HIV sero-postive status disclosure to prospective sex partners and criminal laws that require it: Perspectives of persons who have HIV

Background

Twenty-three US states have criminal statutes requiring HIV-positive persons to disclose their serostatus to prospective sex partners. However, little is known about the affect of these laws on HIV-positive persons, whose sexual behaviors are being regulated and upon whom the effectiveness of these laws depends. To examine these issues we conducted structured focus group discussions with HIV-positive residents of a state with an HIV disclosure law.

Methods

Thirty-one HIV-positive persons participated in three, 90-minute focus group discussions. A structured interview guide addressed participants' perceptions of 1) the effectiveness of the state's law; 2) the impact of the law on HIV-positive persons; and 3) individual and societal ethics guiding serostatus disclosure. Transcripts were uploaded into ATLAS qualitative data analysis software. A grounded theory-based approach was used to guide data coding and identify emergent themes.

Results

Several important themes emerged. HIV-positive participants described how the statute unnecessarily exacerbates existing legal, interpersonal, and emotional vulnerabilities associated with living with HIV. Perceived vulnerability within the justice system was a recurrent theme. Preventing HIV transmission was viewed as an ethical imperative. Participants simultaneously claimed responsibility for becoming infected and perceived themselves as responsible for preventing infection in others.

Conclusions

Although study participants endorsed serostatus disclosure to prospective sex partners as a personal ethical imperative, HIV disclosure laws exacerbate existing social vulnerabilities associated with having HIV. Further research is needed to carefully evaluate the potential of these laws to increase social stigma and otherwise adversely affect the quality of life of persons living with HIV.