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V. Police Abuses and HIV/AIDS

When police commit rape, when they harass those who carry condoms, when they target sex workers and men who have sex with men, and when they publicly stigmatize sex workers as “AIDS carriers,” they are undermining desperately needed HIV/AIDS prevention work by NGOs and the government, and contributing to the spread of HIV in Papua New Guinea.

The HIV/AIDS Epidemic in Papua New Guinea

At least 80,000 people in Papua New Guinea—an estimated 3 to 4 percent of the adult population in the capital and over 1 percent in rural areas—are living with HIV.261 Half are women.262 The epidemic is considered to be generalized in the population and no longer confined to so-called high risk groups; the rate is the highest in the South Pacific region. By 2010, experts predict, at least 13 percent of the population may be HIV-positive.263 AIDS has been the leading cause of death in Port Moresby General Hospital since mid-2001.264

The National AIDS Council, a multi-sectoral committee created by the government in 1997 to manage, with the National Department of Health, the country’s response to the epidemic, attributes the rapid increase of HIV cases to the following:

  • low rates of condom use, combined with poor understanding of HIV transmission;
  • poor access to and poor quality of health services;
  • the low status of women and girls reflected in their inferior access to health care and education, limited employment opportunities that result in their trading sex for money or goods, and high rates of violence against them, including “coerced sex, family or sexual violence” that place them at high risk of HIV infection;
  •  “exceptionally high and rising prevalence” of sexually transmitted infections, which increase the risk of HIV transmission; and
  • a blood supply that is not entirely secure.265

In addition, little voluntary counseling and testing is available. In many parts of the country, it is difficult for people even to learn their HIV status, much less get care if they are HIV positive.266 As of 2004, there was “no treatment or prophylaxis available for children” and no post-exposure prophylaxis for health care workers and rape victims.267 Strong stigma and discrimination faced by people living with HIV/AIDS268 and, as explained in the next section, by sex workers, also discourages them from seeking the limited testing and care that is available.

Police Actions and the Spread of HIV

People are not thinking of the public health consequences of police action.
—Eunice Bruce, World Vision, Port Moresby, September 15, 2004

Police actions can have significant impact on the spread of HIV/AIDS. Human Rights Watch research in several countries has shown that police abuse of children and members of marginalized groups such as sex workers and men and boys who engage in homosexual conduct, poor law enforcement for rape and other crimes of sexual violence, and police harassment of individuals carrying condoms undermines individuals’ capacity to protect themselves and others from HIV.269

According to the National AIDS Council, a contributing factor to Papua New Guinea’s AIDS epidemic is “[p]atterns of male sexual behavior including a high incidence of rape, line-ups or pack rape, sexual assault, and weak law enforcement.”270 Physiologically girls and women are more vulnerable than men and boys to HIV infection during unprotected heterosexual vaginal sex.271 Forced or coerced sex creates an additional risk of trauma: when the vagina or anus is dry and force is used, genital and anal injury are more likely, increasing the risk of HIV transmission. Forced oral sex may cause tears in the skin, also increasing the risk of transmission. Girls and young women face particular risks of contracting HIV through sexual violence and are physiologically more vulnerable than older women.272 In cases of pack rape, exposure to multiple assailants increases the risk of transmission because it increases the likelihood of injury, as well as the risk of exposure to an HIV-positive attacker.

The very possession of condoms—a key tool in preventing the spread of HIV—can trigger police harassment and, in some instances, charges of prostitution in Papua New Guinea. For example, police statements accompanying the charge sheets of those arrested in the Three-Mile Guesthouse raid (detailed in the appendix to this report) list as evidence “used condoms sighted in the rooms and the premises where the defendants were sighted.”273 More than twenty girls and women arrested in the raid reported that police ordered them to chew, and in many cases, to swallow, between one and four condoms.274 “Blow this condom for it goes in you, you do not feel ashame[d] of it,” one of the woman reported later that day that a policeman ordered her.275 Another young woman said that when an officer gave her a condom and told her to chew it, “I chewed and felt like vomiting so I started to take it out. He saw that and with his close fist hit me on my forehead and with his gun butt he hit me on my right buttock. So I swallowed the condom.”276 Human Rights Watch received reports that as recently as June 2005 city council police in Lae confiscated condoms in sex workers’ bags, “blow them up and throw them away.”277

Police have also harassed students for carrying condoms, impeding HIV/AIDS prevention efforts among youth. In October 2002, an NGO (that did not wish to be named here) wrote to the director of the National AIDS Council, Dr. Ninkama Moiya, regarding police harassment of youths carrying condoms.278 According to the letter’s author, the organization provides AIDS education in schools in urban slums.279 Older adolescents in the program, she wrote in the letter, told her that “they were abused and harassed by city policemen for having condom in their pockets,” and she told Human Rights Watch that the police ordered the students to chew the condoms.280 The letter’s author asked the director of the National AIDS Council to intervene with the police, to “advise the authorities concerned to advise their men to discourage what they are doing as it is against what we are preaching on 100% condom use.” When the director later told her he had not received the letter, she explained to us, she sent it again in January 2003. As of September 2004, she said, she had received no response to her letter.

Police harassment for condom possession also directly counteracts much-needed HIV/AIDS prevention work. For example, staff of the Poro Sapot Project of Save the Children in Papua New Guinea regularly distributes condoms to people at the Three Mile Guesthouse and told Human Rights Watch that they had distributed condoms there nine days before the raid.281

Human Rights Watch also heard of one instance in which police physically attacked an HIV/AIDS outreach worker who was distributing condoms.282 According to the director of the project, on January 28, 2005, between 9:00 and 10:00 in the morning, a young male staff member was distributing condoms and talking with people about HIV/AIDS at an old air strip in Lae where sex is commonly negotiated. The director, who was in the city at the time, told us:

He was first verbally abused by 2 uniformed policemen and another man in civilian clothes, who were drinking. As he walked away he was hit on the head by a large rock, cutting him and rendering him unconscious. The attack appeared to be based on his distributing condoms. The 3 men ran away. Passersby hailed a second police car . . . and took him to Lae’s central police station, en route picking up one of the attackers. There police told [the outreach worker] that what he had been doing was wrong since by supplying condoms he was helping people “to pamuck” (have unbridled sex). The attacker was allowed to escape while [the outreach worker] was in the station. No further action was taken by the police. Still bleeding, [the outreach worker] was told to leave and made his way to our Lae office where staff took him to the Angau Memorial General Hospital for treatment. He received 5 stitches (the wound was 4x1.5 cm).283

Sex workers are inhibited from seeking health services by the general social stigma associated with selling sex and by the tendency of police to characterize them as “AIDS carriers.” For example, an eighteen-year-old woman arrested in the Three Mile Guesthouse raid told Human Rights Watch that as the police marched them through the streets, they “were saying, ‘Look, these are the real AIDS carriers.’”284 In a 2004 survey in Port Moresby, sex workers reported that “fear and shame” were the highest barrier to seeking health services.285 Stigma may also deter others from seeking health care services, especially for conditions associated with sex or sex work, for fear of being identified as a sex worker or an “AIDS carrier.” This in turn can prevent people from receiving information about how to protect against HIV/AIDS, and about the care and treatment necessary and available for people living with the disease. In addition, it can prevent sex workers from receiving treatment for sexually transmitted infections, which in turn increase vulnerability to HIV transmission.

In Papua New Guinea, prisons do not distribute condoms even though sex and sexual violence are common in prisons. International guidelines call on states to make condoms available to prisoners throughout their period of detention.286

The National AIDS Council has recognized that condoms are a critical prevention tool and the importance of reaching out to sex workers, members of the police, corrections services, and defense forces, and others;287 staff told Human Rights Watch that they had conducted workshops and peer education for police.288

Papua New Guinea’s HIV Management and Prevention Act (HAMP Act), which went into effect in October 2004 more than a year after it was certified, makes it illegal “to deny a person access, without reasonable excuse, to a means of protection from infection of himself or another by HIV,” including information about the disease, condoms, and other items.289 The act also makes it illegal to discriminate against anyone because he or she is “infected or affected by HIV/AIDS,” unless “the discrimination is no more detrimental than discrimination on the ground of having another life-threatening medical condition.”290 The act does not explicitly require the state to provide condoms and it does not explicitly call for police to stop treating condoms as evidence of illegal sex work. As of mid-2005, it did not appear that police had changed their behavior in response to the act.




[261] See UNICEF, “Families and Children Affected by HIV/AIDS and Other Vulnerable Children in Papua New Guinea: A National Situation Analysis,” draft dated January 31, 2005, p. 14 (citing expert consensus workshop held by the National AIDS Council and UNAIDS November 2004); International Bank for Reconstruction and Development, International Development Association, “Interim Strategy Note for Papua New Guinea,” para. 32. According to the National AIDS Council, surveillance is very weak, but in all areas where sentinel surveillance of antenatal women and sex workers has been conducted, HIV prevalence is higher than 1 percent. National AIDS Council, Papua New Guinea, Papua New Guinea National Strategic Plan on HIV/AIDS, 2004-2008, 2004, secs. 3.3, 2.2.

[262] Ibid.

[263] UNICEF, “Families and Children Affected by HIV/AIDS and Other Vulnerable Children in Papua New Guinea: A National Situation Analysis,” pp. 15-16.

[264] National AIDS Council, Papua New Guinea National Strategic Plan on HIV/AIDS, 2004-2008, sec. 2.2.

[265] Ibid., secs. 2.2, 2.5, 3.1 (stating, “Blood donors are screened for HIV antibody but not HIV antigen, leaving a window open for HIV infection through blood products”). For more information about sexually transmitted diseases and HIV transmission, see United States Centers for Disease Control and Prevention, Fact Sheet: Prevention and Treatment of Sexually Transmitted Diseases as an HIV Prevention Strategy, http://www.cdc.gov/hiv/pubs/facts/hivstd.htm (retrieved October 27, 2003).

[266] National AIDS Council, Papua New Guinea National Strategic Plan on HIV/AIDS, 2004-2008, secs. 3.1. 3.6.

[267] Ibid., sec. 3.1. The provision of post-exposure prophylaxis—a short course of treatment with antiretroviral drugs that reduces the risk of HIV transmission—for occupational exposure and to sexual assault survivors is the standard of care in many countries.

[268] Ibid., sec. 3.6.

[269] See, for example, Human Rights Watch, Hated to Death: Homophobia, Violence, and Jamaica’s HIV/AIDS Epidemic, vol. 16, no. 6(b), November 2004; Human Rights Watch, Unprotected: Sex, Condoms, and the Human Right to Health, vol. 16, no. 6(c), May 2004; Human Rights Watch, Ravaging the Vulnerable: Abuses Against Persons at High Risk of HIV Infection in Bangladesh, vol. 16, no. 6(c), August 2003; Human Rights Watch, Epidemic of Abuse: Police Harassment of HIV/AIDS Outreach Workers in India, vol. 15, no. 5(c), July 2002.

[270] National AIDS Council, Papua New Guinea National Strategic Plan on HIV/AIDS, 2004-2008, sec. 2.4.

[271] Factors that contribute to this increased risk include the larger surface area of the vagina and cervix, the high concentration of HIV in the semen of an infected man, and the fact that many of the other sexually transmitted diseases that increase HIV risk are often left untreated in girls and women (because they are asymptomatic or because health care is inaccessible).

[272] Girls and young women face even greater risk of HIV transmission than adult women because the vagina and cervix of young women are less mature and are less resistant to HIV and other sexually transmitted infections such as chlamydia and gonorrhea that increase HIV vulnerability; because changes in the reproductive tract during puberty make the tissue more susceptible to penetration by HIV; and because young women produce less of the vaginal secretions that provide a barrier to HIV transmission for older women. See, for example, Global Campaign for Microbicides, “About Microbicides: Women and HIV Risk,” http://www.global-campaign.org/womenhiv.htm (retrieved August 28, 2003); UNAIDS, “AIDS: Five Years since ICPD—Emerging Issues and Challenges for Women, Young People, and Infants,” Geneva, 1998, p. 11; Population Information Program, Center for Communications Programs, Johns Hopkins University, Population Reports: Youth and HIV/AIDS, vol. 23, no. 3, Fall 2001, p. 7 (citing studies).

[273] Royal Papua New Guinea Constabulary, “Statement of Facts,” n.d. (naming Inspector Bore and Inspector Florian, mobile squad, as witnesses and describing events of March 12, 2004).

[274] Human Rights Watch individual interviews with three of the women and girls arrested during the Three-Mile Guesthouse raid, Port Moresby, September 15, 2004; individual “Statement of Facts” from twenty-one women and girls, made between March 12 and March 20, 2004, recorded by staff of the National AIDS Council, the Poro Sapot Project of Save the Children in Papua New Guinea, and the National Capital District Provincial AIDS Committee (names withheld, on file with Human Rights Watch).

[275] “Statement of Facts” recorded by Ken Rabuba, March 12, 2004 (name withheld, on file with Human Rights Watch).

[276] “Statement of Facts,” recorded by Bomal Gonapa, National AIDS Council, March 18, 2004 (name withheld, on file with Human Rights Watch).

[277] E-mail from project director of NGO working with sex workers to Human Rights Watch, July 12, 2005 (reporting similar incidents in March, April, and June 2005).

[278] Letter to Dr. Ninkama Moiya from NGO [name withheld], October 10, 2002 (on file with Human Rights Watch).

[279] Human Rights Watch interview with NGO staff member, Port Moresby, September 15, 2005.

[280] Ibid.; and letter to Dr. Ninkama Moiya from NGO [name withheld], October 10, 2002 (on file with Human Rights Watch).

[281] E-mail from director of NGO project working with sex workers to Human Rights Watch, June 30, 2005 (quoting data forms of staff member who distributed the condoms from March 3, 2004). The project’s staff also told us that they distributed 5,604 male condoms to police in Port Moresby from March 1-12, 2004, including at the two police stations closest to the March 12 raid. Ibid.

[282] Ibid. The name of the NGO and the HIV/AIDS outreach worker are withheld by request.

[283] Ibid., (name on file with Human Rights Watch).

[284] Human Rights Watch interview with eighteen-year-old woman, Port Moresby, September 15, 2004.

[285] Monitoring and Research Branch, National Department of Health . . . , “Qualitative Assessment and Response Report on HIV/AIDS/STI Situation Among Sex Workers and their Clients in Port Moresby, Papua New Guinea,”p. 28.

[286] Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV/AIDS, “HIV/AIDS and Human Rights International Guidelines,” from the second international consultation on HIV/AIDS and human rights, 23-25 September 1996, Geneva, U.N. Doc. HR/PUB/98/1, Geneva, 1998, para. 29(e); World Health Organization, “Guidelines on HIV Infection and AIDS in Prisons,” WHO/GPA/DIR/93.3 1993, reissued as UNAIDS/99.47/E, September 1999, art C.20.

[287] National AIDS Council, Papua New Guinea National Strategic Plan on HIV/AIDS 2004-2008, sec. 3.2.

[288] E-mail from Wilfred Peters, National AIDS Council, to Human Rights Watch, May 6, 2005.

[289] HIV/AIDS Management and Prevention (HAMP) Act (2003), no. 4 of 2003, certified August 20, 2003, para. 11. Regarding detainees and persons in custody, the act specifically prohibits discrimination against “detainees and persons in custody” through segregating them or applying additional restrictions or penalties on them, or in access to medical care. The act also prohibits mandatory HIV testing in various circumstances and stigmatizing a person for being infected with or affected by HIV. Ibid., paras. 7(e), 9-10.

[290] HAMP Act (2003), para. 6.


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