For 11 years, the legislation in the field of combating HIV and AIDS remained unchanged. Fortunately, on December 1, 2021, the Council registered two projects that propose to update the old systems of diagnosis and organization of medical care for people with HIV-positive status in Ukraine.
Today, Ukraine is one of the leading countries in Europe in terms of HIV incidence. Every hundredth citizen of Ukraine between the ages of 15 and 49 is infected, but about 30-40% of them do not know about their HIV status. Over the past five years, the Cabinet of Ministers and the Ministry of Health have made revolutionary changes in the fight against HIV / AIDS. According to the sanitary doctor of Ukraine, Igor Kuzin, currently from the diagnosis of a patient with HIV to the beginning of his treatment is only one week.
In 2012, people with HIV did not have access to free ART and were not treated. Only when the patient's immunity dropped to a critical level he was entitled to receive pills. However, despite significant progress, we do not have an encouraging trend towards a positive scenario to overcome the epidemic and reduce new HIV infections.
Due to the coronavirus pandemic, the level of HIV detection has dropped critically, and the incidence of HIV has begun to rise. Moreover, among the 12,000 HIV cases detected in 2021, a third of patients have already developed AIDS. One and a half thousand patients were not saved.
The profile law "On Combating the Spread of Diseases Caused by Human Immunodeficiency Virus (HIV) and Legal and Social Protection of People Living with HIV" was last systematically revised eleven years ago. Now there is a shift: two bills have been registered in the Verkhovna Rada.
Draft Law № 6365 is intended to amend the relevant law in terms of the application of more modern approaches to the prevention, testing and treatment of HIV and AIDS. Bill № 6364 aims to reduce stigma and discrimination against people with positive status by amending the Criminal Code of Ukraine.
What problems do they solve?
The first bill aims to improve the mechanisms of diagnosis and early detection of the disease. In particular, it will legally expand the possibility of testing. After all, it legitimizes self-testing for HIV. Thus, the bill will help speed up the pace of early diagnosis.
The document also provides for greater involvement of social workers and peer counselors in the process of self-testing of citizens. They will be able to quickly guide the latter on the importance of knowing about their HIV status, motivate them to take the test, help with self-testing at the request of the person, and refer the person to a family doctor if the test is positive.
Bill № 6365 also proposes mechanisms to expand the range of entities that will register and keep records of HIV-positive people. They will be distributed to medical institutions of any form of ownership. Thus, we will be able to reduce the burden on public and municipal hospitals, which today are the only ones that register.
Among other things, the bill significantly expands the article on guaranteeing the state supply of citizens with antiretroviral drugs for the prevention and treatment of HIV infection. These measures will cover the costs of pre-exposure and post-exposure prophylaxis, medicines for the prevention and treatment of co-infections, including tuberculosis and hepatitis. In addition, medical devices are added to the list to monitor the effectiveness of treatment free of charge.
A special role in the bill is given to primary health care. In particular, it is about screening and prevention in the primary. The document will also help bring the provisions of the legislation on combating human immunodeficiency virus in line with the provisions of European and international legal acts in this area.
The second bill ends the stigmatization of people with HIV-positive status at the political and legislative levels, namely in the Criminal Code of Ukraine.
Currently, the Criminal Code of Ukraine in Art. 130 provides for the punishment for spreading only one infection - the immunodeficiency virus. No other infection is mentioned in this article. This provision discriminates against people living with HIV. The latter are still prejudiced in society. They are avoided, isolated and condemned only because of their HIV-positive status. The threat of criminal responsibility exclusively for them, on the contrary, pushes people with this disease to constantly avoid medical care, to hide their diagnosis from doctors and relatives. Such behavior has an extremely negative impact on their quality of life and health and makes the HIV epidemic uncontrolled.
The bill proposes to establish equality in the legislation on criminal liability in determining the negative impact of any infectious diseases and to criminalize any intentional infection. After all, there is no more harmful or less harmful incurable infection, and the value of health at the legislative level is the same for all of us.
The new version does not change the conditions and scope of criminal liability for intentionally infecting people with incurable diseases. However, it removes the stigma of living with HIV / AIDS. Assistance from the state motivates people with positive status not to hide their diagnosis. Its decriminalization will simplify access to HIV prevention and treatment.