Beyond criminalization: reconsidering HIV criminalization in an era of reform

Hoppe, Trevor; McClelland, Alexander; Pass, Kenneth A.

doi:10.1097/coh.0000000000000715

Cited by 10 publications

(3 citation statements)

References 24 publications

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“…Structural factors related to racism and stigma play a more fundamental role in producing and sustaining these disparities (and are likely the root structural causes of the sexual network characteristics, like assortativity). For example, HIV criminalization laws, as well as laws that criminalize behaviours (including LGBTQ identities, breastfeeding, sex work, and drug use/possession) disproportionately impact racial minorities and are associated with reduced access to HIV services [ 37 , 38 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

Lessons learned from community engagement regarding phylodynamic research with molecular HIV surveillance data

et al. 2023

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Introduction The widespread implementation of molecular HIV surveillance (MHS) has resulted in an increased discussion about the ethical, human rights and public health implications of MHS. We narrate our process of pausing our research that uses data collected through MHS in response to these growing concerns and summarize the key lessons we learned through conversations with community members. Methods The original study aimed to describe HIV transmission patterns by age and race/ethnicity among men who have sex with men in King County, Washington, by applying probabilistic phylodynamic modelling methods to HIV‐1 pol gene sequences collected through MHS. In September 2020, we paused the publication of this research to conduct community engagement: we held two public‐facing online presentations, met with a national community coalition that included representatives of networks of people living with HIV, and invited two members of this coalition to provide feedback on our manuscript. During each of these meetings, we shared a brief presentation of our methods and findings and explicitly solicited feedback on the perceived public health benefit and potential harm of our analyses and results. Results Some community concerns about MHS in public health practice also apply to research using MHS data, namely those related to informed consent, inference of transmission directionality and criminalization. Other critiques were specific to our research study and included feedback about the use of phylogenetic analyses to study assortativity by race/ethnicity and the importance of considering the broader context of stigma and structural racism. We ultimately decided the potential harms of publishing our study—perpetuating racialized stigma about men who have sex with men and eroding the trust between phylogenetics researchers and communities of people living with HIV—outweighed the potential benefits. Conclusions HIV phylogenetics research using data collected through MHS data is a powerful scientific technology with the potential to benefit and harm communities of people living with HIV. Addressing criminalization and including people living with HIV in decision‐making processes have the potential to meaningfully address community concerns and strengthen the ethical justification for using MHS data in both research and public health practice. We close with specific opportunities for action and advocacy by researchers.

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Section: Resultsmentioning

confidence: 99%

Lessons learned from community engagement regarding phylodynamic research with molecular HIV surveillance data

et al. 2023

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“…The possibility of MHS amplifying issues related to criminalization was a significant matter of concern articulated within the health policy counterpublic. Many feared that data used for MHS/CDR could be accessed by law enforcement or in criminal prosecution of HIV non-disclosure or transmission (Hoppe et al, 2022; McClelland et al, 2020). As P07 (Advocate, PLHIV Network) put it: ‘Molecular HIV surveillance opens up one more potential tool in the toolbox to be used to prosecute and criminalize people living with HIV who are already extremely vulnerable and who already are living inside this transphobic, racist system.’ Discussion of criminalization often centered on whether the science of MHS could be used to determine directionality of transmission (e.g.…”

Section: The Mhs/cdr Health Policy Counterpublicmentioning

confidence: 99%

Health policy counterpublics: Enacting collective resistances to US molecular HIV surveillance and cluster detection and response programs

Molldrem,

Smith

2023

Soc Stud Sci

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Health policies and the problems they constitute are deeply shaped by multiple publics. In this article we conceptualize health policy counterpublics: temporally bounded socio-political forms that aim to cultivate particular modes of conduct, generally to resist trajectories set by arms of the state. These counterpublics often emerge from existing social movements and involve varied forms of activism and advocacy. We examine a health policy counterpublic that has arisen in response to new forms of HIV public health surveillance by drawing on public documents and interview data from 2021 with 26 stakeholders who were critical of key policy developments. Since 2018, the national rollout of molecular HIV surveillance (MHS) and cluster detection and response (CDR) programs in the United States has produced sustained controversies among HIV stakeholders, including among organized networks of people living with HIV. This article focuses on how a health policy counterpublic formed around MHS/CDR and how constituents problematized the policy agenda set in motion by federal health agencies, including in relation to data ethics, the meaningful involvement of affected communities, informed consent, the digitization of health systems, and HIV criminalization. Although familiar problems in HIV policymaking, concerns about these issues have been reconfigured in response to the new sociotechnical milieu proffered by MHS/CDR, generating new critical positions aiming to remake public health. Critical attention to the scenes within which health policy controversies play out ought to consider how (counter)publics are made, how problems are constituted, and the broader social movement dynamics and activist resources drawn upon to contest and reimagine policymaking in public life.

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“…At the societal level, policy interventions play a key role in how HIV epidemics unfold and affect individuals and communities. As Hoppe et al [7] detail, laws and policies that criminalize HIV infection and transmission have had disparate impact on various populations in North America as they have been unevenly applied to people based on race, gender, and sexuality. Moreover, most of these laws have yet to be reformed or ‘modernized’ in light of recent scientific developments in HIV prevention and treatment – particularly the efficacy of preexposure prophylaxis in preventing acquisition and the efficacy of highly active antiretroviral therapy in preventing transmission.…”

Section: Multiple Levels Of Analysis and Engagementmentioning

confidence: 99%

Editorial: Critical social and behavioral sciences perspectives on ending the HIV epidemic

Auerbach

Dubé

2022

Current Opinion in HIV and AIDS

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Beyond criminalization: reconsidering HIV criminalization in an era of reform

Cited by 10 publications

References 24 publications

Lessons learned from community engagement regarding phylodynamic research with molecular HIV surveillance data

Lessons learned from community engagement regarding phylodynamic research with molecular HIV surveillance data

Health policy counterpublics: Enacting collective resistances to US molecular HIV surveillance and cluster detection and response programs

Editorial: Critical social and behavioral sciences perspectives on ending the HIV epidemic

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