title: Canadian consensus statement on HIV and its transmission in the context of criminal law.
abstract: BACKGROUND
  A poor appreciation of the science related to HIV contributes to an overly broad use of the criminal law against individuals living with HIV in cases of HIV nondisclosure.
  
  
  METHODS
  To promote an evidence-informed application of the law in Canada, a team of six Canadian medical experts on HIV and transmission led the development of a consensus statement on HIV sexual transmission, HIV transmission associated with biting and spitting, and the natural history of HIV infection. The statement is based on a literature review of the most recent and relevant scientific evidence (current as of December 2013) regarding HIV and its transmission. It has been endorsed by >70 additional Canadian HIV experts and the Association of Medical Microbiology and Infectious Disease Canada.
  
  
  RESULTS
  Scientific and medical evidence clearly indicate that HIV is difficult to transmit during sex. For the purpose of informing the justice system, the per-act possibility of HIV transmission through sex, biting or spitting is described along a continuum from low possibility, to negligible possibility, to no possibility of transmission. This possibility takes into account the impact of factors such as the type of sexual acts, condom use, antiretroviral therapy and viral load. Dramatic advances in HIV therapy have transformed HIV infection into a chronic manageable condition.
  
  
  CONCLUSIONS
  HIV physicians and scientists have a professional and ethical responsibility to assist those in the criminal justice system to understand and interpret the science regarding HIV. This is critical to prevent miscarriage of justice and to remove unnecessary barriers to evidence-based HIV prevention strategies.
authors.affiliation: Women's College Research Institute, University of Toronto (Co-chair of the Canadian Experts on HIV and Transmission Team), Toronto;
authors.forename: Mona
authors.initials: M
authors.lastname: Loutfy
authors.affiliation: Division of Infectious Diseases, University of Ottawa (Co-chair of the Canadian Experts on HIV and Transmission Team), Ottawa, Ontario;
authors.forename: Mark
authors.initials: M
authors.lastname: Tyndall
authors.affiliation: University of Montreal, Montreal, Quebec;
authors.forename: Jean-Guy
authors.initials: JG
authors.lastname: Baril
authors.affiliation: Division of AIDS, University of British Columbia, Vancouver, British Columbia;
authors.forename: Julio Sg
authors.initials: JS
authors.lastname: Montaner
authors.affiliation: Division of Infectious Diseases, University of Toronto, Toronto, Ontario;
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
authors.affiliation: Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hankins
keywords: Chronic manageable condition; Consensus statement; Criminal law; HIV risks of transmission