HIV Criminal Prosecutions and Public Health: An Examination of the Empirical Research; Patrick O’Byrne, Alyssa Bryan, and Marie Roy; Medical Humanities (July 2013)

Using studies conducted in the United Kingdom, Canada, and several American states, this article analyzes awareness of HIV criminal laws, perceptions of the laws, and the laws' effect on public health. The authors found that the majority of survey respondents were aware of their state or country's HIV criminal laws. However, there was a disparity between survey research, which indicated support for these laws, and qualitative research, which indicated opposition.

While the cited studies demonstrated that most respondents were aware of their respective jurisdiction's HIV criminal laws, most respondents did not accurately understand the laws. It is unclear what effect this lack of understanding has on public health. When looking at perceptions of the laws, the authors found that the majority of participants in survey research studies supported HIV criminal laws in instances of non-disclosure, especially when transmission could or did occur. Nonetheless, many participants in the Canadian survey research studies indicated that HIV criminal laws would increase stigma and deter people from being tested. Qualitative research studies further underscored this sentiment, with focus groups and interviews revealing strong opposition to HIV criminal laws. This opposition was due in part to the perceptions that such laws place the burden of prevention on one party rather than both, that proving disclosure may be impossible, and that the laws increase stigma and deter testing.

Drawing conclusions about the effect of HIV criminal laws on public health is difficult, as multiple studies have demonstrated that the "relationships between HIV criminal laws and persons' sexual, disclosure and testing practices are neither direct nor straightforward." The authors found that HIV criminal laws do not seem to affect the above practices in most people. However, for a majority of the small group that is affected, "these laws were associated with changes that may exacerbate HIV transmission . . . ." Studies further indicated that HIV criminal laws may adversely affect the health care seeking practices of people with HIV, as well as the behavior of treating clinicians. The authors thus concluded that "HIV criminal laws compromise the general public health."