scholarly journals Being Informed: The Complexities of Knowledge, Deception and Consent When Transmitting HIV

2010 ◽  
Vol 74 (3) ◽  
pp. 242-258 ◽  
Author(s):  
Lisa Cherkassky
Keyword(s):  
Informed Consent ◽  
Sexual Intercourse ◽  
Hiv Transmission ◽  
Hiv Status ◽  
Bodily Harm ◽  
Fine Line ◽  
Reasonable Belief ◽  
Hiv Virus ◽  
Grievous Bodily Harm ◽  
A Charge

The offence of inflicting grievous bodily harm under s. 20 of the Offences Against the Person Act 1861 has been confirmed as the most appropriate ground for convicting a reckless transmission of the HIV virus through sexual intercourse.1 An informed consent from the victim, along with a reasonable belief in that consent from the defendant, will now suffice as a defence to such a charge.2 However, it remains unclear how and when the victim must be informed of the relevant circumstances in order to provide consent to infected intercourse, and it is also undecided whether the defendant himself must divulge his HIV status in order to claim an honest belief in the victim's consent.3 Additionally, the fine line of consensual activity drawn in R v Brown4 appears to have been eroded by recent HIV transmission cases.5 This article outlines the development in relation to s. 20 to include HIV offences; it aims to untangle the recent authorities on knowledge, deception and consent in relation to both victims and perpetrators in reckless HIV transmission cases and suggests a way forward for the law in the shape of a new offence.

Rex v. Charles Edmund Seymour

1923 ◽  
Vol 69 (284) ◽  
pp. 89-90
Keyword(s):  
Criminal Court ◽  
Bodily Harm ◽  
Grievous Bodily Harm ◽  
Set Up ◽  
A Charge

This case was tried at the Central Criminal Court, before Mr. Justice Roche, on October 13th. The prisoner pleaded guilty to a charge of assaulting a Mrs. Bles, with intent to do grievous bodily harm. The facts were that Mrs. Bles was walking in Hyde Park, on September 18th, when the prisoner, who was a stranger, suddenly attacked her, and wounded her with a knife. A police constable pursued and overtook the prisoner, who turned upon him and inflicted three wounds. Mrs. Bles was carrying a bag containing 4, and this had disappeared, but whether the prisoner had taken it was uncertain. This point is of importance, in view of the plea of epilepsy which was set up. For, apart from robbery, there was no apparent motive for the crime.

scholarly journals Law, criminalisation and HIV in the world: have countries that criminalise achieved more or less successful pandemic response?

2021 ◽  
Vol 6 (8) ◽  
pp. e006315
Author(s):  
Matthew M Kavanagh ◽  
Schadrac C Agbla ◽  
Marissa Joy ◽  
Kashish Aneja ◽  
Mara Pillinger ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Gender Based Violence ◽  
Hiv Virus ◽  
The World ◽  
Gender Based ◽  
And Gender ◽  
Living With Hiv

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with HIV (PLHIV) knew their HIV status and could suppress the HIV virus through antiretroviral treatment. This article presents a cross-national ecological analysis of the relative success of national AIDS responses under this strategy, where laws were characterised by more or less criminalisation and with varying rights protections. In countries where same-sex sexual acts were criminalised, the portion of PLHIV who knew their HIV status was 11% lower and viral suppression levels 8% lower. Sex work criminalisation was associated with 10% lower knowledge of status and 6% lower viral suppression. Drug use criminalisation was associated with 14% lower levels of both. Criminalising all three of these areas was associated with approximately 18%–24% worse outcomes. Meanwhile, national laws on non-discrimination, independent human rights institutions and gender-based violence were associated with significantly higher knowledge of HIV status and higher viral suppression among PLHIV. Since most countries did not achieve 2020 HIV goals, this ecological evidence suggests that law reform may be an important tool in speeding momentum to halt the pandemic.

scholarly journals Did the Individual Consent to the Risk of Harm? A Comparative Jurisdictional Analysis of Consent in Cases of Sexual Transmission/Exposure to HIV

2018 ◽  
Vol 82 (1) ◽  
pp. 76-105
Author(s):  
David Hughes
Keyword(s):  
Informed Consent ◽  
High Risk ◽  
Sexual Intercourse ◽  
Sexual Transmission ◽  
Unprotected Sexual Intercourse ◽  
Hiv Virus ◽  
The Usa ◽  
Legislative Framework ◽  
Consent Requirement ◽  
The Individual

This article considers the necessary ingredients for an individual to consent to running the risk of the HIV virus being transmitted through high-risk unprotected sexual intercourse. In order to achieve this aim, an assessment of what should equate to a fully informed consent is evaluated. The article will provide a comparative jurisdictional analysis of the consent requirement in three particularised jurisdictions: England, Canada and the USA. A comparison of relational judicial precepts will follow the discussion of extant law in each country. It will be established that few jurisdictions fully consider the requirements of a fully informed consent. The final part of the article will suggest a bespoke new legislative framework that will account for the circumstances that are necessary for an individual to provide a fully informed consent to the risk of acquiring the virus.

scholarly journals Couples Living with HIV

2016 ◽  
Vol 16 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Violeta J. Rodriguez ◽  
Andrew Spence ◽  
Mallory Monda ◽  
JoNell Potter ◽  
Deborah Jones
Keyword(s):  
Perceived Risk ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
Hiv Status ◽  
Safer Conception ◽  
Reproductive Intentions ◽  
Hiv Prevention Strategies ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Men’S Involvement

Background: Desires to have children are not lessened by a woman’s HIV status. Couples may lack information to conceive safely, and men may be especially uninformed. This study examined reproductive intentions, practices, and attitudes among men in HIV-infected couples, including attitudes regarding the perceived risk of vertical and horizontal transmission, safer conception, and preconception planning. Methods: Men ( n = 12) in HIV-infected couples were interviewed regarding reproductive intentions, attitudes, and knowledge and qualitative assessments were coded for dominant themes. Results: Themes primarily addressed concerns about the health of the baby, men’s involvement in pregnancy, safer conception, concerns about HIV transmission and antiretroviral therapy, and HIV infection. Men lacked information on safer conception and newer HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Discussion: Gaps in knowledge regarding preconception practices among men in HIV-infected couples were identified. Results highlight men’s desire for involvement in preconception planning, and opportunities for providers to facilitate this practice and to increase patient education and the use of PrEP are discussed.

scholarly journals Exploring the Factors Considered by People Living with HIV and Their Partners during Preconception

2016 ◽  
Vol 16 (3) ◽  
pp. 239-246 ◽  
Author(s):  
V. Logan Kennedy ◽  
Micaela Collins ◽  
Mark H. Yudin ◽  
Lena Serghides ◽  
Sharon Walmsley ◽  
...  
Keyword(s):  
Logit Model ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
People Living With Hiv ◽  
Relative Importance ◽  
Hiv Status ◽  
Ordered Logit Model ◽  
Living With Hiv ◽  
Shed Light ◽  
Hiv Negative

Data are lacking on factors that may impact conception-related decision-making among individuals living with HIV. This study’s aim was to shed light on these considerations. Participants were invited to complete a survey on preconception considerations. A rank-ordered logit model was fit to estimate the relative importance of listed consideration factors; the interaction of HIV status and the factors was assessed. Fifty-nine participants living with HIV and 18 partners (11 HIV-negative participants and 7 living with HIV) were included. Risk of vertical and horizontal HIV transmission and the effect of antiretroviral therapy on the fetus were the top considerations. However, individuals living with HIV prioritized vertical transmission, whereas HIV-negative participants prioritized horizontal transmission. Other factors of importance were probability of conception, stress of trying to conceive, cost associated with fertility clinics, and stigma associated with certain conception methods. This study builds our understanding of the preconception considerations for people living with HIV.

scholarly journals The Paradoxes of PrEP: Rejection, Reluctancy, and Novel Gay Identities in Biomedical HIV Prevention in Serbia

2022 ◽  
pp. 34-51
Author(s):  
Zoran Milosavljević
Keyword(s):  
Hiv Prevention ◽  
Gay Men ◽  
Hiv Transmission ◽  
Gay Identity ◽  
Hiv Status ◽  
Social Significance ◽  
Gay Communities ◽  
Hiv Status Disclosure ◽  
Status Disclosure ◽  
Hiv Negative

This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men – who have achieved undetectable HIV status through a potent ARV therapy – and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia – "undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone’s HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.

scholarly journals Research on HIV Spreading by Macroscopic Based on Molecular Phylogeny in Anhui Province, China

2020 ◽  
Author(s):  
Zhen Wang ◽  
Zhiyuan Zhang ◽  
Xin Jin ◽  
Hui Wu ◽  
Yuhua Ruan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Dynamic Model ◽  
Hiv Transmission ◽  
Reproduction Number ◽  
Anhui Province ◽  
Entire Population ◽  
Bisexual Men ◽  
Gene Sequences ◽  
Hiv Virus ◽  
History Of

Abstract BackgroundAcquired Immune Deficiency Syndrome (AIDS) is a global pandemic. The disease remains the most challenging public health issue of common concern in all countries because of its high fatality rate, the widespread susceptibility of the entire population to HIV, and the lack of an effective vaccine or cure. Therefore, it is of great significance to study and analyze the spread of HIV/AIDS.MethodsWe applied Bayesian phylogenetic methods to the gene sequence of the two main subtypes (CRF 01AE and CRF 07BC, 340 in total) of the HIV virus in Anhui Province to infer the nearest ancestor and its effective reproduction number (Re) to trace the history of HIV transmission in Anhui Province. Based on the characteristics of HIV transmission between heterosexuals and homosexuals, we established a dynamic model to predict the future trend of HIV drug resistance transmission. Through fitting the two effective reproduction numbers (Re) from the two different methods above, we got some important parameter values. By analyzing the sensitive factors affecting the transmission situation, we proposed relevant measures to reduce the transmission of HIV-resistant strains and effectively prevent and control the HIV epidemic.ResultsThrough the study of gene sequences, it was inferred that the nearest ancestor of the 150 CRF 01AE subtypes was in 1982, while the nearest ancestor of the 190 CRF 07BC subtypes was later (1992). Moreover, the effective reproduction number Re of HIV transmission in Anhui Province has been stable at first, then increased, and then remained stable, from 1.33 in 1992 to 2.20 in 2018. The study of macro-transmission dynamics model found that simply increasing the treatment rate had little effect on reducing the infection rate of the entire population, but would lead to the increase of drug resistance rate instead. This may be due to the inverse ratio between the prevalence of HIV and the lifespan of infected patients after treatment. According to the Sensitivity analysis, a more effective way to control transmission is reducing the number of sexual partners of the MSM population. In addition, we also have unexpected new findings regarding the traditional belief that "bisexual men play a bridge role in the transmission of HIV virus": if simply cutting o the sexual relationship between women and bisexual men, the HIV epidemic will be significantly enhanced instead.ConclusionStudy on gene sequences told us the history of HIV/AIDS spreading in Anhui province and the dynamic model told us its future. The link between them is the the effective reproduction number Re.

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