1. A quantitative study of the impact of a US state criminal HIV disclosure law on state residents living with HIV Carol Galletly, JD PhD Center for AIDS Intervention Research Medical College of Wisconsin

2. IAC2010 Michigan’s criminal HIV disclosure law A person who knows that he or she … is HIV infected, and who engages in sexual penetration with another person without having first informed the other person that he or she … is HIV infected, is guilty of a felony.

3. Michigan’s criminal HIV disclosure law “sexual penetration” means sexual intercourse, cunnilingus, fellatio, anal intercourse, or any other intrusion, however slight, of any part of a person’s body or of any object into the genital or anal openings of another person’s body, but emission of semen is not required. “sexual penetration” means sexual intercourse, cunnilingus, fellatio, anal intercourse, or any other intrusion, however slight, of any part of a person’s body or of any object into the genital or anal openings of another person’s body, but emission of semen is not required. IAC2010

4. Research questions… 1. Awareness Are state residents who are living with HIV aware of this law? Do they understand it? IAC2010

5. Research Questions 2. Effectiveness Does the law increase seropositive status disclosure? Does the law decrease HIV transmission risk? IAC2010

6. Research Questions 3. Harm Does the law serve as an inadvertent disincentive to disclose? Does the law increase HIV-related stigma (felt stigma) or perc’d hostility toward PLWH? IAC2010

7. Research Questions 4. Stance on criminalization Do participants support/oppose criminalization? IAC2010

8. Aware of the law? 384 HIV+ residents of Michigan participated 292 (76%) were aware of the law IAC2010

9. Is the law effective? Awareness of the law was not associated with compliance or abstinence IAC2010

10. Is the law effective? However, just over half of all law- aware participants reported that they believed the law made it more likely that PLWH would disclose to sex partners This belief was associated with compliance (p. =.022) IAC2010

11. Is the law effective? Also, a majority of sexually active, law-aware participants reported that the law was very important in their decision to disclose. Self-reported importance of the law was associated with compliance (p. =.042) IAC2010

12. Is the law harmful? Comfort with disclosure or being identified as PLWH Perceived hostility toward PLWH HIV-related stigma was inversely associated with awareness of the law n/sn/s inverse association (p. =.034) IAC2010

13. Stance on criminalization Oral sex with an uninformed partner 64% supported criminalization Unprotected sex with an uninformed partner 88% supported criminalization Condom-protected sex with an uninformed partner 51% supported criminalization IAC2010

14. Associations with support for criminalization Being a woman Being nonwhite Having less education Having a lower income IAC2010

15. Summary Aware? …in Michigan Aware? …in Michigan Effective? …no independent effect, however some findings were consistent with an effect of the law… Effective? …no independent effect, however some findings were consistent with an effect of the law… Inclined to disclose? Harmful? …no independent effect Harmful? …no independent effect Stance? …surprising support for criminalization Stance? …surprising support for criminalization IAC2010

16. Conclusions First do no harm… Note the characteristics of persons who support criminalization… Are we meeting their needs? Did we prepare them? Do we support them? IAC2010

17. This research was made possible by… A grant from the NIMH (R21) The support of mentors, colleagues, and reviewers Participants living with HIV in Michigan… IAC2010