcommunityfrom outbreoksof epidemicdiseose.Infectious
disecsecon occur wilhino communiiysuchos HIVdid in the eorlyl9B0s,
l o x i n l B B l ,o n d
b e i n i t i o l lbyo u n d b y r o c e ,o s w o st h e o u t b r e o ko f s m o l p
os we sow in the firstoutbreoksof
be confinedto o profession
diseose,Thispcltern in initioloutbreoksoften lecdsto
legionnoires
'blome'theories
where the people
concerningihe originsof the diseqse;
infectedwith ond offectedby the disecseore blomedos originotors,
whereos more oftenthen not itso cose of beingin the wrong ploce ot
t h e w r o n gt i m e ,
outbreoksof
Theseeorlyisolotedcosesore followedby moreserious
obout the firstisoloted
diseose.Wherethereisusuollymorbidcuriosity
ponic
os
the
oulbreoks
become rnore
to
feor
ond
coses,thischonges
Thefeor ond ponic ore oftenfonned by the medio,ihe
widespreod,
whoseresponseis
ond the governmentouthoriiies,
medicolprofession
oltruistic.
not olwoys
Thereisolwoyso need for the couseof the epidemicto be known,
some
whichcon resultin o witchhuntfor the scopegoot,Interestingly,
ore for more emolivethon oihers;scorletfever,plogue,ond
diseoses
while
infusedwithfeor,hysterioond irrotionolity,
AIDSoll ore diseoses
pox
deemed
to be
smqll
ore
o
lesser
degree
influenzoond to
meosles,
ond the
common ploce by medicolond governmentouthorities,
generolcommunity,
ore more octivelysortofter.
Scopegootsfor the more emotivediseases
obout who ore the peopleoffected by the epidemicisoften
Curiosity
orticulotedby the medio,Duringthe Asioticflu epidemicin I890,o
Sydneynewspoperprintedlistsof peoplewho hod cought the diseose.
werethe middleclcss
Of porticulorinterestto reodersof the newspopers
con be drown wiih
Porollels
or the famouswho hod cought influenzo,'
reporiingof well knownpeople who hove HIVinfectionor who hove
'newswotthness'
of reportingon HIVpositivesex
AIDS,os wellos ihe
workers,
recurrenttheme in oll epidemicsisthisseorchfor the
An interesting
rccesetc who ore blomed for
scopegoots-thosepeople,communilies,
ore oftenseenos the
firstintroducingthe infectiousdiseose,'ond
too greotlythot
propogqtorsof the diseoseos well.lt connot be stressed
o
ond sociolclimotehos mojorinfluenceon
the contempororypoliticcrl
the severityof ihe sccpegooting,os well os the selectionof the
scopegootsthemselves.
ln the currentpoliticolclimote,onti-sexworkerfeelingscentreon
"SeXWorkef"lifestyleond being different,ond the
concernsobout the
differentto
beliefthot sexuollyoctive sexworkersore biologicolly
these
beliefsisthe
from
sexuollyoctive people generolly.Resulting
likeHIV
conclusionthot sexworkersore more likelyto tronsmitviruses
thon someonewho moy be engogingin sexwith o similornumberof
p o r t n e r sb u t w h e r en o m o n e yo r g o o d sc h o n g e h o n d s .
A s w e h o v e s e e nw i t hi h e H I V / A I DpSo n d e m i cw o r l dw i d e ,t h i s
scqpegootingcon quicklybecome engenderedin o legislotive
fromework.ln the post in Austrolio,
suchos forced
hove been utilised
lessihon innovotiveheolthstrotegies
usedogoinstthe Chineseond the
voccinotionond quoroniine,primorily
sick
ond infectedso os not to
begon to hide their
poor, Households
ond theirown neighbours,
gornerottentionfrom the heolthouthorities
con
proboblyexocerbotingthe epidemicdiseoseprocess,Comporisons
'hidden' in
people
positive
being
of
be drown with the currentsituotions
the sexindustry,
both new ond old deoling
Thefollowingiso briefoverviewof legislotion
for positive
porticulorly
The
implicotions
HlV.
diseose,ond
with infectious
people engogingin sexwork ore obvious'
Tqsmoniq
Thereisno specificmenlionof positivepeople ond sexworkin
Governmentstotesthot the IGCA
TheTosmonion
legisloiion
Tosmanion
LegolWorkingPortyreportguidesthe content of theirlegislotion,
HIV/AIDS
sexworkersore coveredby the Tosmonion
Posiiive
Acf whichcoversthe legolrightsond
Meosures
Preveniotive
people generolly,
positive
of
responsibilities
.|990.
Sydney:Sydney
r Curson,P. H. (1985)Timesof Crisis:Epidernicsin Sydney lTBBPress
UniversiiV
Compulsoryfesting in Certoin Coses
l0(3) (b) behovesin sucha woy os to ploce otherpersonsoi riskof
b e c o m i n gi n f e c t e dw i i h H l V ,o n d
(c) lslikelyto continueto behovein sucha woy
Thisclouseispossibleprovisionfor ony positivesexworkerto be chorged
if ihey coniinueto work ,
Disc/osureof Informofion
l9 (g) A dentist,Medicolproctitioner,
Nurse,opprovedheolthcore
workercon requestinformotiori
obout o clientof o confidentiolnoture
includingtheredrug usehistory,
sexuolbehoviouretc,
Ironsmissionof HIV
ploce onotherpersonof risklowsexisi
Knowinglyor recklessly
Legclonuson sexworkersto informoll theirclientsif they infectedwith
HIVbefore the service.Clientsmustvoluntorilyoccept ihe risk,Thisgoes
boih woys- clientsmustolso informond get consentif they ore positive
people mustsubmitto "oppropriote
Positive
medicolond psychologicol
ossessment"
lf positivepeople oppeor to not complywiih legolonusploced on them
plocing
to informportners(sexor needleshoring)
ond ore possibly
peopleof riskthen theirmedicolproctilioner
or opproved heolthcore
workermoy informtheirportnersof theirHIVstotus.
Orders
Persons
who ore deemed to be not complyingwith lowsre positive
peopleond theirobligotions
con hove on orderplcce on them thot
restricts
theirmovemenisfor up to 28 dcys or they con be incorceroted
subjecito the order for up to 28 doys.
Theseorderscon be renewedond voriedofterihe 28 doys.lsolation
orderscon be corriedout by policethroughorrestproceduresif
deemed necessory.
seriousness
Methodof tronsmission,
of the riskond postond likelyfuture
person
con offectthe order,
behoviourof the
does it lendweightto condom use,or isthe
Nowherein the legislotion
evidenceof condom useindicotedos odmissible
evidencein o cose of
someoneknowinglyor recklessly
endongeringsomebodyelse.
WestAustrqlio
governHIVpositivepeople ond sexwork.They
Twopiecesof legislotion
Llt9,
I h e H e o l t hA c t l 9 l I ( W A )
s,294in the WA CriminolCode-introducedin 1992mokingit on
offence to couse o personto hove o seriousdisecse
WA Heolthdeportmenthove developedo policydocumenttiiled
"Guidelines
for the monogementof HIVinfectedindividuols
who
which more directlyrelotesto
knowinglyput othersoi riskof Infection",
people ond sexwork.
the issues
of Positive
Generol Action fokenby WA heotthworkers:
TheWA HeolthDeportmenthoso DiseoseControlUnitlBrqnch
which iso
people
who
unil
with
to
work
knowingly
dedicoted
spreodHlV.Thisunit
runso Cose MonogementProgromolong holisticlines,Thereisno wriiten
policy,but sexworkersore not permittedio continuetheiremployment.
lf o inediccl prociitionerisconcernedobout on HIVposiiivepotientond
ControlBronch,the progromprovideseducotionond
noiifythe Diseqse
lf the bronch receiveso publicollegotionor comploint
counselling.
concerningthe worker'soctionsor behoviourthe bronchencourogethe
sexworkersto ceosetheirnormolemployment.Efforlsore mode by the
ore
bronch to find suchworkersolternotiveemployment.Negotiotions
beholf
with
other
ogencies
to
find
suitoble
conducted on their
ossistonce
in the form of Sociolsecurityond
employment,Finonciol
to
to the CESore negotioted,Whereoppropriotereferrols
referrols
eligibility
ond
ore orrongedto ossess
for sickness
medicol services
ond
disobiliiybenefils.Thepersonmoy need psychiotricossessment
treotmeniwhereoppropriote.Everyeffortismode to move the sex
workerout of the industry,
etc (in conjunction
lf thiscction of educotion,supportond inforrnotion
to the relevont
with SIERA)
foilsthe followingwilloccur-pursuont
(WA)
ss,250-258
ond
the CriminolCode
l9l
(the
Act
I
Heolth
legislotion
(WA)
ploced on
Theworkerwillbe issuedo writtenworningond restriciions
o curfewmoy be
his/hermovementsond employment.lf necessory
opplied to the person,lf oll thisfoilsthe personmoy be isoloted(this
provisionisrorelyused).To ochievethisthe ossistqnce
of the policemoy
be enlisted.ThesexworkersCIreolsoreferredto SlERA,.
Guidelinesfor the monogement of HIVinfected individuolswho
knowinglyput olhersof riskof lnfection
:
RecolcitrontDefinition
"A recolcitrontHIVinfectedindividuoliso personwho knowsond
thot they hqve been infectedwith HlV,yet continueto
understonds
thoi exposeothersto the riskof HIVinfection,
engoge in octivities
from doctorsor otherheolthofficiolsto modifytheir
despiteinstructions
behqviour"
A Recolcitront
isc personwho:
c) hos in the post wilfullyond knowinglybehoved in sucho wcy os
to exposeothersto riskof infection;
b) islikelyto continuesuchbehoviourin the future
c) hos been counselledextensively
on the subjectof oppropriote
behoviourchonge,in occordonce with the
ond responsible
but such
Heolthdeportmentof WesternAustrclioguidelines,
counselling
hosbeen followedby no evidenceof success;
dongerof infectionto others
. d) poseso significont
Riskbehoviourisdefinedos unprotectedpenetrotivesex- onol or
voginol,ond the shoringof injectingequipment,
Policystotesthcl if o positivepersondoes not informony likelysexuolor
injectingequipmentshoringportnerthot they hove HlV,ond thot shoring
or penetrotivesexoccurs,then they hove ploced theirportnerot
even if they usecondomsor
risk.Thisriskis not diminished
unreosonoble
endeovourto cleon the injectingequipmentbetweenshoring,
of riskbehoviourmoy be evidencedby one of the following:Allegotions
o) Selfdisclosure
b) Reportby oiher suchos peers
disecsecontrocted ofter the
of o sexuollytronsmissible
c) Dicgnosis
of HIVinfection
diognosis
d) reportof riskbehoviourby otherheolthond welforeogencies
for the provisionof sexuolservicesfor
e) Theplocing of odvertisements
or otherevidencethot on HIV
moneyby o HIVinfectedindividuol,
for money
infectedindividuolhoscontinuedlo providesexuolservices
ollegotionof riskbehoviouron.theport of o HIV
lf thereissignificont
positiveperson,they moy be investigoted,
theircounselling
ond contoct
ControlUrritof the WA Heolth
wiih cose monogersfromthe Diseose
Deportmentintensified,
ApplicotioncCInbe mode throughthe courtsto resirictthe behoviourof
the "recolcitront".
Evidencethot wouldbe stondordin o court of low
mustbe provided
5
Policystotesthot thereshouldbe copocityin the publicheolth
HIVpositiveperson's
legislotion
to ploce restrictions
on o "recolcitront"
livingcircumstonces
or employment,
olreodyin ploce in NSW,
Policyguidelinesore similorto legislotion
Tosmonio
etc,
for cose monogementof HIVpositivepeople ore detoiled,
Guidelines
for monogingthe perceivedpublicheolth
ond processes
Theguidelines
positive
person
ore verysimilorto NSW,Vic etc.
riskfromo HIV
S/oge one- Counselling,educolion ond supporf
this
cose workersworkingwith positivepeople.Wherepossible,
Individuol
cosb workershouldcome fromo serviceor ogency thot isolreodyused
shouldbe mode to put the HIVpositive
by the HIVpositiveperson,Efforts
personin contoct with peer bosedsupport.
Sfoge Two-HIV case monogemenf ponel
from
A monogementponel isinvokedos o consequenceof poor results
ponel
its
responsibilities
to
oport from
stogeone, Thisrnonogement
ond moreforcefullyguidethe HIVpositivepersonowoy
furtherossess
of orgonising
such
hosthe responsibility
fromengogingin riskbehoviours,
j
o
b
p
l
o
c
e
m
e
n
t
,
i
n
c
o
m
e
m
o
i
n
t
e
n
o
n
c
e
i
f
t
h
e
yo r e
gn d
t h i n g so s r e t r o i n i n o
o sexworkeretc.
Theponelmoy sendon officiolletterof worningto the positiveperson,
of Heolth,ond
informingthem of the legolpowersof the Commissioner
them if they continueto ploce othersot risk,
theirobilityto isolote/detoin
Sfoge Three-Restrictionof Activifies
Thecose monogementponel moy chooseto move on to thisoption,
occommodotion
of the positiveperson's
includingrestriction
octiviiies
etc, Currentlythereislitile
employment,sociol
orrongements,
rightof oppeol for the positiveperson,
S/oge Four - lsolotion
on orderfo
of Heolthissues
ThePonelrequeststhot the Commissioner
public
sofety,
of
isolotethe positivepersonin questionin the interests
period
be
limited,
ii
is
not
should
isolotion
the
thot
Althoughstoted
This
definedexoctlyin termsof time likeNSW, Victorioond Tosmonio,
periods
for the truly
of isolotion
meonsthoi therecould be extensive
"recolcitro
person,
positive
ni"
H o m ed e f e n t i o no n d c u r f e w so r e o n o p l i o n ,
lf throughpsychiotric
it isdeterminedthot o psychiotric
ossessment
persons
conditionunderlies
behoviour,then they con be
the positive
voluntorily
or involuntorily
committedto o psychiotric
institution,
Cildnd Low Amendmenf Act (No, 2) 1992
Porf 2 - TheCriminolCode;Amendmenls Re/ofingto lronsmissionof
Drseoses
Thisisinclusionin crimincllow ihe offenceof cousingsomebodygrievous
bodilyhcrm by cousingthem to hove o serious
diseose,Personcould be
for up to 20 yeors
liobleto imprisonment
Heolth Act 1911
The'execuiive
directorof PublicHeolth,if outhorisedby the Minister
con
d e l e g o t et o o n y p u b l i ch e o l t ho f f i c i q lt h e p o w e r1 o , , , , , .
251(5) He moy in wriiingorderony personwhom he hos reosonoble
groundsfor believingor whom he suspects
to be suffering
from or
of o dongerousinfectious
horbouringthe orgonisms
diseose(o) to submithimselfto medicolexominotionby suchmedicolofficeroi
suchtime ond oi suchploce os isspecifiedin the order;ond
(b) to provideor permitthe medicolproctitioner
to tqke suchsomples
ond specimensfromthot personos moy be requiredby the medicol
proctitionerfor the purposeof determiningif thot personissuffering
from thot diseoseor horbouringthoseorgonisms,
but if the personis
yeors
oge
shqll
be
served
under 18
of
the order
on the pcrentsor
guordionof thot personwho shollouthorise
the medicolofficerto do
onythingnecessory
to give effectio the orderond do oll things
necessoryto ensurethot the orderisobeyed by thot person,
Compu/soryexaminotion qn d freotmenf
307,(l) Wheneverthe ExecutiveDirector,PublicHeolthhosreceivedo
signedstotementin whichshollbe setforihthe fullnome ond oddressof
the informonf,whichgivesthe ExecutiveDirector,PublicHeolthreoson
from venereoldiseose,or
to believethot ony personissuffering
the ExecutiveDirector,Public
whenever,in ony othercircumstonces,
Heolthhos reosonoblegroundsto suspectthot ony personissuffering
he moy give notice,in writing,to suchperson
from venereoldiseose;
ond produceto the
requiringhim to consulto medicolprociitioner,
Director,PublicHeolthwithino time to be
sotisfoction
of the Executive
thot
specifiedin the notice,o certificoteof suchmedicolproctitioner
person
ond
if
such
is
or
is
not
suffering
diseose,
certificote
such
is
fromihe
not produced withinthe time stotedin suchnotice,or if the Executive
withsuchcertificoiehe moy, by
Director,PublicHeolthbe not sotisfied
worrontunderhishond,outhoriseony medicolofficerof heolthor ony 2
to exominesuchpersonto oscertoinwhethersuch
medicol proctitioners
personissuffering
fromsuchdiseose,
ond the soidofficeror proctitioners
shollhove power to exominethe personoccordingly,ond shollreport
the resultof hisor theirexominotionto the ExecutiveDirector,Public
Heolihin writing.
Providedthot where the personto be exominediso femole,ond the
one of suchproctitioners
exominotionisio be by 2 medicolproctitioners,
sholl,if so desiredby the personto be exomined,be o femole medicol
proctitioner,
of the
if oble ond willingfo oct, bnd within32 kilometres
ploce wherethe exominotionisto be mode,
thqt the personissuffering
from ony venereol
(2)lf ihe reportdiscloses
disecsein on infectiousstogeond isin the opinionof the Executive
ihe
Director,PublicHeolthlikelyunlessdetoinedto infectotherpersons,
ExecutiveDirector,PublicHeolthmoy be worrontunderhishond in the
prescribedform,ond directedto the prescribedpersons,
orderthe
personto be opprehended,ond to be delqinedfor ony period not
exceeding2 weeksin ony hospitolor otherploce,ond the Executive
Director,PublicHeolthmoy by suchworrontorderony bocteriologicol
ond investigotions
to be mode of ond in respeci
ond otherexominotions
of suchperson,
of thissection
Foroll the purposesof thisond the succeedingsubsections
ploce
of
The
be
o
detention,
gool
deemed
to
sholl
be
hospitol
ony
ExecutiveDirector,PublicHeolthmoy by worrontorderony personto
oPPlieswhom ony suchsubsection
(o) to be detoined in o gool hospitolin the firstinstonce;
from o hospitolor otherploce to o gcol hospitol,
(b) to be tronsferred
Director,Public
(3)lf oftersuchdetentionit sholloppeor to the Executive
person
diseose
in on
from ony venereol
issuffering
Heolththot the
in the
condition,ond thot furtherdetentionisnecessory
infectious
Director,PublicHeolthmoy issuehis
of the public,the Executive
interesis
worrontin suchform,ond direcledto suchpersonsos he shollthinkfit,
of suchperson
if necessory
ond requiringthe opprehension
outhorising
ond ihe detentionof suchpersonin suchploce for suchtime os the
ExecutiveDirector,PublicHeolthmoy thinkfit,ond the Executive
Director,PublicHealthmoy by ony suchworrqntdiiectthot suchperson
shqllbe subjectto ony treotmentond exominotionwhichthe Executive
in the circumstonces.
Direcior,PublicHeqlthmoy thinknecessory
(4)Whenony personissubjectto detentionunderthissectionhe moy
fromtime to time opply in writingto o judge of the SupremeCourtor o
residentor police mogisirotein the districtin whichhe isdetoinedto be
ond thereuponsuchiudge or
exominedby 2 medicolproctitioners,
mogistroteshollby orderdirect any2 or more medicolproctitioners
nomed in the order,one of whom shollbe nominotedby the potientor
some personon hisbeholf,to exominesuchpersonoccordinglyond
reportthe resultof the exominotionto the judge or mogistrofe,ond
everyofficeror outhorityin whosecustodythe personisshollpermitthe
exominotion,lf it oppeorsfrom suchreporithot oll the medicol
proctitioners
ore unonimously
of opinionthqt the personiscured or is
or if suchreportdiscloses
free from venereoldiseose,
thot the personis
stoge,but ihe Executive
sufferingfrom venereoldiseosein on fnfectious
Director,PublicHeolthfoilsto sotisfythe judge or mcgistrotethot the
personwould be likelyto infecfoihersunless
detoined,then the judge or
person,
who shqllbe liberoted
mogistroteshollorderthe reledseof such
from detentionoccordingly;providedthot no opplicotionshollbe mode
by'o personso detoinedwithin6 colendormonthsof o prioropplicotion
hovingbeen mode by suchperson,
(5) Whenony personissubjectto exominotionor detentionunderthe
provisions
of thissection,ond isfound not to be suffering
from venereol
from venereoldiseosebut not in on infectious
diseose,or to be suffering
from venereoldiseosein on infectiousstoge,but
stcge,or to be suffering
not likelyto infectoihers,he shollbe entiiledos of rightto inspectony
writtenstotementmode to the ExecutiveDirector,PublicHeolthunder
subsection(l ), ond to hove o verifiedcopy of everysuchstotement,
(6) Ihissectionshollopplyto ony personundergoingimprisonment,
but
provisions
to
into
is
necessory
in
order
corry
effect
in
so
for
os
the
except
shollnot be interferedwith;
of thissection,the sentenceof imprisonment
providedthqt the periodof ony detentionsufferedhereundershollbe
lf the personstillremoins
reckonedos port of ihe term of imprisonment.
qt the terminotion
liobleto serveony portionof the term of imprisonment
the Minister
moy issuehisorderto ony police
of the detentionhereunder,
person
to the gool or prisonwhere
officer,directinghim to convey the
such personisliobleto completethe sentencel
(7) Everyworrontissuedhereundermoy outhorise
the useof suchforce
to corryit into compleieeffect,ond shollhove
os moy be necessory
effect occordingto itstenor,ond qll policeofficersshollon sightof the
in iisexecutionin so for os they moy be requested
worrontoid ond ossist
so to do by ony personto whom the wqrrontisdirected
of thissectionby oct or
(B)Any personwho controvenesony provision
the corryingintoeffectof ony worronfor order
omission
or obstrucis
to do or submiito onythingwhichsuch
issuedthereunderor refuses
personisby thissection,or ony suchwqrrontor order,requiredto do or
submitto commitson offence,
Victoriq
Guidelineson HIV posifivepeop/e (including sexworkers)
for the monogementin
hosguidelines
Heolthond Communityservices
Victorioof HIVinfectedpeoplewho ore likelyto infectofhers.The
estoblish
o step likeincrementin the monogementof this
Guidelines
issue,
Educotionond Support
Stogeone- Counselling
Siogetwo- FormolRequestfor involvementof the Deportmentof Heolth
ond CommunityServices
Stogethree-Letterof Worning
of Moveinent
Stogefour-Restriction
Stogefive-lsolotion
Victorion Heolth Act 1958(os omended)
.l20
infectonotherperson
(l) A personmustnot knowinglyor recklessly
s
with on infectiousdiseose,Ihe Act hosbeen omendedto includeHIVos
infectious
diseose,
tronsmissible
o sexuolly
Agoinon onusis ploce on the infectedpersonto informoll theirportners.
the ChiefGenerolMonogercon order
Underspeciolcircumstonces,
go to the ChiefGenerolMonoger,
someoneto be tesiedfor HlV,Results
positive,
then con be orderedto
s. l2l , lf the personisfound lo be
u n d e r g oc o u n s e l l i n gD, e p e n d i n go n t h e c o s et h e C h i e fG e n e r o l
on the personsbehoviour
Monogerisempoweredto imposerestrictions
or movements.Incrementolstogesor monogementore ouilined
increosingin severityin occordoncewiih the positivepersonsnon
com:plioncewith the conditionsof the orderbeingoutlinedto them,
in otherstotes,the Victorionlegislotion
Unlikeothersimilorlegislotion
outlinesthe rightsof oppeol for o posiiivepersonogoinstthe imposition
of on order.Theycon oppeol once in the periodof the orderto the
ChiefGenerolMonoger,or in the cose of ony otherorder,once in o 28
d o y p e r i o d ,I h e C G M m u s to d e c i s i o n/ t q k e s o m eo c t i o no n t h e o p p e o l
withinfive doys.Theposiiivepersoncon olsooppeol to the Supreme
Courtogoinston order,who ore requiredto respondurgently,
:
ConfrolAct 1994
Prosfitufion
.l9,
q
o prostituteinfectedwith diseoseto workin o brothel
Permitting
a*n
Onusisploced on operotorsto knowthe heolthstotusof the workers
diseosefrom working,
ond disollowony infectedwithon infectious
submitto monthly
defence existsif operotorscon provethot the workers
sexuolheolthchecks.
workinqwhileinfectedwith o diseqse
20, Prostiiute
10
Agoinstthe lqw to workif you knowyou ore infectedwiih q sexuolly
tronsmitteddiseose.A defence existsin q court of low if the sexworker
con prove thot they were undergoingmonthlysexuolheolthchecksto
determinethe stqtus,
Queenslond
AmendmentAct (.l992)sABstotesthot it ison offenceto
Prostitution
knowinglyinfectonotherwith o notifioblediseose,which coversHIV
C. An onusisploced on the positivepersonto inform
/AIDSond Hepotitis
prospective
sex
ond
needleshoringportnersof theircondition,ond
oll
thot personmustthenfreelycohsentto hove sexor shoreinjecting
equipmentwith them.
TheQueenslqndHeolthDeportmenthosdevelopedo "Protocolfor
o
Monogementof HIVInfectedPeoplewhoseBehoviourConstitutes
publicly
yet
PublicHeolthRisk",
Thisdocumentis
to be
releosedond in l0
yeorssucho protocolneverhos been enocted in Queenslond,
lt ison
incrementolfivestogeprotocolsimilorto othersexistingin NSW,
Victorioond WesternAustrolio,
Tosmonio.
SouthAuslroliq
or policiesconcernedwith HIVpositivesex
No specificlegislotion
workers.
.|987
HeolthAct
hossectionswhich deol with
Publicond Environmentol
controllednotifioblediseoses,
ond the oct iscomplimentedby
guidelines
for monogingpeople who ploce othersoi riskfor HIV
infection
isthot people with o controlled
Underthe SA Act, the requirement
to preventtronsmission
notifioblediseosetoke oll reosonoblemeosures
for positivepeople to
to others,Thereisno requirement
of diseoses
theoreticolly
if o positive
informtheirsexuol/ shoringportners,Therefore
sexworkerwos olwoyshovingsofesex,it could be orgued thot they ore
octing in occordoncewiththe low. Thishosnot been legollytested
however.
Accordingto the l9B7Act, o court orderisneeded to detoin o person,
but no orderisrequiredto restricttheirmovemenifor o shortterm
(subjectto reviewby o mogistrote)
ploce on emphosisthot the HIVpositivestotusof the person
Guidelines
in questionmustbe knownond not rumoured,os wellos serious
concernsond evidencethot unsofesexisoccurringwith theirportners,
on cose by cosemonogement,
Emphosis
Soulh AustrolionGuidelinesfor lhe Monogemenf in SoufhAusfrolioof
people who knowinglyp/oce ofhersqt riskof HIVlnfecfion
Sexworkergroupsnot consultedin developingthe guidelines
likeotherstotes(fourStoges)
Incrementolstogedcontinuumof meosures
11
Educotionond Support
Stogeone- Counselling,
StogeTwo-FormolRequestfor the involvementof ihe SA Heolth
Commission
to monoge the
monogement-.ponelcon be estoblished
Moreintensive
ccse,Thepersonin questioncon hove o communityodvocote present
on thisponel.Theponel moy decide fhot o leiterof worningneedsto
concerns,
be senito the personin questionif they hove serious
of Movementond or Activities
StogeThree-Restriction
moy direstthe personto resideof q certoin
TheHeolthCommission
underthe
plobe,chonge theirworkprocticesond or ploce themselves
of o persondesignotedby the HeolthCommission.
supervision
Thisdirectioncon only be overturnedby o mogistrote
StogeFour-Detention
"quorontine"
for
Lostresort-detentionof o personof o suitobleploce of
oppliesfor extensionwhich
no morethon 72 hoursunlessthe commission
isgrontedby the reviewingmogistrote.Petsoncon be detoinedfor no
of o supremecourt judge,
more thon 6 monthswithoutthe outhorisotion
Appeolprocess
the personcon opply io o mcgistroteto reviewthe decision.
Initiolly,
then if stillnot hoppy with the decisionthey con moke oppeol to the
supremecourtogoinstthe decisionof the mogistrote,
A ustrolion Copitol TerritorY
Public Heolfh (lnfecfiousond Notifiob/eDiseoses)Regulotion
"lnfectious
Diseose",
AIDSiso notifioblediseose,but HIVisnot listedos on
ProstitutionAcf 1992
whichincludesHlV,
Act includesoffencesrelotingio STDs
stepsto stop
to
toke reosonoble
for
foiling
be
chorged
Operotorscon
HIV positivesexworkersfrom providingsexuolservicesos port of the
operotorsbusiness.
It isillegolfor sexworkersond clientswho know they hove HIVto buy or
recordsos
lt isolsoillegolto usemedicole.xominotion
sellsexuolservices,
proveof freedomfrom infection-onuson operotorsto ensurethisdoes
n o th o p p e n ,
clientsond operqtors1o
Condom useisupheldby lqw-onuson workers,
ensurecondom useoccurswitholl orol,voginolond onol peneirotive
sexuolservices
12
NorthernTerrifory
NotifiobleDr'seoses
Act 1981
gBB
Amended in l
to include"HlVlnfectionGrouosI -4"os notifioble
disecses
Underthe Act, o HIVposifivepersonor o personsuspectedof hovingHIV
mustsupplyto o medicolproctifioneror medicolofficernomesond
oddressesof possiblecontocts
A medicolofficermoy servethe HIVpbsitivepersonin writingwith o
noiice directingthem fo corry out meosuresnecessoryfor trectment or
tronsmission
to preventthe possible
of HlV.
A HIV positivepersonservedwilh thisnoticemoy oppeol to o
mogistrote
otherstotes-leoding
Incrbmentolstogesof monogementlike
to
isolotion.
detention/
isnot o publicheolthoffencein NT,
HIVtronsmission
ProstitufionRegulotion Act 1992
lllegolto usemedicol exominotionrecordsos prove of freedom from
infection-onuson sexworkersond operotorsto ensurethisdoes not
hoppen
New SouthWoles
Public Heolth Orders
A publicheolthordermustrequirethe personto whom it oppliesio do
ony one or mofe of the following:
o)
Refroinfrom specifiedconduct
Undergospecifiedtreotment
b)
by o specifiedpersonor by one or more
c)
Undergocounselling
personsbelonging
to o specifiedclossof persons
d)
of o specifiedpersonor one or more
Submitto the supervision
persons belongingto o specifiedclossof persons
e)
Undergospecifiedtreotmentond be detoinedof o specified
ploce whileundergoingthe treotment
f)
Be detoinedof o specifiedploce wherethe orderisin force
TheHIVpositivepersoncon oppeol to the districtor supremecourt on o
motterof lqw or ogoinsto decisionof o districtcourtto continueo public
h e o l t ho r d e r .
NSI/YPublic Heolth Act 1991
tronsmissible
medicol
A personwho knowsthey sufferfrom o sexuolly
condition(whichincludesHIV)isguiltyof on offenceif they hove sexuol
tokesploce, the
intercoursewith o personunlessbefore intercourse
other personhos:
- Beeninformedof the riskof controctingthe conditionfrom the
personwith whom intercourse
isproposed
- Voluntorily
occepted the risk
13
Theowner / occupierof o buildingor ploce who knowinglyollows
tronsmissible
medicqlconditionto sexwork on
somebodywith o sexuolly
ihose premisesolsocommitson offence,
is:"sexuolconnectionby the
Thelegol definitionof sexuolInlercourse
introductionintothe vogino,onusor mouth of o personof cny port of
the penisof onotherperson,or cunnilingus",
Conclusions
of scopegocting'orecertoinlystillwith ustodoy in the AIDS
Theprocesses
pondemic,ond differdependingon geogrophy,sociolond politicol
or groups
climote,ond occordingto culturolnorms,Wholecommunities
who con
ore blomed,triggeringo hunt for qn individuolif possible
roce, socio-economicstotus,
ossumecollectiveguiltfor sexuolity,
evidentin Austroliowith
gender,profession
etc. Thishos been porticulorly
positive
peoplesexworkersond people with
two cotegoriesof HIV
of mentol illness,
histories
It isolsounovoidoblethot epidemicsore olwoyspoliticolevents,As in
o powerfulond nof necessorily
ony politicolevent,the medio ossumes
posiiionin both repoltingevents,ond os o tool to
comprehensive
c o n o c c u ri n
, h i l eu n b i o s e dr e p o r t i n g
i n f l u e n c ep o p u l o ro p i n i o nW
olormist
reports
sploshedin the
or
epidemics,it isusuollythe sensoiionolist
bosedcurrent
ond coveredin personolity
lorgecirculotionnewspopers
showsthot grob the ottentionof the public,Oftenthe
offcirstelevision
ond feorsobout diseose
medio triggersold roiherthon new ossumptions
ond quorontining,
and contogion,suchos the need for isolotion
to AIDShosbeen incrediblyvoried,rongingfrom
Themedio response
siroightforwordfoctuolreporting,througholormisiond feor bosed
to blotontly
storiesobout dongerouscontogionond personolsuffering,
group
who ore not viewed
dishonestpropogondoogoinsfony minority
oitemptsby the
We
hove
olso
seen
(potriorchol)
society.
by
os normol
medio to give usthe humonfoce of AIDSin voryingdegreesof guilt;
Suziethe mortyr,innocentlittleEveqnd wickedShorlene.
lookedto historyfor directionin response
Stotesond lerritories
Austrolion
to the currentAIDSpondemic,Mostcurrenilyutiliseconstructive
developedin the lost100yeorsof epidemics,however,AIDSis
strotegies
unique in mony woys.lt struckof o time in historywhen common
populorbeliefwosthot epidemicswere o thingof the post,mode
redundanlby the qdvonceswe hod mode in medicolscience,Forsome
epidemicdiseoseisnot o port of their
of the youngergenerotions,
Soto be foced with o biologicclcotostropheof the
consciousness.
we ore currentlyfocinggiventhe climoteof pseudo-security
dimensions
diseosein the lote 20thcenturyisextremely
regordinginfectious
1,4
chollengingon mqny levels.Heolthouthorities
hove hod to rethinkthe
diseoseoutbreqksin epidemicproportions.
reolities
of infectious
AIDSpresents
for Austrqlions
mony uniquesociolond politicolchollenges,
To quote AllonM, Brondtfrom his chopterin AIDS;TheBurdenof History
" AIDSmokesexplicito centroiiensionin our polity:the premiumwe
ploce on the rightsof the individuolto fundomentolcivilliberties
versus
public
the notionof the publicgood ond the roleof the stote.in ossuring
welfore".2
Personolfreedomsuffersgreotlyduringoutbreoksof infectiousdiseose,
deemed uncleonby the stofe,oftenmoke up the numbersof
Prostitutes,
personsquorontinedor isolotedduringepidemics,'Thispersoncl
freedomoppeorsto be being impingedupon ogoin in somestotesof
to the HIVepidemic,HIVpositivesexworkersore
Austrolioin response
not offordedthe somerlghtsos otherHIVpositivepeople,ond thisis
ond policythot specificolly
evidentin legislotion
nomesHIVpositivesex
workersos o threotto publicheolth,
It does not oppeor thot we hove leornedfrom exompleslikethe
gmollpox epidemicin l88l thot feor of contogionin
Austrolion
combinotionwith horshcontoinmentpoliciesond penoltiesonlyserves
to drivepeople of riskof infectionowoy from pointsof contoct where
they con receivefoctuolinformotion,
medicolcore ond support.
Whilewe coniinueto moke filV positivesexworkersinvisible
through
we continueto upholddiscriminotory
legislotion,
ottitudestowordsthem,
ond stigmotise
o HIVpositivepopulotion
Activelydecidingto morginolise
who ore in need of the somesupportond core thot oll HIVpositive
people deserveisthe promotionof illness
rotherthon wellness,
2 Fee,E.& FoxD, M, (.|988)AIDS:The
Berkeley,
Burdenof History.
LosAngeles,London:
Universiiy
of ColifornioPress
3 Brondt,A. M. (1985).No
Mogic Bullet:A SociolHistory
of VenereolDiseosein the
'1880,
UnitedStotessince
Press
New York,Oxford:OxfordUniversily
1,5