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Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting
- Source :
- The International journal on drug policy. 43
- Publication Year :
- 2016
-
Abstract
- In 2012, the Supreme Court of Canada (SCC) ruled that people living with HIV (PLWH) could face criminal charges if they did not disclose their serostatus before sex posing a "realistic possibility" of HIV transmission. Condom-protected vaginal sex with a low (i.e.,1500copies/mL) HIV viral load (VL) incurs no duty to disclose. Awareness and understanding of this ruling remain uncharacterized, particularly among marginalized PLWH.We used data from ACCESS, a community-recruited cohort of PLWH who use illicit drugs in Vancouver. The primary outcome was self-reported awareness of the 2012 SCC ruling, drawn from cross-sectional survey data. Participants aware of the ruling were asked how similar their understanding was to a provided definition. Sources of information from which participants learned about the ruling were determined. Multivariable logistic regression identified factors independently associated with ruling awareness.Among 249 participants (39% female), median age was 50 (IQR: 44-55) and 80% had a suppressed HIV VL (50copies/mL). A minority (112, 45%) of participants reported ruling awareness, and 44 (18%) had a complete understanding of the legal obligation to disclose. Among those aware (n=112), newspapers/media (46%) was the most frequent source from which participants learned about the ruling, with 51% of participants reporting that no healthcare providers had talked to them about the ruling. Ruling awareness was negatively associated with VL suppression (AOR:0.51, 95% CI:0.27,0.97) and positively associated with recent condomless sex vs. no sex (AOR:2.00, 95% CI:1.03,3.92).Most participants were not aware of the 2012 SCC ruling, which may place them at risk of prosecution. Discussions about disclosure and the law were lacking in healthcare settings. Advancing education about HIV disclosure and the law is a key priority. The role of healthcare providers in delivering information and support to PLWH in this legal climate should be further explored.
- Subjects :
- Adult
Male
medicine.medical_specialty
Canada
Cross-sectional study
Substance-Related Disorders
media_common.quotation_subject
Common law
Sexual Behavior
Medicine (miscellaneous)
HIV Infections
Disclosure
Article
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Criminalization
Surveys and Questionnaires
Medicine
Humans
030212 general & internal medicine
Prospective Studies
Psychiatry
Duty
media_common
030505 public health
British Columbia
business.industry
Illicit Drugs
Health Policy
virus diseases
Awareness
Middle Aged
Supreme court
Cross-Sectional Studies
Logistic Models
Criminal Behavior
Female
Self Report
0305 other medical science
business
Serostatus
Viral load
Social psychology
Cohort study
Subjects
Details
- ISSN :
- 18734758
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- The International journal on drug policy
- Accession number :
- edsair.doi.dedup.....b6acf098cdb666448304a8bb1a774bf7