AIDS and Behavior

, Volume 10, Issue 5, pp 451–461 | Cite as

Conflicting Messages: How Criminal HIV Disclosure Laws Undermine Public Health Efforts to Control the Spread of HIV

Original Article
First Online:

Abstract

Twenty-three U.S. states currently have laws that make it a crime for persons who have HIV to engage in various sexual behaviors without, in most cases, disclosing their HIV-positive status to prospective sex partners. As structural interventions aimed at reducing new HIV infections, the laws ideally should complement the HIV prevention efforts of public health professionals. Unfortunately, they do not. This article demonstrates how HIV disclosure laws disregard or discount the effectiveness of universal precautions and safer sex, criminalize activities that are central to harm reduction efforts, and offer, as an implicit alternative to risk reduction and safer sex, a disclosure-based HIV transmission prevention strategy that undermines public health efforts. The article also describes how criminal HIV disclosure laws may work against the efforts of public health leaders to reduce stigmatizing attitudes toward persons living with HIV.

Keywords

HIV prevention HIV disclosure Criminal law Public health 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgements

This research was supported by grants R21-MH073495, K02-MH01919, and P30-MH52776 from the National Institute of Mental Health. The authors thank Ralph Resenhoeft for his assistance.

References

  1. Ark. Code Ann. § 5-14-123 (Michie, LEXIS through the 2005 regular session).Google Scholar
  2. Ark. Code Ann. § 5-4-401 (Michie, LEXIS through the 2005 regular session).Google Scholar
  3. Bateson, M.C., & Goldsby, R. (1988). Thinking AIDS: the social response to the biological threat. New York: Addison-Wesley.Google Scholar
  4. Bayer, R. (1996). AIDS prevention — sexual ethics and responsibility. New England Journal of Medicine, 334, 1540–1542.PubMedCrossRefGoogle Scholar
  5. Berkowitz, R., & Callen, M. (1983). How to have sex in an epidemic: one approach. News from the Front, 1–40.Google Scholar
  6. Blankenship, K.M., Bray, S.J., & Merson, M.H. (2000). Structural interventions in public health. AIDS, 14(suppl. 1), S11–S21.PubMedCrossRefGoogle Scholar
  7. Brandt, A.M. (1988). AIDS in historical perspective: four lessons from the history of sexually transmitted diseases. American Journal of Public Health, 78, 367–371.PubMedGoogle Scholar
  8. Brookmeyer, R. (1991). Reconstruction & future trends of the AIDS epidemic in the United States. Science, 253, 37–42.PubMedCrossRefGoogle Scholar
  9. Burris, S. (1999). Studying the legal management of HIV-related stigma. American Behavioral Scientist, 42, 1225–1239.Google Scholar
  10. Burris, S. (2002). Disease stigma in U.S. public health law. Journal of Law, Medicine and Ethics, 30, 179–190.CrossRefGoogle Scholar
  11. Burris, S., Dalton, H.L., Miller, J.L., and the Yale AIDS Law Project (1993). AIDS law today: a new guide for the public. New Haven, CT: Yale University Press.Google Scholar
  12. Cal. Health and Safety Code § 120291 (Deering, LEXIS through 2005 CH. 158).Google Scholar
  13. Cates, W. Jr., & Hinman, A.R. (1992). AIDS and absolutism - the demand for perfection in prevention. New England Journal of Medicine, 327, 492–494.PubMedCrossRefGoogle Scholar
  14. Centers for Disease Control (1985). Epidemiologic notes and reports of self-reported behavioral change among gay and bisexual men—San Francisco. Morbidity and Mortality Weekly Report, 34.Google Scholar
  15. Centers for Disease Control (2001). Revised guidelines for HIV counseling, testing, and referral. Morbidity and Mortality Weekly Report, 50(RR-19), 1–86.Google Scholar
  16. Centers for Disease Control (2003). HIV prevention in the United States: elements of successful HIV prevention programs. Stigma hampers prevention.Google Scholar
  17. Chambers, D.L. (1994). Stonewall at 25: Gay men, AIDS, and the code of the condom. Harvard Civil Rights- Civil Liberties Law Review, 29, 353.Google Scholar
  18. Chesney, M.A., & Smith, A.W. (1999). Critical delays in HIV testing and care: the potential role of stigma. American Behavioral Scientist, 42, 1162–1174.CrossRefGoogle Scholar
  19. Ciccarone, D.H., Kanouse, D.E., Collins, R.L., Miu, A., Chen, J.L., Morton, S.C., et al. (2003). Sex without disclosure of positive HIV serostatus in a probability sample of persons receiving medical care for HIV infection. American Journal of Public Health, 93, 949–954.PubMedGoogle Scholar
  20. Closen, M.L., Bobinski, M.A., Hermann, D.H.J., Hernandez, J.F., Schultz, G.P., & Strader, J.K. (1994). Criminalization of an epidemic: HIV-AIDS and criminal exposure law. Arkansas Law Review, 46, 921.Google Scholar
  21. Cohen, M.S., & Pilcher, C.D. (2005). Amplified HIV transmission and new approaches to HIV prevention. Journal of Infectious Diseases, 191, 1391–1393.PubMedCrossRefGoogle Scholar
  22. Crepaz, N., & Marks, G. (2003). Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care, 15, 379–387.PubMedCrossRefGoogle Scholar
  23. Davis, K.R., & Weller, S.C. (1999). The effectiveness of condoms in reducing heterosexual transmission of HIV. Family Planning Perspectives, 31, 272–279.PubMedCrossRefGoogle Scholar
  24. DeRosa, C.J., & Marks, G. (1998). Preventive counseling of HIV-positive men and self-disclosure of serostatus to sex partners: new opportunities for prevention. Health Psychology, 17, 224–231.CrossRefGoogle Scholar
  25. Devine, P.G., Plant, E.A., & Harrison, K. (1999). The problem of “us” versus “them” and AIDS stigma. American Behavioral Scientist, 42, 1208–1224.CrossRefGoogle Scholar
  26. Ekstrand, M.L., & Coates, T.J. (1990). Maintenance of safer sexual behaviors and predictors of risky sex: the San Francisco Men's Health Study. American Journal of Public Health, 80,973–977.PubMedGoogle Scholar
  27. Elwood, W.N., & Williams, M.L. (1999). The politics of silence: communicative rules and HIV prevention issues in gay male bathhouses. In W.N. Elwood (ed.): Power in the blood: a handbook on AIDS, politics, and communication (pp. 121–132). Mahwah, NJ: Lawrence Erlbaum Associates, Publishers.Google Scholar
  28. Fla. Stat. § 384.24 (2) (LEXIS through April 21, 2005).Google Scholar
  29. Fleming, P.L., Byers, R.H., Sweeney, P.A., Daniels, D., Karon, J.M., & Janssen, R.S. (2000). HIV prevalence in the United States, 9th Conference on Retroviruses and Opportunistic Infections. February 24–28, 2002, Abstract 11.Google Scholar
  30. Fortenberry, J.D., McFarlane, M., Bleakley, A., Bull, S., Fishbein, M., Grimley, D.M., et al. (2002). Relationship of stigma and shame to gonorrhea and HIV screening. American Journal of Public Health, 92, 378–381.PubMedGoogle Scholar
  31. Ga. Code Ann. § 16-5-60 (Michie, LEXIS through all 2005 legislation).Google Scholar
  32. Galletly, C.L., & Pinkerton, S.D. (2004). Toward rational HIV disclosure laws. Journal of Law, Medicine, and Ethics, 32, 327–337.PubMedCrossRefGoogle Scholar
  33. Geary, M.K., King, G., Forsberg, A.D., Delaronde, S.R., Parsons, J., and the Hemophilia Behavioral Evaluative Intervention Project Staff (1996). Issues of disclosure and condom use in adolescents with hemophilia and HIV. Pediatric AIDS and HIV Infection, 7, 418–423.PubMedGoogle Scholar
  34. Glynn, M., & Rhodes, P. (2005). Estimated HIV prevalence in the United States at the end of 2003 [Abstract]. 2005 National HIV prevention Conference, June 12–15 Atlanta, Georgia.Google Scholar
  35. Hoffman, E. (1963). Stigma. notes on the management of spoiled identity. New York: Simon and Schuster, Inc.Google Scholar
  36. Herek, G.M. (1999). AIDS & stigma. American Behavioral Scientist, 42, 1106–1116.Google Scholar
  37. Herek, G.M., & Glunt, E.K. (1988). An epidemic of stigma: public reactions to AIDS. American Psychologist, 43, 886–891.PubMedCrossRefGoogle Scholar
  38. Herek, G.M., Capitanio, J.P., & Widaman, K.F. (2003). Stigma, social risk, and health policy: public attitudes toward HIV surveillance policies and the social construction of illness. Health Psychology, 22, 533–540.PubMedCrossRefGoogle Scholar
  39. Holland, W.H. (1994). HIV/AIDS and the criminal law. Criminal Law Quarterly, 36, 279–316.Google Scholar
  40. Holtgrave, D.R. (2002). Estimating the effectiveness and efficiency of U.S. HIV prevention efforts using scenario and cost-effectiveness analysis. AIDS, 16, 2347–2349.PubMedCrossRefGoogle Scholar
  41. Idaho Code § 39-608 (LEXIS through 2005 session).Google Scholar
  42. 720 Ill. Comp. Stat. 5/12-16.2 (LEXIS through Public Act 94-0241) [Prior to 1/1/93 cited as: Ill. Rev. Stat., Ch. 38, para. 12-16.2].Google Scholar
  43. Ind. Code Ann. § 16-41-7-1 (Michie, LEXIS through 2004 Regular session).Google Scholar
  44. Ind. Code Ann. § 35-42-1-9 (Michie, LEXIS through 2004 Regular session).Google Scholar
  45. Iowa Code Ann. § 709C.1 (West, LEXIS through the 2005 edition (2004 legislation).Google Scholar
  46. Janssen, R.S., Holtgrave, D.R., Valdiserri, R.O., Sheperd, M., Gayle, H.D., & De Cock, K.M. (2001). The serostatus approach to fighting the HIV epidemic: prevention strategies for infected individuals. American Journal of Public Health, 91, 1019–1024.PubMedGoogle Scholar
  47. Kalichman, S.C., & Nachimson, D. (1999). Self-efficacy and disclosure of HIV-positive serostatus to sex partners. Health Psychology, 18, 281–287.PubMedCrossRefGoogle Scholar
  48. Kan. Stat. Ann. § 21-3435 (LEXIS through the 2004 Supplement).Google Scholar
  49. Kaplan, J., Weisberg, R., & Binder, G. (1996). Criminal Law: Cases and materials. New York: Little, Brown and Company.Google Scholar
  50. Klitzman, R., & Bayer, R. (2003). Mortal Secrets: Truth and lies in the age of AIDS. Baltimore, MD: Johns Hopkins University Press.Google Scholar
  51. La. Rev. Stat. Ann. § 14:43.5 (West, NEXIS through 2004 legislation).Google Scholar
  52. Latkin, C.A., Knowlton, A.R., Forman, V.L., Hoover, D.R., Schroeder, J.R., Hackey, M., et al. (2001). Injection drug users’ disclosure of HIV seropositive status to network members. AIDS and Behavior, 5, 297–305.CrossRefGoogle Scholar
  53. Lazzarini, Z., Bray, S., & Burris, S. (2002). Evaluating the impact of criminal laws on HIV risk behavior. Journal of Law, Medicine and Ethics, 30, 239–253.CrossRefGoogle Scholar
  54. Lazarini, Z., & Burris, S. (2005). HIV Criminal Law and Policy Project. Retrieved October 15, 2005, from http://www.hivcriminallaw.org.Google Scholar
  55. Lee, R.S., Kochman, A., & Sikkema, K.J. (2002). Internalized stigma among people living with HIV/AIDS. AIDS and Behavior, 6, 309–319.CrossRefGoogle Scholar
  56. Link, B.G., & Phelan, J.C. (2001). On stigma and its public health implications. U.S. NIH Stigma and Global Health Conference.Google Scholar
  57. Marks, G., & Crepaz, N. (2001). HIV-positive men's sexual practices in the context of self-disclosure of HIV status. Journal of Acquired Immune Deficiency Syndromes, 27, 79–85.PubMedGoogle Scholar
  58. Marks, G., Richardson, J.L., Crepaz, N., Stoyanoff, S., Milam, J., Kemper, C., et al. (2002). Are HIV care providers talking with patients about safer sex and disclosure? A multi-clinic assessment. AIDS, 16, 1953–1957.PubMedCrossRefGoogle Scholar
  59. Md. Code Ann. Health-Gen. I § 18-601.1 (LEXIS through 2004 Regular and Special sessions with changes and corrections through April 25, 2005).Google Scholar
  60. Mich. Comp. Laws § 333.5210 (LEXIS through P.A. 103, 7/21/05).Google Scholar
  61. Miller, C.T., & Kaiser, C.R. (2001). A theoretical perspective on coping with stigma. Journal of Social Issues, 57, 73–92.CrossRefGoogle Scholar
  62. Mo. Ann. Stat. § 191.677 (West, LEXIS through all 2004 legislation).Google Scholar
  63. N. D. Cent. Code § 12.1-20-17 (LEXIS through the 2005 session).Google Scholar
  64. N. J. Stat. Ann. § 2C:34-5 (West, LEXIS current through P.L. 2005 Chapter 114).Google Scholar
  65. Nev. Rev. Stat. Ann. § 201.205 (Michie, NEXIS through the 21st Special session 2004).Google Scholar
  66. Niccolai, L.M., Dorst, D., Myers, L., & Kissinger, P.J. (1999). Disclosure of HIV status to sexual partners: predictors and temporal patterns. Sexually Transmitted Diseases, 26, 281–285.PubMedCrossRefGoogle Scholar
  67. 92 Op. Att’y Gen. Kan. 29 (1992).Google Scholar
  68. O’Brien, M.E., Richardson-Alston, G., Ayoub, M., Magnus, M., Peterman, T.A., & Kissinger, P. (2003). Prevalence and correlates of HIV serostatus disclosure. Sexually Transmitted Diseases, 30, 731–735.PubMedCrossRefGoogle Scholar
  69. Ohio Rev. Code Ann. § 2903.11 (Anderson, LEXIS legislation passed by the 126th Ohio General Assembly 2004).Google Scholar
  70. 21 Okla. Stat. § 1192.1 (LEXIS through all 2004 legislation).Google Scholar
  71. Pilcher, C.D., Tien, H.C., Eron, J.J. V.P.L. Jr., Leu, S.Y., Stewart, P.W., Goh, L.E., et al. (2004). Brief but efficient: acute HIV infection and the sexual transmission of HIV. Journal of Infectious Diseases, 189, 1785–1792.PubMedCrossRefGoogle Scholar
  72. Pinkerton, S.D., & Abramson, P.R. (1997). Effectiveness of condoms in preventing HIV transmission. Social Science and Medicine, 9, 1303–1312.Google Scholar
  73. Ranucci, M.B., & Vosvick, M. (2004). Stigma, coping, pessimism, and symptom load: covariates of depression in men and women with HIV/AIDS. 25th Annual Meeting of the Society of Behavior Medicine, Abstract C-8.Google Scholar
  74. S. C. Code Ann. § 44-29-145 (Law. Co-op., LEXIS through all legislation enacted in 2004).Google Scholar
  75. S.D. Codified Laws §§ 22-18-31 – 22-18-34 (Michie, LEXIS through all 2005 legislation).Google Scholar
  76. Scherbarth, A., & Vosvick, M. (2004). HIV-related stigma, forgiveness and quality of life in a diverse HIV+ population. 25th Annual Meeting of the Society of Behavior Medicine. Abstract: Paper Session #5.Google Scholar
  77. Schulman, D. (1988). Remembering who we are: AIDS and law in a time of madness. AIDS and Public Policy, 3, 75–78.Google Scholar
  78. Shevory, T. (2004). Notorious HIV: the media spectacle of Nushawn Williams. Minneapolis: University of Minnesota Press.Google Scholar
  79. Shriver, M.D., Everett, C., & Morin, S.F. (2000). Structural interventions to encourage primary HIV prevention among people living with HIV. AIDS, 14(Suppl. 1), S57–S62.PubMedCrossRefGoogle Scholar
  80. Sobo, E.J. (1995). Choosing Unsafe Sex. AIDS-Risk denial among disadvantaged women. Philadelphia, PA: University of Pennsylvania Press.Google Scholar
  81. Sobo, E.J. (1997). Self-disclosure and self-construction among HIV-positive people: The rhetorical uses of stereotypes and sex. Anthropology and Medicine, 4, 67–87.CrossRefGoogle Scholar
  82. Sowell, R.L., Seals, B.F., Phillips, K.D., & Julius, C.H. (2003). Disclosure of HIV infection: how do women decide to tell? Health Education Research, 18, 32–44.PubMedCrossRefGoogle Scholar
  83. State v. Roberts, 844 So. 2d 263 (La. App. 2003).Google Scholar
  84. Stein, M.D., Freedberg, K.A., Sullivan, L.M., Savetsky, J., Levenson, S.M., Hingson, R., et al. (1998). Sexual ethics: disclosure of HIV-positive status to partners. Archives of Internal Medicine, 158, 253–257.PubMedCrossRefGoogle Scholar
  85. Sweat, M.D., & Denison, J.A. (1995). Reducing HIV incidence in developing countries with structural and environmental interventions. AIDS, 9(Suppl. A), S251–S257.PubMedGoogle Scholar
  86. Tenn. Code Ann. § 39-13-109 (LEXIS current through the 2004 session).Google Scholar
  87. Tindall, B., & Tillett, G. (1990). HIV-related discrimination. AIDS, 4(suppl. 1), S251–S256.PubMedGoogle Scholar
  88. UNAIDS. (2002). Criminal law, public health and HIV transmission: a policy options paper. UNAIDS, 1–48.Google Scholar
  89. United States Public Health Service (1986). Surgeon General's report on acquired immune deficiency syndrome. Office of the Surgeon General Official Report, 1–36.Google Scholar
  90. United States Public Health Service and CDC (1988). Understanding AIDS. office of the Surgeon General Official report, 1–7.Google Scholar
  91. United States Public Health Service (1992). Surgeon General's report to the American public on HIV infection and AIDS. Surgeon General Official Report, 1–26.Google Scholar
  92. Va. Code Ann. § 18.2-11 (Michie, LEXIS through the 2005 regular session, Acts 2005, cc. 1 to 951).Google Scholar
  93. Va. Code Ann. § 18.2-67.4:1 (Michie, LEXIS through the 2005 regular session, Acts 2005, cc. 1 to 951).Google Scholar
  94. Valdiserri, R.O. (2002). HIV/AIDS stigma: an impediment to public health. American Journal of Public Health, 92, 341–342.PubMedCrossRefGoogle Scholar
  95. Wash. Rev. Code Ann. § 9A.36.011 (West, LEXIS through 2004 General Election (2005 c 2)).Google Scholar
  96. Wolitski, R.J., Rietmeijer, C.A.M., Goldbaum, G.M., & Wilson, R.M. (1998). HIV serostatus disclosure among gay and bisexual men in four American cities: general patterns and relation to sexual practices. AIDS Care, 10, 599–610.PubMedCrossRefGoogle Scholar
  97. Wolf, L.E., & Vezina, R. (2004). Crime and punishment: is there a role for criminal law in HIV prevention policy? Whittier Law Review, 25, 821–886.Google Scholar
  98. Woods, D.R., Davis, D., & Westover, B.J. (1991). “America responds to AIDS”: its content, development process and outcome. Public Health Reports, 106, 616–622.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR)Medical College of WisconsinMilwaukeeUSA

Personalised recommendations