The Public Health Implications of Criminalizing HIV Non-Disclosure, Exposure and Transmission: Report of an International Workshop

Mykhalovskiy, Eric; Betteridge, Jonathan Glenn; Sanders, Chris; Jones, Marcella K.

doi:10.2139/ssrn.2374933

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…Recent research has also identified how HIV non-disclosure legal frameworks compromise patient-clinician relationships (e.g., trust, concerns about confidentiality) in clinical encounters [ 20 ]. Others have argued that the application of this framework undermines the conditions that are needed to promote the shared responsibility of preventing HIV acquisition or transmission (i.e., condom negotiation practices among sex partners) by placing the legal impetus on HIV-positive individuals, thereby contradicting decades of public health messaging that all individuals should take various actions to promote and protect sexual health [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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BackgroundPrevious research has identified the impacts of legal frameworks that criminalize HIV non-disclosure among people living with HIV (e.g., elevated stigma and violence). However, far less is known about the perspectives or experiences of people–particularly, men–who are HIV-seronegative or who are unaware of their status. The objective of this paper is to describe the health and social risks that young men perceive to be associated with an HIV diagnosis in the context of Canada’s current legal framework pertaining to HIV non-disclosure.MethodsWe analyzed data from 100 in-depth interviews (2013–2016) conducted with 85 young men ages 18–30 in Vancouver on the topic of the criminalization of HIV non-disclosure.ResultsOur analysis revealed two dominant narratives in relation to HIV criminalization: (a) interrogation and (b) justification. An interrogation narrative problematized the moral permissibility of criminalizing HIV non-disclosure. In this narrative, Canada’s HIV non-disclosure legal framework was characterized as creating unjust barriers to HIV testing uptake, as well as impeding access to and reducing retention in care for those living with HIV. Conversely, a justification narrative featured a surprising number of references to HIV as a “death sentence”, despite effective treatments being universally available in Canada. However, most of those who presented the justification narrative asserted that the criminalization of HIV non-disclosure was morally justified in light of the perceived negative stigma-related impacts of HIV (e.g., discrimination; being ostracized from sex or romantic partners, friends, family). The justification narrative often reflected a belief that the legal framework provides both punishment and deterrence, which were perceived to supersede any barriers to care for both HIV-positive and -negative individuals.ConclusionPublic education regarding contemporary medical advances in HIV may help contest lay understandings of HIV as a “death sentence”, which is particularly relevant to destabilizing justification narratives. However, significant strengthening of HIV stigma-reduction efforts will be needed to move society away from narratives that attempt to justify Canada’s current HIV non-disclosure legal framework.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Others have also argued that instead of focusing on the shared responsibility that those living without HIVincluding communities and society more broadlyhave in terms of preventing HIV transmission, the criminalization of non-disclosure emphasizes individualized notions of responsibility of HIV prevention. This leaves the onus of HIV prevention left exclusively upon those living with HIV [21,26], thereby contradicting decades of public health HIV prevention messaging.…”

Section: The Criminalization Of Hivmentioning

confidence: 99%

Perspectives of HIV-positive and -negative people who use drugs regarding the criminalization of HIV non-disclosure in Canada: a qualitative study

Chayama

Krüsi

et al. 2020

BMC Public Health

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Background: While previous research has identified how criminalization of HIV non-disclosure can have deleterious effects on those living with HIV, the perspectives of people who use drugsa population disproportionately affected by HIV-should be more meaningfully considered in these discussions. Methods: Using constant comparative techniques, data from 60 interviews with men and women living with and without HIV and who use drugs in Vancouver were analyzed to explore their perceptions about Canada's HIV nondisclosure legal framework. Results: Participants' perspectives on the framework involved three themes: understandings of HIV risk; HIV-related stigma; and their own experiences with HIV. While several participants favored the punitive character of the legal framework, these arguments were premised on misinformed and stigmatized assumptions regarding HIV. Conclusions: The paper concludes by discussing the challenges and opportunities for resisting HIV stigma and misconceptions about HIV within the context of personal accounts that, at times, support criminalization of nondisclosure.

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“…Yet this mapping exercise is characterized as neutral, and the evidence-based data supposedly 'speaks for itself' (Murray et al, 2008). What is perhaps silent in this speech is that individual and collective viral load mapping has emerged in the context of growing rates of stigma and the criminalizing of HIV (Mykhalovskiy et al, 2014). Following Michael and Rosengarten (2012: 4) we 'treat the ethical and political status of both the contraction and the proliferation of affective relations, and the sorts of bodies that emerge out of these patterns, with circumspection'.…”

Section: Community Viral Load Mapping: the Individual And The Collectivementioning

confidence: 99%

HIV, Viral Suppression and New Technologies of Surveillance and Control

2016

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The global response to managing the spread of HIV has recently undergone a significant shift with the advent of 'treatment as prevention', a strategy which presumes that scaling-up testing and treatment for people living with HIV will produce a broader preventative benefit. Treatment as prevention includes an array of diagnostic, technological and policy developments that are creating new understandings of how HIV circulates in bodies and spaces. Drawing on the work of Michel Foucault, we contextualize these developments by linking them to systems of governance and discursive subjectivation. The goal of this article is to problematize the growing importance of viral suppression in the management of HIV and the use of related surveillance technologies. For people living with HIV, we demonstrate how treatment-as-prevention's emphasis on individual and collective viral load is transforming the performative dimensions of embodied risk, affect, subjectivity and sex.

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The Public Health Implications of Criminalizing HIV Non-Disclosure, Exposure and Transmission: Report of an International Workshop

Cited by 4 publications

References 31 publications

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

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

Perspectives of HIV-positive and -negative people who use drugs regarding the criminalization of HIV non-disclosure in Canada: a qualitative study

HIV, Viral Suppression and New Technologies of Surveillance and Control

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