RT Journal Article
SR Electronic
T1 Prevalence and predictors of facing a legal obligation to disclose HIV serostatus to sexual partners among people living with HIV who inject drugs in a Canadian setting:a cross-sectional analysis
JF CMAJ Open
FD Canadian Medical Association
SP E169
OP E176
DO 10.9778/cmajo.20150106
VO 4
IS 2
A1 Patterson, Sophie
A1 Kaida, Angela
A1 Nguyen, Paul
A1 Dobrer, Sabina
A1 Ogilvie, Gina
A1 Hogg, Robert
A1 Kerr, Thomas
A1 Montaner, Julio
A1 Wood, Evan
A1 Milloy, M.-J.
YR 2016
UL http://www.cmajopen.ca/content/4/2/E169.abstract
AB Background: In October 2012, the Canadian Supreme Court ruled that people living with HIV must disclose their HIV status before sex that poses a "realistic possibility" of HIV transmission, clarifying that in circumstances where condom-protected penile-vaginal intercourse occurred with a low viral load (< 1500 copies/mL), the realistic possibility of transmission would be negated. We estimated the proportion of people living with HIV who use injection drugs who would face a legal obligation to disclose under these circumstances.Methods: : We used cross-sectional survey data from a cohort of people living with HIV who inject drugs. Participants interviewed since October 2012 who self-reported recent penile-vaginal intercourse were included. Participants self-reporting 100% condom use with a viral load consistently < 1500 copies/mL were assumed to have no legal obligation to disclose. Logistic regression identified factors associated with facing a legal obligation to disclose.Results: We included 176 participants, 44% of whom were women: 94% had a low viral load, and 60% self-reported 100% condom use. If condom use and low viral load were required to negate the realistic possibility of transmission, 44% would face a legal obligation to disclose. Factors associated with facing a legal obligation to disclose were female sex (adjusted odds ratio [OR] 2.19, 95% confidence interval [CI] 1.13-4.24), having 1 recent sexual partner (v. > 1) (adjusted OR 2.68, 95% CI 1.24-5.78) and self-reporting a stable relationship (adjusted OR 2.00, 95% CI 1.03-3.91).Interpretation: Almost half the participants in our analytic sample would face a legal obligation to disclose to sexual partners under these circumstances (with an increased burden among women), adding further risk of criminalization within this marginalized and vulnerable community.