While I appreciate that Dr Joe Thomas is concerned with his own field, and knows far more about this episode than I ever will, I think he overstates the case. My memory of the case it that there are multiple partners involved, if so knowing consent is highly unlikely. If anything the case to which he refers would emphasise the basic message to the HIV infected that their partners must know of their infection beforehand, and this may help with the infection rates which makes him anxious. As for infection rates Australia has been extremely fortunate compared with, say, Britain or the US, and most particularly with Africa. There are various reasons why we have been so lucky and this instance may be one of them. I don't agree that it has demonised HIV. We are all well beyond that.

While I agree that having unprotected sex with a stranger is silly in this day and age. It is also very important that if a conversation about the issue had taken place between the two parties. That full disclosure of the fact that the man had HIV would be must. I you engaue in an act that you know may cuase another party harm then you should be punished.

Wouldn't it be dreadful if HIV, & AIDS were finally eliminated, by doing something like this charge.

Poor Joe would find himself an expert in nothing.

[Deleted for abuse].

I can't believe this turkey of a writer trotted out the 'xenophobia' word. Like it's an issue that this SOB is an immigrant? He engaged in unprotected sex with a great many partners without disclosing his infected status. That's the ISSUE!

This is so deserving of not only criminal charges and punishment but of somebody, perhaps one or more of his victims, rendering him incapable of ever being able to transmit his infection SEXUALLY ever again.

Wonder if the 'DR' would be of the same sentiments if his daughter, sister or another family member or close friend was a victim of this mongrel behaviour?

Joe,
The crime wasn't in having aids, it is what he did knowing he had it.

It is that, he deliberately or through wanton indifference was party to subverting the well being of others. In short it's the alleged behaviour that is the crime.

The author writes
'This was a golden opportunity for the public health authorities to reinforce the message of “protected sex during every sexual encounter” and it has been squandered.'

Any parent with any sense will see this as a golden opportunity to teach their boys and girls some morals. Commonsense and decency has been lost since we embraced secular dogma. This is more rotten fruit being produced by those shaking their puny fists at God and decency.

<<This was a golden opportunity for the public health authorities to reinforce the message of “protected sex during every sexual encounter” and it has been squandered.>>
Wake up doc.
The safe sex mantra is clearly not working, otherwise how did those 12-100 women come to be at risk?
It's long past time to enact a serious prevention policy.
1 year jail for each person unknowingly infected.
10 years jail for each person knowingly infected.
Namby pamby approaches don't work.
It's time to get tough.
Put the perpetrator's away where they can't repeat offend,
and provide serious disincentives to dissuade potential offenders.

I agree that Joe doesn't seem to get the point of the Health Department putting out a warning to women who may have had sex with this HIV infected man.

Obviously at least one woman he did have sex with has found out she is now HIV positive and has told her medical practitioner who the culprit was.

By law, medical practitioners have to report these sorts of viral diseases to the health department.
Even if the disease is something like syphilis or herpes, they still often send letters to the person who passed it on (if known), in order to protect present or future sexual partners.

This is not a moral issue or a religious issue, it is a public health issue.
What if the women who had sex with this infected man were married and went on to have 'lawful' sex with their poor husbands, who then contracted a possibly fatal virus?

What if the women become pregnant and pass it on to innocent children?
These women must be found for this reason.

All cases of HIV must be reported to the authorities straight away, and acted upon to help prevent further spread.

"Ït is unfortunate that the Australian public health authorities’ response was not based on the sound public health principles of respect to privacy and confidentially. Breach of confidentially and the criminalisation of alleged behaviours which facilitate HIV transmission is not a sound HIV prevention policy."
It is surprising how the author can hold such a narrow and irresponsible view.
It is malicious for HIV carriers to knowingly run the risk of infecting others. It is irresponsible to claim that the interests of the HIV carrier should over-ride any other interests. Such non-thinking has contributed to the spread of HIV in developing countries.
The interests of the community must come first. It is perfectly just to prosecute someone for such irresponsible behaviour.
It is irresponsible to claim that “protected sex during every sexual encounter” is safe sex, when the failure rate of condom use is at least one in four. Abstinence is the only safe sex there is.

'This is not a moral issue or a religious issue, it is a public health issue. '

I see Suzie so this man should not be charged and left to continue sleeping with loose women. But its not a moral issue.

Having unprotected sex without informing his partners knowing that it could kill the partner goes beyond negligence to attempted murder.

While most people responsibly manage their HIV status, this man is as much a threat to society as someone walking around blind folded firing with pistol.

While there is no need to make HIV a notifiable disease, punishing those who inflict harm on others always is.

The truth is that condoms are closer to 99.5% effective. When they don't work it is because people don't use them or don't use them correctly or most often in developing countries,simply don't have access to them. Using condoms and lube correctly is the best prevention we have against HIV and it has been systematically proven through meta-analysis of research that to promote only abstinance programs is not efficacious.
It is equally true that the majority of people with HIV are responsible people who go out of their way to ensure that they do not pass on the infection. Unfortunately, up to 30% of infections are passed on by people who do not even know that they have it yet. In Australia 25-30% of infections are contracted by people in long term relationships. How could criminalising either of these groups serve a worthwhile purpose?
Joe Thomas does not not articulate the position well but it is generally accepted in Australia that this is indeed a health issue which should be dealt with through counselling in a confidential manner because to do otherwise risks driving people away from testing,treatment and counselling which may in turn cause more infections and more hardship for more people.
He also failed to leave room for what our laws indeed do, which is that in the rare, extreme cases where someone with HIV deliberately sets out to infect someone else we see a role for the criminal law if they are proven guilty.
The problem is that too often a person with HIV is judged guilty in the media long before they ever get near to a court and the very principle of innocent until proven guilty so central to our justice system goes out the window.
We must ensure that this does not occur again in this case.

"In addition, many HIV scientists believe that if a person is knowingly living with HIV and is consistently taking antiretroviral treatment, they will have low viral load and therefore, their potential to transmit the virus, even during unprotected sex is negligible. Swiss authorities even went ahead and made a public health announcement to this effect."

However, if there greater likelihood a virus will be transmitted (genes passed-on) freely, there is less pressure on the virus to allow its host to survive. The related risk is, the one in a million virus-under-pressure is passed-on to another community of sexually active people not taking antiretroviral drugs.

StevieC,
"The truth is that condoms are closer to 99.5% effective.
.........
It is equally true that the majority of people with HIV are responsible people who go out of their way to ensure that they do not pass on the infection."

Taking those two statements together, what you are saying is that after contracting HIV they suddenly become responsible and take the precautions they obviously didn't take before.

What prevented them from taking the precautions first up to reduce the risk?

'Majority' isn't good enough.

Why should spreading HIV be a criminal offence if spreading other category 3 communicable diseases isn't?

I would agree that if there was malicious intent then there should be a criminal charge, but it should be the same for all communicable diseases spread with malicious intent.

Influenza is also a category 3 communicable disease & kills more people in Australia each year than HIV, Hep C & Hep B combined yet nobody seems to mind.

Just as the transmission of HIV can be prevented with safer sex practices the transmission of influenza can be prevented with safer hygiene practices (handwashing, not touching the "T-zone" etc).

Why aren't people that have the flu but don't use safer hygiene practices guilty of a criminal offence if people that have HIV that don't use safer sex practices are? (In fact in some Australian States it is an offence for someone with HIV to have sex even if they use safer sex practices if they don't disclose their condition first!)

Runner <" I see Suzie so this man should not be charged and left to continue sleeping with loose women. But its not a moral issue."

I never said he shouldn't be charged Runner. Because he has knowingly put these women's health at risk, he should certainly be charged with assault at the very least....but preferably attempted murder.

This story was not about whether these women were 'loose' or not (except in your mind), but rather about the huge public health risk this man's actions caused.

I hope he get's what he deserves.

Swampy. It used to be the case that if you had a notifiable disease such as Syphilis or Tuberculosis you were legally obliged to submit to treatment. This may have meant an isolation setting and it may not have been your 'cup of tea'. However refusal meant police could collect and force you to undergo treatment in the same way Mental Health patients under Involuntary Treatment orders are today. Refusal could also lead to charges. Whether this has changed I don't know.

I actually agree with your argument - the unexaggerated version! To knowingly (maliciously) place another person at risk of infection (sexually transmitted disease is often the main concern as the mode of transmission is so specific and so preventable) is akin to GBH and other infections like flu, measles, whooping cough, where the sufferer 'soldiers on' despite knowing they have that disease and infect others along the way - ditto. Especially when advised to stay at home by their Doctor.

However, while such diseases do cause fatalities in the vulnerable, all are either curable or the immune system kills off the bug. Not so HIV. Treatable yes, curable no. When the condition develops into AIDS you are doomed. In other words this complaint is a death sentence sooner or later. In this respect I believe the current approach in terms of preventative medicine and education and legal deterrents are correct.

Thanks for your comments divine_msn, I'm glad that you agree, more or less, with my argument.

People with active TB that are considered likely to expose other people to TB can be, & still are, placed into isolation in a single hospital room with negative air pressure & airborne precautions. Patients can be allowed to stay home if the risk of transmission is considered low, but will receive extensive counselling on TB and prevention of it's transmission. If a patient is considered high risk for transmission and is unwilling to undertake steps to prevent transmission they can be placed into isolation under a mandatory health order if the risk is considered great enough. All services relating to the care and management of TB are performed at no charge to the patient.

There are similar steps that can be undertaken if a person is found to be recklessly transmitting HIV (or other communicable diseases). Counselling and education on risks of transmission including regular follow up should always be undertaken in the first instance & criminal prosecution should only be undertaken as a last resort.

What would be ideal is if all treatment & services relating to the care and management of HIV were performed free of charge (it's done that way in the UK) and that the antiviral medications could be collected from community pharmacies instead of just from hospital pharmacies. The limited number of hospital pharmacies, their limited opening hours & the increasing costs of the antivirals make adherence to the medications very difficult for a large number of HIV positive people. The resulting increase in the viral pool due to poor adherence contributes to increased risk of transmission.

A few years ago the idea of a "chronic illness healthcare card", which would allow anyone with a chronic illness to obtain the medications needed to manage their condition at a discounted rate, was put before the Government, but unfortunately the idea was not taken up. In the long run it would have saved the Government and taxpayers many millions in avoided healthcare costs and hospital presentations.

People with HIV have rights as well as responsibilities. While having right to health and well-being, they have a responsibility to keep their infection within themselves not to transmit anyone else. If someone knowingly transmits HIV to others, it is a criminal act and they should be punished after proving the act. We should keep HIV status confidential and support HIV positive to live a productive life and take preventive measures. This will help them live and those not tested for HIV, go for HIV testing and follow prevention.

PLHIV should disclose their HIV status to their sexual partners and make proper use of condoms at all times during every sexual act, and condoms should be accessible to them. Condoms should be used even while PLHIV on Antiretroviral Therapy and when viral load is undetectable as it is not yet approved that they are risk free. Undetectable viral load does not mean that they have no virus, they can still transmit HIV to others during unprotected sex or through blood to blood contact. Sometimes they can transmit drug resistant HIV virus to others.

Condoms are safe if used properly, with valid date and with lubricants. If condom breaks during the sexual act by mistake, Post Exposure Therapy should be accessible to all not limiting to only medical community. Abstinence to sex is not the solution as sex is a biological need, even if HIV positive.

If the unprotected sex happens between both parties with consent, it is a different issue. "If I risk my life to HIV knowingly by having unprotected sex with PLHIV, I am responsible. No one can punish me as I can decide for myself".

But majority of the HIV infection happens unknowingly from those not yet tested for HIV and we need to change our prevention strategy and create a friendly environment so that every individual go for HIV testing and get their HIV status known.

We should not support those who transmit HIV knowingly. We should take them to court and they should be punished so that no one knowingly transmit HIV to others anymore.