Nondisclosure prosecutions and population health outcomes: examining HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following nondisclosure prosecution media releases in Ottawa, Canada.
BACKGROUND
During the past decade, the intersection of HIV and criminal law has become increasingly discussed. The majority of studies to date have approached this topic from a sociological or legal perspective. As a result, the potential effect of nondisclosure prosecutions on population health and HIV prevention work remains mostly unknown.


METHODS
A descriptive quantitative-qualitative study was undertaken to examine HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following regional media releases about a local nondisclosure prosecution. As part of this study, first, we reviewed the trends in HIV testing and HIV diagnoses from 2008 through 2011 in Ottawa, Canada. Second, we explored the attitudes and beliefs of local MSM about HIV, HIV prevention, HIV serostatus disclosure, nondisclosure prosecutions, and public health.


RESULTS
Quantitatively, the findings of this study revealed that, in comparison to the period preceding the media releases about a local nondisclosure prosecution, HIV testing and HIV diagnoses among men who have sex with men did not significantly change after the media releases of interest. Qualitatively, a subgroup of 27 men who have sex with men (12 HIV-positive, 15 HIV-negative) noted their beliefs that the local public health department openly shares information about people living with HIV with the police. Moreover, some HIV-positive participants stated that this perceived association between the local public health department and police services caused them to not access public health department services, notwithstanding their desires to seek assistance in maintaining safer sexual practices.


CONCLUSIONS
Nondisclosure prosecutions likely undermine HIV prevention efforts.
Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada. pjobyrne@uottawa.ca
Patrick
P
O'Byrne
Jacqueline
J
Willmore
Alyssa
A
Bryan
Dara S
DS
Friedman
Andrew
A
Hendriks
Cynthia
C
Horvath
Dominique
D
Massenat
Christiane
C
Bouchard
Robert S
RS
Remis
Vera
V
Etches
D000328:Adult; D001294:Attitude to Health; D002170:Canada; D030881:Disclosure / Q000331:legislation & jurisprudence*; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008402:Mass Media; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D036301:Qualitative Research; D013997:Time Factors; D055815:Young Adult