The public health implications of HIV criminalization: past, current, and future research directions

Mykhalovskiy, Eric

doi:10.1080/09581596.2015.1052731

Cited by 31 publications

(27 citation statements)

References 53 publications

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“…Further impediments to HIV prevention and treatment implementation exist in the legal arena, as Canada has become one of the most active nations in the criminalization of HIV non-disclosure [92]. The escalating use of criminal law to prosecute HIV non-disclosure raises concerns about the implications on public health efforts to prevent HIV transmission, including the law's potential negative effect on HIV stigma and HIV testing [93][94][95].…”

Section: Emerging Priorities In the Hiv Responsementioning

confidence: 99%

A historical review of HIV prevention and care initiatives in British Columbia, Canada: 1996‐2015

Olding

Enns

Panagiotoglou

et al. 2017

Journal of the International AIDS Society

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Introduction: British Columbia has made significant progress in the treatment and prevention of HIV since 1996, when Highly Active Antiretroviral Therapy (HAART) became available. However, we currently lack a historical summary of HIV prevention and care interventions implemented in the province since the introduction of HAART and how they have shaped the HIV epidemic. Guided by a socio-ecological framework, we present a historical review of biomedical and health services, community and structural interventions implemented in British Columbia from 1996–2015 to prevent HIV transmission or otherwise enhance the cascade of HIV care. Methods: We constructed a historical timeline of HIV interventions implemented in BC between 1996 and 2015 by reviewing publicly available reports, guidelines and other documents from provincial health agencies, community organizations and AIDS service organizations, and by conducting searches of peer-reviewed literature through PubMed and Ovid MEDLINE. We collected further programmatic information by administering a data collection form to representatives from BC’s regional health authorities and an umbrella agency representing 45 AIDS Service organizations. Using linked population-level health administrative data, we identified key phases of the HIV epidemic in British Columbia, as characterized by distinct changes in HIV incidence, HAART uptake and the provincial HIV response. Results and Discussion: In total, we identified 175 HIV prevention and care interventions implemented in BC from 1996 to 2015. We identify and describe four phases in BC’s response to HIV/AIDS: the early HAART phase (1996–1999); the harm reduction and health service scale-up phase (2000–2005); the early Treatment as Prevention phase (2006–2009); and the STOP HIV/AIDS phase (2010-present). In doing so, we provide an overview of British Columbia’s universal and centralized HIV treatment system and detail the role of community-based and provincial stakeholders in advancing innovative prevention and harm reduction approaches, as well as “seek, test, treat and retain” strategies. Conclusions: The review provides valuable insight into British Columbia’s HIV response, highlights emerging priorities, and may inform future efforts to evaluate the causal impact of interventions.

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Section: Emerging Priorities In the Hiv Responsementioning

confidence: 99%

A historical review of HIV prevention and care initiatives in British Columbia, Canada: 1996‐2015

Olding

Enns

Panagiotoglou

et al. 2017

Journal of the International AIDS Society

View full text Add to dashboard Cite

show abstract

“…For example, an early PEPFAR strategy through USAID (the Action for West Africa Region, AWARE program) was to promote model omnibus HIV legislation in HIV-affected countries, using 'best practice' discourse [32,33]. Between 2005 and 2010, 18 countries in West and Central Africa adopted versions of this model law that included provisions criminalizing transmission of HIV [34], despite evidence such criminalization promotes HIV stigma and other harms [5,[35][36][37][38]. This model legislation is no longer promoted by PEPFAR, given the preponderance of evidence that criminalization may make HIV epidemics worse.…”

Section: Resultsmentioning

confidence: 99%

Anti-Homosexual Legislation and HIV-Related Stigma in African Nations: What Has Been the Role of PEPFAR?

et al. 2017

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“…There is no evidence that criminalization operates as a deterrent, but rather that it may instead hinder public health by encouraging people to avoid testing. [1,[3][4][5] The risks at the individual and societal levels are disproportionate to the benefits when we consider that the accused faces a lengthy (and costly) period of time in prison should they be convicted. Moreover, while using a condom to protect one's sexual partner might fulfill the principle of nonmaleficence, not to mention demonstrating an ethic of care, this nonetheless fails to meet the rigid legal requirements imposed by the realistic possibility test.…”

Section: Theoretical Framework: Toward a Critical Bioethics Of The Crmentioning

confidence: 99%

“…The subject of lurid media coverage, efforts to punish HIV-positive individuals for exposing their sexual partners to HIV have been loudly denounced by activists and advocates, many of whom insist that criminalization increases stigma, frustrates public health efforts that encourage testing, and signals a regressive return to the moral panic climate of the early years of the AIDS epidemic. [1][2][3][4][5] Expanding on the promising conceptual framework offered by critical bioethics, [6,7] we explore the emotionally charged and ethically uncertain climate of the criminalization of HIV nondisclosure in Canada. We suggest that a critical bioethics for HIV/AIDS must include considerations of "bioethics on the ground," which Heimer conceives as the ways in which the "more inchoate moral sentiments of ethics on the ground get transformed into decisions and courses of action...…”

Section: Introductionmentioning

confidence: 99%

Untitled

Kilty¹,

Orsini²,

Balogh³

2017

aporia

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This article highlights the ethically uncertain and emotionally charged climate that governs the criminalization of HIV nondisclosure in Canada. Focusing on AIDS Service Organizations (ASO), we suggest that interlocutors perform critical work that helps people living with HIV/AIDS make sense of their rights and responsibilities. Semi-structured interviews with 62 ASO staff across Canada revealed this shifting landscape of HIV advocacy in the age of criminalizing HIV nondisclosure. Drawing on a critical bioethics approach that is informed by considering the role of emotion in decision-making, this article critiques the liberal model of the rational actor that is central to traditional discussions of bioethics and law. Our findings suggest that ASO workers have varying degrees of knowledge about the intricacies of legal duties of disclosure, which affect how they balance their own emotions and thoughts about nondisclosure with their professional duties to provide support and counselling. Ultimately, we argue that critical bioethics in the context of criminalization commands us to appreciate the inherently affective nature of the environment in which bioethical decisions are made.

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The public health implications of HIV criminalization: past, current, and future research directions

Cited by 31 publications

References 53 publications

A historical review of HIV prevention and care initiatives in British Columbia, Canada: 1996‐2015

A historical review of HIV prevention and care initiatives in British Columbia, Canada: 1996‐2015

Anti-Homosexual Legislation and HIV-Related Stigma in African Nations: What Has Been the Role of PEPFAR?

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