A New Jersey law requiring individuals with HIV to disclose their HIV-positive status to their sexual partners does not appear to be an effective HIV prevention intervention, according to a study published online on September 20 in the American Journal of Public Health.
Fifty-one percent of study participants were aware that New Jersey had such a law. However, persons who were aware of the law were just as likely as persons who were unaware of the law to disclose their HIV status, engage in less risky sexual behaviors (such as fewer number of partners), and use condoms. The majority of participants, regardless of being aware or unaware of the law, reported having been in compliance with the law for the previous year - that is, they abstained from sex or they informed their prospective partners of their HIV-positive status.
In fact, 85 percent of participants reported that they would not be willing to engage in unprotected sex with an HIV-negative partner who was not informed of their HIV-positive status.
Awareness of the law was not associated with negative outcomes for HIV-positive study participants. Participants who were aware of the law did not perceive greater social hostility toward persons living with HIV, or experience more discomfort with HIV status disclosure or more HIV-related stigma. Conversely, those who were unaware of the law perceived more social hostility toward persons living with HIV, experienced greater HIV-related stigma and were less comfortable with HIV status disclosure.
Principal Investigator Carol Galletly, JD, PhD, of the Center for AIDS Intervention Research at the Medical College of Wisconsin, and her colleagues surveyed a sample of 479 people in New Jersey who are HIV-positive between March 22, 2010 and October 6, 2010. Participants varied by sex and race: 45 percent of were female, two-thirds were African-American, 16 percent were Hispanic, and 13 percent were Caucasian. The study population ranged from ages 19 to 66.
The article, "New Jersey's HIV exposure law and the HIV-related attitudes, beliefs, and sexual and seropositive status disclosure behaviors of a sample of persons living with HIV," was written by Galletly, along with Laura R. Glasman, PhD, Steven D. Pinkerton, PhD, and Wayne DiFranceisco, MA.
A majority of U.S. states have enacted laws that regulate the sexual behavior of people living with HIV. Most of these laws require individuals with HIV to disclose their HIV status to prospective sex partners. In New Jersey, violation of the law is a felony. This designation is typical, and some states even require individuals who have violated these laws to register as sex offenders.
Galletly and her colleagues also asked participants about responsibility for HIV prevention. Ninety percent believed that a person living with HIV bears at least half the responsibility for insuring that an HIV-negative partner doesn't contract HIV through sex. Thirty-four percent thought the HIV-positive person has full responsibility.
While these results are specific to New Jersey, several states have enacted similar versions of this law. Researchers are working to compare findings from different states.
Galletly's research was funded by Public Health Law Research, a national program of the Robert Wood Johnson Foundation, as well as a grant from the National Institute of Mental Health.
The article is available online at http://ajph.aphapublications.org, and alternatively at the Social Science Research Network (SSRN): http://ssrn.com/abstract=2152097
Watch an online video teaser of the results: http://youtu.be/DBjIpl7tn5Q
Additional URL(s):
Abstract at AJPH
Full paper download at SSRN