Sexual practices and STI/HIV testing among gay, bisexual, and men who have sex with men in Ottawa, Canada: examining nondisclosure prosecutions and HIV prevention

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

“…In O'Byrne et al 's15 16 survey study, among participants who were HIV negative or unsure of their status, 17% noted that HIV criminal laws affected their testing; these participants also reported more unprotected anal sex than the 83% of participants who noted that HIV criminal laws do not affect their testing practices 15 16. In this same study, respondents who noted being HIV negative or unsure of their status, and who indicated that HIV criminal laws affected their testing, were also less likely to undergo STI, but not HIV, testing 15 16. Anonymous testing confounded the results surrounding HIV testing because noting that HIV criminal laws affected testing corresponded to a higher preference for, and use of, anonymous HIV-testing services 13.…”

“…In light of the aforementioned survey data, these findings were unsurprising. First, the number of men who reported being affected by HIV criminal laws in O'Byrne et al 's15 16 previous survey studies was so small that it would probably not have produced an effect at the aggregate level. Second, analyses of anonymous testing were not undertaken as part of O'Byrne et al 's27 population-level HIV testing project, meaning that changes in HIV testing could still have occurred, but were simply not captured.…”

“…Second, Adam et al 14 reviewed the responses from 934 PHAs who had participated in two previous research projects in Ontario, and found that 96% (n=420/438) in one study and 87% (n=430/492) in the other study reported being aware of Canadian HIV criminal laws. Third, O'Byrne et al 's15 16 survey in Ottawa found that 90.2% of the gay, bisexual and men who have sex with men (MSM) respondents, of which ∼10% were HIV-diagnosed, were aware that people can be prosecuted for HIV-status non-disclosure.…”

“…O'Byrne et al 's15 16 27 studies in Ottawa have further highlighted that the relationships between HIV criminal laws and persons’ sexual, disclosure and testing practices are neither direct nor straightforward. In O'Byrne et al 's15 16 survey study, among participants who were HIV negative or unsure of their status, 17% noted that HIV criminal laws affected their testing; these participants also reported more unprotected anal sex than the 83% of participants who noted that HIV criminal laws do not affect their testing practices 15 16.…”

“…While the participants who were concerned about HIV criminal laws were thus still accessing testing, they were doing so in a manner that prevented public health follow-up and support and access to treatment. Lastly, the participants in O'Byrne et al 's15 16 research who reported that HIV criminal laws either affected their testing or made them afraid to speak with nurses/physicians were more likely to be HIV positive, signalling that HIV criminal laws undermine the provision of both healthcare and HIV-prevention services for persons diagnosed with HIV.…”