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Open Access Highly Accessed Research article

Nondisclosure prosecutions and population health outcomes: examining HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following nondisclosure prosecution media releases in Ottawa, Canada

Patrick O’Byrne2*, Jacqueline Willmore1, Alyssa Bryan1, Dara S Friedman1, Andrew Hendriks1, Cynthia Horvath1, Dominique Massenat2, Christiane Bouchard1, Robert S Remis3 and Vera Etches1

Author affiliations

1 Ottawa Public Health, Ottawa, Canada

2 Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada

3 University of Toronto, Toronto, Canada

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Citation and License

BMC Public Health 2013, 13:94  doi:10.1186/1471-2458-13-94

Published: 1 February 2013

Abstract

Background

During the past decade, the intersection of HIV and criminal law has become increasingly discussed. The majority of studies to date have approached this topic from a sociological or legal perspective. As a result, the potential effect of nondisclosure prosecutions on population health and HIV prevention work remains mostly unknown.

Methods

A descriptive quantitative-qualitative study was undertaken to examine HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following regional media releases about a local nondisclosure prosecution. As part of this study, first, we reviewed the trends in HIV testing and HIV diagnoses from 2008 through 2011 in Ottawa, Canada. Second, we explored the attitudes and beliefs of local MSM about HIV, HIV prevention, HIV serostatus disclosure, nondisclosure prosecutions, and public health.

Results

Quantitatively, the findings of this study revealed that, in comparison to the period preceding the media releases about a local nondisclosure prosecution, HIV testing and HIV diagnoses among men who have sex with men did not significantly change after the media releases of interest. Qualitatively, a subgroup of 27 men who have sex with men (12 HIV-positive, 15 HIV-negative) noted their beliefs that the local public health department openly shares information about people living with HIV with the police. Moreover, some HIV-positive participants stated that this perceived association between the local public health department and police services caused them to not access public health department services, notwithstanding their desires to seek assistance in maintaining safer sexual practices.

Conclusions

Nondisclosure prosecutions likely undermine HIV prevention efforts.

Keywords:
Canada; Criminal law; Disclosure; HIV; Population health; Testing; Qualitative; Quantitative