Many HIV-positive people’s understanding of the law on HIV transmission is … – aidsmap

In this study, 33 people waiting for their clinical appointments at a large clinic in Manchester completed written questionnaires. Using open questions, respondents were invited to describe their understanding of various issues in their own words. The key themes in these responses were analysed qualitatively.

While the majority of respondents were gay men of white British ethnicity, ten respondents were heterosexual, five were women and seven were African.

Respondents were asked: “Do you understand the legal issues surrounding HIV transmission in England and Wales? Particularly consider any circumstances where it is against the law to pass on HIV, and the way that the law deals with people who pass on HIV”.

A few respondents were able to describe the law with reasonable accuracy.

However most respondents had a poor understanding. While some frankly stated that they had “no idea” of what the law was, others appeared to have confidence in their knowledge but in fact had an incomplete understanding. This could put some individuals at risk of prosecution.

On the other hand, several respondents overestimated the burden of the law on people with HIV. For example one man said: “I understand it is unlawful to pass on HIV” when in fact it is only unlawful in certain circumstances. Similarly another thought that “it is illegal to have unsafe sex when you know you are HIV+” although this would depend on whether HIV transmission and disclosure had occurred or not. Some respondents thought that the criminal offence could be manslaughter or attempted murder, rather than grievous bodily harm.

The researchers note that when individuals overestimate how the law restricts their own behaviour or the nature of punishment, this could contribute to feelings of stigmatisation and marginalisation.

Explanations of the law often entailed descriptions of specific sexual practices (especially sex without a condom), disclosure of HIV status and the nature of the relationship between sexual partners.

Some suggested that there might a duty to disclose to certain people who are not sexual partners, while other respondents felt that disclosure might depend on the type of relationship.

“Not clear about disclosure and the law and if there (in particular) [is] a difference between casual encounters and regular partner sexual activity.”

“It is essential to disclose your status before entering a relationship.”

Rather than considering the absolute risk of transmission, some respondents appeared to assess the need for disclosure based on the longevity or importance of the relationship, with obligations to a regular partner being stronger than those to a casual partner.

Respondents frequently described their own ethical position rather than a clear description of the law.

“I feel it is immoral to knowingly pass on HIV.”

“Not a good idea to pass on your own HIV to innocent people. Pass it on to others is ungodliness.”

A number of respondents mentioned rights and responsibilities. However the rights and responsibilities described were always those of the respondent, of the person living with HIV. There was little mention of (HIV negative) sexual partners having some responsibility for avoiding HIV infection.