The role of the police in the HIV response: the Law Enforcement and HIV Network (LEAHN)admin
The role of the police in the HIV response: the Law Enforcement and HIV Network (LEAHN)
HIV Australia | Vol. 14 No. 1 | March 2016
By Nick Crofts and Melissa Jardine
Police are the first responders to a range of complex situations involving criminal, civil or public health related issues, some of which may relate to HIV. Law enforcement, HIV and public health are therefore inextricably linked; however many law enforcement agencies do not perceive these connections.
The Global Commission on HIV and the Law 2012 report clearly outlines the need for reform of policing practice, and the opportunity to recruit police as partners, facilitators and even leaders in HIV prevention strategies.
One significant recommendation in the report1 is that reform of policy and law must go hand in hand with reform of law enforcement practices and implementation of policy and law by police; critically, these are different activities requiring different focuses.
The report also states: ‘In many countries, the law (either on the books or on the streets) dehumanises many of those at highest risk for HIV.’2
Police are the key group translating ‘law on the books’ to ‘law on the street’ (or often acting without reference to the law at all). Police routinely enforce the criminalisation of activities such as drug use or sex work, meaning that law enforcement practices are one of the major determinants of the risk environment for people at greatest risk of HIV.
In many situations police may use existing law to meet more pressing community or political pressures. It is therefore essential that police are engaged as partners in the HIV response and supported to change their approach.
The Law Enforcement and HIV Network (LEAHN) was established to ensure that law enforcement officers and agencies are equipped to support a human rights based response to HIV in their jurisdictions. Set up by police, LEAHN is an international network of people involved in HIV prevention, particularly those working in law enforcement and public health.
LEAHN facilitates knowledge sharing, advocacy and peer education enabling police and public health professionals to share advice and experiences about HIV prevention and harm reduction programs.
Achieving cultural change
One of the biggest remaining challenges, as LEAHN sees it, is the need to reform police culture.
Policing ‘culture’ is subject to a variety of influences that are difficult for an outsider to discern. In many countries, this culture is male-oriented and male-dominated, self-protecting, and embodies the prejudices and attitudes of the wider society.
Changing behaviours is secondary to changing the culture; culture, through peer influence, is often a far stronger determinant of behaviour than police training.
Implementing training within police academies on human rights, harm reduction policing, and the necessity for a partnership approach to addressing HIV – all this is good and necessary, but is not in itself sufficient to change police behaviours.
The closed culture which a new police officer enters after leaving the academy determines many aspects of his or her behavior on the job; and if this is not a culture supportive of human rights and partnerships in the HIV response, the training will be quickly forgotten. Similarly, short-term or one-off training workshops have little impact if the participants return to an unchanged culture and work environment.
To engage police in the response to HIV, it is necessary to understand the world from their point of view, to appreciate the multiple pressures on them, and to ask ‘what’s in it for them?’ Too often, advocacy to police from the HIV sector sounds to them like ‘help us do our job’; the usual police response is ‘we’re too busy doing our job’ (as they perceive it to be).
Police agencies worldwide are undergoing budgetary cutbacks; everywhere, they are subject to the same mantra: ‘focus on the traditional role of policing, that of identifying and catching criminals; ignore the marginal activities such as partnering with public health’.
What this imperative forgets is that police have always had a critical partnership role in public health – in road trauma, violence and other crime prevention, dealing with mental health crises and many other issues; this role is not marginal, it is central to the police mandate.
The fact that this role is under-recognised and under-rewarded means that police do not immediately understand that their partnership role in HIV prevention and care is part of a normal and central contribution police make to a healthy and safe society.
In many countries, there are structural drivers of counter-productive police behaviours, such as low pay and status and inadequate training.
The global move towards professionalisation of police is founded on the understanding of the critically important role they have, in partnerships, across the widest range of health and welfare issues, and that if they are adequately paid and trained they will be more amenable to learning new roles and attitudes – and more accountable.
None of this is to be read as excusing adverse police behaviours in relation to people and communities at risk of HIV; rather, without an understanding of the drivers of this behavior, attempts to change it will be unsuccessful.
Creating police allies in the global response to HIV
In our experience, there are three common erroneous strains of thought among many civil society, non-government organisations (NGOs) and agencies involved in the HIV response, which may affect their willingness to work with police:
- that police are merely passive implementers of the law; so that if the law is reformed, police attitudes and behaviours towards most at risk (MAR) communities will automatically fall in line.
- that police are the enemy, and that their behaviours are not amenable to change without confrontation, and/or
- that training and sensitisation of police is adequate to change police behaviour towards MAR communities.
‘Police can be your worst enemy, or your best friend’ is a truism to the HIV program manager. While in many situations, police are the enemy of a human rights based approach to HIV prevention and care among vulnerable populations, this is not always the case.
In some instances, changes in police behaviours have been in advance of law reform, through partnership with the HIV sector and beneficial exercise of discretion.
Some HIV programs around the world have been able to work with police, rather than against them, to help ameliorate hostile policing practices which are key drivers of HIV risk (among many other risks to MAR communities).
An example of such achievements is a more sensitive approach to patrolling near needle-syringe program outlets, with standard operating procedures in some jurisdictions now recommending no targeting of needle exchanges.
Similarly, in Ghana, police not only stopped harassing women carrying condoms as sex workers, but have begun carrying condoms themselves for distribution to sex workers.3 Such approaches are by no means universal, but the list of positive examples is growing.4
The Global Commission on HIV and the Law clearly recognises the potential positive role of police, and the urgent need to harness this force to the cause of HIV prevention:
‘The legal environment – laws, enforcement and justice systems –has immense potential to better the lives of HIV-positive people and to help turn the crisis around.’ (p. 7)5
‘There are instances where legal and justice systems have played constructive roles in responding to HIV, by respecting, protecting and fulfilling human rights. To some such an approach may seem a paradox – the AIDS paradox. But compelling evidence shows that it is the way to reduce the toll of HIV.’ (p. 9)6
Given this background, LEAHN was established to help build informed, trained and supportive police forces as strong allies in the fight against HIV.
LEAHN provides a crucial infrastructure that connects police to the HIV sector and communicates harm reduction best practice within the domain of law enforcement. In some ways, police and security forces are a hard to reach key population – despite being identifiable through their uniforms, they may not see themselves as ‘at-risk’ or as important actors in the HIV response.
LEAHN, therefore, plays a dual role: it channels health and safety information among law enforcement officers to prevent transmission risk through needle-stick injury or unsafe sexual behaviours, and acts as a conduit between police and key populations to repair strained relations and build mutually beneficial trust for effective implementation of HIV prevention services.
The impact of peers
Culture change in a closed culture is best achieved through peer-led interventions, such as modeling and peer education to create a sustainable and supportive environment, which LEAHN helps to create. Key to LEAHN’s success is a network of serving or retired police or law enforcement officers (known as Country Focal Points – CFPs) who provide the impetus to connect to their peers and the HIV sector.7
LEAHN is expanding, with 20 CFPs representing different countries. The CFPs have produced a video in which they explain why they see police engagement in the HIV response as critical.8
As peers, CFPs are a credible and authoritative source of information about best practice harm reduction approaches, facilitating information sharing between senior and junior officers and specialist and general police.
This work takes place in a range of ways, including training sessions, face-to-face discussions, internal policy review and via social media channels. The CFP cultivates all these opportunities and nurtures the learning process.
The network facilitates information sharing within and across countries, highlighting examples where police and law enforcement have been key partners in harm reduction, and turning examples of best practice into tools which can be used as impetus for police in other countries to adopt harm reduction approaches.
Such examples may even convince non-government organisations that it is worthwhile engaging with police, where it may have otherwise been deemed too difficult or dangerous.
Some police keenly see the benefits of harm reduction and are early adopters of new practices, while others require ongoing persuasion. In the latter case, the LEAHN peer network provides essential infrastructure to buttress messages which challenge ineffective practices and unhelpful norms in order to convince officers to change their old habits.
LEAHN, through its International Police Advisory Group, has published a Statement of Support by police for harm reduction approaches to policing vulnerable populations.9
This Statement has been signed by over 10,000 police worldwide, and continues to accrue more support. It was launched by a delegation of police from LEAHN at the UN Commission on Crime Prevention and Criminal Justice in Vienna in April 2013.
It carries a strong message – informing police that this approach is not foreign to policing practices, but is in fact policy among many police agencies already, and has enormous support among police peers and colleagues.
It also informs the HIV community that there are many police ready and willing to engage in a partnership to confront not only HIV but the underlying human rights issues affecting MAR communities.
There is a pressing need for more sustained engagement with police around HIV prevention and care; it needs to be better framed as culture change, and integrated with global movements to professionalise policing.
It is our hope that through the work of LEAHN, HIV health professionals and communities most affected by HIV can work together help to achieve positive change within the police force.
3 Open Society Foundations. (2014). To Protect and Serve: How Police, Sex Workers, and People Who Use Drugs Are Joining Forces to Improve Health and Human Rights. Open Society Foundations, New York. Retrieved from: www.opensocietyfoundations.org
5 Global Commission on HIV and the Law. (2012). op. cit., 7.
Professor Nick Crofts is the founding Director of the Centre for Law Enforcement and Public Health and founder of the Law Enforcement and HIV Network (LEAHN). He is an epidemiologist and public health practitioner who has been working in the fields of HIV/AIDS, illicit drugs, harm reduction and law enforcement for over 30 years.
Melissa Jardine is a PhD Candidate at the UNSW Law School. She served ten years as a police officer with Australia’s Victoria Police in a variety of operational and investigative roles. She works as a consultant for the Centre for Law Enforcement and Public Health and LEAHN.