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Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial


Scott Burris


Temple University - James E. Beasley School of Law

Leo Beletsky


Northeastern University - School of Law; Northeastern University - Bouvé College of Health Sciences

Joseph A. Burleson


University of Connecticut Health Center

Patricia Case


Harvard Medical School

Zita Lazzarini


University of Connecticut Health Center


Arizona State Law Journal, 2007
Temple University Legal Studies Research Paper No. 2007-03

Abstract:     
All states have criminal laws that can be used to punish sexual behaviors that pose some risk of HIV transmission; half have HIV-specific laws criminalizing sexual contact by people with HIV unless they abstain from unsafe sex, or disclose their HIV status and obtain consent from their partners. Whether these laws influence behavior is unknown. Illinois and New York exhibit contrasting legal conditions. Illinois has an HIV-specific law explicitly requiring disclosure by HIV+ persons. New York has no HIV-specific law. This study tests the null hypothesis that differences in law and beliefs about the law do not influence condom use in anal or vaginal sex.

In this empirical study, 490 people at elevated risk of HIV were interviewed, 248 in Chicago and 242 in New York City. Approximately half in each state were men who have sex with men ("MSM") and half were injecting drug users ("IDUs"). Respondents were classified as MSM if they reported ever having had sex with a man, and as IDUs if they reported having injected drugs at least twice in the last three months. One-hundred sixty two subjects reported known HIV infection (Chicago 58; New York City 104). Three-hundred twenty-eight reported being HIV negative or not knowing their HIV status. Indicators of the law were 1) residence in the state, and 2) belief that it is a crime for a person with HIV to have sex with another person without disclosing his or her serostatus. Using stepwise logistic regression, we examined independent predictors of unprotected sex, adjusting for factors including age, race/ethnicity, disclosure, biological sex at birth, sexual orientation and number of partners.

People who lived in a state with a criminal law explicitly regulating sexual behavior of the HIV-infected were little different in their self-reported sexual behavior from people in a state without such a law. People who believed the law required the infected to practice safer sex or disclose their status reported being just as risky in their sexual behavior as those who did not. Our data do not support the proposition that passing a law prohibiting unsafe sex or requiring disclosure of infection influences people's normative beliefs about risky sex. Most people in our study believed that it was wrong to expose others to the virus and right to disclose infection to their sexual partners. These convictions were not influenced by the respondents' beliefs about the law or whether they lived in a state with such a law or not. Because law was not significantly influencing sexual behavior, our results also undermine the claim that such laws drive people with and or at risk of HIV away from health services and interventions.

We failed to refute the null hypothesis that criminal law has no influence on sexual risk behavior. Criminal law is not a clearly useful intervention for promoting disclosure by HIV+ people to their sex partners. Given concerns about possible negative effects of criminal law, such as stigmatization or reluctance to cooperate with health authorities, our findings suggest caution in deploying criminal law as a behavior change intervention for seropositives.

Number of Pages in PDF File: 53

Keywords: HIV/AIDS, criminal law, public health

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Date posted: April 3, 2007  

Suggested Citation

Burris, Scott and Beletsky, Leo and Burleson, Joseph A. and Case, Patricia and Lazzarini, Zita, Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial. Arizona State Law Journal, 2007; Temple University Legal Studies Research Paper No. 2007-03. Available at SSRN: http://ssrn.com/abstract=977274

Contact Information

Scott C. Burris (Contact Author)
Temple University - James E. Beasley School of Law ( email )
1719 N. Broad Street
Philadelphia, PA 19122
United States
215-204-6576 (Phone)
215-204-1185 (Fax)
HOME PAGE: http://www.temple.edu/lawschool/phrhcs/index.html
Leo Beletsky
Northeastern University - School of Law; Northeastern University - Bouvé College of Health Sciences ( email )
400 Huntington Ave.
Boston, MA 02115
United States
617-373-5540 (Phone)
Joseph A. Burleson
University of Connecticut Health Center ( email )
263 Farmington Avenue
Farmington, CT 06030
United States
Patricia Case
Harvard Medical School ( email )
250 Longwood Avenue
Boston, MA 02115
United States
Zita Lazzarini
University of Connecticut Health Center ( email )
263 Farmington Avenue
Farmington, CT 06030
United States
860-679-5495 (Phone)
860-679-5464 (Fax)
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