A quantitative study of the impact of a US state

criminal HIV disclosure law on state residents living

with HIV

Carol Galletly, JD PhDCenter for AIDS Intervention Research

Medical College of Wisconsin

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Michigan’s criminal HIV disclosure law

A person who knows that he or she … is HIV infected, and who engages in sexual penetration with another person without having first informed the other person that he or she … is HIV infected, is guilty of a felony.

Michigan’s criminal HIV disclosure law

“sexual penetration” means sexual intercourse, cunnilingus, fellatio, anal intercourse, or any other intrusion, however slight, of any part of a person’s body or of any object into the genital or anal openings of another person’s body, but emission of semen is not required.

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Research questions…

1. Awareness

Are state residents who are living with HIV aware of this law? Do they understand it?

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Research Questions

2. Effectiveness

Does the law increase seropositive status disclosure?Does the law decrease HIV transmission risk?

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Research Questions

3. Harm

Does the law serve as an inadvertent disincentive to disclose?

Does the law increase HIV-related stigma (felt stigma) or perc’d hostility toward PLWH?

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Research Questions

4. Stance on criminalization

Do participants support/oppose criminalization?

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Aware of the law?

384 HIV+ residents of Michigan participated

292 (76%) were aware of the law

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Is the law effective?

Awareness of the law was not associated with compliance or abstinence

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Is the law effective?

However, just over half of all law-aware participants reported that they believed the law made it more likely that PLWH would disclose to sex partners

This belief was associated with compliance (p. = .022)

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Is the law effective?

Also, a majority of sexually active, law-aware participants reported that the law was very important in their decision to disclose.

Self-reported importance of the law was associated with compliance (p. = .042)

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Is the law harmful?

Comfort with disclosure or being identified as PLWH

Perceived hostility toward PLWH

HIV-related stigma was inversely associated with awareness of the law

n/s

n/s

inverse association (p. = .034)

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Stance on criminalization

Oral sex with an uninformed partner 64% supported criminalization

Unprotected sex with an uninformed partner 88% supported criminalization

Condom-protected sex with an uninformed partner 51% supported criminalization

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Associations with support for criminalization

Being a womanBeing nonwhiteHaving less educationHaving a lower income

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Summary

Aware? …in Michigan Effective? …no independent effect,

however some findings were consistent with an effect of the law…

Inclined to disclose? Harmful? …no independent effect Stance? …surprising support for

criminalization

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Conclusions

First do no harm…

Note the characteristics of persons who support criminalization…

Are we meeting their needs? Did we prepare them?Do we support them?

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This research was made possible by…

A grant from the NIMH (R21)

The support of mentors, colleagues, and reviewers

Participants living with HIV in Michigan…

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