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Tatham C. Life and love under criminalization: The experiences of people living with HIV in Canada. PLoS One 2024; 19:e0306894. [PMID: 39052618 PMCID: PMC11271884 DOI: 10.1371/journal.pone.0306894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 06/23/2024] [Indexed: 07/27/2024] Open
Abstract
Based upon qualitative interviews with 54 women and men living with HIV across Ontario, Canada, this paper examines the impact of HIV criminalization on the sexual and romantic relationships of people living with HIV. This research highlights the navigation strategies people living with HIV create and employ to both navigate and protect themselves from the law. Through a thematic and intersectional analysis, this study shows how adoption of these strategies is unequal, with access to navigation strategies varying along lines of gender, race, and sexual orientation. As a result, women and racialized people living with HIV face more difficulties navigating the impact of the law. HIV criminalization in Canada fuels and validates HIV stigma and produces vulnerability both within and outside of the relationships of people living with HIV. This paper seeks to understand HIV criminalization from the perspective of those governed by the law, in hopes of producing knowledge which will contribute to legal reform, inform policy, and support the development of efficacious secondary prevention initiatives.
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Affiliation(s)
- Christopher Tatham
- Department of Sociology and Anthropology, University of Guelph, Guelph, Ontario, Canada
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Hastings C, French M, McClelland A, Mykhalovskiy E, Adam B, Bisaillon L, Bogosavljevic K, Gagnon M, Greene S, Guta A, Hindmarch S, Kaida A, Kilty J, Massaquoi N, Namaste V, O'Byrne P, Orsini M, Patterson S, Sanders C, Symington A, Wilson C. Criminal Code reform of HIV non-disclosure is urgently needed: Social science perspectives on the harms of HIV criminalization in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:8-14. [PMID: 38087186 PMCID: PMC10868573 DOI: 10.17269/s41997-023-00843-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/16/2023] [Indexed: 02/09/2024]
Abstract
The criminalization of HIV non-disclosure represents a significant issue of concern among people living with HIV, those working across the HIV sector, public health practitioners, and health and human rights advocates around the world. Recently, the government of Canada began a review of the criminal law regarding HIV non-disclosure and invited feedback from the public about potential reforms to the Criminal Code. In light of this public consultation, this commentary examines social science research from Canadian scholars that documents the intersecting damaging effects of HIV criminalization. Canadian social scientists and other researchers have shown that HIV criminalization is applied in uneven and discriminatory ways, impedes HIV prevention efforts, perpetuates HIV stigma, and has a damaging impact on the daily lives of people living with HIV. We argue that there is an urgent need for reforms that will significantly restrict how the criminal law is applied to HIV non-disclosure.
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Affiliation(s)
- Colin Hastings
- Department of Sociology and Legal Studies, University of Waterloo, Kitchener-Waterloo, ON, Canada.
| | - Martin French
- Department of Sociology and Anthropology, Concordia University, Montreal, QC, Canada
| | - Alexander McClelland
- Institute of Criminology and Criminal Justice, Carleton University, Ottawa, ON, Canada
| | | | - Barry Adam
- Department of Sociology, University of Windsor, Windsor, ON, Canada
| | - Laura Bisaillon
- Department of Health and Society, University of Toronto, Toronto, ON, Canada
| | | | - Marilou Gagnon
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Saara Greene
- School of Social Work, McMaster University, Hamilton, ON, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
| | - Suzanne Hindmarch
- Department of Political Science, University of New Brunswick, Fredericton, NB, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Jennifer Kilty
- Department of Criminology, University of Ottawa, Ottawa, ON, Canada
| | - Notisha Massaquoi
- Department of Health and Society, University of Toronto, Toronto, ON, Canada
| | - Viviane Namaste
- Simone de Beauvoir Institute & Women's Studies, Concordia University, Montreal, QC, Canada
| | | | - Michael Orsini
- Institute of Feminist and Gender Studies and the School of Political Studies, University of Ottawa, Ottawa, ON, Canada
| | - Sophie Patterson
- Faculty of Health & Medicine, Lancaster University, Lancaster, England
| | - Chris Sanders
- Department of Sociology, Lakehead University, Thunder Bay, ON, Canada
| | | | - Ciann Wilson
- Department of Psychology, Wilfrid Laurier University, Kitchener-Waterloo, ON, Canada
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Kasadha B, Tariq S, Freeman-Romilly N, Pope C, Namiba A, Nyatsanza F, Hinton L, Rai T. "We decided together": a qualitative study about women with HIV navigating infant-feeding decisions with the father of their children. BMC Pregnancy Childbirth 2024; 24:41. [PMID: 38184571 PMCID: PMC10770965 DOI: 10.1186/s12884-023-06198-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends that women with HIV breastfeed for a minimum of one year. In contrast, United Kingdom (UK) guidelines encourage formula feeding, but breastfeeding can be supported under certain circumstances. Infant-feeding decisions often involve personal and social networks. Currently, little research addresses how individuals with HIV in high-income countries navigate infant-feeding decisions with the father of their children. METHODS Semi-structured remote interviews were conducted with UK-based individuals with a confirmed HIV positive diagnosis who were pregnant or one-year postpartum, and two partners. Using purposive sampling, pregnant and postpartum participants were recruited through HIV NHS clinics and community-based organisations, and where possible, fathers were recruited via them. Data were analysed using thematic analysis and organised using NVivo 12. RESULTS Of the 36 women interviewed, 28 were postpartum. The majority were of Black African descent (n = 22) and born outside the UK. The key factors in women navigating HIV and infant-feeding discussions with respect to their baby's father were the latter's: (1) awareness of woman's HIV status; (2) relationship with the woman; (3) confidence in infant-feeding decision; (4) support and opinion about woman's infant-feeding intentions. Most women made a joint decision with biological fathers when in a long-term (> one year) relationship with them. Single women tended not to discuss their infant-feeding decision with the father of their child, often for safety reasons. CONCLUSION Women in ongoing relationships with the father of their child valued their support and opinions regarding infant-feeding. In contrast, single women chose not to involve the father for reasons of privacy and safety. Clinical teams and community-based organisations should support mothers in discussing infant-feeding decisions regardless of relationship status. When appropriate, they should also support discussions with their partners, but remain sensitive to circumstances where this may put women at risk.
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Affiliation(s)
- Bakita Kasadha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
- Central and North West London NHS Foundation Trust, London, UK
| | | | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Tanvi Rai
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Factors Influencing the Acceptability of Nominal, Non-nominal, and Anonymous HIV Testing Options Among Young Men Living in Vancouver, Canada: A Qualitative Study. J Assoc Nurses AIDS Care 2023; 34:15-23. [PMID: 36656091 DOI: 10.1097/jnc.0000000000000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Individuals unaware of their HIV seropositive status continue to represent a key "driver" of the HIV epidemic. Strategies to improve initiation into the HIV treatment cascade, including among young men, are required. This study assesses the acceptability of three HIV testing options among young cisgender men living in Vancouver, British Columbia. Using a modified grounded theory approach, we conducted semi-structured interviews with 45 young cisgender men ages 18-30 years to identify the factors influencing the acceptability of diverse HIV testing approaches. Participants ascribed value to non-nominal testing as a means of providing a secure pathway to HIV-related care for those who test positive while also safeguarding privacy. Anonymous HIV testing was problematized by participants as potentially creating difficulty in accessing ongoing HIV-related care. Most participants preferred non-nominal testing. Nevertheless, based on principles of equity, we argue that anonymous access to one's serostatus should be available, especially within a criminalized context.
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Bourne A, Melendez-Torres GJ, Thanh Ly A, Kidd P, Cogle A, Brown G, Lyons A, Carman M, Rulee J, Power J. Anxiety about HIV criminalisation among people living with HIV in Australia. AIDS Care 2021; 34:942-948. [PMID: 34082630 DOI: 10.1080/09540121.2021.1936443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many countries, including Australia, have laws that enable criminal prosecution of an individual based on reckless or intentional transmission of HIV to another person. Previous research has suggested that criminalisation of HIV may serve to hamper public health efforts by inhibiting HIV status disclosure or testing. Limited research to date has sought to examine the broader impact of criminalisation on the health and wellbeing of people living with HIV, which this paper aims to address. Drawing on cross-sectional data from 895 people living with HIV in Australia, this paper describes associations between standard measures of mental health and resilience with a newly devised scale measuring anxiety about HIV criminalisation. Findings suggest that laws criminalising HIV transmission have a broadly negative impact on wellbeing of people living with HIV, a situation that is exacerbated for gay and bisexual men, and other people living with HIV who may face intersecting forms of marginalisation based on race, gender or class. There is little justification for these laws being applied in Australia and the findings add weight to advocacy seeking to overturn criminalisation across the world.
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Affiliation(s)
- Adam Bourne
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, UK
| | - An Thanh Ly
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - Paul Kidd
- Fitzroy Legal Service, Melbourne, Australia
| | - Aaron Cogle
- National Association for People with HIV Australia, Sydney, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW Sydney, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - John Rulee
- National Association for People with HIV Australia, Sydney, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
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Ng C, Chayama KL, Krüsi A, Small W, Knight R. Perspectives of HIV-positive and -negative people who use drugs regarding the criminalization of HIV non-disclosure in Canada: a qualitative study. BMC Public Health 2020; 20:1220. [PMID: 32778084 PMCID: PMC7418386 DOI: 10.1186/s12889-020-09291-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 07/23/2020] [Indexed: 11/19/2022] Open
Abstract
Background While previous research has identified how criminalization of HIV non-disclosure can have deleterious effects on those living with HIV, the perspectives of people who use drugs – a population disproportionately affected by HIV– should be more meaningfully considered in these discussions. Methods Using constant comparative techniques, data from 60 interviews with men and women living with and without HIV and who use drugs in Vancouver were analyzed to explore their perceptions about Canada’s HIV non-disclosure legal framework. Results Participants’ perspectives on the framework involved three themes: understandings of HIV risk; HIV-related stigma; and their own experiences with HIV. While several participants favored the punitive character of the legal framework, these arguments were premised on misinformed and stigmatized assumptions regarding HIV. Conclusions The paper concludes by discussing the challenges and opportunities for resisting HIV stigma and misconceptions about HIV within the context of personal accounts that, at times, support criminalization of non-disclosure.
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Affiliation(s)
- Cara Ng
- British Columbia Centre on Substance Use, 4th Floor, 1045 Howe Street, Vancouver, B.C, V6Z 2A9, Canada
| | - Koharu Loulou Chayama
- British Columbia Centre on Substance Use, 4th Floor, 1045 Howe Street, Vancouver, B.C, V6Z 2A9, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Andrea Krüsi
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - Will Small
- British Columbia Centre on Substance Use, 4th Floor, 1045 Howe Street, Vancouver, B.C, V6Z 2A9, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, 4th Floor, 1045 Howe Street, Vancouver, B.C, V6Z 2A9, Canada. .,Department of Medicine, University of British Columbia, Vancouver, Canada.
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