Criminalization of HIV Exposure: A Review of Empirical Studies in the United States

Abstract

This review of literature identifies and describes U.S. empirical studies on the criminalization of HIV exposure, examines findings on key questions about these laws, highlights knowledge gaps, and sets a course for future research. Studies published between 1990 and 2014 were identified through key word searches of relevant electronic databases and discussions with experts. Twenty-five empirical studies were identified. Sixteen of these studies used quantitative methods with more than half of these being cross-sectional survey studies. Study samples included male and female HIV-positive persons, HIV-positive and -negative men who have sex with men, public health personnel, and medical providers. Research questions addressed awareness of and attitudes toward HIV exposure laws, potential influences of these laws on seropositive status disclosure for persons living with HIV, HIV testing for HIV-negative persons, safer sex practices for both groups, and associations between HIV exposure laws and HIV-related stigma. Surveys of the laws and studies of enforcement practices were also conducted. Attention should be shifted from examining attitudes about these laws to exploring their potential influence on public health practices and behaviors related to the HIV continuum of care. Studies examining enforcement and prosecution practices are also needed. Adapting a theoretical framework in future research may be useful in better understanding the influence of HIV exposure laws on HIV risk behaviors.

Addressing Stigma Through a Virtual Community for People Living with HIV: A Mixed Methods Study of the PositiveLinks Mobile Health Intervention

“…HIV-related stigma can be complicated by other sources of stigma that PLWH also experience based on gender, sexual orientation, race or ethnicity, poverty, substance use, or mental illness [ 9 – 11 ]. The criminalization of HIV transmission further contributes to stigma and discrimination against PLWH [ 12 , 13 ]. Stigma is associated with poor physical and mental health for PLWH [ 14 – 18 ], lower medication adherence [ 19 – 21 ], and lower linkage to and retention in HIV care [ 22 – 24 ].…”

Criminalization of HIV non-disclosure: Narratives from young men living in Vancouver, Canada

“…While the Canadian HIV non-disclosure legal framework is ostensibly used to ‘govern’ the risk of HIV transmission, there is growing concern that the criminalization of HIV non-disclosure fails to prevent HIV transmission and instead increases overall harm [ 16 ]. For example, HIV non-disclosure legal frameworks have been implicated in increasing HIV-related discrimination [ 17 ], including the inequitable application of criminal charges among racialized individuals (e.g., Black and Indigenous people) [ 18 , 19 ].…”

Quality Control of Next-Generation Sequencing-Based HIV-1 Drug Resistance Data in Clinical Laboratory Information Systems Framework

“…These records can then be anonymized and associated with sample submissions. Health care information security systems need to preserve the confidentiality of health records, especially when people living with HIV can be convicted for criminal offenses in some countries for not disclosing their HIV status to their sexual partners [ 17 ].…”