There have been many anecdotal reports that publicity about HIV criminalisation drives people away from health care services. The studies listed below confirm those reports, showing that HIV-prosecutions increase a sense of state surveillance and undermine the therapeutic relationship healthcare providers depend on to facilitate frank discussion about risk taking behaviours. (For the effects of HIV criminalisation on service provision, see Makes prevention & healthcare more difficult.)
Reports that following the high profile prosecution of an HIV positive sex worker (no transmission), sex workers became fearful of HIV testing for HIV. In the four-week period following the court case, attendance at the sex worker outreach medical service dropped from an average of 40 per night to three.
Survey of people living with HIV found 30% were concerned about disclosing their sexual practices to service provider (and 13% were uncertain) ‘because of the current legal situation’.
Survey of more than 700 PLHIV found that almost half felt it was somewhat reasonable or very reasonable to avoid testing because of fear of prosecution.
Found that HIV testing and HIV diagnoses among men who have sex with men did not significantly statistically change after media releases about a local nondisclosure prosecution. However, some MSM expressed their belief that the local public health department openly shares information with police. Some HIV-positive participants perceived an association between local public health and police services which caused them to not access public health services.
Found that people at high risk of HIV living in states with HIV-specific statutes were no more or less likely to report HIV testing. However, HIV testing decreased following media coverage of HIV cases. The application of criminal laws had a negative impact on HIV testing rates among those most at risk of HIV infection, adversely affecting public health.
Details the relationships between nondisclosure prosecutions and STI/HIV testing practices. Only a minority of survey participants reported that HIV criminal prosecutions affected their willingness to get tested for HIV, or made them afraid to speak with nurses and physicians about their sexual practices. However, that group may also be at higher risk of HIV infection, reporting higher rates of unprotected penetrative anal intercourse and internal ejaculation with (on average) a higher number of different sexual partners within the previous two months. This same group also reported less STI/HIV testing and a preference for anonymous HIV testing.
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.
Details the major areas of concern and the harm which both direct and indirect criminalization inflict on an individual’s human rights and the health of society as a whole.
Countries that criminalise same-sex relationships, sex work and drug use have significantly more people with undiagnosed HIV and lower rates of viral suppression than countries that do not criminalise, or criminalise these areas to a lesser extent. Countries with human rights protections in place fared much better than those without on these HIV-related indicators, according to an analysis by Dr Matthew Kavanagh of Georgetown University.
In this brochure, Zimbabwe Lawyers for Human Rights and HIV Justice Worldwide explain why the section 79 of the Criminal Code violates the rights of people living with HIV and is a barrier to HIV prevention and care.
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.
Aims to quantify the potential impact of non-disclosure prosecutions on HIV testing and transmission among MSM. Found that fear of prosecution over HIV non-disclosure was reported to reduce HIV testing willingness by a minority of HIV-negative MSM in Toronto; however, this reduction had the potential to significantly increase HIV transmission at the community level which has important public health implications.
Revisits the analysis described in Sweeney et al. (Association of HIV diagnosis rates and laws criminalizing HIV exposure in the United States), but stratifies the diagnosis rate into two response variables: i) the proportion of PLHIV diagnosed, and ii) annual percentage change in HIV prevalence. Counter to the conclusions of Sweeney et al., the researchers' analyses indicate that laws criminalizing HIV exposure are associated with a lower proportion of HIV diagnosis and increased HIV prevalence.
At the end of the 5-year strategy in which countries around the world focused their AIDS response on reaching people living with HIV with testing and treatment services, this article provides an ecological analysis of whether those countries with criminalising legal environments achieved more or less success. It found that countries that have adopted a criminalising approach to key populations saw less success than those that chose not to criminalise. This analysis suggests a new global AIDS strategy that includes a focus on law reform may hold promise in achieving goals that were missed in 2020.
Article analysing of the first case of HIV transmission in the UK. The authors conclude that far from protecting the public, the judgment has endorsed abrogation of individual responsibility in sexual partnerships by asserting a legal duty of disclosure on the infected partner. It is likely to undermine uptake of HIV testing and risks a one third increase in new HIV infections in Scotland. It also underlines the need for research scientists to anticipate that potentially incriminating results, even in unlabelled studies, may be followed up by forensic requests from individual study participants or by police warrant and recommends an urgent review by the Scottish Executive to minimise the negative effects on public health and molecular science.
This study assesses the association of three types of MSM-related sexual behavior-related stigma (family, healthcare, general social stigma) measured at both individual and site levels and the presence/absence of laws criminalizing HIV transmission with HIV testing behaviors to inform HIV surveillance and prevention efforts among HIV-negative MSM in a holistic and integrated way. The study found that site-level HIV-specific criminalization laws were associated with an approximate 5% reduction in the prevalence of receiving any HIV test.
