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.

The impact of criminalization of HIV non-disclosure on the healthcare engagement of women living with HIV in Canada: A comprehensive review of the evidence

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.

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.

Nondisclosure prosecutions and HIV prevention: Results from an Ottawa-based gay men’s sex survey

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.

Nondisclosure Prosecutions and Population Health Outcomes: Examining HIV Testing, HIV Diagnoses, and the Attitudes of Men Who Have Sex with Men Following Nondisclosure

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.