Planned Parenthood tells HIV-positive youth it’s okay to keep their status secret from sex partners

I’ve long been an admirer of Planned Parenthood, which is constantly under attack from Christians for its pro-choice stance on abortion and its advocacy of birth control. But in this case I think they made a serious misstep—at least if I interpret their literature correctly.

Over at the International Planned Parenthood Federation (IPPF) site, you can find a description and a free download of their booklet, Healthy, Happy and Hot: A Young Person’s Guide to their Rights, Sexuality, and Living with HIV. And in that booklet you will find the advice that it’s up to infected people themselves whether or not to tell their partner. While the booklet does give good advice how to have sex if you’re HIV positive, it also asserts that people have a right to decide whether or not to disclose your status, and that apparently goes for your sex partners as well.

Here are some screenshots from that booklet:Screen shot 2015-12-27 at 6.56.48 AM

Screen shot 2015-12-27 at 6.54.17 AM

When you share your HIV status. In other words, you don’t have to share your HIV status with your partner; it’s your right not to. There’s no advice I can find that you should and must share your status with those partners.

Screen shot 2015-12-27 at 6.54.07 AM

This is odious, for regardless of the kind of sex you have with your partners, there’s always a finite chance of infecting them. Apparently, for the IPPF, the “right” to keep your status to yourself trumps the “right” of your partner to know you’re infected, knowledge that is critical since infection can be fatal, and always burdens one with long-term and expensive medical care.

In fact, many states in the US require you to tell your sexual partners if you’re HIV positive. The American Civil Liberties Union has collected those laws, and violation of the disclosure rule can land you a felony conviction. Your partner does not have to become infected for you to violate those laws. Here, for instance, is the law in Illinois:

Screen shot 2015-12-27 at 7.05.45 AM

But note that the pamphlet says that these disclosure laws violate the right of HIV-positive people to decide whether, when, and whom to tell about their status.

I’m not sure what is going on here, or why the IPPF considers nondisclosure to partners a “right”. It isn’t, at least not by any reasonable lights. The “right” of partners to know that you’re infected surely trumps whatever “right” you have to keep that status to yourself.  Perhaps I’ve misinterpreted this pamphlet, but I don’t think so, although they do mention that there are laws. Nor am I sure whether the US branch of the IPPF agrees with this stand.

Clearly, if you’re not having sexual contact with someone, or otherwise putting them at risk, there’s no need to tell people you’re infected. But the line should be drawn, as it is in most states, at sex.

I’m always wary when someone asserts something as a simple “right”: all too often that’s simply a way to shut down further discussion. In fact, I’d prefer to avoid all talk of rights, and discuss why the law allows people to do some things and not others. In this case it comes down to public health and to morality, which themselves come down to what kind of society we prefer to live in. I would prefer to live in a society in which HIV infected people are required to tell their sexual partners of their status. To me, that’s better than an unproductive discussion about competing “rights.”

105 Comments

  1. Cindy
    Posted December 27, 2015 at 1:06 pm | Permalink

    A typical pro choice argument is that people have the right to protect their bodies from harm.

    Somehow, this logic is being thrown out the window when it comes to those who should be denied the right to choose whether or not to expose themselves to HIV.

    Shame on you PP.

    • Posted December 28, 2015 at 2:48 am | Permalink

      + 1

    • Posted December 31, 2015 at 10:02 am | Permalink

      I think a lot of it is to do with fear. Your chances of contracting HIV, even during unprotected sex is very low (I think it may be something like 5%, but I can’t remember the exact figure). So, yes I think HIV-positive people don’t have to tell people about their status. If they are in a long term relationship, then obviously it is in their best interest (and their partner’s to do so). That is were the moral question lies.

      What PP may be alluding to is casual sex, or “hookups” (note as it is addressed to “young people”). If someone is engaging in sexually risky behaviour then it is their responsibility to ensure that they are practising safe sex. They must also know that whoever they sleep with may have a STI (HIV among them) and that the person may not necessarily tell them (or even know).

      So, on the whole PP should have stressed to disclose for long-term relationships (or potential long-term relationships), while the “hookup” arena is more murky (with potential legal consequences).

  2. Scott Draper
    Posted December 27, 2015 at 1:08 pm | Permalink

    Whether or not to tell your partner is a moral decision and it doesn’t seem to be with in the purview of Planned Parenthood to offer advice on that. It should limit itself to making people aware of the possible consequences of not telling.

    • GBJames
      Posted December 27, 2015 at 1:16 pm | Permalink

      It isn’t simply a question of morality, of course. There are real-world physical consequences for other people involved. An HIV-positive person’s right to privacy ends at the point where another person is put at unknowing risk.

      • gravelinspector-Aidan
        Posted December 27, 2015 at 1:39 pm | Permalink

        One reason – not by any means the only one – for being cautious about disclosing one’s HIV status is that there have been no small number of breakups after which one of the partners has disclosed the other partner’s status against their wishes. People do do horrible and unconscionable things to other people.
        I’ve a friend who has been in that boat. It’s not a nice place to be.

        • GBJames
          Posted December 27, 2015 at 2:03 pm | Permalink

          I’m sure it isn’t. Neither is it a nice place to be to find yourself HIV-positive because a knowing partner didn’t feel you deserved to know your risk.

          It seems to me that the only responsible thing for an HIV-positive person to do if they don’t want to disclose their status is to avoid sex.

          • gravelinspector-Aidan
            Posted December 27, 2015 at 10:46 pm | Permalink

            I’ll let you discuss that with my friend. By taking the other tack, he has been badly hurt.

            • Posted December 28, 2015 at 2:51 am | Permalink

              To me, exposing the partner to unknown lethal risk is even more “horrible and unconscionable”.

              • gravelinspector-Aidan
                Posted December 28, 2015 at 11:36 am | Permalink

                AIDs can kill people. But only if they live in a country with inadequate health care or don’t look after themselves. Which includes taking your drugs and putting rubber on if you’re swapping body fluids with someone else who you haven’t had that conversation with.

              • Posted December 31, 2015 at 10:09 am | Permalink

                People’s mindsets are still stuck in the 1980’s (when there was no treatment available). Since then, the person is most likely taking antiretrovirals, which suppresses the presence of HIV in the blood and body fluids (but does not completely eliminate it) enough for the person to no longer be that infectious (we studied this in our biochem class).

                If the person is unlucky enough to contract HIV, they can still live a normal life-span (although they do have to take a cocktail of drugs for the rest of their life). That does not make it a death sentence, and perpetuating that myth deepens that stigma around HIV.

              • Cindy
                Posted December 31, 2015 at 10:17 am | Permalink

                1) the risk is not nonexistent

                2) it is immoral to lie to people and to play Russian roulette with their lives and health

                I am appalled at your attitude.

                Knowingly exposing people to a disease is immoral as all hell and a violation of bodily autonomy.

                If you think that someone is going to turn you down because of your HIV status, you shouldn’t be having sex with them if you can only do it by engaging in DECEIT.

              • GBJames
                Posted December 31, 2015 at 11:03 am | Permalink

                I, too, am appalled. It is as if we’re being told that a game of Russian Roulette with someone else’s life is no problem because the gun has fewer bullets than it used to.

      • Scott Draper
        Posted December 27, 2015 at 1:53 pm | Permalink

        It’s a moral issue as to whether you give a damn about those real world physical consequences. Your last sentence is a moral claim.

        • GBJames
          Posted December 27, 2015 at 2:05 pm | Permalink

          Did you miss the “isn’t simply” part?

          • Scott Draper
            Posted December 27, 2015 at 3:13 pm | Permalink

            No, it’s just that I don’t agree.

            • GBJames
              Posted December 27, 2015 at 3:28 pm | Permalink

              Just to be clear… you think that this issue has NO non-moral, purely physical aspects. Right? Like the development of AIDS has only moral implications.

              Are all illnesses like this in your worldview?

              • Scott Draper
                Posted December 27, 2015 at 3:46 pm | Permalink

                Please note my original comment:

                It should limit itself to making people aware of the possible consequences of not telling.

                Whether or not these consequences should affect a person’s decision-making is a moral question.

              • GBJames
                Posted December 27, 2015 at 3:53 pm | Permalink

                Given that view, they are nothing EXCEPT a morality-expressing organization. They exist because they believe, as I do, that women have a right to control their own bodies. Saying that they should limit themselves to non-moral statements would mean they couldn’t advocate for the rights of women (and men) to birth control, let alone access to abortion.

          • Posted December 27, 2015 at 7:24 pm | Permalink

            I think Scott was just trying to say that it’s not PP’s place to issue commands, but to inform people about the consequences (legal and medical) of disclosure/non-disclosure.

            • GBJames
              Posted December 27, 2015 at 7:32 pm | Permalink

              How is recommending that people inform their partners of being HIV-positive any more “issuing commands” than any of the other comments in the PP commentary? How is “Don’t tell if you don’t want to” any less of a “command” than “if you are HIV-positive, don’t have sex with an uninformed partner”?

              I don’t get it. How is it PP’s role to say one but not the other?

              • Posted December 27, 2015 at 7:50 pm | Permalink

                I just don’t think Scott intended his comment as a defense of the pamphlet. I think he was saying that PP should not be telling people it’s ok to withhold the fact that one is HIV positive. If they simply informed people of the consequences of non-disclosure, it would imply that disclosure is the best course of action.

                My own opinion is that a more explicit recommendation to disclose is warranted.

        • Ken Kukec
          Posted December 27, 2015 at 8:50 pm | Permalink

          If that’s the case, why does PP give kids half-a-loaf’s worth of advice, telling them of the reasons why they might want not to disclose their HIV status? Shouldn’t they STF up about the issue completely, if it isn’t their place to give “moral advice”?

          How about infecting a partner with an STD generally, or getting a partner who doesn’t want to get pregnant, pregnant? Can PP advise kids against that? Can it give them any advice regarding the protection of their partners? Or all such topics beyond PP’s moral remit? If not, how does this topic differ?

          Plus, as others here have mentioned, some jurisdictions have laws requiring disclosure to sex partners. In those jurisdictions, PP’s advice about avoiding disclosure would come perilously close to abetting criminal conduct.

          Just because a question has a moral dimension doesn’t mean it has only a moral dimension.

    • Dower_House
      Posted December 27, 2015 at 4:56 pm | Permalink

      In the UK the law requires you to tell your sexual partners that you are HIV positive.
      This has been tested in the courts too.

      Recent evidence suggests that so long as an HIV person is being treated and has a low viral load (usual when on treatment) then the risk of infection is very low in an HIV negative partner.

      WHO
      http://www.who.int/mediacentre/news/releases/2012/hiv_medication_20120718/en/

      • Scott Draper
        Posted December 27, 2015 at 5:48 pm | Permalink

        I would think that in the US, failing to tell a partner would render one susceptible to a lawsuit.

        • tomh
          Posted December 27, 2015 at 6:30 pm | Permalink

          In many states failing to tell a partner can render one susceptible to prosecution. Twenty four states have laws that require persons who are aware that they have HIV to disclose their status to sexual partners and 14 states require disclosure to needle-sharing partners.

          • Scott Draper
            Posted December 27, 2015 at 7:00 pm | Permalink

            I wonder if those laws pass constitutional muster. Compulsory speech?

            • Ken Kukec
              Posted December 27, 2015 at 9:02 pm | Permalink

              You mean, like the way that railroads can’t be compelled to post “railroad crossing” signs?

              The “compulsory speech” doctrine is limited to public statements of conscience — things like reciting the pledge of allegiance or making people “swear” to an oath. Even if the doctrine were more generally applicable, the courts wouldn’t hesitate to carve a gaping “public safety” exception into it, one that would easily encompass HIV-disclosure laws.

    • eric
      Posted December 28, 2015 at 7:56 am | Permalink

      I agree with your first part but not your second. Yes, this is an area where (IMO) the law should not necessarily impose the correct moral choice by force; legally it should be up to the infected person, while morally, they should tell.

      However, when it comes to a PP brochure, they absolutely can and should make the moral argument, not just cite the law. After all, whether to use BC is also a moral rather than a legal choice, and they spend a lot of time and pamphlet space arguing in favor of it. They are a non-government organization with a cause; its is certainly within their purview to promote certain choices/courses of action over others, even if the law is neutral on the subject.

  3. Mumblingidiot
    Posted December 27, 2015 at 1:12 pm | Permalink

    I’m not reading that. They seem to be right down the middle, not really advocating for either side. Although it doesn’t explicitly say they are all for telling your partner, it also doesn’t say that they’re pro not telling your partner. They seem to be completely objective in this regard.

    • Diane G.
      Posted December 27, 2015 at 4:18 pm | Permalink

      It might be objective but is it ethical to take no position when there’s a mortal risk involved with one of two possible decisions?

  4. Diana MacPherson
    Posted December 27, 2015 at 1:33 pm | Permalink

    I think I also detect one implied reason that it’s OK not to disclose one’s HIV status because you are having an extra marital affair, got infected and don’t want you partner to divorce you. I understand reserving judgement when counselling an HIV patient, but shouldn’t that counselling ask the person to examine their choices and the harm they may inflict on others?

    • Heather Hastie
      Posted December 27, 2015 at 1:51 pm | Permalink

      I saw that too.

      I think PP should be taking a more responsible position by advising people they should discuss the issue with sexual partners.

    • Ken Kukec
      Posted December 27, 2015 at 9:21 pm | Permalink

      There are no circumstances (or at least none that I can yet think of) in which disclosure is not the only moral choice to make.

      I can think of a number of circumstances where HIV-disclosing parties should receive assistance — at governmental expense, where needed — to protect them and to mitigate the consequences of their disclosure.

      • Diana MacPherson
        Posted December 28, 2015 at 11:20 am | Permalink

        I can think of some – having to disclose to your employer for example. I don’t think that would be a requirement unless the person plans on bleeding everywhere and the blood getting in the orfices of the coworkers.

        • Ken Kukec
          Posted December 28, 2015 at 2:17 pm | Permalink

          I meant disclosure to a sex partner, not a third party. (Employers certainly have no right to know, unless the nature of the employment is such that it presents a risk of exposure to others.)

          Sorry, I should have been explicit in this limitation.

  5. rickflick
    Posted December 27, 2015 at 1:33 pm | Permalink

    Planned Parenthood should rethink this. I would hope they’d get enough pushback to force reconsideration.

  6. skiptic
    Posted December 27, 2015 at 1:36 pm | Permalink

    Dumb, dumb, dumb PP.

  7. Mark Sturtevant
    Posted December 27, 2015 at 1:48 pm | Permalink

    Peoples’ attitudes about HIV have generally changed for the better, as it is not the stigma that it used to be. We know that the odds of transmission per encounter are pretty low, and vanishingly low if it is being successfully treated, and really really low with use of a condom.
    But I do not understand how PP can say that ones’ privacy rights about their HIV status over-tops the right of a person to know that their partner has a transmissible life threatening illness, and that the risks of transmitting that illness is not 0.
    What the pamphlet should be about is an informative summary of what the legal rights really are, state by state.

    • Heather Hastie
      Posted December 27, 2015 at 2:04 pm | Permalink

      Yeah. It’s not the big issue it once was, and young people are pretty well informed, and are therefore more likely to handle it well.

      And maybe I’m getting old, but should you really be in a sexual relationship with someone you can’t trust enough to talk to about such stuff?

      Perhaps, for someone living with HIV, they should remember what it was like for them? They could maybe reflect on how they contracted it, presumably from someone who didn’t tell them about their status.

      • Gregory Kusnick
        Posted December 27, 2015 at 2:18 pm | Permalink

        Remember, this is the International Planned Parenthood Federation. Not all of the people they serve get to choose who they have sexual relationships with. In many cases it’s their parents who do the choosing.

        • Heather Hastie
          Posted December 27, 2015 at 3:32 pm | Permalink

          Thanks for that – I didn’t know they were in countries where there were such situations. There are perhaps conditions where I would change my opinion. I was thinking of societies like mine (NZ) and the US.

        • Posted December 28, 2015 at 2:59 am | Permalink

          The title “Healthy, happy and hot” definitely excludes such disadvantaged people from the leaflet’s target group.

    • eric
      Posted December 28, 2015 at 7:59 am | Permalink

      What the pamphlet should be about is an informative summary of what the legal rights really are, state by state.

      It should do that, but IMO they should also go further and argue that discussing ones’ status with your partner is the right thing to do even where the law permits you not to.

  8. Gregory Kusnick
    Posted December 27, 2015 at 1:51 pm | Permalink

    Seems to me the key claim is this one:

    You know best if and when it is safe for you to disclose your status.

    I’m willing to concede there may be sexual situations in which not disclosing may be the least bad option. It’s easy for us privileged Westerners to say “Well, you just shouldn’t have sex if you’re not willing to disclose,” but what if you’re a prostitute, or an abused spouse, or in some other dicey situation I can’t begin to imagine? I think the pamphlet is on the mark in saying that it’s the people actually in those situations who are best qualified to decide whether disclosure is a good idea, regardless of what the law says.

    • Diana MacPherson
      Posted December 27, 2015 at 3:08 pm | Permalink

      And someone’s they aren’t because they can’t think clearly. It would be better if they had listed some questions top ask yourself and offer counselling.

    • Posted December 28, 2015 at 3:01 am | Permalink

      Prostitutes and abused spouses being advised how to be “healthy, HAPPY and HOT”? I don’t think so.

      • Gregory Kusnick
        Posted December 28, 2015 at 11:45 am | Permalink

        I confess I don’t know enough prostitutes to have an informed opinion on their happiness or hotness. But on the assumption that they’re human beings, it seems plausible that they would want to think of themselves as happy and hot.

        Conversely, it seems implausible that IPPF would train their workers to apply some sort of happiness-and-hotness litmus test before handing out pamphlets. The language about safe disclosure is presumably there for a reason, so it seems reasonable to infer that the pamphlet’s intended audience includes people for whom disclosure may be dangerous.

        Perhaps I’m guessing wrong as to who those people might be. Again, I’m no expert — which is why I’m willing to give IPPF the benefit of the doubt instead of asserting categorically that they’re Doing It Rong.

        • Posted December 28, 2015 at 3:30 pm | Permalink

          Disclosure is always dangerous – as someone above pointed out, it can lead to your status being disclosed to all mankind. This cannot make non-disclosure OK.
          Maybe I am too much of a Puritan, but from the quotes given in this blog post, I get the impression that the pamphlet gives young HIV-infected people tips how to make a lot of sex with partners they do not know properly, a behavior that would be applauded by HIV if it could think.

  9. Posted December 27, 2015 at 1:54 pm | Permalink

    That’s just plain insane!

    Maybe their position is that viruses have rights too.

    • Ken Kukec
      Posted December 27, 2015 at 9:32 pm | Permalink

      In the immortal words of Mitt Romney, “ corporations viruses are people, my friend.”

    • Posted December 28, 2015 at 3:02 am | Permalink

      + 1

  10. Historian
    Posted December 27, 2015 at 2:00 pm | Permalink

    This rather distressing pamphlet inspired me to do a little research. Note that the pamphlet was issued by the International Planned Parenthood Federation, not Planned Parenthood in the United States, although the latter seems affiliated in some way with former. Planned Parenthood of the United States has a web page dedicated to HIV.

    https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids

    On this page, I could find no reference to the pamphlet, although perhaps I missed it. In fact, I could find no reference at all to the disclosure issue. So, again, unless I missed it, it seems that Planned Parenthood in the United States does not have a position on disclosure to partners. Whatever the case, Planned Parenthood in the United States should disavow it immediately. A Google search indicates that the right-wing is already using this pamphlet to attack Planned Parenthood in the United States.

    • Posted December 27, 2015 at 2:21 pm | Permalink

      According to Wikipedia, “Planned Parenthood Federation of America (PPFA), usually referred to simply as Planned Parenthood, is a non-profit organization that provides reproductive health services in the United States and internationally. PPFA is an affiliate of the International Planned Parenthood Federation (IPPF) and one of its larger members.”

      Other sites I found don’t make it clear whether or not they’re a separate entity, and, as you say, the right-wing is jumping on this issue. It looks like the only hope for PPFA is to follow your recommendation, and the sooner the better!

    • JJH
      Posted December 27, 2015 at 2:56 pm | Permalink

      I also went to the PP USA site. This is what I found:

      What If I Have HIV/AIDS?
      Consult a health care provider who has experience treating HIV/AIDS.
      Inform sex partner(s) who may also be infected.
      Protect your sex partner(s) from HIV by following safer sex guidelines.

      Now while it is not as explicit as I think it should be about informing potential sex partners prior to engaging, it nowhere advocates not telling potential sex partners.

      As far as the moral argument goes: Sure I’ll give you a ride to the store in my car. Oh, did we run into a tree and now you’re crippled for life? I guess maybe I should have told you that I’m legally blind and I like to drive really fast. The only difference is one involves sex and the other one doesn’t.

    • Hempenstein
      Posted December 27, 2015 at 3:25 pm | Permalink

      Same question I had. Thanks all for the legwork.

  11. Posted December 27, 2015 at 2:20 pm | Permalink

    from this being from IPP, I can understand that there are countries that don’t just interfere with if someone can reveal their status but can and will harm them if they do. That’s what I get from the pamphlet, be careful to whom you reveal your status to and do reveal it if you can.

    • Posted December 28, 2015 at 3:06 am | Permalink

      And if you decide that you “cannot” reveal and your partner gets HIV (and maybe cannot get adequate treatment because it all happens in one of “those” countries) – sorry, baby!

  12. Ken Kukec
    Posted December 27, 2015 at 2:50 pm | Permalink

    Better that Planned Parenthood should sell fetal tissue to Satanists for Black Mass rituals than that it should give such lousy advice to kids.

  13. Posted December 27, 2015 at 2:52 pm | Permalink

    The dangerous language and position in this pamphlet is a cause for outrage and should be corrected immediately.

    Planned Parenthood is one of the most trusted and effective informal arms of public health. For them to contribute to the spread of HIV, especially outside of the US, is an unacceptable tragedy and immoral.

    Their staff must be retrained on this matter and mitigate the harms done by this appalling risk-communication debacle.

  14. Ken Kukec
    Posted December 27, 2015 at 3:28 pm | Permalink

    I can think of no intimacy more selfish than having sex without disclosing to your partner that you’re HIV positive. It’s like engaging in frottage with a sleeping partner — if clandestine frottage could infect your partner with an incurable, potentially deadly, disease.

  15. wetherjeff
    Posted December 27, 2015 at 3:42 pm | Permalink

    For me, the important thing here is consent. You cannot consent if you don’t fully understand the situation. It’s unconscionable in my mind not to tell a partner that you are HIV positive, especially as it could have devastating consequences for the other party. Would PP advise it’s OK to not use a condom if you tell your partner you are using one? I’m pretty sure they wouldn’t because it would violate consent. What’s the difference with disclosing HIV status? To me the principle is the same – you can’t consent if you are not aware. I know there are very real issues regarding HIV status being leaked, but if you don’t want it leaked and you don’t trust your partner don’t have sex. If you expect your partner to disclose (and who wouldn’t?), then you should disclose yourself. It’s only fair and decent. I think PP have got this very wrong.

    • Ken Phelps
      Posted December 27, 2015 at 4:31 pm | Permalink

      Excellent point. I think you could make a case that an infected individual having sex with an uninformed partner is exactly equivalent to sex with a blind drunk or unconscious partner. In either case, what passes for consent (“Hey, she chose to drink at *my* party and pass out in *my* room, she knows the kind of stuff that can happen.”) is not consent at all.

  16. Aaron Logan
    Posted December 27, 2015 at 4:34 pm | Permalink

    I won’t address the moral issue of HIV non-disclosure but I would like to draw attention to the arguments against criminalization of non-disclosure from a public health/ prevention point of view. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966663/
    http://www.cdnaids.ca/actionalert-takingactiononthecrimin

    • Posted December 27, 2015 at 5:10 pm | Permalink

      Thanks, Logan.

      I’ve taken a look at the Am J Public Health article.

      “Laws that criminalize HIV exposure may actually undermine public health efforts by, for example, providing a disincentive for persons at risk to be tested (lest individuals become aware of their infection and have to disclose it to sex partners) or by reinforcing discrimination against persons living with HIV (PLHIV) and exacerbating HIV-related stigma.”

      The problem with the may language here is that they don’t cite any evidence for this view. They do provide one comment on a Canadian study referring to the counseling setting in which criminalization appears to have impacted the openness of PLHIV people in counseling. But that’s it.

      While I don’t have empirical evidence for what I’m about to say either, the absence of having legal ramifications around disclosure may be similar to de-policing and the uptick in violence post-Ferguson due to less proactive policing. That is, if we remove criminalization of not reporting or purposefully exposing to HIV, we might see an increase the incidence of infection.

      • Aaron Logan
        Posted December 27, 2015 at 5:54 pm | Permalink

        But hasn’t the effect of criminalization been studied, Adams, as indicated in the paragraph immediately preceding the one you quoted. If criminalization hasn’t decreased the incidence of infection, how do you imagine decriminalization will increase the incidence?

        Lack of Empirical Evidence of Laws’ Effectiveness

        The criminal law may affect HIV risk behaviors in three primary ways: incapacitation, norm setting, and deterrence. Incapacitation is unlikely to reduce new infections because relatively few persons are incarcerated for HIV exposure2,10 and new infections can occur in prison.11 There is also little evidence to suggest that criminalizing HIV exposure changes social norms: studies have found that persons living in states with and without HIV-specific laws10,12 and persons who are aware and unaware of their state’s HIV-specific law13 do not differ on perceived responsibility for preventing HIV transmission.10 Evidence that the criminal law produces a deterrent effect—such as prompting persons with HIV to disclose more often or have safer sex with fewer partners—has been mixed. Awareness of a state’s HIV-specific law was associated with sooner (but not more frequent) seropositive status disclosure in one study,14 and fear of prosecution for nondisclosure was associated with seropositive status disclosure in another.15 Other studies have found no evidence of deterrence,10,12 and none have found effects of sufficient magnitude to reduce HIV prevalence at a population level.

        • Posted December 27, 2015 at 6:06 pm | Permalink

          Hey Aaron (I didn’t mean to call you Logan above.)

          Thanks for engaging.

          I’ll respond to this part of the paragraph you quoted: “studies have found that persons living in states with and without HIV-specific laws and persons who are aware and unaware of their state’s HIV-specific law do not differ on perceived responsibility for preventing HIV transmission.”

          My thoughts. I’m unsure of when we instituted criminalization, though I could hypothesize that the act of making not reporting criminal in a number of states in the US raised the importance of doing so across the board. It may have impacted provider risk communication behavior, even in states where criminalization hasn’t occurred. And doing this may partly explain the lack of difference found in perception of responsibility between the studies and states quoted above.

          To remove the legal structure may have adverse consequences on how providers convey information.

          • Aaron Logan
            Posted December 27, 2015 at 8:05 pm | Permalink

            Further to my comment elsewhere, how does a person providing information regarding their HIV sero-status help in assessing risk of transmission? In preventing transmission?

            Still, there is no evidence that criminal laws reduce HIV prevalence.

            • Posted December 27, 2015 at 8:53 pm | Permalink

              @Aaron:

              Risk of transmission to whom?

              Information about seropositive conversion means that those whom a person has had sex with prior to testing positive have a higher probability of having become infected than those one has had sex with after one seroconverts.

              As such, the moral and public health imperative for disclosing one’s seropositivity to past partners is strengthened by this knowledge of the more-infectious pre-seroconversion period.

              Yet, even if the risk is lower than prior to seroconversion, not telling a future partner that one is HIV positive still places that partner at risk. This is especially so outside of the US where being on HAART and having your viral load consistently suppressed may not be as easily taken for granted.

              Are you implying that the risk to future partners is so negligible that not disclosing to future partners is justifiable?

              • Aaron Logan
                Posted December 27, 2015 at 9:49 pm | Permalink

                To their potential sex partner. Sorry if that wasn’t clear. We’re talking about laws that criminalize non-disclosure and I had thought that meant one must disclose one’s HIV status prior to engaging in sex. A newly infected person does not know they are infected and can only disclose that they are untested or negative as of their last test. How does this person’s honest disclosure help their potential sex partner accurately assess the risk of acquiring HIV from this unknowingly infected person?

                So more generally, how does it help me to assess my risk of acquiring HIV from someone by asking them to disclose their status? They may not know, had a false positive or false negative test result, they may lie, etc. How do criminal laws against non-disclosure affect my ability to assess my risk of exposure?

                Informing past sexual partners that you have become infected and have potentially exposed them to HIV is a different question, one that I have not addressed even obliquely.

                My implication was not that it was justifiable to not disclose being infected with HIV. Rather my assertion was that given the way the science is being reported some HIV infected persons might honestly believe they pose zero risk of infecting another and therefore have no moral or legal obligation to disclose. I’m sorry that you impugned me rather than the reporting.

              • Posted December 27, 2015 at 10:02 pm | Permalink

                @Aaron:

                I have read all of your comments on this post (not just the ones to me) and they do read as though you are trying to make the case that disclosure is not helpful.

                1. You shared a public health article calling into question the effectiveness knowingly exposing someone with HIV criminalized

                2. You shared that you don’t think disclosure would help you understand your own risk.

                3. And you’ve shared that people with HIV may not think they are obligated to tell their partners due to ideas about transmissibility post seroconversion being low.

                I am somewhat distressed by your use of the word impugned and probably won’t enjoy engaging you further, but thank you for the dialog. Some parts were stimulating.

              • Aaron Logan
                Posted December 27, 2015 at 11:16 pm | Permalink

                @charleenadams Well, no, disclosure is not helpful (nor is it enjoyable discussing it with those who consider it a moral absolute). That’s the nature of HIV infection. Find out how to protect yourself from HIV. Don’t rely on the law or your partner’s disclosure to protect you. Take it from someone who’e been HIV+ for over 30 years. And think about the morality of using criminal law to deal with a public health issue in a country where most kids get abstinence-only sex ed.

              • Posted December 28, 2015 at 3:24 am | Permalink

                I want to rescue the first point in my comment above Aaron’s, which listed themes I saw in his comments; as, at present, my words read like garbled gibberish.

                I wrote: “You shared a public health article calling into question the effectiveness knowingly exposing someone with HIV criminalized”

                But my exhausted head hit “Post Comment” too soon.

                It should have read:

                You shared a public health article calling into question the effectiveness of making not reporting a positive HIV status a crime.

                (There, I can see sleep now.)

              • GBJames
                Posted December 28, 2015 at 8:03 am | Permalink

                @Aaron: I’m not sure why you conflate legal mandates with moral statements. In the case of the PP statement at the core of this discussion are recommendations by PP as to what is moral. I don’t see how wrapping an argument against legal sanctions for not exposing your status is relevant.

    • Posted December 28, 2015 at 12:32 am | Permalink

      I’ll go ahead and address the moral issue by saying that that AJPH article is a prime example of how mealy-mouthed and group-thinked the flagship journal of public health in the US has become. At issue is not simply incidence. You can contract HIV, know about it, and try your hardest to spread the stuff, and I guarantee in the big picture, you will have a tough time making that incidence figure budge one iota. Meanwhile though, there will be people downstream that will be affected — esp. if there is no public health authority working in conjunction with the judicial system to (as discreetly as possible) deal with the public health problem. And it is a public health problem.

      To step away from HIV for a moment, it would be similar to the case where you have asymptomatic males who are convinced there’s nothing wrong with them, except 30 or 40 cases of penicillin-resistant gonorrhea keep popping up, with everybody pointing to that person. Eventually someone HAS to step up to the plate and enforce the goddamned statutes — and that will involve a series of least-restrictive steps, every one of them intended to get the person treated. individual caseworkers’ loads are usually mostly people who will bend over backwards to help out, once they realize there is a problem — bit there will always be one or two every year whose files grow and grow and grow as they leave a trail of destruction downstream.

      Just what the hell is the purpose of any kind of disease control measures? To sit around passively, until the sociopaths come to their senses? I also note the authors of the AJPH missed quite a few conflicting tidbits, which would’ve meant citing some of our work, where we had astonishingly low attack rates and a healthy, non-intrusive (for the most part, unless you were a raving asshole) system for addressing the public mandate to… you know… actually control disease.

      I’m afraid our PHS has basically lost the plot. And I’m not surprised. The AJPH has been cranking out crap for nearly two decades now. That the mental disease has spread to Canada is news to me, though. The folks up there tended to really have it together. Now that I think of it, though… many are retired or retiring. I’m pretty sure STD levels are rising in the bigger places up there, too. If it was up to me, I’d pull the plug on a lot of the system, at this point, as people have just lost the plot. There’s no sense of mission anymore.

      The systems work great when they are tried – like really tried… for realz… with contact tracing in place. We have the proof. But mostly the response has been “meh… that’s only Colorado Springs”. Well it was working… people weren’t getting unduly bludgeoned, and it was cheap and effective… something to be emulated in NYC, Chicago, etc. LA is actually still doing great stuff – but they are a light in the wilderness at this point.

    • Posted December 28, 2015 at 1:23 am | Permalink

      BTW, you raise many good points, e.g. about the window period. When a person knows vs. when they don’t know… that kind of thing.

      In practice (which I have much of), the grey area of someone being unjustly accused of “knowingly” transmitting HIV (when they in-fact did not know)… never happened. It just never came up. The worst of the worst has ALWAYS been the Gaetan Dugas type… KNEW but was determined to put everything on everybody he pooned. Either complete sociopaths or complete denialists that HIV had anything to do with anything. And we ran into a lot of them.

      What do we do? Let the worst gay persons’ nightmare go on the rampage? Some segments of the gay community said “yes”, but a larger contingent asked us to ignore the more idiotic of the politically-motivated, and to simply treat this disease like any other.

      In any case, the larger politically-motivated folks won out in the big cities. And the nuts was essentially chopped off of any systems to deal with disease control proactively — which is why we now see 90% of new HIV infections in gay males in all the big cities. The epidemiological picture has not budged since day one. It is truly tragic. And it is public health malfeasance, due to a misperception that such surveillance and control measures are tantamount to there being a “bedroom police” when such systems are maintained. They chose death for themselves and others over the freedoms for other to remain uninfected. That sucks.

  17. Posted December 27, 2015 at 4:39 pm | Permalink

    If you can’t tell your sexual partner that you have HIV, sex should not be on the table.

    If women are in relationships where knowledge of HIV status threatens their safety, every effort should be made to provide a way for them to start over without their partners. But this would, in some circumstances, require extensive social services and would invariably disrupt the lives of children, though perhaps for the better.

    In cultures where this wouldn’t be possible, we should vamp up our literacy and humanitarian programs.

    I whole-heartedly agree with those who’ve brought up consent and how having sex with someone without informing them of a positive HIV status is a form of un-consensual sex. That said, the arguments for women informing their partners go beyond what’s in the best interest of their current or future sex partners. It’s a matter of viral containment. And women knowing their HIV status tips men off to their status and should prompt testing on the part of the men, who transmit the virus more frequently than women, and who may have transmitted the virus to the women doing the disclosing.

    • Posted December 31, 2015 at 10:30 am | Permalink

      Isn’t it very biased and sexist to implicitly assume it is women’s fault for spreading the disease? Come on, that horse has been flogged for a long time by those who hold social and political power, by blaming their own bad sexual behaviour solely on women.

      If you look at most of the developing world you will find that: 1) Most women do not have a choice with how they can practice sex, which means that 2) They cannot get their husbands to use condoms, and that leads to 3) Infection by powerless women who have no say in their own sex lives.

      While individual people’s choices do matter in the spread of infection, it is not the greatest determining factor. The lack of empowerment of females, poverty, and lack of adequate medical care and social support play a far greater role.

  18. Jay Salhi
    Posted December 27, 2015 at 5:02 pm | Permalink

    A friend of mine died because his partner did not disclose that he was HIV positive. And he died rather painfully. As far as am concerned, the partner is a murderer. The PP pamphlet is inexcusable.

    • Posted December 28, 2015 at 3:21 am | Permalink

      You are right! I am very sorry for your friend and all who loved him.

  19. Filippo
    Posted December 27, 2015 at 5:13 pm | Permalink

    I haven’t read the pamphlet, but surely PP doesn’t presume to be “offended” at the idea/prospect of a partner asking the other what his/her HIV status is. Does PP think that the other ought not be put in a position to decide whether to lie to the partner?

    The question should be asked up front. But it goes without saying that there are people who will lie without the least blink of an eye (thinking to the effect, “If I tell the truth, I’ll NEVER get to indulge myself”).

  20. Posted December 27, 2015 at 5:38 pm | Permalink

    Yep. It is public health malfeasance. I don’t read minds yet, but attribute this kind of “hands-off” mentality to built-in desires to root for the underdog (supposedly, the infected).
    That the right of the uninfected to remain so is the central point of public health disease control (and usually enshrined in law in the local statutes, besides) seems to not cross the minds of many of the people involved in the biz, apparently. The local PP have been some of the smartest whips in town – great to work with in the past. They “got” it. And now they have to be well-versed in swat team tactical procedures, to boot. My hat’s off to the locals (C Spgs).

    Especially as it’s been 8 years since the dissolution of the last of the adult health services programs locally. That’s no drug & alcohol, no STD services now. I think there’s still a nursing division, though it is a shell of what it once was. So the long-standing service of STD/HIV/Hep trend reporting (some 35 unbroken years in some disease reporting) has been no more for quite some time here. But now there’s a rise in STD and presumably HIV… how much? Don’t really know, the reporting systems have been unmanned for 8 years. Our health department doesn’t know how much disease there is, really.

    When there was a push to make public health agencies “client centered” — i.e. the doctor-patient model, that was kind-of the beginning of the end. The public health is not only a series of doc-client or counselor-client visits; it is first and foremost a surveillance exercise. You cannot have good control measures without first knowing the extent of the problem. And that means counting cases… collecting case reports… gleaning the important stuff from all of them… and doing so as a concerted effort across the military, private and public sectors. That’s a lot of work. Not being done anymore.

    Anyway, when we were in biz, it was pretty obvious what the main message re: an HIV-positive person’s responsibilities not to spread… things were coordinated just fine. Practitioners really understood the rationale behind not caring if there was 3,000-30,000 chambers in the handgun, we’re still talking a game of Russian Roulette being carried out on the unwitting and usually unwilling.

    In fact, the same laws apply even if the person is begging to be “bred”. (really, really wants to be HIV positive, usually to gain a kind of special status). Even if the person consents, there is a public mandate to not be spreading this shit around. To put it clinically. The larger society has it in their larger best interest to have the individual remain uninfected. And that is the end of that story.

    • Posted December 28, 2015 at 3:26 am | Permalink

      “The right of the uninfected to remain so is the central point of public health disease control.”

      Very well said!

  21. Aaron Logan
    Posted December 27, 2015 at 6:10 pm | Permalink

    Then there is the fact a person is most infectious during that period of time from becoming infected to sero-conversion. During this window period, a person will test HIV negative. So does disclosure provide any information upon which to assess risk? That would be an excellent discussion for sex ed classes in those jurisdictions which allow for comprehensive sex ed.

    • Posted December 31, 2015 at 10:38 am | Permalink

      No, it is not a one-way relationship. It is up to the person to practise safe-sex (by using condoms) and not only rely on disclosure. Ignorance spreads HIV, not a lack of “informed consent” (whose definition is very loose anyway).

      Your specific scenario could fit into, say a hookup scenario in which both parties disclose their STI status. In that case, the person should know that they could potentially be exposing themselves to infection (either through a window period or false negative) and practise the appropriate behaviour to mitigate the risk.

      A different scenario is in the start of a long-term relationship. But that is avoided if the two get tested regularly and are open about their status.

  22. Randy Schenck
    Posted December 27, 2015 at 7:44 pm | Permalink

    I was thinking years ago, when this was considered a death sentence, in some sports it was automatic removal from playing if you were HIV? But anyway, for planned parenthood this just seems totally against their culture. The right not to disclose is the same as saying you have the right to lie. Not all lies require speech. Some require silence.

  23. Aaron Logan
    Posted December 27, 2015 at 8:35 pm | Permalink

    Then there is reporting like this which may lead persons with an undetectable viral load to believe that being undetectable is the same as being HIV negative and therefore do not have a moral or legal obligation to disclose their status.

    No-one with an undetectable viral load, gay or heterosexual, transmits HIV in first two years of PARTNER study http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748
    “No transmissions is not the same as zero chance of transmission.” “They established that there was a 95% chance that (in a couple whose sexual activity is average for the group studied) the greatest-possible risk of transmission from a partner was 0.45% per year and from anal sex was 1% a year.”

    HIV Transmission Risk Essentially 0 if Heterosexual Partner Has Undetectable Viral Load
    http://www.natap.org/2013/HIVwomen/HIVwomen_01.htm
    “A multistudy review of HIV-discordant heterosexual couples estimated an HIV transmission rate of 0.0 to 0.14 per 100 person-years when the positive partner has an undetectable viral load thanks to antiretroviral therapy”

  24. Craw
    Posted December 27, 2015 at 9:42 pm | Permalink

    This seems like PP is taking the NRA approach: any conceivable precedent that could be used against their position in any way must be fought. There are reasons to worry about forced disclosure in general, so if you see this as the camel’s nose …
    This is of course completely indefensible.

  25. JDW
    Posted December 28, 2015 at 2:16 am | Permalink

    If someone is HIV+, on meds, and virally suppressed, they aren’t infectious. It’s as simple as that.

    People who don’t know their status are a greater risk to the health of their partner than someone who is and who is taking medication to deal with it.

    People have the “right” to keep secrets. If you are worried about a partner’s HIV status, use a condom or take PrEP. Relying on the other person to keep you safe is a fool’s errand.

    • Posted December 28, 2015 at 2:28 am | Permalink

      And if they’re not on meds and not virally suppressed? Is it still okay? I’m sorry, but I disagree with you. Condoms are not 100% effective at preventing AIDS, particuarly if you have anal intercourse repeatedly. And your assertion of a “right” means nothing to me.

      • Aaron Logan
        Posted December 28, 2015 at 5:44 am | Permalink

        No, it’s not okay to fail to disclose to a potential partner that you are HIV+, full stop. But since a person can be honestly mistaken about their HIV status or might lie about it, how does disclosure keep you safe?

        Isn’t the moral position to trust but verify and practice the safest sex possible until you both pass successive STI tests spaced far enough apart to ensure there are no infections?

        • Historian
          Posted December 28, 2015 at 8:59 am | Permalink

          In an ideal world people should be tested before having sex with each other according to recommended protocols. But, this is not an ideal world. At the very least, before having sex with a potential partner, a person should ask the partner the following questions, regardless of what the partner spontaneously discloses.

          1.Have you ever been tested for HIV?
          2.If so, when?
          3.What were the results of the test?
          4.If positive, are you taking drugs to control the infection? What is your current viral load?
          5.If you’ve been tested, have you had sex since then? If so, how many partners? Based on what you know of these partners, do you think it likely that any of them could be infected?
          6.If you have not been tested, how many partners have you had in the last five years? Based on what you know of these partners, do you think it likely that any of them could be infected?

          Based on these answers and the person’s evaluation of the potential partner’s credibility, the person can determine whether or not to have sex with the potential partner. Is this a surefire way to assure safe sex? Of course not. But, this information is better than no information. The person can then decide whether to proceed with sex and the degree of safe sex practices to use.

          As in so many other aspects of life, a person’s decision whether or not to have sex is a matter of individual responsibility (barring coercion). The wise person will take measures to reduce the chances of a bad outcome.

        • eric
          Posted December 28, 2015 at 10:53 am | Permalink

          since a person can be honestly mistaken about their HIV status or might lie about it, how does disclosure keep you safe?

          Let’s not make perfection the enemy of good here. If most everyone were honestly disclosing, the rate of unanticipated infection could be expected to go down. It might not go to zero (because of honest mistakes and liars), but there would be an improvement, and an improvement is a good thing to work towards.

        • Posted December 28, 2015 at 1:34 pm | Permalink

          I see now that you admit that it is immoral to not inform a potential partner.

          However, your response to Jerry also looks as though you are claiming that disclosure is irrelevant.

          Here is what you wrote to me:
          “@charleenadams Well, no, disclosure is not helpful (nor is it enjoyable discussing it with those who consider it a moral absolute). That’s the nature of HIV infection. Find out how to protect yourself from HIV. Don’t rely on the law or your partner’s disclosure to protect you. Take it from someone who’e been HIV+ for over 30 years. And think about the morality of using criminal law to deal with a public health issue in a country where most kids get abstinence-only sex ed.”

          Your words to me, coupled with the what you’ve written here (about the need to practice safe sex regardless of what a partner tells you) suggest that you don’t actually think disclosure to a potential partner is necessary. It is no wonder, then, that you’ve also argued that non-disclosure should not be criminal.

          Perhaps you have sex in a culture where the presumption is that either person may be HIV positive and that sex is still on the table, because you trust your methods of safe sex. But, as others have mentioned, condoms are not perfect. Since you’ve shared that you already have HIV and have been on ART for a long time, perhaps you are not worried about reinfection and the, however faint, possibility of being reinfected with a strain that can catawampus your current treatment regime and raise your viral load.

          But these are factors that another person might want to know when making their decision to have sex. I, for one, would absolutely want to know if the other person knows they have HIV, especially if the sex on the table is casual. That knowledge would change the type of physical contact I’d choose to have. And, while a condom is ALWAYS a given in casual sex, the condom failure rate is simply unacceptable given knowledge of HIV.

          If the sex was not casual but with a friend I loved and wanted to be with, I would most certainly feel betrayed if that information was withheld, as it would call into question every ounce of trust and intimacy that had been shared. How can you love someone and not protect them, their emotions, and their body to the very best of your ability?

          • Aaron Logan
            Posted December 28, 2015 at 4:35 pm | Permalink

            For the record, I disclose my HIV status to everyone I have sex with. I disclose to all my family and friends and, occasionally, strangers. I think that the evidence suggests criminalizing non-disclosure does nothing to halt the spread of HIV and may hinder efforts to do so. I’m not going to address further any of your inferences or hypotheses.

            • Posted December 29, 2015 at 3:11 pm | Permalink

              I’m going to respond to this comment from Aaron, but my comments are intended broadly and are not directed towards Aaron.

              As I read it, Aaron has presented a normative claim that nondisclosure should be permissible both legally and morally, and did so by posting the AJPH’s task-force discussion of the possibly negative public health impacts of criminalizing nondisclosure, including bigotry, and their call for additional research and by asserting that HIV is typically spread not by those who already know they’re HIV positive, but by those who don’t. Therefore, the claim is that we shouldpermit nondisclosure, because nondisclosure laws are discriminatory and disclosure doesn’t impact spread of HIV.

              I engaged Aaron on the topic of the effectiveness of reducing the incidence of HIV infection via criminal law despite the criminality of nondisclosure being off-topic to whether IPPF—an international body servicing more than 180 countries—should condone nondisclosure and read the AJPH paper because I’m interested in equity, along with the ethical, legal, and social implications of policy. It is certainly possible that US state laws contribute to bigotry, necessitating some kind of redress, though the place of intervention is unclear. That said, I have worked with the Johns Hopkins’ arm of the Multicenter Aids Cohort Study and am invested in the health of people with HIV, and still I cannot approve the attempt to spread the idea that nondisclosure is a right nor that it is permissible on the assumption that those who know they are HIV positive—especially outside the US—are being treated and treated so effectively that the risk of transmission is so minute that partners needn’t even know about.

              My normative claim: We shouldprotect all people from stigma, but withholding HIV positive status from partners is not the way to do this; for doing so places some people unnecessarily and un-consensually at risk of contracting a life-threatening illness and robs partners of more autonomy (the ability to make informed decisions) than choosing to withhold affords the withholders.

    • Emerson
      Posted December 28, 2015 at 6:20 am | Permalink

      Here, https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/understand-your-test-results/viral-load/ possibly quotes the study your talking about (1600 heterosexual couples observed in ten years). But this site gives other reasons to keep using codons:
      “However, even when your viral load is undetectable, HIV can still exist in semen, vaginal and rectal fluids, breast milk, and other parts of your body. For this reason, you should continue to take steps to prevent HIV transmission. For example:
      1. HIV may still be found in your genital fluids (semen or vaginal fluids). The viral load test only measures the amount of HIV in your blood. Although ART also lowers viral load in genital fluids, HIV can sometimes be present in your genital fluids even when it is undetectable in your blood.
      2. Your viral load may go up between tests. When this happens, you may be more likely to transmit HIV to your partner(s). Your viral load may go up without you knowing it because you may not feel any different.
      3. Sexually transmitted diseases (STDs) can increase your viral load in your genital fluids. This means that if you are living with HIV and also have an STD, you may be able to transmit HIV to your partner(s) even if your viral load is undetectable.”

    • Sigmund
      Posted December 28, 2015 at 8:09 am | Permalink

      “If someone is HIV+, on meds, and virally suppressed, they aren’t infectious. It’s as simple as that.”
      That is simply not true.
      If they are not producing viral particles due to anti-retroviral drug treatment they WILL still have virus present within some of their cells. Any situation where they can transmit cells to another person who is not undergoing anti-retroviral treatment (for example sex or sharing needles) will result in an environment where the virus can be reactivated in the transmitted cells and therefore can infect the previously uninfected individual. Cell to cell transmission of HIV is an important route.
      Anti-retroviral treatment makes it much more difficult to transmit the virus but it doesn’t, despite what some may claim, reduce the chance of transmission to negligible levels. And that is even ignoring the very real chance that a HIV+ individual’s virus undergoes a mutation that results in a non negligible viral count.
      It is increasingly common to read propaganda that states that HIV+ patients who are on antiretroviral therapy are uninfectious. That is not true. They are much less likely to infect than those who are not on anti-retrovirals, but having penetrative sex without condoms with such individuals doesn’t mean it’s no longer a game of Russian roulette, it just increases the number of chambers in the revolver.

    • Ken Kukec
      Posted December 28, 2015 at 11:15 am | Permalink

      People have the “right” to keep secrets.

      What is the source of this “right,” and what are its limits? (And what are you attempting to signal with the semiotic quotation marks in which you’ve encased it?)

      The law recognizes no such “right,” inasmuch as it would render every litigant’s right to compulsory process — the (actual, textual) right of those involved in legal proceedings to adduce every person’s testimony, as guaranteed by the Constitution — void and meaningless.

      So it’s not as simple as that. It never is, and especially not here. It’s just that simple.

  26. Posted December 29, 2015 at 8:42 am | Permalink

    I wonder if their policy is the same for other STDs?

  27. Posted December 29, 2015 at 3:41 pm | Permalink

    I’m not sure what is going on here, or why the IPPF considers nondisclosure to partners a “right”. It isn’t, at least not by any reasonable lights. The “right” of partners to know that you’re infected surely trumps whatever “right” you have to keep that status to yourself. Perhaps I’ve misinterpreted this pamphlet, but I don’t think so, although they do mention that there are laws. Nor am I sure whether the US branch of the IPPF agrees with this stand.

    “Freedom for Aggression,” as I call it, is a common position among “gay rights” supporters, though they avoid yelling it from the rooftops. For instance, you cite the ACLU, are you aware that the ACLU supports the same position the IPPF does?

    https://www.aclu.org/blog/speak-freely/hiv-not-crime

    https://www.aclu.org/blog/us-conference-mayors-takes-hiv-criminalization

    • Posted January 22, 2016 at 5:05 pm | Permalink

      I don’t see why anyone should care about the position of ACLU or “gay rights” supporters, particularly if this position is that it is OK to get people infected.


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