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11-03-2013 | Infectious disease | Article

HIV transmission and the law: guidance needed for support services

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medwireNews: Support services for those living with HIV will benefit from improved guidance about the criminalization of HIV transmission, according to a UK study.

Clinical and social care providers participating in the study, which involved a series of focus-group discussions, demonstrated "significant confusion" about legal definitions and what constituted criminal liability, making it difficult for them to provide appropriate, well-founded advice to their patients and clients.

Furthermore, the consensus among participants was that criminalization of the sexual transmission of HIV reinforces existing, negative perceptions about HIV, further compromising the ability of service-providers to support the health and wellbeing of people with HIV.

In a press statement, lead author Catherine Dodds (Sigma Research, London School of Hygiene & Tropical Medicine, UK) said: "Although HIV health and social care professionals expressed diverse views about their potential role in such cases, they gave a clear sense that criminal prosecutions for the transmission of HIV would not improve public health.

"Instead, it was most common to hear descriptions of such cases leading to increased stigma, reduced trust between service users and providers, and traumatic consequences for those involved in such cases."

In England and Wales, it is a criminal offence to intentionally or recklessly transmit HIV to another person.

To better understand how this criminalization affects the provision of support for people with HIV, the researchers held seven focus groups in which a total of 75 clinical and community service-providers were invited to openly discuss any issues related to the criminalization of sexual transmission of HIV.

The findings demonstrate considerable variation in participants' understanding of what constitutes reckless sexual behavior for those with HIV, and the specific precautionary measures such people should take to ensure that they are not criminally liable.

There was also variation, particularly between clinical and non-clinical service-providers, about when and how to raise the topic of criminal liability, and whether the responsibility of service-providers is to protect the interests of service-users or others who may be at risk for infection.

"Increased awareness and understanding of, and inter-organisational communication about, legal issues is critical," says study co-investigator Matthew Weait (Birkbeck College, University of London, UK).

To this end, the group recommend collating all valuable information about criminal prosecution for the sexual transmission of HIV into a single, frequently updated website. In addition, continuous professional development in criminal law should be available for all service-providers.

Such initiatives should be promoted by national, regional, and local "champions" who have an interest in, and experience of, criminal prosecutions for sexual transmission of HIV, conclude the authors on the Sigma Research website.

By Christopher Walsh, medwireNews Reporter

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