Barry D Adam
University Professor of Sociology,
Senior Scientist & Director of Prevention Research
Courts (whether they know it or not) becoming
actors in the field of HIV prevention
Based on a model of human behaviour that
holds that
HIV-positive people can and should assume the
responsibility of warning others of the potential for
infection,
and that prospective partners, once informed of that
potential, will act appropriately to avoid infection
Elevation of disclosure as primary requirement
Not associated with higher rates of protected sex
among gay and bisexual men
Consistent practice of safer sex usually does not
require discussion and proceeds without it.
Benny Henriksson and Sven Axel Månsson, “Sexual Negotiations,” in Culture
and Sexual Risk, ed. Han ten Brummelhuis and Gilbert Herdt (1995), 170.
Those who decide from encounter to encounter
whether to disclose or not, and who then disclose
inconsistently, have higher rates of unprotected
sex than either those who disclose consistently or
those who do not disclose.
Trevor Hart et al., “Partner Awareness of the Serostatus of HIV-Seropositive
Men Who Have Sex with Men,” AIDS and Behavior 9 (2005): 163; Limin Mao et
al., “‘Serosorting’ in Casual Anal Sex of HIV-Negative Gay Men Is Noteworthy
and Is Increasing in Sydney, Australia,” AIDS 20 (2006): 1204–6.
Risks stigmatization/rejection
HIV-positive people have reported that
“rejection from partners following disclosure
took many forms, including refusal to have sex,
unwillingness to engage in particular sex
practices, emotional distancing, abrupt or
longer term relationship dissolution, and even
(although rarely) acts of violence.”
Michael Stirratt, “I Have Something to Tell You,” in HIV+ Sex: The Psychosocial
and Interpersonal Dynamics of HIV-Seropositive Gay and Bisexual Men’s
Relationships, ed. Perry N. Halkitis, Cynthia A. Gómez, and Richard J. Wolitski
(Washington, DC: American Psychological Association, 2005), 103.
Harder to do in a relationship of dependency
Difficulty that many women experience in disclosing
to men on whom they are dependent
Karolynn Siegel, Helen-Maria Lekas, and Eric Schrimshaw, “Serostatus
Disclosure to Sexual Partners by HIV-Infected Women Before and After the
Advent of HAART,” Women and Health 41, 4 (2005), 63.
and among those who feel disadvantaged by their
age, attractiveness, or ethno-cultural background
“I do worry that, you know, I might disclose to
someone even before sex and then it becomes
his word against mine later—right?—and if I
go to court . . . I’d probably lose my job.”
“What if one that’s negative makes a decision
to . . . have sex without a condom, and then he
gets infected and then it all comes back to me
and then I’m charged? I’m in jail . . . so I’m
really careful around that.”
Barry D Adam, Richard Elliott, Winston Husbands, James Murray and John
Maxwell. 2008. “Effects of the criminalization of HIV transmission in Cuerrier
on men reporting unprotected sex with men” Canadian Journal of Law and Society
23 (1–2):137–153.
Some “conveyed their serostatus to their
partners by mentioning or exhibiting various
embodiments of their serostatus: that they
received disability payments, worked in
HIV/AIDS services, lived in an HIV/AIDS
residence, or had visible HIV/AIDS
symptoms.”
Stirrat, “I Have Something to Tell You,” 114. Cf. Barry D. Adam, “Constructing
the Neoliberal Sexual Actor” Culture, Health and Sexuality 7 (2005), 340; Julianne
Serovich, et al., “Methods of HIV Disclosure by Men Who Have Sex with Men
to Casual Sexual Partners,” AIDS Patient Care and STDs 19 (2005): 823–32.
Presumes both partners are certain of their
sero-status
Shifts responsibility back towards HIV+ people
.
Need to test the presuppositions
underlying the obligation to disclose as HIV
prevention strategy and public policy by
examining their operationalization in everyday
life
To see how PHAs perceive the law and the
legal obligation to disclose
How PHAs are affected by changing public
climate of increasing prominence of criminal
discourses
Follows preliminary research reported in:
Barry D Adam, Richard Elliott, Winston Husbands,
James Murray and John Maxwell. 2008. “Effects of
the criminalization of HIV transmission in Cuerrier
on men reporting unprotected sex with men”
Canadian Journal of Law and Society 23 (1–2):137–153.
the sources of legal information available to PHAs,
including how they have been advised by ASOs, health
providers, and other relevant agencies,
how criminal prosecutions, and media coverage of
these legal proceedings, affect understanding of rights
and responsibilities of self and others
how public climate is affecting the perceptions,
treatment, and possible stigmatization of PHAs
how legal proceedings and associated public discourse
affect decisions to test for HIV,
how they affect disclosure practices of self and sexual
partners, and
how they affect safer sex practices of self and others.
Series of meetings of people from academic,
community, government, and PHA organizations
Division into a research team and advisory
committee
Research team:
Barry D Adam, Sociology, University of Windsor &
Senior Scientist & Director of Prevention Research, OHTN
Richard Elliott, ED, Canadian HIV/AIDS Legal Network
Patrice Corriveau, Criminologie, Université d’Ottawa
Robb Travers, Psychology, Wilfrid Laurier University
Ken English, AIDS Bureau, Ministry of Health & Long
Term Care
Trevor Gray, Youth Outreach Coordinator, Prisoners’ HIV/AIDS Support
Action Network,
Murray Jose, Executive Director, Toronto People With AIDS Foundation,
Rick Kennedy, Executive Director, Ontario AIDS Network,
Kara Gillies, Executive Director, Voices of Positive Women,
Frank McGee, AIDS Coordinator, AIDS Bureau , Ontario Ministry of
Health and Long-Term Care,
Fanta Ongoiba, Executive Director, Africans in Partnership Against AIDS,
Ryan Peck, Executive Director, HIV & AIDS Legal Clinic (Ontario),
John Plater, lawyer and co-chair of the Ontario Advisory Committee on
HIV and AIDS and past president of Hemophilia Ontario,
Michael Smith, Senior Policy Advisor, Public Health Agency of Canada,
Michael Sobota, Executive Director, AIDS Thunder Bay.
Set of questions on AIDS and the law in
OHTN Cohort Study
Positive Spaces, Health Places
Interviews with 100 PHAs, broadly
representative of the demographics of HIV in
Ontario
Interviews with PHAs who have
experienced a threat of legal consequences from a
partner, family member, employer, etc in relation to
their HIV status (e.g. non-disclosure)
been served with a public health order (e.g. Section
22)
been processed by the criminal justice system related
to their HIV status (e.g. police action, charge,
prosecution, etc)
complained to criminal justice or public health
authorities about having been exposed or infected by
HIV
