Class 13 - HIV Criminalization Flashcards
3 situations for HIV-specific criminal statutes or general criminal laws:
- unintentional HIV transmission
- perceived or potential HIV exposure, and/or
- non-disclosure of known HIV-positive status
UNAIDS and COCQ-SIDA condemns what?
actual and intentional transmission of HIV
2 ways to criminalize HIV
73 counties have HIV-specific criminal laws
39 countries used general criminal laws (i.e: Canada)
True or False
In Canada, people can be charged and prosecuted simply for not disclosing their status to their sexual partners
True
In Canada, no law explicitly imposes an duty to disclose before sex. This duty has been established by the Supreme Court.
What is the Supreme courts position?
Legal duty to disclose before sex that poses a “realistic possibility” of HIV transmission
Negated if the accused’s viral load at the time of sexual relations was low or undetectable AND condom protection was used.
In Canada, more than half convictions involved no HIV transmission.
What does this entail?
The person was found guilty of not disclosing their HIV status but there was no HIV transmission to their sexual partner
So in Canada the actual HIV transmission is not important when deciding if the person is guilty or not
Numerous cases involved a defendant with a low/undetectable viral load
Qb’s interpretations of what is a « realistic possibility of transmission »:
QC: VL<200 + treatment + VL testing 4-6 months «Case by case basis»
Qb’s interpretations of what is a “realistic possibility of transmission” is set by what/who?
Director of Criminal and Penal Prosecution (DCPP)
- they are not responsible for making criminal laws
- their criteria is not in the law; it is simply a position
- the hope is that a judge would be like we will not charge this person guilty because they meet the three criteria and thus realistic transmission is not possible = which is what the judge needs to decide on (realistic possibility of transmission)
Except for rare exception, disclosure of HIV status is ______
not mandatory
Why is it harmful to criminalize HIV?
Suppose to be treated like a public health matter but it is being treated like a crime
Barriers to HIV disclosure
Personal support
Employment
Education
Confidence
Emotional/ Sex life
(In)depedene: housing, financial, emotional, immigration
3 Generations of HIV/AIDS
Pre-1996: “You are going to die”
1996-2008: “You live, but it will be difficult”
After 2008: “You will live well, and you can no longer transmit HIV”
**In board terms, the period of diagnosis can affect the relationship of the person to the disease, to treatment, to the health care professionals, to mortality, and to many other aspects of life
what can nurses do to maintain a safe space for HIV patients?
Non judgmental + Open + Trusting = creating a safe space for disclosure and sharing
common tensions when it comes to nursing and HIV positive patients:
Tension: the criminal justice system influences provider practices and reasoning…
- Privilege vs. Limits to that privilege;
- Treatment vs. Autonomy;
What you think the patient should receive Tx versus what they want to do - Disclosure vs. No-Disclosure…
In the vast majority of cases, it is the choice of the person living with HIV to disclose or not; they have a right to confidentiality
why are medical records and its contained documentation very important in this context?
Medical records can be adduced as evidence
