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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 25, Issue 3, Pages 135-140
Consensus Statement

Canadian consensus statement on HIV and its transmission in the context of criminal law

Mona Loutfy,1 Mark Tyndall,2 Jean-Guy Baril,3 Julio SG Montaner,4 Rupert Kaul,5 and Catherine Hankins6

1Women’s College Research Institute, University of Toronto (Co-chair of the Canadian Experts on HIV and Transmission Team), Toronto, Canada
2Division of Infectious Diseases, University of Ottawa (Co-chair of the Canadian Experts on HIV and Transmission Team), Ottawa, Ontario, Canada
3University of Montreal, Montreal, Quebec, Canada
4Division of AIDS, University of British Columbia, Vancouver, British Columbia, Canada
5Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada
6Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


INTRODUCTION: A poor appreciation of the science related to HIV contributes to an overly broad use of the criminal law against individuals living with HIV in cases of HIV nondisclosure.

METHOD: To promote an evidence-informed application of the law in Canada, a team of six Canadian medical experts on HIV and transmission led the development of a consensus statement on HIV sexual transmission, HIV transmission associated with biting and spitting, and the natural history of HIV infection. The statement is based on a literature review of the most recent and relevant scientific evidence (current as of December 2013) regarding HIV and its transmission. It has been endorsed by >70 additional Canadian HIV experts and the Association of Medical Microbiology and Infectious Disease Canada.

RESULTS: Scientific and medical evidence clearly indicate that HIV is difficult to transmit during sex. For the purpose of informing the justice system, the per-act possibility of HIV transmission through sex, biting or spitting is described along a continuum from low possibility, to negligible possibility, to no possibility of transmission. This possibility takes into account the impact of factors such as the type of sexual acts, condom use, antiretroviral therapy and viral load. Dramatic advances in HIV therapy have transformed HIV infection into a chronic manageable condition.

DISCUSSION: HIV physicians and scientists have a professional and ethical responsibility to assist those in the criminal justice system to understand and interpret the science regarding HIV. This is critical to prevent miscarriage of justice and to remove unnecessary barriers to evidence-based HIV prevention strategies.