Effective Tool of Hiv Prevention? a Review of Taiwan Court Cases and International Empirical Studies on Criminalization of Hiv Transmission and Exposure

Criminal law has been adopted by governments throughout the HIV epidemic to deter and punish transmission or exposure. Proponents of the laws argue that the criminalization of non-disclosed HIV transmission is to encourage persons living with HIV (PLWH) to disclose their positive serostatus to partners, increase HIV-protective behaviors, and ultimately reduce new infections. However, emerging evidence casts doubts on the effectiveness of these laws. Key concerns raised by criminalization of HIV transmission include lack of empirical evidence of laws’ effectiveness, possible negative impact on public health efforts, criminalizing low-to- no-risk activities, potential for discriminatory enforcement and ethical tensions. Due to human rights and public health concerns, using criminal laws and prosecutions to address transmission of HIV is appropriate has become one of the most controversial issues in the debate of global HIV policy. Taiwan has enacted HIV-specific statutes to criminalize sexual exposure, sharing contaminated injection equipment, or donating blood or tissue since the promulgation of HIV Infection Control and Patient Rights Protection Act (HIV Act) in 1990. The Legislature has increased penalty and criminalized non-disclosure in the absence of the actual transmission of HIV under Article 21 of the HIV Act over these years without keeping pace with the considerable advance in scientific understanding of HIV and its transmission as well as in the development of effective antiretroviral therapy to suppress viral load. To provide a better picture of the application of Article 21 of the HIV Act and to assess the public health impact of criminalization as a structural intervention to prevent HIV, the objectives of this project are 1) to review court decisions from the Judicial Yuan database to presents the actual application of the crime, 2) to systematically review literature to identify and describe international empirical studies on the criminalization of HIV exposure published between 1990 and 2018, 3) to explore alternatives that should be considered in view of the fact that the objectives said to be served by criminalization can be achieved by public health interventions. Results of this project may inform the public, the PLWH community and policymakers of evidence as the basis for the debate on criminalization of HIV transmission and toward more evidence-based and effective responses to HIV.

Project ID:PF10901-1624
External Project ID:MOST108-2410-H182-012-MY2