Within days of her arrest as a suspect in the 2007 murder of British student Meredith Kercher, Amanda Knox was told that she had tested HIV positive.  This was a lie and the circumstances surrounding this fake test form part of her appeal to the European Court of Human Rights (ECHR).

You can read more about the ECHR submission here:

As she records in her book, “Waiting to Be Heard”; the HIV episode occurred in November 2007, during the first month of her incarceration and almost a year before she was charged.  She and her boyfriend Raffaele Sollecito were in custody because a judge had decided that they “might kill again” and because she might be a flight risk.  This was an abuse of the Italian law on preventive detention which is only intended for suspected terrorists and known violent offenders.

The trap is sprung

The fake HIV test result news was announced to Amanda at a nightly infirmary appointment – this was a daily occurrence while her mental state was being assessed.

On this occasion, the ‘doctor’ was someone she had not seen before.

He said, “We got the results of your blood test.  You tested positive for HIV.”

This was followed by, “Don’t worry.  It could be a mistake.  We’ll need to do more tests.”

This episode was highly irregular for a number of reasons

Firstly, prisoners who have just been arrested are not routinely tested for HIV.  A 2015 study, ‘HIV treatment and care among Italian inmates: a one month point survey’*, covers HIV testing procedure in the prison service.  It states; “HIV tests cannot take place without the consent of the person concerned and may be recommended but not imposed on inmates who display high risk behaviours.”

Amanda had not been asked if she wished to be tested for HIV, nor had she consented.

Secondly, she had not been in prison long enough to have displayed, ‘high risk behaviours’.  In any case, she was still in solitary confinement at this point, so no sexually risky behaviour could even be contemplated.

Thirdly, Italian guidelines state, ‘Detainees should be informed with all relevant information concerning HIV prevention’.  No such information was provided.  The doctor (if it was a doctor), merely said, “Don’t worry, it could be a mistake.  We’ll need to do more tests.”

Fourthly, the ‘test’ or ruse was badly thought through and was medically illiterate.

In recent years, two types of HIV test have been commonly used, known as third and fourth generation tests.  Back in 2007, the most likely test used in the Italian prison service would have been the third generation test.  (In the UK as recently as 2012, the third generation test was still widely used.)

The difference between the two tests is that the third generation one is unlikely to identify people who have been infected within the previous three months.  (The fourth generation test may reduce this time lag to less than one month.)

In Amanda’s case this means that if she had caught HIV during the three months since arriving in Italy, the test would not have detected it.  Even a fourth generation test carried out in early November 2007 would have been too soon to have established an intimate connection between Amanda and any other suspect in the Kercher case.  She simply had not known any of them for long enough for a newly acquired infection to have showed up yet.

The police counted on Amanda not knowing enough about HIV tests to see through the subterfuge.

Fifthly, when carried out properly, HIV tests are very reliable.  False positives are put at below 1%.  No doctor would say “Don’t worry, it could be a mistake” because this would raise false hopes when it was 99% likely that there was no error.

A tangled web

The prison authorities appear to have been so concerned about a 20-year-old American girl’s health, that they decided to test her for HIV without requesting her permission and present her with a result without providing counselling and support, contravening their own guidelines.

If a test really had shown Amanda to be HIV positive, this would have meant that she had been infected before leaving the USA the previous summer.  The prevalence of HIV in heterosexual female teenagers in Washington State is not high enough for this to have been a realistic concern.

It’s a hoax

So the only possible explanation for the hoax, was that it was intended to apply extra psychological pressure to Amanda to trigger a confession or at least a confirmation that she had sexual contact with another suspect (apart from Raffaele); a revelation that would have shored up the prosecution’s implausible theory of the crime.

Stolen diary

When no such admission was forthcoming, her diary, in which she had written the names of previous sexual partners, was stolen and its contents were leaked to the media.  Unsurprisingly, no incriminating names appeared on the list, but its publication served the purpose of the prosecution as it portrayed Amanda as sexually liberated and therefore in their eyes capable of anything, including murder, a practice known as ‘slut shaming’.

In 2014 a Milan court ruled in Amanda’s favour when her civil suit against RCS Media Group and its newspaper Corriere della Sera, for publishing the diary’s contents was finally settled.  The ruling stated that RCS Media had exceeded the limits of freedom of information by unlawfully publishing her sensitive personal data.

No valid medical reason

To recap, there was no medical reason for the authorities to carry out a test; Italian and World Health Organisation ethical guidelines were not followed and it was too soon for such a test to imply any sexual connection to any of the other suspects, so it was useless from an investigatory standpoint.  The test was a ruse, plain and simple.

The right to obtain medical records

Any individual, whether a European citizen or not, is entitled, under Directive 95/46/EC to ask for and receive copies of any data, including medical records, that an EU member state holds about them.  Amanda’s lawyers may already be in possession of a copy of her Italian medical records and these records should confirm that no HIV test was carried out.

The context of the ‘test’ in the criminal investigation

Amanda Knox and Raffaele Sollecito were arrested on November 6th 2007 after being interrogated as de facto suspects but without lawyers, in violation of Italian and European law.  In the weeks that followed, the police were tasked with assembling evidence that physically tied the suspects to the crime.  In this they were singularly unsuccessful.

No DNA evidence placed Amanda or Raffaele in the room where Meredith was killed.  No reliable witnesses had come forward to state that they were seen in the vicinity of the house at a relevant time (though there was eventually no shortage of unreliable witnesses).

No CCTV footage was ever produced that showed them to be in the area (though footage of someone else, who was clearly not Amanda, was produced).  Patrick Lumumba had an alibi and had to be released.  A shoe print from Meredith’s room was proved not to have been left by Raffaele.  A random knife taken from Raffaele’s apartment did not have Meredith’s DNA on it (lab contamination and abuse of technology clouded the matter for years).  A contaminated bra clasp would later prove to be another red herring.

The case against Amanda and Raffaele was in danger of collapsing.  DNA samples from Meredith’s room pointed to a fourth suspect, Rudy Guede, who was most likely a single attacker, though the police refused to countenance this.  If the ‘sex game’ crime theory was to be credible, the police needed to establish a sexual connection between the suspects.

Setting up a fake HIV test result announcement could have been the trigger that made Amanda crumble and name other suspects among her sexual partners.  Of course the ploy could never have worked because there was no such connection.

A low point

The HIV episode was a new low in Perugian police duplicity.  As we have seen in so many aspects of the Kercher case, the ruthlessness and incompetence shown by the police and prosecution was almost without parallel.

6 January 2016 – Comment from Avrom Brendzel

One reason that the timing of the follow-up report that Knox did not have HIV is suspicious is that Italian procedural law is quite specific that persons under precautionary detention who have AIDS or HIV must not be confined in a regular prison, but instead must be detained in a suitable prison hospital or, if necessary, in a regular hospital, national health care facility, or home, under house arrest (CPP Articles 275.4-bis and 275.4-ter). The care of such an individual suffering from AIDS or HIV must conform to the requirements decided upon by a decree of the Ministry of Health, to be adopted in agreement with the Ministry of Justice; diagnostic tests may be conducted to ascertain the severity of illness and the judge notified of the medical condition in order for the judge to order appropriate conditions of precautionary detention (CPP Article 286-bis).

Knox was under precautionary detention in prison when the alleged HIV test was conducted. If it was a real test, certainly it would have been entered into her medical record to conform with Italian procedural law, and the follow-up on the test of the second sample and announcement of results would not have been delayed, because of the significance of a positive result to the conditions of detention. Furthermore, it is strange that Sollecito, Knox’s known and acknowledged sexual contact, and also under precautionary detention, had not been quickly tested if Knox was HIV positive.

Thus, unless there are medical records that indicate otherwise, I suggest that the evidence is conclusive that the report to Knox of a (false) positive HIV test result was a scam.



*HIV treatment and care among Italian inmates: a one-month point survey
Monarca,G. Madeddu,R. Ranieri, S. Carbonara, G. Leo, M. Sardo, F. Choroma, S. Casari, D. Marri, A. A. Muredda,F. A. Nava, S. Babudieri, and SIMSPe–SIMIT Group


BMC Infect Dis. 2015; 15: 562.

Published online 2015 Dec 10. doi:  10.1186/s12879-015-1301-5