Will New York's New Partner Notification Law Increase The Threat Of Domestic Violence?
One particularly thorny aspect of New York's new contact tracing law has to do with the danger of domestic violence arising from the disclosure of an individual's HIV status.
The language of the law itself gives a nod toward the problem, but is very vague, stating only that the Department of Health, working with various public and private groups, must "develop a protocol" for the identification and screening of those at risk -- either those who have just tested positive or their contacts -- for domestic violence. When the protocol is complete, it will become part of the (not-yet-published) regulations governing the implementation of the law.
Laura Edidin, an attorney, is HIV-Related Violence Program Coordinator at the Gay and Lesbian Anti-Violence Project, and social worker Diane Dolan-Soto is Coordinator of AVP's Domestic Violence Program. The two women have been working together on defining the scope of the problem and possible approaches, and Dolan-Soto participated in the Albany working group charged with developing the protocol.
Edidin offers examples of the intersection between HIV-related violence and domestic violence: "If the abusive person in the relationship is positive, he or she may force the other person to have unprotected sex. If the other person is positive, the perpetrator may use that as an excuse to have sex outside the relationship, may use it as an excuse to psychologically abuse the partner by demeaning him or her on the basis of HIV status, or may threaten to disclose the person's HIV status. If a partner comes home and tells his or her partner about being positive, that sometimes will spark domestic violence. But it also comes up in relationships where there are already issues of power and control."
Identifying and screening individuals who may be at risk can be next to impossible. According to Edidin, the law seems to assume an existing relationship of trust between the doctor and the patient that makes it possible for the right kind of questions to be asked. If that ever existed -- doubtful in this area, because people are often afraid to admit or unable to articulate what they are experiencing -- it is certainly rare in this era of HMOs.
If it is difficult to identify whether the newly diagnosed person, who is sitting in someone's office answering questions, is at risk for domestic violence, it is immensely harder to identify when a contact, who's not there and not being questioned, is at risk.
AVP is asking that the regulations move away from the traditional view of domestic violence as occurring in a heterosexual relationship, between an abusive husband and a battered wife. They ask, first, that the law recognize and treat seriously the threat of domestic violence in same-sex relationships, and in the case of young people living with their parents or guardians. Then, they ask for a broad definition of domestic violence. According to Edidin, AVP defines domestic violence as "any pattern of behavior that is used to dominate, coerce, or control another person." The definition includes physical abuse, sexual abuse, psychological abuse, and the imposition of economic control.
"Relating it back to HIV-related violence," says Edidin, "isolation is a common tactic for perpetrators of domestic violence. And for people who have HIV or AIDS, that might mean isolating them from the medical services they need, or destroying their medication."
And the consequences can go beyond the immediate. Individuals with compromised immune systems tend to experience trauma more severely than others, while stress and trauma work to compromise the immune system further. The problems feed on each other.
The rationale for the contact tracing law is that HIV is a public health issue. But so is domestic violence. The irony, as Edidin points out, is that a measure aimed at countering one public health concern -- HIV -- could result in exacerbating another -- domestic violence.
This article was provided by Body Positive. It is a part of the publication Body Positive.