Association of HIV diagnosis rates and laws criminalizing HIV exposure in the United States

Abstract

We found no association between HIV or AIDS diagnosis rates and criminal exposure laws across states over time, suggesting that these laws have had no detectable HIV prevention effect.

HIV criminalization exacerbates subpar diagnosis and treatment across the United States

“…In their article, “Association of HIV diagnosis rates and laws criminalizing HIV exposure in the United States” Sweeney et al [1] find no association between a state’s criminal exposure laws and the rates of HIV or AIDS diagnosis. Thirty-three states in the United States have implemented laws criminalizing behaviour, including needle sharing and sexual contact, that could put others at risk of transmission [2].…”

“…Thirty-three states in the United States have implemented laws criminalizing behaviour, including needle sharing and sexual contact, that could put others at risk of transmission [2]. As highlighted by Sweeney et al [1], the public health impact of these laws should be assessed. However, it was not considered that the annual number of diagnoses alone is uninformative without taking into account epidemiological trajectories.…”

“…We conducted the analysis described in Sweeney et al [1], but stratified the diagnosis rate into two response variables: i) the proportion of PLHIV diagnosed, and ii) annual percentage change in HIV prevalence. The data required for the replication of the results, and the relevant analysis code, are provided at https://github.com/prathasah/US-law-and-HIV.…”

“…The data required for the replication of the results, and the relevant analysis code, are provided at https://github.com/prathasah/US-law-and-HIV. All socio-economic factors described in [1] were used as explanatory variables. Since our first outcome normalized the total HIV diagnoses with the number of PLHIV (instead of the population size), we included population sizes of states as an additional explanatory variable in our model.…”

“…As the authors and others have argued [1,3], laws criminalizing HIV exposure can deter people from seeking diagnosis. Given the effectiveness of current antiretrovirals in preventing HIV transmission, diagnosis and treatment are fundamental to both improving individual health outcomes as well as protecting others.…”