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Effects of the Criminalization of HIV Transmission in Cuerrier on Men Reporting Unprotected Sex with Men

Published online by Cambridge University Press:  18 July 2014

Barry D. Adam ,
Richard Elliott ,
Winston Husbands ,
James Murray  and
John Maxwell
Barry D. Adam
Affiliation:
Department of Sociology and Anthropology, University of Windsor Windsor, ON N9B [email protected]
Richard Elliott
Affiliation:
Canadian HIV/AIDS Legal Network Toronto, ON, Canada
Winston Husbands
Affiliation:
Research and Program Development, AIDS Committee of Toronto, Toronto, ON, Canada
James Murray
Affiliation:
AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Toronto, ON, Canada
John Maxwell
Affiliation:
Special Projects, AIDS Committee of Toronto, Toronto, ON, Canada
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Abstract

This paper reports on the perceptions and practices of men who have frequent unprotected sex with men in a socio-legal environment defined by the 1998 decision of the Supreme Court of Canada in R. v. Cuerrier. HIV-positive people are increasingly finding themselves in court since Cuerrier, and many are trying to take account of legal reasoning in their own conduct. The judicial construction of behaviour likely to transmit HIV relies on a set of presumptions concerning individual responsibility, rational and contractual interaction, and consenting adults that raises a series of ambiguities and uncertainties among HIV-positive people attempting to implement them in everyday life. While some express support for the reasoning in Cuerrier, others struggle with practical dilemmas in sexual interaction, and a minority strand of ethical reasoning advances a “buyer beware” principle. This latter view occurs in a social environment where HIV-positive people experience strong disincentives to disclose in the face of potential rejection or discrimination once their sero-status is known. Examination of the social consequences of Cuerrier raises questions about the viability of relying on the enforcement of disclosure, through threat of criminal prosecution, as an effective method of HIV prevention, especially when most practical, day-to-day HIV prevention occurs when safer sex is practised consistently regardless of disclosure.

Résumé

Cet article dresse un portrait des perceptions et des pratiques des hommes qui ont des rapports sexuels fréquents et non protégés avec d'autres hommes dans un climat sociolégal défini par la décision, en 1998, de la Cour suprême du Canada dans l'affaire R. c. Cuerrier. Depuis cette décision, les personnes séropositives se retrouvent de plus en plus souvent en cour et plusieurs d'entres elles essaient d'incorporer des raisonnements légaux dans leurs propres comportements. La construction judiciaire des comportements à risque en matière de transmission du VIH repose sur un ensemble de présuppositions concernant la responsabilité individuelle, les interactions rationnelles et contractuelles ainsi que les adultes consentants. Ces présuppositions suscitent une série d'ambiguïtés et d'incertitudes chez les personnes séropositives qui essaient de les incorporer dans leur vie quotidienne. Tandis que certaines personnes supportent le raisonnement dans l'affaire Cuerrier, d'autres luttent avec les dilemmes pratiques dans les interactions sexuelles, et une minorité avance un raisonnement éthique qui repose avant tout sur la mise en garde. Ce type de raisonnement est commun dans un environnement social dans lequel les personnes séropositives sentent des pressions les incitant à ne pas divulguer leur séropositivité, d'autant plus qu'elles risquent de faire face à un rejet ou une discrimination suite à cette divulgation. Un examen des conséquences sociales de Cuerrier mène à un questionnement sur la viabilité d'une stratégie de renforcement de la divulgation par la menace d'une poursuite en cour criminelle comme méthode efficace de prévention du VIH, d'autant plus que la prévention de la transmission du VIH a lieu, de façon pragmatique et quotidienne, lorsque les gens se protègent lors des rapports sexuels plutôt que de se fier sur la divulgation.

Type
Research Article
Information
Canadian Journal of Law and Society / La Revue Canadienne Droit et Société , Volume 23 , Issue 1-2 , April 2008 , pp. 143 - 159
Copyright
Copyright © Canadian Law and Society Association 2008

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References

1 [1998] 2 S.C.R 371 [Cuerrier].

2 Weeks, Jeffrey, Invented Moralities: Sexual Values in an Age of Uncertainty (New York: Columbia University Press, 1995), 137Google Scholar.

3 Myers, Ted, Allman, Dan, Calzavara, Liviana, Maxwell, John, Remis, Robert, Swantee, Carol, and Travers, Robb, Ontario Men's Survey (Toronto: Faculty of Medicine, University of Toronto, 2004)Google Scholar; Adam, Barry D., Husbands, Winston, Murray, James, and Maxwell, John, “Circuits, Networks, and HIV Risk Management,” AIDS Education and Prevention 20 (2008): 420–35CrossRefGoogle ScholarPubMed.

4 Cuerrier at paras. 128, 129; for a detailed discussion of the judgment in Cuerrier see Elliott, Richard, After Cuerrier: Canadian Criminal Law and the Non-disclosure of HIV-Positive Status (Montreal: Canadian HIV/AIDS Legal Network, 1999)Google Scholar.

5 Results of weekly poll: “Should HIVers who have unprotected sex without disclosing their status face criminal charges?” Poz, October 2003, 7Google Scholar.

6 Kok, Gerjo, “Targeted Prevention for People with HIV/AIDS,” Patient Education and Counseling 36 (1999), 239CrossRefGoogle ScholarPubMed; Kalichman, Seth, Rompa, David, Cage, Marjorie, DiFonzo, Kari, Simpson, Dolores, Austin, James, Luke, Webster, Buckles, Jeff, Kyomugisha, Florence, Benotsch, Eric, Pinkerton, Steven, and Graham, Jeff., “Effectiveness of an Intervention to Reduce HIV Transmission Risks in HIV-Positive People,” American Journal of Preventive Medicine 21, 2 (2001), 84–92CrossRefGoogle ScholarPubMed; Patterson, Thomas, Shaw, William, and Semple, Shirley, “Reducing the Sexual Risk Behaviors of HIV+ Individuals,” Annals of Behavioral Medicine 25, 2 (2003), 138CrossRefGoogle ScholarPubMed; Kalichman, Seth, Rompa, David, and Cage, Marjorie, “Group Intervention to Reduce HIV Transmission Risk Behavior among Persons Living with HIV/AIDS,” Behavior Modification 29 (2005), 256CrossRefGoogle ScholarPubMed.

7 Smith, Gary and Van de Ven, Paul, Reflecting on Practice: Current Challenges in Gay and Other Homosexually Active Men's HIV Education (Sydney: National Centre in HIV Social Research, 2001), 18Google Scholar.

8 Stirratt, Michael, “I Have Something to Tell You,” in HIV+ Sex: The Psychosocial and Interpersonal Dynamics of HIV-Seropositive Gay and Bisexual Men's Relationships, ed. Halkitis, Perry N., Gómez, Cynthia A., and Wolitski, Richard J. (Washington, DC: American Psychological Association, 2005), 103Google Scholar.

9 Klitzman, Robert and Bayer, Ronald, Mortal Secrets: Truth and Lies in the Age of AIDS (Baltimore: Johns Hopkins University Press, 2003), 51Google Scholar.

10 Stirrat, , “I Have Something to Tell You,” 114Google Scholar.

11 Adam, Barry D., “Constructing the Neoliberal Sexual Actor” Culture, Health and Sexuality 7 (2005), 340CrossRefGoogle ScholarPubMed.

12 Serovich, Julianne, Oliver, Daniel, Smith, Sarah, and Mason, Tina, “Methods of HIV Disclosure by Men Who Have Sex with Men to Casual Sexual Partners,” AIDS Patient Care and STDs 19 (2005): 823–32CrossRefGoogle ScholarPubMed.

13 Parsons, Jeffrey, Schrimshaw, Eric, Bimbi, David, Wolitski, Richard, Gómez, Cynthia, and Halkitis, Perry, “Consistent, Inconsistent, and Non-Disclosure to Casual Sexual Partners among HIV-Seropositive Gay and Bisexual Men,” AIDS 19 (2005): S91–92CrossRefGoogle ScholarPubMed.

14 Duru, O Kenrik, Collins, Rebecca, Ciccarone, Daniel, Morton, Sally, Stall, Ron, Beckman, Robin, Miu, Angela, and Kanouse, David, “Correlates of Sex without Serostatus Disclosure among a National Probability Sample of HIV Patients,” AIDS and Behavior 10 (2006): 495–507CrossRefGoogle ScholarPubMed.

15 Stoller, Nancy, Lessons from the Damned: Queers, Whores and Junkies Respond to AIDS (New York: Routledge, 1998)Google Scholar; Manfrin-Ledet, Linda and Porche, Demetrius, “The State of the Science,” Journal of the Association of Nurses in AIDS Care 14, 6 (2003), 56CrossRefGoogle Scholar; Siegel, Karolynn, Lekas, Helen-Maria, and Schrimshaw, Eric, “Serostatus Disclosure to Sexual Partners by HIV-Infected Women Before and After the Advent of HAART,” Women and Health 41, 4 (2005), 63CrossRefGoogle ScholarPubMed.

16 Marks, Gary and Crepaz, Nicole, “HIV-Positive Men's Sexual Practices in the Context of Self-Disclosure of HIV Status,” Journal of Acquired Immune Deficiency Syndromes 27 (2001), 79CrossRefGoogle ScholarPubMed; Hart, Trevor, Wolitski, Richard, Purcell, David, Parsons, Jeffrey, Gómez, Cynthia, and Seropositive Urban Men's Study Team, “Partner Awareness of the Serostatus of HIV-Seropositive Men Who Have Sex with Men,” AIDS and Behavior 9 (2005): 163CrossRefGoogle ScholarPubMed; Larkins, Sherry, Reback, C.J., Shoptaw, Steven, and Veniegas, R.C., “Methamphetamine-Dependent Gay Men's Disclosure of Their HIV Status to Sexual Partners,” AIDS Care 17 (2005): 527CrossRefGoogle ScholarPubMed.

17 Parsons, Jeffrey and Halkitis, Perry N., “Sexual and Drug-Using Practices of HIV-Positive Men Who Frequent Public and Commercial Sex Environments,” AIDS Care 14 (2002), 823CrossRefGoogle ScholarPubMed; Larkins, et al. , “Methamphetamine-Dependent Gay Men's Disclosure,” 526Google Scholar; Vicioso, Kalil, Parsons, Jeffrey, Nanin, Jose, Purcell, David, and Woods, William, “Experiencing Release,” Journal of Sex Research 42 (2005): 17CrossRefGoogle ScholarPubMed.

18 Reback, Cathy, Larkins, Sherry, and Shoptaw, Steven, “Changes in the Meaning of Sexual Risk Behaviors among Gay and Bisexual Male Methamphetamine Abusers Before and After Drug Treatment,” AIDS and Behavior 8 (2004), 87CrossRefGoogle ScholarPubMed; Sheon, Nicholas and Crosby, G. Michael, “Ambivalent Tales of HIV Disclosure in San Francisco,” Social Science and Medicine 58 (2004), 2111CrossRefGoogle ScholarPubMed; Hart et al., “Partner Awareness”; Stirratt, “I Have Something to Tell You.”

19 Collins, Chris, Morin, Stephen, Shriver, Michael, and Coates, Thomas, Designing Primary Prevention for People Living with HIV (San Francisco: UC San Francisco AIDS Research Institute, 2000)Google Scholar; Simoni, Jane and Pantalone, David, “HIV Disclosure and Safer Sex,” in Positive Prevention: Reducing HIV Transmission among People Living with HIV/AIDS, ed. Kalichman, Seth C., 65–98 (New York: Kluwer Academic/Plenum, 2005)CrossRefGoogle Scholar.

20 Remis, Robert, Swantee, Carol, Schiedel, Lorraine, and Liu, Juan, Report on HIV/AIDS in Ontario 2005 (Toronto: Ontario HIV Epidemiologic Monitoring Unit, 2007)Google Scholar.

21 Marks and Crepaz, “HIV-Positive Men's Sexual Practices”; Kalichman, Seth, Rompa, David, Luke, Webster, and Austin, James, “HIV Transmission Risk Behaviours among HIV-Positive Persons in Serodiscordant Relationships,” International Journal of STD and AIDS 13 (2002): 677–82, 681CrossRefGoogle ScholarPubMed.

22 Henriksson, Benny and Mansson, Sven Axel, “Sexual Negotiations: An Ethnographic Study of Men Who Have Sex with Men,” in Culture and Sexual Risk: Anthropological Perspectives on AIDS, ed. Han ten Brummelhuis and Gilbert Herdt (1995; reprint, London: Routledge, 2003), 170Google Scholar.

23 Hart et al, “Partner Awareness”; Mao, Limin, Crawford, June, Hospers, Harm, Prestage, Garrett, Grulich, Andrew, Kaldor, John, and Kippax, Susan, “‘Serosorting’ in Casual Anal Sex of HIV-Negative Gay Men Is Noteworthy and Is Increasing in Sydney, Australia,” AIDS 20 (2006): 1204–6CrossRefGoogle ScholarPubMed.

24 Adam et al., “Circuits, Networks.”

25 Myers et al, Ontario Men's Survey; Adam et al., “Circuits, Networks.”

26 Adam, et al. , Risk Management, 39Google Scholar.

27 This joint policy statement by the Canadian Institutes of Health Research, the National Sciences and Engineering Research Council of Canada, and the Social Sciences and Humanities Research Council of Canada is available at http://pre.ethics.gc.ca/english/pdf/TCPS%20October%202005_E.pdf.

28 Interview excerpts are identified by the interviewee's participant number (e.g., 002) and sero-status (HIV- or HIV+).

29 Adam, Barry D., Husbands, Winston, Murray, James, and Maxwell, John, “Risk Construction in Reinfection Discourses of HIV-Positive Men,” Health, Risk and Society 7 (2005): 63–71CrossRefGoogle Scholar.

30 Brenner, Bluma, Roger, Michel, Routy, Jean-Pierre, Moisi, Daniela, Ntemgwa, Michel, Matte, Claudine, Baril, Jean-Guy, Thomas, Réjean, Rouleau, Danielle, Bruneau, Julie, Leblanc, Roger, Legault, Mario, Tremblay, Cecile, Charest, Hugues, Wainberg, Mark, and the Quebec Primary HIV Infection Study Group, “High Rates of Forward Transmission Events After Acute/Early HIV-1 Infection,” Journal of Infectious Diseases 195 (2007): 951–59CrossRefGoogle ScholarPubMed.

31 Adam, “Constructing the Neoliberal Sexual Actor.”

32 Adam, Barry D., “Infectious Behaviour,” Social Theory and Health 4 (2006), 168CrossRefGoogle Scholar.

33 Smart, Barry, Economy, Culture and Society (Buckingham, UK: Open University Press, 2003), 7Google Scholar.

34 Davis, Mark, “HIV Prevention Rationalities and Serostatus in the Risk Narratives of Gay Men,” Sexualities 5 (2002), 281CrossRefGoogle Scholar.