Showing posts with label criminalized. Show all posts
Showing posts with label criminalized. Show all posts

Wednesday, January 27, 2016

Injections, Infections, Condoms, and Care: Thoughts on Negligence and HIV Exposure

Many states have criminal statutes specifically criminalizing the transmission of the Human Immunodeficiency Virus (HIV). This Note argues that tort, rather than criminal, law should regulate the wrongful transmission of HIV/AIDS. The Note then examines the applicability of various tort doctrines to the peculiar problems presented by this particularly notorious plague, including assumption of the risk and disclosures.

In his groundbreaking work on the Acquired Immune Deficiency Syndrome (AIDS) epidemic’s early days, journalist Randy Shilts recounts the chilling story of the man believed1 by many to be the epidemic’s North American “Patient Zero”: Ga¨etan Dugas, an Air Canada flight attendant.2 Dugas, whose work provided him with free air travel across the globe, gained a reputation for peculiar post-coital activity While turning up the lights, Dugas pointed out lesions on his body and told his partners, “I’ve got gay cancer. . . . I’m going to die and so are you.”3 Dugas’s behavior—the careless, shameless, and intentional spread of a frightful, then-fatal disease—represented an unsavory stereotype for homosexuals and terrified heterosexual, polite society.

In the years that followed, understandings of this new “gay cancer” evolved. Scientists across the nation renamed the disease Acquired Immune Deficiency Syndrome (AIDS) and discovered its methods of progression and transmission. Fear, however, remained the epidemic’s signature trait. Fear was the foundation for wild-eyed calls for quarantine,4 widespread discrimination against those living with AIDS (and those who have died because of it),5 and laws criminalizing transmission and exposure to HIV.

More than half of U.S. states have laws criminalizing transmission of HIV. Generally, the laws require HIV-positive individuals to disclose that they are HIV-positive to their sexual partner prior to sexual activity. Iowa’s statute takes the somewhat unusual construction of illegalizing HIV exposure but naming disclosure as an affirmative defense.6 However, not all of the statutes require disclosure. Alabama’s, for example, apparently regards disclosure as irrelevant. It facially disallows any sexual contact leading to infection.7 Regardless of their specific constructions, these statutes impose criminal sanctions on HIV-positive individuals for the perceived risk presented by what is called their “serostatus”—the quality of being either HIV-positive or HIV-negative.

The application of such criminal statutes results in convictions like that of Nick Rhoades, an Iowa man whose viral load was reduced through avid treatment to undetectable levels, which greatly reduced his chances of transmitting the virus.8 Rhoades—who used a condom during the incident in question—was sentenced to twenty-five years in prison on the basis of a single sexual encounter because he did not disclose his HIV-positive status to his sexual partner.9 Though Rhoades did not infect his sexual partner, he was still convicted.10 The Iowa statute specifically notes that actual transmission is not required for criminal sanctions; merely the possibility that transmission could occur is sufficient.11 On the other hand, cases like Nushawn Williams’s—who infected more than ten sexual partners, allegedly with the intention of transmitting the HIV virus12—lead to hysteria and support for criminal statutes regarding HIV exposure.13 In reality, intentional infections are exceedingly rare, though when they occur (or allegedly occur), they are widely and notoriously reported,14 further warping public understanding of the issue.


This Note argues that criminal sanctions, by virtue of the societal reproof inhering in them and their rigid application in comparison to tort liability, are an inappropriate response to the problem of HIV exposure…

Full PDF article at:   http://goo.gl/mHdRgQ

By:  Dustin J. Lee*
* J.D. Candidate, Cornell Law School, 2016



Friday, October 30, 2015

Structural Determinants of Dual Contraceptive Use among Female Sex Workers in Gulu, Northern Uganda

To describe the characteristics of female sex workers (FSWs) who do and do not use dual contraceptives (i.e. male condoms plus a non-barrier method) in Gulu, northern Uganda.

The present analysis was based on data gathered as part of a questionnaire-based, cross-sectional study conducted between May 2011 and January 2012. FSWs aged 14years or older were recruited through peer-led or sex worker-led outreach and community-based services. Logistic regression was used to identify correlates of dual contraceptive use.

Among the 400 FSWs who participated, 180 (45.0%) had ever used dual contraceptives. In the multivariate model, dual contraceptive use was positively associated with older age, prior unintended pregnancy, and HIV testing. Having to rush sexual negotiations owing to police presence was negatively associated with dual contraceptive use.

Although a history of unintended pregnancy and accessing HIV testing might promote contraceptive use, criminalized work environments continue to pose barriers to uptake of sexual and reproductive health services among FSWs in post-conflict northern Uganda. Integrated links between HIV and sexual health programs could support contraceptive uptake among FSWs.

Purchase full article at: http://goo.gl/RQmYsB

  • 1Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
  • 2The AIDS Support Organization, Gulu, Uganda.
  • 3Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. Electronic address: gshi@cfenet.ubc.ca.  


Thursday, October 22, 2015

Arresting HIV: Fostering Partnerships between Sex Workers and Police to Reduce HIV Risk and Promote Professionalization within Policing Institutions: A Realist Review

In many countries around the world sex work is criminalised and its regulatory control is therefore often in the hands of the police. In addition to the impact of this criminalised legal environment, much literature describes the negative impact that certain police practices can have on the ability of sex workers and the programs that work with sex workers to access essential HIV prevention, treatment, care and support services. This situation has resulted in persistent concentrated HIV epidemics among sex workers in many countries of the world. 

The need for multi-sector partnerships between police and HIV programs is increasingly recognised in various UN declarations and resolutions yet descriptions of the process or key ingredients required to actually establish and sustain these necessary partnerships between police and sex workers [or the programs that provide essential services to sex workers] are sparse. 

The paper seeks to establish key considerations and critical processes that are required to foster partnerships that if further investigated and scaled up, could result in an enhanced enabling environment for the provision of essential HIV services for sex workers around the globe. This paper is based on a realist review that investigated isolated examples of partnership formation between law enforcement and HIV programs working with sex workers. This methodology research is designed to work with complex social interventions and is based on the emerging 'realist' approach to evaluation. A realist review methodology was chosen given the paucity of relevant literature in this vein and the authors’ familiarity with the grey literature and relationships with experts who work in this sphere. 

The review found that political and police leadership, civil society strengthening and police reform in relation to HIV, are critical factors and key ingredients in changing the enabling environment in which sex work takes place to ensure that HIV prevention, individual and public health as well as HIV prevention and the promotion of human rights are the number one priority. 

Further research into this relationship is needed to provide evidence for effective HIV programming with police.

Full article at: http://goo.gl/nF8pwM

By:
Brigitte Tenni, Jenae Carpenter, Nicholas Thomson
The Nossal Institute for Global Health, Level 4, Alan Gilbert Building, 161 Barry St, The University of Melbourne, Carlton, Vic. 3010, Australia

Nicholas Thomson
Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, #5041, Baltimore, Maryland, 21205, United States of America