For the past three decades, legislative approaches to prevent HIV transmission have been used at the national, state, and local levels. One punitive legislative approach has been enactment of laws that criminalize behaviors associated with HIV exposure (HIV-specific criminal laws). In the USA, HIV-specific criminal laws have largely been shaped by state laws. These laws impose criminal penalties on persons who know they have HIV and subsequently engage in certain behaviors, most commonly sexual activity without prior disclosure of HIV-positive serostatus. These laws have been subject to intense public debate. Using public health law research methods, data from the legal database WestlawNext© were analyzed to describe the prevalence and characteristics of laws that criminalize potential HIV exposure in the 50 states (plus the District of Columbia) and to examine the implications of these laws for public health practice. The first state laws were enacted in 1986; as of 2011 a total of 67 laws had been enacted in 33 states. By 1995, nearly two-thirds of all laws had been enacted; by 2000, 85 % of laws had been enacted; and since 2000, an additional 10 laws have been enacted. Twenty-four states require persons who are aware that they have HIV to disclose their status to sexual partners and 14 states require disclosure to needle-sharing partners. Twenty-five states criminalize one or more behaviors that pose a low or negligible risk for HIV transmission. Nearly two-thirds of states in the USA have legislation that criminalizes potential HIV exposure. Many of these laws criminalize behaviors that pose low or negligible risk for HIV transmission. The majority of laws were passed before studies showed that antiretroviral therapy (ART) reduces HIV transmission risk and most laws do not account for HIV prevention measures that reduce transmission risk, such as condom use, ART, or pre-exposure prophylaxis. States with HIV-specific criminal laws are encouraged to use the findings of this paper to re-examine those laws, assess the laws’ alignment with current evidence regarding HIV transmission risk, and consider whether the laws are the best vehicle to achieve their intended purposes.
There were marked differences in the socio-economic gradient by cause. Mortality rates for women in the least and most advantaged NS-SEC classes were similar for breast cancer. In contrast, compared to women in the most advantaged class, mortality rates were three times as high for the least advantaged women for lung cancer and cerebrovascular disease, around five times as high for ischaemic heart disease and all digestive diseases, and six times as high for respiratory diseases.
This article reports on a longitudinal analysis of a sample of residents who were aged 65 or over when interviewed for the 1994 General Household Survey. It investigates the associations between various personal characteristics as established at the interview and the probability of survival during a ten year follow-up period. Smoking was the most important factor of those measured in determining the likelihood of survival. Smokers at the time of the interview had a mortality risk, on average, 78 per cent greater than non-smokers. Non-drinkers and those who had less than one unit of alcohol per week at the time of the interview appeared to have a higher mortality risk than those who drank between one unit and the recommended government maximum per week. However, further analysis suggested that this result might be a product of the health status of individuals at the time of the interview. Type of housing tenure and region of residence were better predictors of mortality risk than occupation-based social class. Office for National Statistics Box one Variables included in this analysis Variables Definition Demographic variables Marital Status Married/cohabiting or Other (single/divorced/separated/widowed) Behavioural variables Smoking Current smoker or non-smoker Alcohol consumption Average weekly units 'negligible' less than one unit per week 'moderate' 1 to 21 units per week (men) 1 to 14 units (women) 'heavy' greater than 21 units (men) greater than 14 units (women) Socioeconomic variables Tenure Owns/rents Availability of car None/with car Registrar General's Social Class (RGSC) Own RGSC Occupation was originally classified to Socioeconomic Group (SEG): this was subsequently mapped to RGSC General environmental variables Region Region of residence Northern and Western including the North, Yorkshire and Humberside North West and West Midlands Southern and Eastern including the East Midlands, East Anglia, Greater London, Outer Metropolitan area, Outer South East and South West.
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