How HIV Criminalisation Undermines the HIV Response

Makes prevention & healthcare more difficult

Healthcare providers deliver fundamental healthcare and support but they are also the frontline in HIV prevention. While HIV diagnosis is focussed on the health and welfare of  individual patients, diagnosis also plays a crucial role reducing HIV transmission by ensuring people do not unknowingly place their sexual partners at risk. Health care providers are charged with educating people about safe sex practice and providing support to ensure safe sex practice on an ongoing basis. Criminalisation undermines healthcare providers’ capacity to do their job.


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HIV Care Nurses’ Knowledge of HIV Criminalization: A Feasibility Study

Identifies knowledge gaps among Canadian and U.S. nurses related to several aspects of HIV-related criminal laws influencing nursing clinical practices. Argues nurses should increase their knowledge of HIV-related criminal laws to ensure the success of population health initiatives and to reduce stigma and discrimination experienced by people living with HIV.


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Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting

Findings from a survey of people with HIV who use illicit drugs found that most were not aware of the 2012 Supreme Court ruling, which may place them at risk of prosecution. Discussions about disclosure and the law were lacking in healthcare settings.


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Prosecution of non-disclosure of HIV status: Potential impact on HIV testing and transmission among HIV-negative men who have sex with men

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.


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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.


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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.


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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.


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