HIV Criminalization May Discourage Testing, Study Shows

Sean Strub, who founded POZ magazine and is an anti-HIV-criminalization activist, calls the Canadian study “important” but shares Galletly’s concerns about replicating its results.

“Finding a direct link between criminalization and a reluctance to test, disclose or access treatment is going to be difficult except with people with HIV who are exceptionally well-informed or in places where there has been tremendous media coverage of the HIV criminalization phenomenon,” says Strub.

The role of the media in prosecution of HIV criminal laws is something Galletly says needs to be explored as well.

“What I think what we need to do, besides working to repeal laws that single persons out based on fear and discriminatory attitudes and with no empiric data, is to better understand how media coverage of prosecutions shapes the impact of these laws on HIV-positive and HIV-negative persons,” she says.

The study from Canada does have several limits, as the authors acknowledge. The sample was not randomized, subjects were recruited in high-risk sexual activity locations, and the demographic skews to white, gay men. The results, therefore, cannot be generalized.

O'Byrne says a larger study looking at the same issues has already collected data and is in the process of analysis. The preliminary analysis “confirms” the findings of the May 3 study, he says.

The National Gay and Lesbian Task Force has also weighed in on the study. Darlene Nipper, deputy executive director for the group, says that the organization opposes HIV criminalization and that this study bolsters that case.

“[Criminalization of HIV] is unsound policy and, while this study is limited in scope, it indicates that when people are threatened with punishment they are less likely to be open and honest with medical professionals,” Nipper tells TAI. “The focus should instead be on making HIV prevention and treatment programs easily accessible to everyone who can benefit from them."

The issue of criminalization is slowly shaping into a national and international dialog. In several states, citizen groups are working to repeal HIV-specific laws. In Congress, a bill has been introduced by Rep. Barbara Lee (D-Calif.) that would encourage reform of state and federal HIV policies. And in 2010, President Barack Obama’s National HIV/AIDS Strategy called on states to revisit their laws.

Last week, the Global Commission on HIV and the Law recommended that HIV-specific laws be repealed. The report also recommends that those convicted under such laws be pardoned.

All those recommendations are based in part on a growing body of scientific literature showing that HIV-specific criminal laws are not effective in stopping transmission of the virus.

“Incidence of HIV infection in states with and without HIV exposure laws does not differ, as one would expect if the laws were preventing new infections,” says Galletly, who has been a leading researcher on the impact of HIV criminalization laws on behavior.

In the end, the complicated and messy problem of addressing HIV risk and prevention won’t be solved with just one study.

“There is a lot of research showing criminalization doesn't slow the spread of HIV; the O'Byrne study is another piece of a complicated jigsaw puzzle,” says Strub. “But as the pieces get filled in, and the picture becomes clear, it will be obvious that criminalization creates more new HIV infections than it prevents.”

The Advocate partnered with The American Independent to bring you this story. The American Independent is a progressive nonprofit news organization committed to impact journalism.