HIV criminal prosecutions and public health: an examination of the empirical research

O’Byrne, Patrick; Bryan, Alyssa; Roy, Marie

doi:10.1136/medhum-2013-010366

Cited by 24 publications

(10 citation statements)

References 32 publications

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“…States with laws that criminalize non-disclosure of HIV status do not appear to have lower transmission of HIV at the population level compared with states that do not (34, 71). Instead, heavy-handed legal statutes in Atlanta, Miami and Seattle in particular can deter PLHIV from learning their status to avoid possible criminal liability for non-disclosure (72). Since PLHIV not aware of their status are estimated to contribute to approximately 91.5% of new transmissions (71), such laws can have the unintended consequence of contributing to local HIV epidemics.…”

Section: Discussionmentioning

confidence: 99%

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

et al. 2018

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Since the discovery of the secondary preventive benefits of antiretroviral therapy, national and international governing bodies have called for countries to reach 90% diagnosis, ART engagement and viral suppression among people living with HIV/AIDS. The US HIV epidemic is dispersed primarily across large urban centers, each with different underlying epidemiological and structural features. We selected six US cities, including Atlanta, Baltimore, Los Angeles, Miami, New York, and Seattle, with the objective of demonstrating the breadth of epidemiological and structural differences affecting the HIV/AIDS response across the US. We synthesized current and publicly-available surveillance, legal statutes, entitlement and discretionary funding, and service location data for each city. The vast differences we observed in each domain reinforce disparities in access to HIV treatment and prevention, and necessitate targeted, localized strategies to optimize the limited resources available for each city's HIV/AIDS response.

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Section: Discussionmentioning

confidence: 99%

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

et al. 2018

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“…The criminalization of HIV non-disclosure has been shown to represent a structural barrier to the healthcare engagement of PLWH (Mykhalovskiy, 2015; O’byrne, Bryan, & Roy, 2013a; Patterson et al, 2015b). The tension between public health and criminal justice system approaches to HIV prevention is arguably most acutely felt by marginalized and otherwise criminalized groups, including PLWH who use illicit drugs.…”

Section: Introductionmentioning

confidence: 99%

Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting

Patterson

Kaida

Hogg

et al. 2017

International Journal of Drug Policy

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Background In 2012, the Supreme Court of Canada (SCC) ruled that people living with HIV (PLWH) could face criminal charges if they did not disclose their serostatus before sex posing a “realistic possibility” of HIV transmission. Condom-protected vaginal sex with a low (i.e., <1500 copies/mL) HIV viral load (VL) incurs no duty to disclose. Awareness and understanding of this ruling remain uncharacterized, particularly among marginalized PLWH. Methods We used data from ACCESS, a community-recruited cohort of PLWH who use illicit drugs in Vancouver. The primary outcome was self-reported awareness of the 2012 SCC ruling, drawn from cross-sectional survey data. Participants aware of the ruling were asked how similar their understanding was to a provided definition. Sources of information from which participants learned about the ruling were determined. Multivariable logistic regression identified factors independently associated with ruling awareness. Results Among 249 participants (39% female), median age was 50 (IQR: 44–55) and 80% had a suppressed HIV VL (<50 copies/mL). A minority (112, 45%) of participants reported ruling awareness, and 44 (18%) had a complete understanding of the legal obligation to disclose. Among those aware (n = 112), newspapers/media (46%) was the most frequent source from which participants learned about the ruling, with 51% of participants reporting that no healthcare providers had talked to them about the ruling. Ruling awareness was negatively associated with VL suppression (AOR:0.51, 95% CI:0.27,0.97) and positively associated with recent condomless sex vs. no sex (AOR:2.00, 95% CI:1.03,3.92). Conclusion Most participants were not aware of the 2012 SCC ruling, which may place them at risk of prosecution. Discussions about disclosure and the law were lacking in healthcare settings. Advancing education about HIV disclosure and the law is a key priority. The role of healthcare providers in delivering information and support to PLWH in this legal climate should be further explored.

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“…However, little is known about their effectiveness as an HIV prevention method (1-3), and even less is known about the potential negative impacts of the laws. The purpose of this review is to identify and describe U.S. empirical studies on the criminalization of HIV exposure, examine findings on key questions about these laws, highlight knowledge gaps, and set a course for future research.…”

Section: Introductionmentioning

confidence: 99%

Criminalization of HIV Exposure: A Review of Empirical Studies in the United States

et al. 2016

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This review of literature identifies and describes U.S. empirical studies on the criminalization of HIV exposure, examines findings on key questions about these laws, highlights knowledge gaps, and sets a course for future research. Studies published between 1990 and 2014 were identified through key word searches of relevant electronic databases and discussions with experts. Twenty-five empirical studies were identified. Sixteen of these studies used quantitative methods with more than half of these being cross-sectional survey studies. Study samples included male and female HIV-positive persons, HIV-positive and -negative men who have sex with men, public health personnel, and medical providers. Research questions addressed awareness of and attitudes toward HIV exposure laws, potential influences of these laws on seropositive status disclosure for persons living with HIV, HIV testing for HIV-negative persons, safer sex practices for both groups, and associations between HIV exposure laws and HIV-related stigma. Surveys of the laws and studies of enforcement practices were also conducted. Attention should be shifted from examining attitudes about these laws to exploring their potential influence on public health practices and behaviors related to the HIV continuum of care. Studies examining enforcement and prosecution practices are also needed. Adapting a theoretical framework in future research may be useful in better understanding the influence of HIV exposure laws on HIV risk behaviors.

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HIV criminal prosecutions and public health: an examination of the empirical research

Abstract: A review of the extant literature from a public health perspective leads to the conclusion that HIV criminal laws undermine public health.

Cited by 24 publications

References 32 publications

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

Building the Case for Localized Approaches to HIV: Structural Conditions and Health System Capacity to Address the HIV/AIDS Epidemic in Six US Cities

Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting

Criminalization of HIV Exposure: A Review of Empirical Studies in the United States

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