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AIDS Behav. 2019 Mar 21. doi: 10.1007/s10461-019-02463-2. [Epub ahead of print]

Awareness and Understanding of HIV Non-disclosure Case Law and the Role of Healthcare Providers in Discussions About the Criminalization of HIV Non-disclosure Among Women Living with HIV in Canada.

Author information

1
Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
2
Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
3
British Columbia Positive Living Society, Vancouver, Canada.
4
Faculty of Medicine, University of British Columbia, Vancouver, Canada.
5
British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada.
6
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
7
British Columbia Women's Hospital and Health Centre, Vancouver, Canada.
8
The Kirby Institute, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
9
School of Social Work, McMaster University, Hamilton, ON, Canada.
10
Department of Family Medicine, McGill University, Montreal, Canada.
11
Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada.
12
Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
13
Women's College Research Institute, Women's College Hospital, Toronto, Canada.
14
Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. kangela@sfu.ca.

Abstract

In 2012, the Supreme Court of Canada ruled that people with HIV are legally obligated to disclose their serostatus before sex with a "realistic possibility" of HIV transmission, suggesting a legal obligation to disclose unless they use condoms and have a low HIV viral load (< 1500 copies/mL). We measured prevalence and correlates of ruling awareness among 1230 women with HIV enrolled in a community-based cohort study (2015-2017). While 899 (73%) participants had ruling awareness, only 37% were both aware of and understood ruling components. Among 899 aware participants, 34% had never discussed disclosure and the law with healthcare providers, despite only 5% being unwilling to do this. Detectable/unknown HIV viral load, lack of awareness of prevention benefits of antiretroviral therapy, education ≤ high-school and high HIV-related stigma were negatively associated with ruling awareness. Discussions around disclosure and the law in community and healthcare settings are warranted to support women with HIV.

KEYWORDS:

CHIWOS; Canada; Community based research; Criminalization of HIV non-disclosure; HIV; Women

PMID:
30900043
DOI:
10.1007/s10461-019-02463-2

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