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Friday, 10 July 2009

New Zealand: 'HIV predator' case increases testing and stigma

Following the intense media reporting of the alleged 'HIV predator' case, the New Zealand AIDS Foundation reports that the case has increased stigma against people already living with HIV, and also increased the number of people coming forward for HIV tests.

The New Zealand Herald quotes NZAF's national communications co-ordinator Dawn O'Connor.

"While people in New Zealand are aware of the need to get tested the media interest has created a stigma and discrimination against people living with HIV," she said yesterday.
It then goes on to try and assess the number of HIV tests taken up since the man's name and photo was released last month.
The NZAF would not say how many tests it had carried out, "out of respect for its clients and their right to confidentiality", but confirmed a marked increase in demand for HIV testing and counselling compared with this time last year. [...] HIV support group Body Positive said 25 to 30 people had now been tested. Craig Webster, a social worker for the agency, said calls continued to come in from all over the country, averaging five to 10 per day.
It's a conundrum that challenges those who argue that criminal HIV exposure and transmission laws and media reports of prosecutions increase HIV-related stigma and, therefore, have a negative effect on testing.

From the research I've been reading and digesting recently, there really is no proof at all that criminal laws or media reports about prosecutions dissuade people at high risk of HIV from taking an HIV antibody test. Although in some cases they might actually persuade some people to test, and in others, may dissuade someone who is highly aware of their actions and the legal repercussions not to test, their aggregate effect on testing is probably neutral.

A colleague who studies the behaviour of people with, and at risk of, HIV in the UK said to me recently that claiming that criminal laws and prosecutions put people off from testing "ascribes too much cool calculation to people who are generally getting on with their lives, and not wanting to think much about HIV." I think she's right: there are plenty of reasons why people don't test for HIV but for most people, worrying about being arrested doesn't register on the radar at all. HIV is already so stigmatised that the additive effect of being criminalised once you know your HIV-positive status is unlikely to be a significant deterent. This suggests to me that the links made between stigma and testing are perhaps not quite as straightforward as some advocates argue.

However, there is no doubt that for people already diagnosed with HIV criminalisation palpably increases the stresses and fears of living with HIV – and adversely affects their decisions to disclose and take sexual risks – but that is not necessarily the same as putting people off testing.

If anyone knows of studies from outside of the US (I am aware of two: Burris et al, 2007 and Wise 2008) and the UK (summarised in Chalmers 2008) that measure the impact of criminalisation on HIV testing, please let me know!



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