Does criminalisation of HIV transmission truly promote public health goals? Review of ten African HIV laws

Over ninety World Health Organization Member States have been reported to criminalise HIV transmission and at least fourteen African countries recently adopted new criminal laws to punish HIV transmission. Although the legislative intent behind such laws was to halt the spread of HIV, there is barely any sound logic or evidence to support the presumption that criminalisation could accomplish such preventative goals. In this context, this commentary reviews whether the new laws of ten African countries - Benin, Guinea, Guinea-Bissau, Mali, Niger, Sierra Leone, Togo, Mauritania, Kenya, and Madagascar - serve the originally intended goals. With an overview of each law, five problems of the laws that hamper prevention efforts have been identified: (1) over-broadly stated mental culpability, (2) lack of specificity in punishable behaviours, (3) no appropriate defence clauses, (4) punishment for simply creating a risk of transmission rather than causing transmission, and (5) the punishing of mother-to-child-transmission. It is concluded that employment of public health measures rather than such criminalisation might be a better policy option for African countries to fight against HIV.