Canada: M.D.s Oppose Jail for Unsafe Sex by HIV Carriers

Canadians living with HIV should no longer face a possible prison sentence for failing to disclose their infection to sexual partners, British Columbia health experts said in a new editorial. People with HIV, unlike people with other STDs, are being singled out because of stigma and fear, said Dr. Julio Montaner, director of the British Columbia Center for Excellence in HIV/AIDS.

A study published this year found that early antiretroviral therapy for HIV patients reduced the likelihood of sexual transmission by 96 percent.

Nonetheless, Canada "now ranks among the world leaders" in the rate of prosecutions of people for allegedly exposing sexual partners to HIV, Montaner and colleagues M-J Milloy and Thomas Kerr wrote in the Canadian Medical Association Journal.

"Do we place a burden on males infected with [human papillomavirus] to have to disclose every time that they have a sexual encounter that they have HPV?" asked Montaner in an interview. "We don't, and that's only one example."

"To put the burden on the person infected with HIV that they have to disclose when they may be on treatment or using a condom, or doing both, is really not appropriate," Montaner said. "We can't have a discourse that, on the one hand, says things are different now -- we can identify HIV, we can treat it, you can have a near normal life -- and, on the other hand, says if you [do not disclose] to another person we are ready to put you in jail," said Montaner.

"Let me be clear -- I think that people who behave irresponsibly, they need to be judged accordingly and there are laws to address those issues. If you mislead somebody, if you misrepresent your status -- but to have a policy that selectively targets HIV" is discriminatory and discourages testing and treatment, Montaner said.

The article, "Ending Canada's HIV Trials," was published ahead of the print edition of the Canadian Medical Association Journal (2011;doi:10.1503/cmaj.111848).

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