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

描述（由申请人提供）：美国大多数州都有针对艾滋病毒的刑法，要求艾滋病毒感染者（PLWH）向潜在的性伴侣披露他们的阳性血清状态。虽然法律的假定目的是增加对性伴侣的血清状况披露（假设知情的伴侣会弃权或采取更安全的性行为），但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，这些法律可能会阻止艾滋病毒感染风险较高的人接受检测，阻止艾滋病毒感染者卫生保健人员披露其血清阳性状况并利用与艾滋病毒有关的卫生保健服务。《美国国家艾滋病毒/艾滋病战略》要求各州立法者考虑审查这些法律，以确保它们与预防和治疗艾滋病毒感染的公共卫生办法相一致。我们目前正在进行全国首个多州研究，直接检查艾滋病毒刑事暴露法对艾滋病毒感染者和有感染风险的人的影响（R01-MH091875）。然而，我们的研究调查和材料是英文的，这使我们无法检查这些法律对一个非常重要的美国亚群体的影响，说西班牙语的拉丁裔移民，英语调查对他们来说是参与的障碍。我们建议与拉丁裔艾滋病委员会和社区服务组织网络合作，这些组织正在执行父母补助金的目标，将父母研究的西班牙语横断面调查翻译和管理到全州艾滋病毒阳性和有风险的西班牙语拉丁裔移民样本中。我们将在补充项目中增加研究调查，包括评估参与者对驱逐出境的恐惧以及他们对适用于艾滋病毒/艾滋病的美国移民法的看法的措施。因此，补充研究将扩大母体研究，包括一个重要的亚人群，以了解艾滋病毒暴露法的影响，并在该人群中检查驱逐出境问题和感知移民法对研究结果的相关影响。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): A majority of US states have HIV-specific criminal laws that require persons living with HIV (PLWH) to disclose their positive serostatus to prospective sex partners. Although the laws' presumptive purpose 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 impact of these laws, which could range from deterring persons at elevated risk for HIV infection from being tested, to deterring PLWH from disclosing their seropositive status and utilizing HIV-related health care services. The National HIV/AIDS Strategy for the United States asks state lawmakers to consider reviewing these laws to ensure that they are consistent with public health approaches to preventing and treating HIV infection. We are currently conducting the first multi-state study in the nation to directly examine the impact of criminal HIV exposure laws on persons living with and at risk for HIV infection (R01-MH091875). However, our study surveys and materials are in English and prevent us from examining the impact of these laws on a very important US subpopulation, Spanish-speaking Latino immigrants for whom a survey in English serves as a barrier to participation. We propose to partner with the Latino Commission on AIDS and the networks of community service organizations that are carrying out the aims of the parent grant to translate and administer the parent study's cross sectional survey in Spanish to statewide samples of HIV-positive and at risk Spanish-speaking Latino immigrants. We will augment the study survey in the supplemental project by including measures to assess participants' fear of deportation and their perceptions of US immigration law as it applies to HIV/AIDS. The supplemental study will thus expand the parent study, both by including an important subpopulation in our efforts to understand the impact of HIV exposure laws, and by examining, within this population, the related impact of deportation concern and perceived immigration law on study outcomes. 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 explore the impact of US criminal HIV exposure laws on the HIV-prevention behaviors of Spanish speaking Latino immigrants--a vulnerable subpopulation not included in the English language parent study. Additionally, we will explore the impact of perceived immigration law on the same HIV-related behaviors. The results of the supplement will provide information on two potential structural-level threats to the success of our national HIV prevention strategy.