Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Faculty of Health and Medicine, University of Lancaster, Lancaster, UK.
Womens Health (Lond). 2022 Jan-Dec;18:17455065221075914. doi: 10.1177/17455065221075914.
People living with human immunodeficiency virus in Canada can face criminal charges for human immunodeficiency virus non-disclosure before sex, unless a condom is used and their viral load is <1500 copies/mL. We measured the reported impact of human immunodeficiency virus non-disclosure case law on violence from sexual partners among women living with human immunodeficiency virus in Canada.
We used cross-sectional survey data from wave 3 participant visits (2017-2018) within Canadian HIV Women's Sexual and Reproductive Health Cohort Study; a longitudinal, community-based cohort of women living with human immunodeficiency virus in British Columbia, Ontario and Quebec. Our primary outcome was derived from response to the statement: '[HIV non-disclosure case law has] increased my experiences of verbal/physical/sexual violence from sexual partners'. Participants responding 'strongly agree/agree' were deemed to have experienced increased violence due to the law. Participants responding 'not applicable' (i.e. those without sexual partners) were excluded. Multivariate logistic regression identified factors independently associated with increased violence from sexual partners due to human immunodeficiency virus non-disclosure case law.
We included 619/937 wave 3 participants. Median age was 46 (interquartile range: 39-53) and 86% had experienced verbal/physical/sexual violence in adulthood. Due to concerns about human immunodeficiency virus non-disclosure case law, 37% had chosen not to have sex with a new partner, and 20% had disclosed their human immunodeficiency virus status to sexual partners before a witness. A total of 21% self-reported that human immunodeficiency virus non-disclosure case law had increased their experiences of verbal/physical/sexual violence from sexual partners. In adjusted analyses, women reporting non-White ethnicity (Indigenous; African/Caribbean/Black; Other), unstable housing and high human immunodeficiency virus-related stigma had significantly higher odds of reporting increased violence from sexual partners due to human immunodeficiency virus non-disclosure case law.
Findings bolster concerns that human immunodeficiency virus criminalization is a structural driver of intimate partner violence, compromising sexual rights of women living with human immunodeficiency virus. Human immunodeficiency virus non-disclosure case law intersects with other oppressions to regulate women's sexual lives.
在加拿大,携带人类免疫缺陷病毒(HIV)的人在发生性行为前若未披露 HIV 信息,可能会面临刑事指控,除非使用了安全套,且其病毒载量<1500 拷贝/ml。我们评估了 HIV 不披露案例法对加拿大 HIV 阳性女性性伴侣暴力的影响。
我们使用了加拿大 HIV 女性性健康和生殖健康队列研究(Canadian HIV Women's Sexual and Reproductive Health Cohort Study)的第 3 波参与者访视(2017-2018 年)的横断面调查数据;这是一个在不列颠哥伦比亚省、安大略省和魁北克省开展的、基于社区的 HIV 阳性女性纵向队列研究。我们的主要结局是从以下陈述中得出的:“HIV 不披露案例法增加了我与性伴侣之间的言语/身体/性暴力经历”。回答“强烈同意/同意”的参与者被认为因该法律而经历了更多的暴力。对那些回答“不适用”(即没有性伴侣)的参与者进行了排除。多变量逻辑回归确定了与 HIV 不披露案例法导致性伴侣暴力增加相关的独立因素。
我们纳入了第 3 波 619/937 名参与者。中位年龄为 46 岁(四分位间距:39-53 岁),86%的参与者在成年期经历过言语/身体/性暴力。由于担心 HIV 不披露案例法,37%的参与者选择不与新伴侣发生性关系,20%的参与者在有证人在场的情况下向性伴侣披露了自己的 HIV 状况。共有 21%的参与者自我报告称,HIV 不披露案例法增加了他们与性伴侣之间的言语/身体/性暴力经历。在调整后的分析中,报告非白人种族(土著人;非洲/加勒比/黑人;其他)、住房不稳定和高度的 HIV 相关耻辱感的女性,报告因 HIV 不披露案例法而导致性伴侣暴力增加的可能性显著更高。
研究结果支持了以下观点,即 HIV 刑事定罪是亲密伴侣暴力的结构性驱动因素之一,损害了 HIV 阳性女性的性权利。HIV 不披露案例法与其他压迫形式交织在一起,对女性的性生活进行监管。