Cecilia Chung and Laurel SpragueJuly 23, 2014

AIDS 2014Melbourne, Victoria, Australia

Intersections of Disclosure and Prosecution

Transgender People in the US Respond to Criminal Laws Based on HIV Status

Respondent Voices

In order to file charges, I [would have] had to disclose my rape, my [HIV] status and I would have to give up my privacy and be subjected to public scrutiny (African American transgender woman, age 60 or older).

I was the one charged...there was absolutely NO physical contact...simply saying yes to sex... after 9 months in jail, and a front page news article in hopes that SOMEONE would come forward, the charges were dropped...not before my reputation, both professionally and personal, was ruined (White transgender woman, age 40-49).

The Sero Project Study on HIV Criminalization

• Purpose of the Study– Research led by and for people living with HIV – Identify the views of people living with and affected by

HIV about the use of HIV-related criminal laws

Study Methods

On-line questionnaire

Anonymous responses

Wide community distribution

Survey available for 8 weeks • from June to August 2012

20-30 minutes completion time

IRB approval through • Eastern Michigan University

Transgender Respondents

US respondents = 3034, 2% identified as transgender or third sex

Transgender male 19 37%Transgender female 18 35%Third sex 14 27%Total 51 100%

Transgender male

Transgender female Third sex

HIV-negative 74% 28% 46% Unknown HIV status 0% 0% 15% HIV-positive 21% 72% 31% Prefer not to answer 5% 0% 8%

Enabling Legal EnvironmentDisa

bli

ng

Do you feel confident that you could protect yourself legally from accusations that you engaged in sexual behavior without disclosing your HIV-positive status?

Not confident Somewhat confident Completely confident

40%

32%28%28%

24%

48%

55%

25%

20%

Cisgender maleCisgender femaleTransgender/third sex

HIV-positive respondents only

Have you ever worried about being falsely accused of not disclosing your HIV status?

Transgender women living with HIV were the most frequently worried about false accusations of non-disclosure (23%).

Never A few times Frequently

60%

30%

9%

74%

21%

4%

43% 43%

14%

Cisgender maleCisgender femaleTransgender/third sex

HIV-positive respondents only

Do you believe a person living with HIV could get a fair hearing in your state if accused of not disclosing

his or her HIV status to a sexual partner?

Not Applicable No or probably not

Not sure Probably or yes

3%

49%

28%

21%

5%

43%

22%20%

5%

52%

33%

14%

Cisgender maleCisgender femaleTransgender/third sex

HIV-positive respondents only

Why or why not?

• As a poz trans woman, I find it doubtful that I would be given a fair hearing in any court of law (Latina trans woman, age 24-29).

• Because although this state has become fairly tolerant with regards to the LBGT community, there is still a lot of intolerance when it comes to the transgender community that extends to the court system (African American trans woman, age 60 or older).

• As for being transgender, ….we have been treated very badly by the system here (White trans woman, age 40-49).

HIV Disclosure

Should a person living with HIV disclose her/his status to a potential sexual partner before engaging in sexual

activities?

Never has to disclose

Should always disclose if asked

Should always disclose even if

not asked

Depends on the circumstances

4%

19%

46%

30%

3%7%

65%

25%

6%

22%

37%35%

Cisgender maleCisgender femaleTransgender/third sex

Should a person living with HIV who is a sex worker disclose her/his status to a client before engaging in

sexual acts?

Never has to disclose

Should always disclose if asked

Should always disclose even if

not asked

Depends on the circumstances

7%

22%

50%

22%

6%

12%

58%

24%

10%

18%

31%

41%

Cisgender maleCisgender femaleTransgender/third sex

Criminal Laws and Attitudes toward HIV Testing, Treatment, and Disclosure

How reasonable is it to avoid testing, treatment, or disclosure because of fear of prosecution?

Not reasonable Somewhat reasonable Very reasonable

42%

34%

24%

52%

30%

18%

39%37%

24%

A person, who is otherwise feeling healthy, states he or she does not take an HIV test out of fear of being prosecuted if the HIV test came back positive

A person, who otherwise is feeling healthy, avoids getting treatment for HIV out of fear people might find out he or she is HIV positive and press charges against him or her

A person does not disclose his or her positive HIV status to a current sex-ual partner out of fear of being prosecuted by a previous partner to whom he or she did not disclose HIV status

Transgender and third sex respondents only

Summary in Comparison with Cisgender Respondents

• Transgender and third sex respondents were the most likely to focus on the context ("it depends on the circumstances") when determining whether there should be criminal charges for non-disclosure related to sex, drug use, or sex work.

• Transgender and third sex respondents were the most likely to say that it is reasonable for a person living with HIV to avoid testing, treatment and disclosure for fear of criminalization.

• Transgender and third sex respondents living with HIV expressed the strongest sense of legal vulnerability, indicating:• Much less confidence that they could protect themselves legally from

accusations that they had not disclosed their status• Much more frequent worries about being falsely accused of non-

disclosure• The lowest levels of trust that a person living with HIV could get a fair

court hearing if accused of non-disclosure

Next Steps

Research that people living with HIV need: Violence related to disclosure With specific questions for transgender people living

with HIV

Thank you

to the people living with HIV and members of affected communities who generously shared their time, thoughts and

experiences with us and made this research possible.