Awareness and Understanding of HIV Non-disclosure Case Law and the Role of Healthcare Providers in Discussions About the Criminalization of HIV Non-disclosure Among Women Living with HIV in Canada


In 2012, the Supreme Court of Canada ruled that people with HIV are legally obligated to disclose their serostatus before sex with a “realistic possibility” of HIV transmission, suggesting a legal obligation to disclose unless they use condoms and have a low HIV viral load (< 1500 copies/mL). We measured prevalence and correlates of ruling awareness among 1230 women with HIV enrolled in a community-based cohort study (2015–2017). While 899 (73%) participants had ruling awareness, only 37% were both aware of and understood ruling components. Among 899 aware participants, 34% had never discussed disclosure and the law with healthcare providers, despite only 5% being unwilling to do this. Detectable/unknown HIV viral load, lack of awareness of prevention benefits of antiretroviral therapy, education ≤ high-school and high HIV-related stigma were negatively associated with ruling awareness. Discussions around disclosure and the law in community and healthcare settings are warranted to support women with HIV.


En 2012, la Corte Suprema de Canadá dictaminó que las personas con VIH están legalmente obligadas a revelar su estado serológico antes de tener relaciones sexuales con una “posibilidad realista” de transmisión del VIH, lo que sugiere una obligación legal de divulgar a menos que usen condones y tengan una carga viral baja (< 1500 copias/mL). Medimos la prevalencia y los correlatos de la conciencia dominante entre 1230 mujeres con VIH inscritas en un estudio de cohorte basado en la comunidad (2015–2017). Si bien 899 (73%) de los participantes tenían conciencia sobre el gobierno, solo el 37% conocía y entendía los componentes dominantes. Entre los 899 participantes conscientes, el 34% nunca había discutido la divulgación y la ley con los proveedores de atención médica, a pesar de que solo el 5% no estaba dispuesto a hacerlo. La carga viral del VIH detectable/desconocida, la falta de conciencia de los beneficios de prevención de la terapia antirretrovírica, la educación en la escuela secundaria y el alto estigma relacionado con el VIH se asociaron negativamente con la conciencia dominante. Las discusiones sobre la divulgación y la ley en entornos comunitarios y de atención médica están justificadas para apoyar a las mujeres con VIH.

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  1. 1.

    Insight Start Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. N Engl J Med. 2015;373:795.

  2. 2.

    Samji H, Cescon A, Hogg RS, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE. 2013;8(12):e81355.

  3. 3.

    Forbes JC, Alimenti AM, Singer J, et al. A national review of vertical HIV transmission. AIDS. 2012;26(6):757–63.

  4. 4.

    Bujan L, Pasquier C. People living with HIV and procreation: 30 years of progress from prohibition to freedom? Hum Reprod. 2016;31(5):918–25.

  5. 5.

    Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral Therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375(9):830–9.

  6. 6.

    Carr RL, Gramling LF. Stigma: a health barrier for women with HIV/AIDS. J Assoc Nurses AIDS Care. 2004;15(5):30–9.

  7. 7.

    Moyer E, Hardon A. A disease unlike any other? Why HIV remains exceptional in the age of treatment. Med Anthropol. 2014;33(4):263–9.

  8. 8.

    Turan J, Nyblade L. HIV-related stigma as a barrier to achievement of global PMTCT and maternal health goals: a review of the evidence. AIDS Behav. 2013;17(7):2528–39.

  9. 9.

    MacIntosh J. HIV/AIDS stigma and discrimination: a canadian perspective and call to action. Interam J Psychol. 2007;41(1):93–102.

  10. 10.

    Ho S, Hollowa A. The impact of HIV-related stigma on the lives of HIV-positive women: an integrated literature review. J Clin Nurs. 2016;25(1–2):8–19.

  11. 11.

    Amin A. Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV. JIAS. 2015;18(supplement 5):20302.

  12. 12.

    Burris S, Cameron E. The case against criminalization of HIV transmission. JAMA. 2008;300(5):578–81.

  13. 13.

    Jurgens R, Cohen J, Cameron E, et al. Ten reasons to oppose the criminalization of HIV exposure or transmission. Reprod Health Matters. 2009;17(34):163–72.

  14. 14.

    The Global Network of People Living with HIV (GNP +). The Global Criminalization Scan Report 2010.

  15. 15.

    Mykhalovskiy E. The public health implications of HIV criminalization: past, current, and future research directions. Crit Public Health. 2015;25(4):373–85.

  16. 16.

    Patterson S, Milloy M-J, Ogilvie G, et al. 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. JIAS. 2015;18(1):20572.

  17. 17.

    Mykhalovskiy E. The problem of “significant risk”: exploring the public health impact of criminalizing HIV non-disclosure. Soc Sci Med. 2011;73(5):668–75.

  18. 18.

    O’Byrne P, Bryan A, Roy M. HIV criminal prosecutions and public health: an examination of the empirical research. Med Hum. 2013;39(2):85–90.

  19. 19.

    UNAIDS. The Gap Report 2014.

  20. 20.

    Rhode D. Feminist critical theories. Stanford Law Rev. 1990;42(3):617–38.

  21. 21.

    Logie CH, James L, Tharao W, Loutfy MR. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS Med. 2011;8(11):e1001124.

  22. 22.

    Obermeyer CM, Baijal P, Pegurri E. Facilitating HIV disclosure across diverse settings: a review. Am J Public Health. 2011;101(6):1011–23.

  23. 23.

    World Health Organization. Gender dimensions of HIV status disclosure to sexual partners: rates, barriers and outcomes 2004.

  24. 24.

    Mackinnon E, Cromptom C. The gender of lying: feminist perspectives on the non-disclosure of HIV status. UBC Law Rev. 2012;45(2):407–47.

  25. 25.

    Fekete E, Williams S, Skintac M, Boguscha L. Gender differences in disclosure concerns and HIV-related quality of life. AIDS Care. 2016;28(4):450–4.

  26. 26.

    Adam BD, Corriveau P, Elliott R, Globerman J, English K, Rourke S. HIV disclosure as practice and public policy. Crit Public Health. 2015;25(4):386–97.

  27. 27.

    Kapiriri L, Tharao W, Muchenje M, Masinde KI, Ongoiba F, et al. They should understand why’ the knowledge, attitudes and impact of the HIV criminalisation law on a sample of HIV + women living in Ontario. Global Public Health. 2016;11:1231.

  28. 28.

    Greene S, Symington A, Ion A, Carvalhal A & Loutfy M. Judging mothers: criminalization’s creep into the health and social care of HIV-positive mothers. Poster 213. 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR); St John’s, Newfoundland. 2014.

  29. 29.

    Loutfy MR, Sherr L, Sonnenberg-Schwan U, et al. Caring for women living with HIV: gaps in the evidence. J Int AIDS Soc. 2013;16:18509.

  30. 30.

    Loutfy MR, Sonnenberg-Schwan U, Margolese S, Sherr L. Women for positive action. A review of reproductive health research, guidelines and related gaps for women living with HIV. AIDS Care. 2013;25(6):657–66.

  31. 31.

    Aziz M, Smith K. Treating women with HIV: is it different than treating men? Curr HIV/AIDS Rep. 2012;9:171–8.

  32. 32.

    Monforte A, Anderson J, Olczak A. What do we know about antiretroviral treatment of HIV in women? Antiv Ther. 2013;18(sup 2):27–34.

  33. 33.

    Khosla P, Ion A & Greene S. SUPPORTING MOTHERS IN WAYS THAT WORK: A Resource Toolkit for Service Providers Working with Mothers Living with HIV Hamilton, Ontario: The HIV Mothering Study Team, The Ontario Women’s HIV/AIDS Initiative (WHAI); 2016 [Available from:

  34. 34.

    Aziz M, Smith K. Challenges and successes in linking HIV-infected women to care in the United States. Clin Infect Dis. 2011;52(suppl 2):231–7.

  35. 35.

    Schafer K, Brant J, Gupta S, et al. Intimate partner violence: a predictor of worse HIV outcomes and engagement in care. AIDS Patient Care STDs. 2012;26(6):356–65.

  36. 36.

    Logie C, James L, Tharao W, Loutfy M. ‘‘We don’t exist’’: a qualitative study of marginalization experienced by HIV-positive lesbian, bisexual, queer and transgender women in Toronto, Canada. JIAS. 2012;15(2):10.

  37. 37.

    Colley G, Cescon A, Raboud J et al. Continuum of HIV Treatment in Canada, 2003–2012 [Oral Presentation: O042]. 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR 2014); St John’s, Newfoundland, Canada 2014.

  38. 38.

    Lourenco L, Colley G, Nosyk B, et al. High levels of heterogeneity in the HIV cascade of care across different population subgroups in British Columbia, Canada. PLoS ONE. 2014;9(12):e115277.

  39. 39.

    Palmer AK, Cescon A, Chan K, et al. Factors associated with late initiation of highly active antiretroviral therapy among young HIV-positive men and women aged 18 to 29 years in Canada. J Int Assoc Provid AIDS Care. 2014;13(1):56–62.

  40. 40.

    Cescon A, Patterson S, Davey C, et al. Late initiation of combination antiretroviral therapy in Canada: a call for a national public health strategy to improve engagement in HIV care. J Int AIDS Soc. 2015;18(1):20024.

  41. 41.

    Carter A, Min JE, Chau W, et al. Gender inequities in quality of care among HIV-positive individuals initiating antiretroviral treatment in British Columbia, Canada (2000–2010). PLoS ONE. 2014;9(3):e92334.

  42. 42.

    Tapp C, Milloy MJ, Kerr T, et al. Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare. BMC Infect Dis. 2011;11:86.

  43. 43.

    Puskas CM, Forrest JI, Parashar S, et al. Women and vulnerability to HAART non-adherence: a literature review of treatment adherence by gender from 2000 to 2011. Curr HIV/AIDS Rep. 2011;8(4):277–87.

  44. 44.

    Samji H, Taha T, Moore D, et al. Predictors of unstructured antiretroviral treatment interruption and resumption among HIV-positive individuals in Canada. HIV Med. 2015;16(2):76–87.

  45. 45.

    Raboud J, Blitz S, Walmsley S, Thompson C, Rourke SB, Loutfy MR. Effect of gender and calendar year on time to and duration of virologic suppression among antiretroviral-naive HIV-infected individuals initiating combination antiretroviral therapy. HIV Clin Trials. 2010;11(6):340–50.

  46. 46.

    Cescon A, Patterson S, Chan K, et al. Gender differences in clinical outcomes among HIV-positive individuals on antiretroviral therapy in Canada: a multisite cohort study. PLoS ONE. 2013;8(12):e83649.

  47. 47.

    Patterson S, Cescon A, Samji H, et al. Life expectancy of HIV-positive individuals on combination antiretroviral therapy in Canada. BMC Infect Dis. 2015;15:274.

  48. 48.

    Logie C, Tharao W, Loutfy M. Structural barriers and legal challenges experienced by diverse women living with HIV in Ontario, Canada [oral presentation]. OHTN Research Conference; 2013; Toronto, 2013.

  49. 49.

    Bernard E, Bennett-Carlson R. Criminalization of HIV non-disclosure, exposure and transmission: background and current landscape. Geneva: UNAIDS; 2012.

  50. 50.

    Canadian HIV/AIDS legal network. The criminalization of HIV non-disclosure in Canada and internationally, 2014.

  51. 51.

    Canadian HIV/AIDS Legal Network. Consent: HIV non-disclosure and sexual assault law. Ontario, 2015.

  52. 52.

    Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

  53. 53.

    Grulich A, Bavinton B, Jin F et al. HIV Transmission in Male Serodiscordant Couples in Australia, Thailand and Brazil [Oral presentation: 1019LB]. Conference on retroviruses and opportunistic infections; Seattle, Washington, 2015.

  54. 54.

    Rodger A, Cambiano V, Bruun T et al. HIV transmission risk through condomless sex If HIV + partner on suppressive art: partner study. Conference on retroviruses and opportunistic infections (CROI); Boston, 2014.

  55. 55.

    Provincial Court of Nova Scotia. R. v. J.T.C., 2013 NSPC 105. 2013.

  56. 56.

    AIDS Action Now. Supreme Court decisions increase risk of violence, coercion & criminalization against women with HIV 2012.

  57. 57.

    Patterson S, Kaida A, Nguyen P, et al. Prevalence and predictors of facing a legal obligation to disclose HIV serostatus to sexual partners among a cohort of people living with HIV who inject drugs in a Canadian setting: a cross sectional analysis. CMAJ Open. 2016;4(2):169–76.

  58. 58.

    Loutfy M. A clinician’s perspective on the criminalization of women living with HIV CATIE2014.

  59. 59.

    Loutfy M, Tyndall M, Baril JG, Montaner JS, Kaul R, Hankins C. Canadian consensus statement on HIV and its transmission in the context of criminal law. Can J Infect Dis Med Microbiol. 2014;25(3):135–40.

  60. 60.

    Kazatchkine C, Bernard E, Eba P. Ending overly broad HIV criminalization: Canadian scientists and clinicians stand for justice. J Int AIDS Soc. 2015;18:20126.

  61. 61.

    Kazatchkine C, Gervais L. Canada’s newest sex offenders. Winnipeg: Winnipeg Free Press; 2016.

  62. 62.

    Symington A. Focus: R v Mabior and R v DC: injustice amplified by HIV non-disclosure ruling. Univ Toronto Law J. 2013;63(3):485–95.

  63. 63.

    Feder E. Panel asks how HIV criminalization affects positive women. Daily Xtra. 2014.

  64. 64.

    James A. Activists gather to protest trial of woman with HIV facing criminal charges. The Barrie Examiner. 2013.

  65. 65.

    Canadian HIV/AIDS Legal Network, HIV/AIDS Legal Clinic Ontario, Coalition des organismes communautaires québécois de lutte contre le sida, Positive Living Society of British Columbia, Canadian AIDS Society, Toronto People with AIDS Foundation, et al. Unjust Supreme Court ruling on criminalization of HIV major step backwards for public health and human rights. Statement from the Canadian HIV/AIDS Legal Netork 2012.

  66. 66.

    Meuse M. HIV disclosure laws endanger women says B.C. Civil Liberties Association British Columbia: CBC News; 2016.

  67. 67.

    Barré-Sinoussi F, Karim SA, Albert J, et al. Expert consensus statement on the science of HIV in the context of criminal law. JIAS. 2018;21:e25161.

  68. 68.

    Public Health Agency of Canada. Estimates of HIV prevalence and incidence in Canada, 2014 Ottawa: Surveillance and Epidemiology Division and Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada.; 2015.

  69. 69.

    Public Health Agency of Canada. Population specific HIV/AIDS status report: Women 2012.

  70. 70.

    Shokoohi M, Bauer GR, Lacombe Duncan A et al. Social determinants of health and self-rated health status: a comparison between women living with HIV and women from the general population in Canada [Poster Presentation]. Canadian Conference on HIV/AIDS Research (CAHR); 2018; Vancouver, 2018.

  71. 71.

    Loutfy M, de Pokomandy A, Carter A, et al. Cohort profile: the Canadian HIV women’s sexual and reproductive health cohort study (CHIWOS). PLoS ONE. 2017;12(9):e0184708.

  72. 72.

    Israel B, Schulz A, Parker E, Becker A. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.

  73. 73.

    Kaida A, Carter A, Lemay J et al. Hiring, training, and supporting peer researchers: Operationalizing community-based research principles within epidemiological studies by, with, and for women living with HIV (Abstract O106, Oral). 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR 2014); St. John’s, Newfoundland, 2014.

  74. 74.

    Webster K, Carter A, Proulx-Boucher K, et al. Strategies for recruiting women living with human immunodeficiency virus in community-based research: lessons from Canada. Prog Community Health Partnersh. 2018;12(1):21–34.

  75. 75.

    Patterson S. The impact of HIV non-disclosure case law on the healthcare engagement of women living with HIV in Canada. Canada: Simon Fraser University; 2016.

  76. 76.

    Positive Living Society of British Columbia. Disclosure: Telling someone you are living with HIV Vancouver 2015.

  77. 77.

    Positive Women’s Network & BC Women’s Hospital and Health Centre. HIV disclosure: figuring out how to tell romantic and sexual partners 2015.

  78. 78.

    Positive Women’s Network & CATIE. HIV disclosure and the law, 2015.

  79. 79.

    Allard P, Kazatchkine C, Symington A. Criminal prosecutions for HIV non-disclosure: protecting women from infection or threatening prevention efforts? In: Gahagan J, editor. Women and HIV prevention in Canada: implications for research, policy and practice. Toronto: Women’s Press; 2013. p. 195–218.

  80. 80.

    Collins P. It’s all in the family: intersections of gender, race and nation. Hypatia. 1998;13(3):62–82.

  81. 81.

    Wright K, Naar-King S, Lam P, Templin T, Frey M. Stigma scale revised: reliability and validity of a brief measure of stigma for HIV + youth. J Adolesc Health. 2007;40(1):96–8.

  82. 82.

    Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.

  83. 83.

    Carter A SP, Nohpal A, Colley G et al. Validating self-report of undetectable viral load against laboratory plasma viral load measures in a multi-site cohort of women living with HIV in British Columbia. 24th Canadian Association of HIV Research (CAHR) Conference; Toronto, Ontario, 2015 (Abstract EPH112, Poster).

  84. 84.

    Patterson S, Kaida A, Ogilvie G, et al. Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting. Int J Drug Policy. 2017;43:113–21.

  85. 85.

    Medjuck M, Seatter E, Summers M & Sangam G. The criminalization of HIV non disclosure: what does it mean for policy and practice for a women-specific ASO? [Poster presentation: SS71]. 24th Annual Canadian Conference on HIV/AIDS research (CAHR); Toronto, Ontario, 2015.

  86. 86.

    Montaner M, Pacey K, Pelltier L, Tyndall M & Shannon K. HIV disclosure laws within a criminalized sex industry: the failure of prevention strategies and policy to protect the basic human rights of sex workers. Oral presentation THAE0305. AIDS 2008; Mexico City; 2008.

  87. 87.

    Greene S, Odhiambos J, Muchenje M et al. “How do you prove that you told?”: how women living with HIV react and respond to learning about Canadian law that criminalizes HIV non-disclosure. Cult Health Sex. 2019.

  88. 88.

    Savage S, Braund R, Stewart T. The effect of R v. Mabior on HIV/AIDS service provision. Poster 208. 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR); St John’s, Newfoundland, 2014.

  89. 89.

    Galletly CL, Pinkerton SD, DiFranceisco W. A quantitative study of Michigan’s criminal HIV exposure law. AIDS Care. 2012;24(2):174–9.

  90. 90.

    Mahajan AP, Sayles JN, Patel VA, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.

  91. 91.

    Montaner JS, Lima VD, Barrios R, et al. Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study. Lancet. 2010;376(9740):532–9.

  92. 92.

    Supreme Court of Canada. R. v. Mabior. 2 S.C.R. 584 2012.

  93. 93.

    Wawrzyniak AJ, Ownby RL, McCoy K, Waldrop-Valverde D. Health literacy: impact on the health of HIV-infected individuals. Curr HIV/AIDS Rep. 2013;10(4):295–304.

  94. 94.

    Adam B, Elliot R, Corriveau P, Travers R, English K. How criminalization is affecting people living with HIV in Ontario 2012.

  95. 95.

    Cain R, Collins E, Bereket T, et al. Challenges to the involvement of people living with HIV in community-based HIV/AIDS organizations in Ontario, Canada. AIDS Care. 2014;26(2):263–6.

  96. 96.

    Pacific AIDS Network. HIV & the Law: Resources for People Living with HIV 2016.

  97. 97.

    Carter A, Greene S, Nicholson V, et al. Breaking the glass ceiling: increasing the meaningful involvement of women living with HIV/AIDS (MIWA) in the design and delivery of HIV/AIDS services. Health Care Women Int. 2015;36(8):936–64.

  98. 98.

    O’Byrne P, Gagnon M. HIV criminalization and nursing practice. Aporia. 2012;4(2):5–34.

  99. 99.

    Positive Women’s Network & BC Women’s Hospital and Health Centre. HIV disclosure: how health care and social service providers can support positive people, 2015.

  100. 100.

    Pacific AIDS Network. HIV and the law: resources for service providers, 2016.

  101. 101.

    Canadian HIV/AIDS Legal Network. Disclosure of HIV status after cuerrier: resources for community based AIDS organizations, 2004.]content/uploads/2013/11/Disclosure+After+Cuerrier+Resource+Guide+-+ENG.pdf.

  102. 102.

    Canadian HIV/AIDS Legal Network. HIV disclosure and the law: a resource kit for service providers 2012.

  103. 103.

    Gagnon M. Legal and clinical implications of HIV non disclosure: a practical guide for HIV nurses in Canada. 2013.

  104. 104.

    Loutfy MR, Margolese S, Money DM, Gysler M, Hamilton S, Yudin MH. Canadian HIV pregnancy planning guidelines: No. 278, June 2012. Int J Gynaecol Obstetr. 2012;119(1):89–99.

  105. 105.

    Mallinson R, Rajabiun S, Coleman S. The provider role in client engagement in HIV care. AIDS Patient Care STDs. 2007;21(s1):77–84.

  106. 106.

    Sohler N, Li X, Cunningham C. Gender disparities in HIV health care utilization among the severely disadvantaged: can we determine the reasons? AIDS Patient Care STDs. 2009;23(9):775–83.

  107. 107.

    Tatham C. Sexuality, prevention work & the criminalization of non-disclosure of HIV. Poster 209. 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR); St John’s, Newfoundland, 2014.

  108. 108.

    O’Byrne P, Bryan A, Woodyatt C. Nondisclosure prosecutions and HIV prevention: results from an Ottawa-based gay men’s sex survey. J Assoc Nurses AIDS Care. 2013;24(1):81–7.

  109. 109.

    O’Byrne P, Bryan A, Roy M. Sexual practices and STI/HIV testing among gay, bisexual and men who have sex with men in Ottawa, Canada: examining nondisclosure prosecutions and HIV prevention. Crit Public Health. 2013;23(2):225–36.

  110. 110.

    Sanders C. Discussing the limits of confidentiality: the impact of criminalizing HIV nondisclosure on public health nurses’ counseling practices. Public Health Ethics. 2014;7(3):253–60.

  111. 111.

    Amon J. The, “Right to Know” or “know your rights”? Human rights and a people-centred approach to Health Policy. In: Biehl J, Petryna A, editors. When people come first: critical studies in global health. Princeton: Princeton University Press; 2013. p. 91–108.

  112. 112.

    Ahmed A, Kaplan M, Symington A, Kismodi E. Criminalising consensual sexual behaviour in the context of HIV: consequences, evidence, and leadership. Glob Public Health. 2011;6(Suppl 3):S357–69.

  113. 113.

    The Center for Reproductive Rights, Canadian HIV/AIDS Legal Network, Catholics for Choice, Center for Health and Gender Equity (CHANGE), Fundación para Estudio e Investigación (FEIM), International AIDS Women’s Caucus, et al. Joint Statement to Commission on the Status of Women, 54th Session re: Criminal Legislation that Contravenes the Beijing Platform for Action 2010.

  114. 114.

    Ahmed A, Hanssens C, Kelly B. Protecting HIV-positive women’s human rights: recommendations for the United States National HIV/AIDS strategy. Reprod Health Matters. 2009;17(34):127–34.

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The authors would like to thank all CHIWOS participants for giving their time and voices to this study. CHIWOS is funded by the Canadian Institutes of Health Research (CIHR), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund. SP received support in the form of a Study Abroad Studentship from the Leverhulme Trust, AC received support from a CIHR Doctoral Award, AdP received salary support through the Fonds de Recherche du Quebéc—Santé (FRQS) (Chercheur-boursier clinicien), and AK received salary support through a Tier 2 Canada Research Chair in Global HIV and Sexual and Reproductive Health. M-JM is supported by the United States National Institutes of Health (U01-DA0251525), a New Investigator award from CIHR and a Scholar award from the Michael Smith Foundation for Health Research. His institution has received an unstructured gift from NG Biomed Ltd., a private firm seeking to produce medical cannabis, to support him. He is the Canopy Growth professor of cannabis science, a position created by arms’ length gifts to the University of British Columbia by Canopy Growth, a licensed producer of cannabis, and the Government of British Columbia’s Ministry of Mental Health and Addictions.

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Appendix A

Appendix A

Brief definition of 2012 SCC ruling discussed with all participants answering CHIWOS survey questions on the criminalization of HIV non-disclosure.

In Canada, people living with HIV can face criminal charges for not telling their sexual partners what their HIV status is, even if they do not intend to transmit HIV, and even if no HIV transmission actually occurs. In 2012, the Supreme Court of Canada ruled that people living with HIV must disclose their HIV status to a sexual partner before having sex unless they use condoms AND have a viral load of 1500 copies/mL or less. People who do not meet these criteria can face a criminal charge of aggravated sexual assault if they do not tell their sexual partners they have HIV. To summarize, people living with HIV are legally required to disclose their HIV status to sex partners UNLESS they use a condom AND have a viral load less than 1500 copies/mL.”

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Patterson, S., Nicholson, V., Milloy, M. et al. Awareness and Understanding of HIV Non-disclosure Case Law and the Role of Healthcare Providers in Discussions About the Criminalization of HIV Non-disclosure Among Women Living with HIV in Canada. AIDS Behav 24, 95–113 (2020) doi:10.1007/s10461-019-02463-2

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  • HIV
  • Women
  • Criminalization of HIV non-disclosure
  • Canada
  • Community based research