Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-27T20:17:36.341Z Has data issue: false hasContentIssue false
  • English
  • Français

HIV treatment as prevention: not an argument for continuing criminalisation of HIV transmission1

Published online by Cambridge University Press:  16 December 2013

John G. Francis  and
Leslie P. Francis
John G. Francis*
Affiliation:
University of Utah
Leslie P. Francis
Affiliation:
University of Utah
*
[email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

HIV prevention and treatment are undergoing impressive technological and practice changes. In-home rapid testing, prophylaxis before risky sex, and treatment as prevention give cause for remarkable optimism and suggest the possibility of an AIDS-free generation. These changes in HIV prevention and treatment might affect HIV policy in several different directions. One direction would be further entrenchment of the currently prevailing punitive approach. A different direction would be a shift away from use of the criminal law as a method for discouraging risky behaviour and towards a strategy aimed to encourage the use of the new treatment and prevention possibilities. When such abrupt technological changes are accompanied by sharp changes in regulatory regimes, they are identified in the public policy literature as a ‘punctuated equilibrium’. A shift away from criminalisation in HIV policy, if sufficiently widespread and transformative, could reach the level of a punctuated equilibrium. This paper presents a critical assessment of the implications of the changes in available forms of treatment and prevention for the continued appeal of criminalisation as an approach to HIV policy. We conclude that criminalisation is less justifiable in the light of what might be circumstances ripe for a punctuated equilibrium.

Type
Articles
Information
International Journal of Law in Context , Volume 9 , Issue 4 , December 2013 , pp. 520 - 534
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

This paper was presented at the ESRC seminar Criminalising Contagion: Legal and Ethical Challenges of Disease Transmission and the Criminal Law, at the University of Southampton, 10 January 2013. We are grateful to David Gurnham and to participants in the conference for comments on earlier versions of this paper.

References

AIDS 2012 (2012) AIDS 2012 Promotional Video. Available at: <http://www.aids2012.org/Default.aspx?pageId=369> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
AIDS LEGAL COUNCIL OF CHICAGO (2010) HIV and Undocumented Immigrants: Your Legal Rights. Available at: <http://www.aidslegal.com/Publications/Undocumented_Immigrants_English.pdf> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
Alimi, Bisi (2012) ‘An HIV Home Testing Kit Won't Give You Emotional Support’, The Guardian [online] (5 July). Available at: <http://www.guardian.co.uk/commentisfree/2012/jul/05/hiv-home-testing-kit> (last accessed 3 November 2012). (last accessed 3 November 2012).' href=https://scholar.google.com/scholar?q=Alimi,+Bisi+(2012)+‘An+HIV+Home+Testing+Kit+Won't+Give+You+Emotional+Support’,+The+Guardian+[online]+(5+July).+Available+at:++(last+accessed+3+November+2012).>Google Scholar
Battin, Margaret P., Francis, Leslie P., Jacobson, Jay A. and Smith, Charles B. (2009) The Patient as Victim and Vector: Ethics and Infectious Disease. New York: Oxford University Press.Google Scholar
Baumgartner, F. and Jones, B. (1993) Agenda and Instability Politics. Chicago: University of Chicago Press.Google Scholar
Bayer, Ronald (1991) ‘AIDS: The Politics of Prevention and Neglect’, Health Affairs 10(1): 87–97.Google Scholar
BrownDavid, K David, K, Sun, Lena H. and Botelho, Alyssa A. (2012) ‘Making Case for More AIDS Funding’, Washington Post [online] (28 July). Available at: <http://english.htu.cn/washington%20post/2012/07/28/Ax3.pdf> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
Brown, Ingrid (2009) ‘Stigma at Home, Fear of Deportation Haunt Jamaican Illegal Immigrants with HIV/AIDS’, Washington Post [online] (18 December). Available at: <http://www.washingtonpost.com/wp-dyn/content/article/2009/12/17/AR2009121703006.html?sid=ST2009122101687> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Burris, Scott and Weait, Matthew (2011) ‘Criminalisation and the Moral Responsibility for Sexual Transmission of HIV’, working paper prepared for the Third Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law, 7–9 July 2011. Available at: <http://ssrn.com/abstract=2126714 (last accessed 5 November 2012).Google Scholar
Carpenter, Anna (2012) ‘Women and HIV/AIDS: Toward a Jurisprudence of Social and Economic Rights.’ Available at: <http://ssrn.com/abstract=2143429> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
CENTERS FOR DISEASE CONTROL AND PREVENTION (2002) ‘Approval of a New Rapid Test for HIV Antibody’, Morbidity and Mortality Weekly Report 51(46): 1051–52.Google Scholar
CENTERS FOR DISEASE CONTROL AND PREVENTION (2012) ‘HIV Among African Americans.’ Available at: <http://www.cdc.gov/hiv/topics/aa/ (last accessed 3 November 2012).Google Scholar
Chalmers, James (2008) Legal Responses to HIV and AIDS. Oxford and Portland, OR: Hart Publishing.Google Scholar
DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH (2012) DC Takes on HIV. Available at: <http://dctakesonhiv.com/ (last accessed 3 November 2012).Google Scholar
Dodds, Catherine, Bourne, Adam and Weait, Matthew (2009) ‘Responses to Criminal Prosecutions for HIV Transmission among Gay Men with HIV in England and Wales’, Reproductive Health Matters 17(34): 135–45.Google Scholar
Fauci, Anthony S. and Folkers, Gregory K. (2012) ‘Towards an AIDS-Free Generation’, Journal of the American Medical Association 308(4): 343–44.Google Scholar
Francis, Leslie P. and Francis, John G. (2012) ‘Criminalizing Health-Related Behaviors Dangerous to Others? Disease Transmission, Transmission Facilitation, and the Importance of Trust’, Criminal Law and Philosophy 6(1): 47–63.Google Scholar
Ganguli, Ishani (2008) ‘Screening: It's Not So Easy; Researchers Find Oral Test is Fast But Not Always Accurate’, Washington Post [online] (5 August). Available at: <http://www.washingtonpost.com/wp-dyn/content/article/2008/08/01/AR2008080102753.html (last accessed 3 November 2012).Google Scholar
GLOBAL NETWORK OF PEOPLE LIVING WITH HIV/AIDS (2010) 2010 Global Criminalisation Scan Report. Available at: <http://www.gnpplus.net/programmes/human-rights/global-criminalisation-scan/1648-2010-global-criminalisation-scan-report> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Gould, Stephen Jay (2007) Punctuated Equilibrium. Cambridge, MA: Harvard University Press.Google Scholar
Gray, Stephen (2012) ‘New Call for HIV At-home Testing Kits in the UK’, Pink News, [online] (6 July). Available at: <http://www.pinknews.co.uk/2012/07/06/new-call-for-hiv-at-home-testing-kits-in-the-uk/> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
Grudin, Jonathan (2012) ‘Punctuated Equilibrium and Technology Change,’ Interactions [online] (September/October). Available at: <http://interactions.acm.org/archive/view/september-october-2012/punctuated-equilibrium-and-technology-change> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Jay, Jonathan S. and Gostin, Lawrence O. (2012) ‘Ethical Challenges of Preexposure Prophylaxis for HIV’, Journal of the American Medical Association 308(9): 1–2.Google Scholar
Johnson, Chris (2012) ‘AIDS 2012: Clinton Announces “Blueprint” for “AIDS free” generation’, Washington Blade [online] (July 23). Available at: <http://www.washingtonblade.com/2012/07/23/aids-2012-clinton-announces-blueprint-for-aids-free-generation/> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
KELLEY, Colleen F., HAALAND, Richard E., PATEL, Pragna, EVANS-STRICKFADEN, Tammy, FARSHY, Carol, HANSON, Debra, MAYER, Kenneth, LENNOX, Jeffrey L., BROOKS, John T. and HART, Clyde E. (2011) ‘HIV-1 RNA Rectal Shedding Is Reduced in Men With Low Plasma HIV-1 RNA Viral Loads and Is Not Enhanced by Sexually Transmitted Bacterial Infections of the Rectum’, Journal of Infectious Diseases 204(5): 761–67.Google Scholar
LIANG, T. S., ERBELDING, E., JACOB, C. A., WICKER, H., CHRISTMYER, C., BRUNSON, S., RICHARDSON, D. and ELLEN, J. M. (2005) ‘Rapid HIV Testing of Clients of a Mobile STD/HIV Clinic’, AIDS Patient Care and STDs 19(4): 253–57.Google Scholar
Loch, C. H. and Huberman, B. A. (1999) ‘A Punctuated-Equilibrium Model of Technology Diffusion’, Management Science 45(2): 160–77.Google Scholar
Mackinnon, Emily and Crompton, Constance (2012) ‘The Gender of Lying: Feminist Perspectives on the Non-Disclosure of HIV Status’, University of British Columbia Law Review 45(2): 407–47.Google Scholar
Mcneil, Donald G. Jr., (2012a) ‘Rapid H.I.V. Home Test Wins Federal Approval’, New York Times [online] (3 July). Available at: <http://www.nytimes.com/2012/07/04/health/oraquick-at-home-hiv-test-wins-fda-approval.html> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
Mcneil, Donald G. Jr., (2012b) ‘Another Use for Rapid Home H.I.V. Test: Screening Sexual Partners’, New York Times [online] (5 October). Available at: <http://www.nytimes.com/2012/10/06/health/another-use-for-home-hiv-test-screening-partners.html?pagewanted=all&_r=0> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
Mcneil, Donald G. Jr., (2012c) ‘Unlikely Model in H.I.V. Efforts: Sex Film Industry’, New York Times [online] (6 November). Available at: <http://www.nytimes.com/2012/11/06/health/unlikely-model-for-hiv-prevention-porn-industry.html?pagewanted=all&_r=0> (last accessed 7 November 2012).+(last+accessed+7+November+2012).>Google Scholar
Meier, Benjamin Mason, Brugh, Kristen Nichole and Halima, Yasmin (2012) ‘Conceptualizing a Human Right to Prevention in Global HIV/AIDS Policy’, Public Health Ethics 5(3): 262–82. Available at: <http://ssrn.com/abstract=2155933 (last accessed 5 November 2012).Google Scholar
NAT (National AIDS Trust) (2007) Access to HIV Treatment and Care in the UK: Cases Related to Charging. Available at: <http://www.nat.org.uk/Media%20library/Files/PDF%20documents/NAT-Access-to-treatment-and-care-cases.pdf> (last accessed 7 November 2012).+(last+accessed+7+November+2012).>Google Scholar
NAT (National AIDS Trust) (2011) HIV Treatment as Prevention. Available at: <http://www.nat.org.uk/media/Files/Publications/May-2011-HIV-Treatment-as-Prevention.pdf> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
NHS (National Health Service) (2012) HIV and AIDS—Treatment. Available at: <http://www.nhs.uk/Conditions/HIV/Pages/Treatmentpg.aspx> (last accessed 7 November 2012).+(last+accessed+7+November+2012).>Google Scholar
Nwankwo, T. O and Aniebue, U. U. (2011) ‘Percutaneous Injuries and Accidental Blood Exposure in Surgical Residents: Awareness and Use of Prophylaxis in Relation to HIV’, Nigerian Journal of Clinical Practice 14(1):34–37.Google Scholar
NYE COUNTY (Nevada) (2012) ‘Ryan White Part A Funds.’ Available at: <http://www.nyecounty.net/index.aspx?NID=291> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
ORASURE TECHNOLOGIES (2012) OraQuick: Where to Buy. Available at: <http://www.oraquick.com/where-to-buy> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
PASCOE, S. J., LANGHAUG, L. F., MUDZORI, J., BURKE, E., HAYES, R., and COWAN, F. M. (2009) ‘Field Evaluation of Diagnostic Accuracy of an Oral Fluid Rapid Test for HIV, Tested at Point-of-service Sites in Eural Zimbabwe’, Aids Patient Care and STDs 23(7): 571–76.Google Scholar
PRESIDENTIAL COMMISSION (on the Human Immunodeficiency Virus Epidemic) (1988) Report of the Presidential Commission on the Human Immunodeficiency Virus Epidemic. Available at: <http://www.eric.ed.gov/PDFS/ED299531.pdf> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
PUBLIC AGENDA (2009) Impressions of HIV/AIDS in America: A Report of Conversations with People Throughout the Country. Available at: <http://www.publicagenda.org/files/pdf/HIV-AIDS-May-2009.pdf> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Rawls, John (1971) A Theory of Justice. Cambridge, MA: Harvard University Press.Google Scholar
Rothenberg, Karen and Paskey, Steven (1995) ‘The Risk of Domestic Violence and Women with HIV Infection: Implications for Partner Notification, Public Policy, and the Law’, American Journal of Public Health 85: 1569–76.Google Scholar
Stewart, Nikita (2010) ‘Bringing Free HIV Testing to the Crowd at Motor Vehicles’, Washington Post [online] (1 October). Available at: <http://www.washingtonpost.com/wp-dyn/content/article/2010/09/30/AR2010093007265.html> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Sayles, J. N., Rurangirwa, J., Kim, M., Kinsler, J., Oruga, R. and Janson, M. (2012) ‘Operationalizing Treatment as Prevention in Los Angeles County: Antiretroviral Therapy Use and Factors Associated with Unsuppressed Viral Load in the Ryan White System of Care’, AIDS Patient Care and STDs 26(8): 463–70.Google Scholar
Siegfried, N., et al. (2011) ‘Antiretrovirals for Reducing the Risk of Mother-to-child Transmission of HIV Infection’, Cochrane Database of Systematic Reviews [online]. Available at: <http://summaries.cochrane.org/CD003510/antiretrovirals-for-reducing-the-risk-of-mother-to-child-transmission-of-hiv-infection> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
TERRENCE HIGGINS TRUST (2012) ‘Post Exposure Prophylaxis.’ Available at: <http://www.tht.org.uk/sexual-health/HIV-STIs/HIV-AIDS/Post-exposure-prophylaxis> (last accessed 7 November 2012).+(last+accessed+7+November+2012).>Google Scholar
TORONTO GLOBE AND MAIL (2011/2012) ‘HIV Killer Has High Libido and Could Reoffend, Crown Says’, Toronto Globe and Mail [online] (published 27 June 2011, last updated 24 August 2012). Available at: <http://www.theglobeandmail.com/news/national/hiv-killer-has-high-libido-and-could-reoffend-crown-says/article589067/> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
True, James L., Jones, Bryan D. and Baumgartner, Frank R. (2007) ‘Punctuated-Equilibrium Theory: Explaining Stability and Change in Public Policymaking’, in Sabatier, Paul A. (ed.), Theories of the Public Policy Process, 2nd edn.Boulder, CO: Westview Press, 155–88.Google Scholar
UNAIDS (2008) ‘UNAIDS Recommendations for Alternative Language to Some Problematic Articles in the N'Djamena Legislation on HIV.’ Available at: <http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/manual/2008/20080912_alternativelanguage_ndajema_legislation_en.pdf> (last accessed 5 November 2012). (last accessed 5 November 2012).' href=https://scholar.google.com/scholar?q=UNAIDS+(2008)+‘UNAIDS+Recommendations+for+Alternative+Language+to+Some+Problematic+Articles+in+the+N'Djamena+Legislation+on+HIV.’+Available+at:++(last+accessed+5+November+2012).>Google Scholar
UNAIDS (2012) UNAIDS 2012 Fact Sheet. Available at: <http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/201207_FactSheet_Global_en.pdf> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
US AID (and Family Health International) (2008) Disseminating and Replicating Best Practices in West Africa. Available at: <http://www.fhi.org/NR/rdonlyres/ee6tr3nar6mnnri7b5fkesexfwlau5jno4p3a4m2vzcwqzh6n4jediytkw6ceonvtdhvzvvx4bd27m/AWAREDissemBestPracticesWAHV.pdf> (last accessed 3 November 2012).+(last+accessed+3+November+2012).>Google Scholar
US DEPARTMENT OF STATE (2012) ‘PEPFAR BLUEPRINT: Creating an AIDS-free Generation.’ Available at: <http://www.pepfar.gov/documents/organization/201386.pdf> (last accessed 3 July 2013).+(last+accessed+3+July+2013).>Google Scholar
Valdesseri, Ronald (2012) ‘HRSA Seeks Public Input on Ryan White Reauthorization, blog.AIDS.gov [blog] (16 May). Available at: <http://blog.aids.gov/2012/05/hrsa-seeks-public-input-on-ryan-white-reauthorization.html> (last accessed 5 November 2012).+(last+accessed+5+November+2012).>Google Scholar
Weait, Matthew (2005) ‘Criminal Law and the Sexual Transmission of HIV: R v. Dica,’ Modern Law Review 68(1): 121–34.Google Scholar
Weait, Matthew and Azad, Yusef (2005) ‘The Criminalization of HIV Transmission in England and Wales: Questions of Law and Policy’, HIV/AIDS Policy & Law Review 10(2): 5–12.Google Scholar
Winston, Morton E. and Landesman, Sheldon H. (1989) ‘AIDS and a Duty to Protect’, in Levine, Carol (ed.), Cases in Bioethics: Selections from the Hastings Center Report. New York: St Martin's Press, 39–42.Google Scholar
Wolf, Leslie and Vezina, Richard (2004) ‘Crime and Punishment: Is There a Role for Criminal Law in HIV Prevention Policy?’, Whittier Law Review 25: 821–86.Google Scholar