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

描述（由申请人提供）：美国24个州都有针对艾滋病毒的刑法，要求艾滋病毒感染者向未来的性伴侣披露其阳性血清状态。此外，没有这些法律的美国各州的立法者经常提出此类立法。虽然这些法律的假定目的是增加向性伴侣披露血清状况（假设知情的伴侣会禁欲或进行更安全的性行为），但人们对这些法律的效力知之甚少。人们对这些法律的潜在负面影响所知更少，这些影响包括不鼓励进行艾滋病毒检测和破坏中央预防艾滋病毒的信息，以及助长与艾滋病毒有关的耻辱感，并通过增加披露艾滋病毒阳性状况的潜在负面后果来阻止（而不是促进）披露血清阳性状况。美国艾滋病毒披露法律也采取了几种不同的形式，这引入了进一步的可变性和额外的特定法规的关注。 只有一项实证研究直接评估了美国艾滋病毒披露法律对艾滋病毒感染者的影响。这项研究是在密歇根州进行的，密歇根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审查法律对艾滋病毒阴性或血清状况不明的有感染艾滋病毒风险的人的影响。拟议的项目将扩大我们对艾滋病毒披露法律的成功初步研究。我们将在美国四个州的每个州调查400名艾滋病毒感染者和200名有感染风险的人的全州样本，其中三个州有不同版本的艾滋病毒披露法律，一个州没有法律。研究结果将确定法律对艾滋病毒阳性和阴性高危个人的积极和消极影响。比较各州的不同法律有进一步的潜力，以确定哪些方面的刑事披露法律是有用的，在促进预期的结果（安全性行为的血清不一致的夫妇，或禁欲），哪些方面有意想不到的负面后果。这项研究的结果将为与艾滋病毒有关的立法提供信息，这些立法往往是在没有科学证据的情况下起草的。研究结果还将为关于刑法在遏制疾病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.