The Expert Consensus Statement on the Science of HIV in the Context of Criminal Law – Five-year Impact Report: Bringing Science to Justice
In 2018, twenty leading HIV scientists published the ‘Expert Consensus Statement on the Science of HIV in the Context of Criminal Law’ (Expert Consensus Statement) to address the misuse of HIV science in punitive laws and prosecutions against people living with HIV for acts related to sexual activity, biting or spitting. The process involved undertaking detailed analysis of the best available scientific and medical research data on HIV transmission, treatment effectiveness and forensics. Building on an initial scoping report published in 2020, the HIV Justice Network (HJN) undertook further research between April and July 2023 examining the impact of the Expert Consensus Statement in cases and advocacy in the five years since its publication.
Position Statement on Harm Reduction
Acknowledges the harms caused by stigma and criminalisation. In particular, it acknowledges that the harms of criminalisation are borne disproportionally by Indigenous peoples in Canada. The Statement recognises that while people make their own health decisions, these decisions are only one factor influencing health outcomes.
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The problem of ‘significant risk’: Exploring the public health impact of criminalizing HIV non-disclosure
Emphasizes that the concept of significant risk undermines communication about transmission risk during HIV counselling and contributes to contradictory advice about disclosure obligations. Criminalization discourages openness about HIV non-disclosure in counselling relationships. The recontextualization of public health interpretations of significant risk in criminal proceedings can intensify criminalization.
Special issue on the ramifications of the current context of criminal prosecutions for non-disclosure of HIV status on nursing practice
Summarizes a full-day meeting of health providers to address nondisclosure prosecutions and nursing practice. Issues included criminal law and serostatus disclosure, public health legislation surrounding HIV care and management, civil liabilities related to HIV-related care, and professional regulations and standards that influence nursing practice. Report includes recommendations.
Discussing the Limits of Confidentiality: The Impact of Criminalizing HIV Nondisclosure on Public Health Nurses’ Counselling
Found HIV criminalisation negatively impacts nursing practice as public health nurses endeavour to control information about the limits of confidentiality at the outset of HIV post-test counselling. Individual practice varies as nurses pragmatically balance ethical and professional concerns. Some intentionally withhold information about the risk of subpoena, while others talk to clients about confidentiality in ways that focus on the risk of harm associated with criminalisation.
Examining public health nurses’ documentary practices: the impact of criminalizing HIV non-disclosure on inscription styles
Found that public health nurses’ anticipation that medical and public health records could be used as evidence in court is affecting public health nurses’ reasoning and documentary practices during HIV post-test counselling. Nurses have real concerns that notes will be misinterpreted and given a legal significance contrary to their original purpose, and fear their professional competence could be attacked. Traditional counselling practices prioritising client care and risk reduction are in conflict with HIV criminalisation.
HIV criminal prosecutions and public health: an examination of the empirical research
Concludes that HIV-related criminal laws either fail to influence or increase STI testing avoidance, unprotected anonymous sexual contacts, and avoidance of health care because respondents do not feel safe speaking with health professionals. Suggests HIV-related criminal laws compromise public health and clinicians’ abilities to establish therapeutic relationships and to undertake HIV prevention and treatment work.
Criminalizing HIV transmission and exposure in Canada: A public health evaluation
Considers HIV non-disclosure criminal cases in Canada through a public health framework, evaluating the arguments for and against the criminalization of HIV transmission and exposure.
Conflicting messages: How criminal HIV disclosure laws undermine public health efforts to control the spread of HIV
Demonstrates how HIV disclosure laws disregard the effectiveness of universal precautions and safer sex, while criminalizing activities that are central to harm reduction efforts. Argues that criminalization uses disclosure-based HIV transmission prevention strategy as an implicit alternative to risk reduction and safer sex, undermining public health efforts. Describes how criminal HIV disclosure laws work against public health efforts to reduce HIV stigma.
Criminal Law and Public Health Practice: Are the Canadian HIV Disclosure Laws an Effective HIV Prevention Strategy?
Considers the effect of HIV criminalisation on HIV prevention, finding that although criminal laws might prevent HIV transmission in a few isolated cases, it is unlikely they would influence overall population-level rates of HIV transmission. Some evidence suggests these laws could exacerbate HIV transmission.