A Multi-State Analysis of the Impact of HIV Exposure Laws

描述（由申请人提供）：美国有24个州有针对艾滋病毒的刑法，要求艾滋病毒感染者向潜在的性伴侣披露他们的阳性血清状态。此外，美国没有这些法律的州的立法者经常提出这样的立法。虽然这些法律的假定目的是增加对性伴侣的血清状态披露（假设知情的伴侣会弃权或采取更安全的性行为），但人们对其有效性知之甚少。人们对这些法律的潜在负面影响了解得更少，这些负面影响从阻碍艾滋病毒检测和破坏艾滋病毒预防的中心信息，到通过增加披露艾滋病毒阳性状况的潜在负面后果，促进艾滋病毒相关的耻辱和阻止（而不是促进）披露血清阳性状况。美国艾滋病毒信息披露法也采取了几种不同的形式，这带来了进一步的可变性和额外的法规具体问题。只有一项实证研究直接评估了美国艾滋病毒信息披露法对艾滋病毒感染者的影响。这项研究是在密歇根州进行的，该州有艾滋病毒披露法，由拟议项目的PI进行。没有直接的实证研究考察了法律对艾滋病毒阴性或血清状态未知的艾滋病毒感染风险者的影响。拟议的项目将扩大我们关于艾滋病毒披露法律的成功初步研究。我们将在美国四个州调查400名艾滋病毒感染者和200名有感染风险的人，其中三个州有不同版本的艾滋病毒披露法，另一个没有法律。这项研究的结果将确定法律对艾滋病毒阳性和艾滋病毒阴性的高危人群的积极和消极影响。对不同法律的州进行比较，可以进一步确定刑事信息披露法的哪些方面有助于促进预期结果（血清不一致的夫妇之间更安全的性行为，或性禁欲），哪些方面会产生意想不到的负面后果。这项研究的结果将为艾滋病毒相关的立法提供参考，这些立法往往是在没有科学证据的情况下起草的。调查结果还将为有关刑法在疾病控制工作中的作用的政策讨论提供信息。

DESCRIPTION (provided by applicant): Twenty-four US states have HIV-specific criminal laws that require persons living with HIV to disclose their positive serostatus to prospective sex partners. Moreover, lawmakers in US states without these laws regularly propose such legislation. Although the presumptive purpose of the laws is to increase serostatus disclosure to sexual partners (with the assumption that informed partners will abstain or practice safer sex), little is known about their effectiveness. Even less is known about the potential negative effects of the laws, which range from discouraging HIV testing and undermining central HIV prevention messages to fostering increased HIV-related stigma and deterring (rather than promoting) seropositive status disclosure by increasing the potential negative consequences of disclosing one's HIV-positive status. US HIV disclosure laws also take several different forms, which introduces further variability and additional statute-specific concerns. Only one empirical study has directly assessed the effects of US HIV disclosure laws on persons living with HIV. The study was conducted in Michigan, a state with an HIV disclosure law, by the PI of the proposed project. No direct empirical studies have examined the impact of the laws on HIV-negative or serostatus unknown persons at risk for HIV infection. The proposed project will expand our successful preliminary study on HIV disclosure laws. We will survey statewide samples of 400 persons living with HIV and 200 persons at risk for the infection in each of four US states, three with different versions of HIV disclosure laws and one with no law. Results from the study will determine positive and negative effects of the laws on HIV-positive and HIV- negative, at-risk individuals. Comparison of states with differing laws has the further potential to determine which aspects of criminal disclosure laws are useful in terms of promoting the intended outcome (safer sex behavior within sero-discordant couples, or sexual abstinence) and which aspects have unintended negative consequences. The results of the study will inform HIV-related legislation, which is often drafted without the benefit of scientific evidence. Results will also inform policy discussions on the role of the criminal law in disease containment efforts. PUBLIC HEALTH RELEVANCE: We will gather empirical data on a highly controversial issue--the criminalization of undisclosed exposure to HIV. Results will inform HIV-related legislation, which is often drafted without the benefit of scientific evidence. Results will also inform policy discussions on the role of the criminal law in disease containment efforts.