HIV treatment as prevention: not an argument for continuing criminalisation of HIV transmission

Francis, John G.; Francis, Leslie P.

doi:10.1017/s1744552313000281

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…HIV criminalization laws impute a host of assumptions about the HIV-positive community and their sexual partners. 51 These laws were created during an era of public fear and scientific mystery about the evolution, progression, and transmission of the disease. Such legislation was enacted on speculation about the underlying risk of infection and the criminal intent of individuals living with HIV.…”

Section: Discussionmentioning

confidence: 99%

Cruel Intentions? HIV Prevalence and Criminalization During an Age of Mass Incarceration, U.S. 1999 to 2012

Sykes

Hoppe

Maziarka³

2016

Medicine

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A 2014 U.S. Department of Justice Best Practices Report advocates that states eliminate HIV-specific criminal penalties except under 2 conditions: when a human immunodeficiency virus (HIV)-positive person intentionally commits a sex crime or transmits the virus by engaging in behavior that poses a significant risk of transmission, regardless of actual transmission. We assess the premise of these exceptions to understand whether these best practices are based on scientific evidence about the population at risk of infection and the risk of sexual violence by HIV-positive individuals.We employ nationally representative, cross-sectional survey data from the Current Population Survey (CPS), the Survey of Inmates in State, Federal, and Local Jails (SISFLJ), and the National Health and Nutrition Survey (NHANES).Data from the CPS, SISFLJ, and NHANES are weighted and combined to analyze bias in the population at risk of HIV. Linear probability models are employed to estimate the likelihood that HIV-positive inmates are incarcerated for violent or sexual offenses, net of socioeconomic factors.We find significant measurement bias in HIV prevalence rates. The selection of national surveys for population denominators distorts contemporary estimates of HIV prevalence by 7% to 20%. Our findings also illustrate that HIV-positive inmates are 10 percentage-points less likely to be incarcerated for violent offenses than HIV-negative inmates.National best practice guidelines may undermine effective social policy that aims to curtail stigma within HIV-positive communities because scientific evidence neither include inmates into prevalence denominators (as a measure of the population at risk) nor assess the likelihood that HIV-positive inmates commit violent or sexual crimes.

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Section: Discussionmentioning

confidence: 99%

Cruel Intentions? HIV Prevalence and Criminalization During an Age of Mass Incarceration, U.S. 1999 to 2012

Sykes

Hoppe

Maziarka³

2016

Medicine

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Fairness in the Use of Information About Carriers of Resistant Infections

Francis

2020

Public Health Ethics Analysis

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One standard menu of approaches to the prevalence of anti-microbial resistance diseases is to enhance surveillance, fund research to develop new antimicrobials, and educate providers and patients to reduce unnecessary antimicrobial use. The primarily utilitarian reasoning behind this menu is unstable, however, if it fails to take fairness into account. This chapter develops an account of the fair uses of information gained in public health surveillance. We begin by sketching information needs and gaps in surveillance. We then demonstrate how analysis of information uses is incomplete if viewed from the perspectives of likely vectors of disease who may be subjects of fear and stigma and likely victims who may be coerced into isolation or quarantine. Next, we consider aspects of fairness in the use of information in non-ideal circumstances: inclusive participation in decisions about information use, resource plans for those needing services, and assurances of reciprocal support. Fairness in information use recognizes the ineluctable twinning of victims and vectors in the face of serious pandemic disease.

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Counting Numbers

Francis

2021

Sustaining Surveillance: The Importance of Information for Public Health

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Surveillance began with counting the numbers of people in the population. At various times in history, numbers have been used to assess the overall strength of the population, to identify the march of dangerous contagion, or to determine needs for food or labor. But even simple counting of population numbers, vital statistics, or reports of disease has been controversial. Information is power and the most rudimentary surveillance can be used both for good and for harm. This chapter sets ethical questions about these basic surveillance methods in historical and epistemological context. It gives examples of uses of data about population numbers, vital statistics, or outbreaks that have been clearly beneficial, as well as examples that have bordered on the genocidal. Counting numbers, as a rudimentary epidemiological method, also presents the opportunity to explore ethical problems raised by epidemiology as a science, such as incomplete data, biased data, or false negatives or positives. Today, with increasing understanding of disease and availability of prevention or treatment, the advantages of outbreak detection may be shared far more widely and more equally. Nonetheless, outbreak detection can generate fear and hostility if patterns of disease track otherwise disfavored groups. COVID-19 has revealed the importance of demographic data about the distribution of disease burdens—data that may either generate mistrust as people see their disadvantage starkly, or that may foster trust if the result is increased attention to disparities in treatment and in health.

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HIV treatment as prevention: not an argument for continuing criminalisation of HIV transmission

Cited by 3 publications

References 21 publications

Cruel Intentions? HIV Prevalence and Criminalization During an Age of Mass Incarceration, U.S. 1999 to 2012

Cruel Intentions? HIV Prevalence and Criminalization During an Age of Mass Incarceration, U.S. 1999 to 2012

Fairness in the Use of Information About Carriers of Resistant Infections

Counting Numbers

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