A study led by the Medical College of Wisconsin (MCW) and published online in the American Journal of Public Health found that 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.
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 (CAIR) at MCW, 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. Galletly is an associate professor of psychiatry and behavioral medicine at MCW.
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., all of CAIR.
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. Wisconsin does not have a criminal HIV exposure law; however, Wisconsin code allows for enhanced penalties for persons who commit certain serious sexual crimes while knowing that they are HIV-positive.
Galletly and her colleagues also asked participants about responsibility for HIV prevention. 90% 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. 34% 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 ajph.aphapublications.org . A short video summary is also available at http://www.youtube.com/user/phlrrwjf.
The Center for AIDS Intervention Research at MCW is one of five HIV prevention research centers in the United States funded by the National Institute of Mental Health. CAIR's missions are to conceptualize, conduct, and scientifically evaluate the effectiveness of new intervention strategies to prevent HIV infection in populations vulnerable to the disease. CAIR's research also develops improved strategies to promote health and alleviate adverse mental health consequences among persons living with HIV. CAIR is committed to disseminating its findings both to the scientific community and to public health providers so they benefit from Center research.
About the Medical College of Wisconsin
The Medical College of Wisconsin is the state's only private medical school and health sciences graduate school. Founded in 1893, it is dedicated to leadership and excellence in education, patient care, research and service. More than 1,200 students are enrolled in the Medical College's medical school and graduate school programs. A major national research center, it is the largest research institution in the Milwaukee metro area and second largest in Wisconsin. In FY 2010 — 11, faculty received more than $175 million in external support for research, teaching, training and related purposes, of which more than $161 million is for research. This total includes highly competitive research and training awards from the National Institutes of Health (NIH). Annually, College faculty direct or collaborate on more than 2,200 research studies, including clinical trials. Additionally, more than 1,350 physicians provide care in virtually every specialty of medicine for more than 400,000 patients annually.
About Public Health Law Research
Public Health Law Research (PHLR) is a national program of the Robert Wood Johnson Foundation, with direction and technical assistance by Temple University. The program is dedicated to building the evidence base for laws that improve public health. PHLR funds research, improves research methods, and makes evidence more accessible to policy-makers, the media, and the public. For more information about PHLR, visit publichealthlawresearch.org .
About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org . Follow the Foundation on Twitter www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.
