After CDC admission, should we have to disclose?

[PozLawyer]

DISCLAIMER: I am a lawyer and I promise that, as a legal matter, in most states there are disclosure laws that impose varying levels of punishment for failure to disclose, often involving YEARS to LIFE in prison.  These laws can be and still are enforced...

But after the CDC finally admitted what everyone already knew, which is that HIV+ undetectable patients do not transmit HIV, should we as a MORAL or ETHICAL matter have to disclose? 

I don't mean lie -- I mean, when our partners choose not to even bring up the subject, is it still OUR responsibility to disclose (morally)?

CDC Statement: When ART results in viral suppression, defined as less than 200 copies/ml or undetectable levels, it prevents sexual HIV transmission. Across three different studies, including thousands of couples and many thousand acts of sex without a condom or pre-exposure prophylaxis (PrEP), no HIV transmissions to an HIV-negative partner were observed when the HIV- positive person was virally suppressed. This means that people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.

Full CDC September 27, 2017 memo is here: https://pozlawyer.com/wp-content/uploads/2017/09/CDC-Statement.pdf

[mecch]

Complicated question. There is more than one question.

Non-disclosure is still a crime in some parts. It should not be a crime.  Transmission is a different situation. 

Therefore, as long as nondisclosure is "on the books" we should disclose in those locations, because we put ourselves at risk of prosecution if we do not.

I know many, MANY, gay men who are absolutely traumatised and scandalised by HIV+ gay men and do not want to have sex with one, and can't even bring themselves to date one or say anything generous or kind about HIV+ people. 

Therefore, it is best to disclose to potential partners because really, I don't want to have sex with someone who doesn't want anything to do with me, knowing the fact I'm HIV+.  And we "should" show other people respect, even if they don't respect or understand us, to let them choose what they want to do based on this information.

[PozLawyer]

I agree it's crazy complicated.  I guess I was asking more about random hookups with no strings.

I'm out of touch to be honest on the issue of disclosure to potential dates or friends with benefits.  I met my (HIV-) husband the day I found out I am HIV+, and we are about to hit 3 years now.

I do firmly believe that in a random hookup it is each party's responsibility to protect himself.  If neg partner does not ask or simply assumes, they take a HUGE risk.  Not from undetectable HIV+ folks, but from people who are not on treatment or do not know their status...

And yes, the laws are terrible and discriminatory.  Some states are working to fix it--others want to make it even worse. *sigh* #dividedAmerica

[Jim Allen]

The CDC acknowledgement of something we already know does not change the reality of either criminal laws or civil penalties in countries and/or states that have them.

From a relationship point of view, personally it's going to be easier to be upfront than disclosure or accidental disclosure later on down the line in the relationship.

Personally i think or at least I apply that to any of my conditions before a relationship gets serious.

As for hookup's or causal sex, if it's legally required than that is the way it is for now. CDC does not change that.

Jim

[PozLawyer]

The CDC acknowledgement of something we already know does not change the reality of either criminal laws or civil penalties in countries and/or states that have them.

Agreed.  However some courts in states whose laws are ambiguous are taking note of the fact that undetectable=uninfectious.  Hopefully we can move all jurisdictions into that direction.

From a relationship point of view, personally it's going to be easier to be upfront than disclosure or accidental disclosure later on down the line in the relationship.

Agree again.  I'm not sure how one could ever start a relationship without disclosing.  It's just one of those things.  Like "I have children," or "I'm still married," etc.  People have strong feelings about dating HIV+ people, unfortunately.

[mecch]

The Swiss Statement on this is quite old now and a few years ago Swiss judges started taking it into consideration in cases where one party was arguing some kind of reckless endangerment by an undetectable HIV+ person (other party). 

What a mess, really.

[Jim Allen]

People have strong feelings about dating people - period.
I think when dating people look for things in partners. If we are all honest most of us, I certainly have rejected partners in the past for a wide range of reasons.

It's part of the dating game, it is a shame that essentially for something that is medically easy to manage people would be rejected but that is their progative to do so.

Move on look for someone more suitable has always been my take on it.

Jim

[PozLawyer]

The Swiss Statement on this is quite old now

Yep.  And American HIV experts have been screaming at CDC ever since to get on the same page.

The government here is reluctant to say anything unambiguously, especially when it comes to HIV, and ESPECIALLY if it involves not using a condom every single time.  This is true even when the scientific consensus is overwhelming.

See also: climate change!

[PittGurl]

I hate to sound ignorant but what are the laws of disclosure in USA -specifically PA?  For myself, I struggle with guilt of ever doing what someone did to me so I always disclose....several have walked away.

[PozLawyer]

I hate to sound ignorant but what are the laws of disclosure in USA -specifically PA?  For myself, I struggle with guilt of ever doing what someone did to me so I always disclose....several have walked away.

Pennsylvania is tricky but people have been prosecuted for failure to disclose.  I don't give legal advice on internet forums, so I have not conducted a full analysis.  But I am linking to very good resources and already-completed analyses here:

http://www.hivlawandpolicy.org/states/pennsylvania

Pages 384-400 of this LARGE document: http://www.hivlawandpolicy.org/sites/default/files/HIV%20Criminalization%20in%20the%20U.S.%20A%20Sourcebook%20on%20State%20Fed%20HIV%20Criminal%20Law%20and%20Practice_0.pdf

If the PDF link does not work, click here to scroll down half-way and find it: http://www.hivlawandpolicy.org/sourcebook

[PittGurl]

Thank you - it is sorta scary to read some of that stuff....the law has so much power!!!  I wish i could prosecute the person that gave this to me. He refuses to submit a test and he is a well known athlete

[PozLawyer]

Thank you - it is sorta scary to read some of that stuff....the law has so much power!!!  I wish i could prosecute the person that gave this to me. He refuses to submit a test and he is a well known athlete

It sounds like you acquired this from someone who you thought you trusted, and for that I am sorry.  Whether or not he would be prosecuted would be the state's decision, not yours (although you would be the complaining witness/victim).  Also, this area of law is in a lot of flux in a lot of states because of all the recent science.  Several states with non-disclosure laws on the books are either rewriting those laws, or judges are refusing to apply them in cases where there is no risk of transmission.  It changes literally on a daily basis.

Unless there is some act of deception, lying about status, "stealthing" (removing or tampering with condom), I firmly believe it is incumbent upon both partners to know their own status, ask each other, and to be responsible for the choice they make regarding what protection, if any, to use.

Whether or not a state can prosecute someone for failure to disclose, I do not believe it is our moral or ethical obligation to wear a badge, even though state law may as a legal matter require disclosure.  If someone wants to know my status, they can ask me.  If they want to have sex with me and don't care to ask my status, I am not responsible for any assumption they may make.  (that being said, I am UD and would not be transmitting HIV)

If this person DID deceive you somehow, and he has $$ assets, talk to a PA lawyer.  I can think of some common-law civil claims that could apply.  But it would be for $$ remedy, not jail time, and if the person has no money, then I would see no point in bringing legal action. 

[PittGurl]

Thank you but really .....i wanna stop him from doing it to other women which i am sure is happening when you hope from city to city, state to state, and being from another country. Being a high profile person, that is sorta scary bc they have the money to shut me up or worse.

[PozLawyer]

Thank you but really .....i wanna stop him from doing it to other women which i am sure is happening when you hope from city to city, state to state, and being from another country. Being a high profile person, that is sorta scary bc they have the money to shut me up or worse.

I'm not doubting you but how can you be sure you contracted it from him?  I am very much against the criminalization of HIV but if you KNOW it was from him, and you can PROVE it, and he's continuing to have unprotected sex while not on treatment/undetectable... well then that changes my opinion a bit.

But my point is that you have an evidence problem either way.  If you were to try to have him prosecuted, the first thing the state would have to prove that he has HIV, and he hasn't taken a test if I remember your prior post correctly.  And unless you have a VERY compelling explanation as to how you could have acquired it only from him, it will be impossible for a prosecutor to get a warrant from a judge to collect blood even if you did find a sympathetic prosecutor.  Even with a compelling explanation, I have never heard of a judge issuing a warrant compelling someone to give blood in order to conduct an HIV test that the person has refusing to take.  That's a HUGE search & seizure issue, and a judge would be extremely reluctant to issue such a warrant (again, that's assuming you could find a prosecutor willing to even ask, which I think you would have a hard time doing).

Most cases of prosecution seem to be where it is known that the defendant has HIV (e.g., "victim" finds HIV meds in cabinet, defendant admits it to others, etc.).  Perhaps there's an example somewhere in that 500-page document, but I would be shocked if there's ever been a case of someone being ordered to take an HIV test for purposes of criminal prosecution when it is not already known with certainty that they have HIV.

[mecch]

PittGurl it seems you have unresolved feelings about becoming HIV+ and the vector of the transmission - the typhoid mary character.  Well he really may be a typhoid mary, I'm not doubting you!

Why don't you go to an HIV / AIDS service centre, or any kind of social service centre, for example maybe one that has an STD clinic, and discuss what the laws and procedures are if you wish to make a legal complaint in your state. 
And, if they are not helpful, then the next step would be simply to contact a lawyer and pay a lawyer to advise you on what is and is not possible. Preferably a good lawyer who would tell you the COST TO YOU to pursue a legal claim, and the chances of it doing any good whatsoever.

I seriously considered the same things as you and in my country I went and got the information from the agencies and a lawyer and it wasn't worth it to me. Professionals would would be implicated explained to me why it wasn't worth it.

[PozLawyer]

And, if they are not helpful, then the next step would be simply to contact a lawyer and pay a lawyer to advise you on what is and is not possible. Preferably a good lawyer who would tell you the COST TO YOU to pursue a legal claim, and the chances of it doing any good whatsoever.

I seriously considered the same things as you and in my country I went and got the information from the agencies and a lawyer and it wasn't worth it to me. Professionals would would be implicated explained to me why it wasn't worth it.

The only thing I would add is that in the United States you can usually find lawyers that will talk to you for free regarding your case and whether it is worth it.  If they take on the case, they will either take it on a contingency fee or they will give you an estimate of the cost to you per hour or flat fee.

However, I agree that it is probably not worth it and, unless this other person is very wealthy with lots of assets, you will have a hard time finding a lawyer that is willing to take it on.

[NewAdventure1]

Interesting I found this post..
That being said, I went to my ID Doc last week for my 6 month labs, and he handed me a piece of paper that discussed new HIV Disclosure Laws in North Carolina. Basically the new law states if a person is HIV Positive and has been Undetectable for 6 Months, remains in care, they no longer have to disclose to their sexual partners about their status, and the kicker to top it off is that they don’t even have to use condoms. (which would just increase other risk of the plethora of other STI’s)

On the opposite end, If a person is NOT Undetectable, NOT in Care, they HAVE to disclose their status and use protection. (Condoms, opposite partner PrEP).

This was extremely startling to me as When I was diagnosed almost 5 years ago and began treatment immediately, that the discussion between my Doc and I was totally about disclosure, protection, and even abstinence.

While I think this is good news for some, I still see how it can cause increase in STI rates of other diseases. But, I think it may motivate more to get tested and get on treatment in some ways.

[leatherman]

While I think this is good news for some, I still see how it can cause increase in STI rates of other diseases.

this change in law is about criminalization not healthy practices per se. Up till now, if an HIV+ partner didn't disclose and was accused by a partner, the HIV+ person could receive jail time for not disclosing and jail time for not using a condom. This law is now better defined by science. If an HIV+ person is UD for 6 months now, that person in a trial would not be criminalized for not disclosing or not using condoms. The science behind this is "undetectable = untransmittable". (check out TasP aka Treatment as Prevention) Also now, a sexual encounter reverts to the way it should be - both partners are equal in this activity. If you don't make your partner use a condom, or you don't use a condom, then that's YOUR issue, your personal responsibility. Your partner is not responsible for your lack of judgment.

Personally I don't think we'll see an increase in STI rate because a bunch of pozzies are having sex and not going to jail for having sex. This change in law just brings NC in line with science. As the majority of states that don't criminalize HIV+ sex have lower rates of STIs than NC, we really shouldn't see rates rise from this law change. Instead as science has shown that HIV criminalization stigmatizes people, reducing testing and treatment adherence, this law change will actually help lower rates of HIV

Of course anyone having sexual intercourse ought to be using condoms. As NC is now #1 in syphilis (the Charlotte Ryan White TGA and the NC Regional Quality Committees now both have quality improvement projects tackling this syphilis issue), along with almost as high rates of chlamydia and gonorrhea, not using a condom is our area is pretty stupid. (never fear, SC is trailing just a few positions behind. of course, all the states with the highest rates are currently in the South where education and access to health care are issues).

(btw I live just south of CLT in SC but get my services in NC, so, across the states, I'm the Consumer Chair of the CLT TGA, the SC RW Part C, and the NC Regional (statewide) Quality Committees.)

[CaveyUK]

kudos to NC.

Lets hope other states follow their lead!