The 130th Annual Meeting of APHA

Abstract #47529

Zita Lazzarini, JD, MPH, Division of Medical Humanities, Health Law, and Ethics, University of Connecticut Health Center, 263 Farmington Ave. MC-6325, Farmington, CT 06030, 860-679-5494, lazzarini@nso.uchc.edu, Scott Burris, JD, Temple University Law School, 1719 N. Broad Street, Philadelphia, PA 19122, Sarah Bray, BA, New York University Law School, 248 Wyckoff St. #4B, Brooklyn, NY 11217, Kim M. Blankenship, PhD, Center for Interdisciplinary Research on AIDS, Yale University, 40 Temple Street, Suite 1B, New Haven, CT 06510, and Patricia Case, MPH, DSc, Department of Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA 02115.

Background: Criminal law is one “structural intervention” used to influence risk behavior by people with HIV. Most states have HIV-specific laws. All have criminal laws that can punish sexual, drug use or other behaviors that can transmit HIV. Little empirical data exists on these laws’ use or their impact. Methods: This project tests a multi-disciplinary model for evaluating the effect of criminal law on HIV risk behavior. We report 3 steps: 1) prevalence and characteristics of the 52 states and territories’ laws; 2) prosecutions for HIV exposure, 1986-2001; and 3) preliminary results of multivariate analysis and 3 state survey. We test the hypothesis that severity of laws, frequency of enforcement, and media attention to cases is not associated with interstate differences in self-reported HIV risk behavior/risk perception and HIV/AIDS cases. Results: 27 states specifically criminalize behaviors by persons with HIV. 15 punish exposure through sexual intercourse or exposure to bodily fluids; 8 use of contaminated injection equipment; 12 donation of blood, tissue or organs; and 3 behavior that poses minimal risk (e.g. spitting). Since 1986, there have been 316 prosecutions and 184 convictions for exposure to HIV. Cases receiving the most media attention included both high and low risk behavior. Conclusions: Laws regulating HIV risk behavior vary significantly. Laws are widespread but rarely enforced. Many prosecutions involve low risk behavior. High-risk behavior is treated inconsistently. Our model and data do not refute the null hypothesis that U.S. criminal law has no significant effect on HIV/AIDS case or risk behavior/perception.

Learning Objectives: Participants will be able to

• Describe the characteristics and prevalence of typical HIV-specific criminal exposure and transmission laws.
• Recognize the unusual character of prosecutions for HIV exposure, including rarity, specific behaviors targeted, and media attention to cases in the context of other criminal prosecutions.
• Relate characteristics of laws, prosecutions and media attention to risk behaviors and perceptions through the interdisciplinary model used here.

Keywords: HIV Risk Behavior, Criminal Justice

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.