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Who? What? Where? When? And with What Consequences? An Analysis of Criminal Cases of HIV Non-disclosure in Canada1

  • Eric Mykhalovskiy (a1) and Glenn Betteridge (a2)

The use of criminal-law powers to respond to people with HIV who place others at risk of HIV infection has emerged as a focal point of AIDS advocacy at global, national, and local levels. In the Canadian context, reform efforts that address the criminalization of HIV non-disclosure have been hampered by the absence of data on the contours, scale, and outcomes of criminalization. This article responds to that gap in knowledge with the first comprehensive analysis of the temporal trends, demographic patterns, and aggregate outcomes of Canadian criminal cases of HIV non-disclosure. The authors draw on insights into the role that rendering social phenomena in numerical terms plays for the governance of social life in order to make criminalization “visible” in ways that might contribute to activist responses. The article examines temporal trends, demographic patterns, and outcomes separately. In each instance, the pattern or trend identified is described, potential explanations for findings are offered, and an account is given of how the data have informed efforts to reform criminal law. Particular attention is paid to the following key findings: a sharp increase in criminal cases that began in 2004; the large proportion of recent criminal cases involving defendants who are heterosexual Black, African, and Caribbean men; and the high proportion of criminal cases resulting in conviction. The article closes with suggestions for future research.

Le recours aux pouvoirs du droit pénal en vue de prendre des mesures à l'égard des personnes qui ont contracté le VIH et qui présentent un risque de transmission de ce virus à d'autres est devenu un élément central de l'activisme en ce qui a trait au sida, tant aux niveaux international, national que local. Dans le contexte canadien, les efforts de réforme visant à traiter la criminalisation de la non-divulgation de la séropositivité au VIH ont été ralentis par l'absence de données sur les profils, l'échelle et les effets de la criminalisation. Cet article vise à corriger une telle lacune en matière de connaissances grâce à la toute première analyse exhaustive des tendances temporelles, des modèles démographiques et de l'ensemble des résultats d'affaires criminelles canadiennes en matière de non-divulgation de la séropositivité au VIH. Cet article s'inspire de points de vue à propos du rôle que joue la représentation d'un phénomène social en termes numériques pour la gouvernance de la vie sociale, afin de rendre «visible» la criminalisation par des moyens qui pourraient contribuer aux mesures activistes. Cet article examine les tendances temporelles, les modèles démographiques et les résultats séparément. Pour chaque cas, nous décrivons la tendance ou le modèle que nous avons identifié, nous proposons d'éventuelles explications par rapport aux conclusions, et donnons un compte rendu de la façon dont les données ont servi de base aux efforts de réforme en matière de droit pénal. Une attention toute particulière est accordée aux principales conclusions suivantes: augmentation considérable des affaires criminelles depuis 2004; grande proportion d'affaires criminelles récentes incluant des défendeurs qui sont des hétérosexuels de race noire, des Africains et des hommes des Caraïbes; et importante proportion d'affaires criminelles aboutissant à une condamnation. L'article se termine par des suggestions en vue de recherches à venir.

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2 Wolf, L.E. and Vezina, R., “Crime and Punishment: Is There a Role for Criminal Law in HIV Prevention Policy?Whittier Law Review 25 (2004): 821–86; Mykhalovskiy, E., “The Problem of ‘Significant Risk’: Exploring the Public Health Impact of Criminalizing HIV Non-disclosure,” Social Science and Medicine 73 (2011): 670–77; O'Byrne, P., “Criminal Law and Public Health Practice: Are the Canadian HIV Disclosure Laws an Effective HIV Prevention Strategy?Sexuality Research and Social Policy 9, 1 (2012): 7079.

3 Burris, S. and Cameron, E., “The Case against Criminalization of HIV Transmission,” Journal of the American Medical Association 300, 5 (2008): 578–80; Burris, S. et al. , “Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial,” Arizona State Law Journal 39 (2007): 467517.

4 UNAIDS, Criminalization of HIV Transmission. Policy Brief (2008); Open Society Institute, 10 Reasons Why Criminalization of HIV Exposure or Transmission Is Bad Public Policy (2008); Azad, Y., “Developing Guidance for HIV Prosecutions: An Example of Harm Reduction?HIV/AIDS Policy and Law Review 13, 1 (2008): 1319.

5 For recent examples see Mykhalovskiy, , “The Problem with ‘Significant Risk’”; Dodds, C. et al. , “Responses to Criminal Prosecutions for HIV Transmission among Gay Men with HIV in England and Wales,” Reproductive Health Matters 17, 34 (2009): 135–45; Adam, B. et al. , “Effects of the Criminalization of HIV Transmission in Cuerrier on Men Reporting Unprotected Sex with Men,” Canadian Journal of Law and Society 23, 1–2 (2008): 143–59, http://dx.doi.Org/10.1353/jls.0.0040; Galletly, C.L. et al. , “HIV-Positive Persons' Awareness and Understanding of Their State's Criminal HIV Disclosure Law,” AIDS and Behavior 13 (2009): 1262–69.

6 Weait, M., Intimacy and Responsibility: The Criminalisation of HIV Transmission (Abingdon, UK: Routledge-Cavendish, 2003); Grant, I., “The Boundaries of the Criminal Law: The Criminalization of the Non-disclosure of HIV,” Dalhousie Law Journal 31 (2008): 123–80.

7 Bernard, E.J., HIV and the Criminal Law (London: NAM, 2010); Lazzarini, Z., Bray, S., and Burris, S., “Evaluating the Impact of Criminal Laws on HIV Risk Behavior,” Journal of Law, Medicine and Ethics 30 (2002): 239–53.

8 R v Cuerrier, [1998] 2 SCR 371.

9 For a discussion of reformism and feminist interventions in Canadian rape law see Los, M., “The Struggle to Redefine Rape in the Early 1980s,” in Confronting Sexual Assault: A Decade of Legal and Social Change, ed. Roberts, J.V. and Mohr, R. M., 2056 (Toronto: University of Toronto Press, 1994).

10 Ontario Working Group on Criminal Law and HIV Exposure, “We Need Prosecutorial Guidelines for HIV Non-Disclosure,”

11 Mykhalovskiy, E., Betteridge, G., and McLay, D., HIV Non-disclosure and the Criminal Law: Establishing Policy Options for Ontario (Toronto: Ontario HIV Treatment Network, 2010).

12 Porter, T.M., Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton, NJ: Princeton University Press, 1995); Miller, P. and Rose, N., “Governing Economic Life,” Economy and Society 19, 2 (1990): 131; Latour, B., Science in Action (Milton Keynes, UK: Open University Press, 1987).

13 Elliott, R., After Cuerrier: Canadian Criminal Law and the Non-disclosure of HIV-Positive Status (Toronto: Canadian HIV/AIDS Legal Network, 1999).

14 See Mykhalovskiy et al., HIV Non-disclosure and the Criminal Law.

15 In December 2010, following lobbying efforts by CLHE, MAG committed to producing prosecutorial guidance for criminal cases of HIV non-disclosure and other sexually transmitted infections. On CLHE's activist work see McCaskell, T., “Disrupting the Criminalization of HIV,” Our Schools Our Selves 20, 3 (2011): 133–56.

16 Mykhalovskiy, E. and Sanders, C., “‘There is no excuse for this wanton, reckless, selfindulgent behavior’: A Critical Analysis of Media Representation of the Criminalization of HIV Non-disclosure in Canada” (paper presented at Ontario HIV Treatment Network Annual Conference, Toronto, 2008).

17 Mykhalovskiy et al., HIV Non-disclosure and the Criminal Law.

18 See, e.g., Roberts, J.V., “Racism and the Collection of Statistics Relating to Race and Ethnicity,” in Crimes of Colour: Racialization and the Criminal Justice System in Canada, ed. Chan, W. and Mirchandani, K., 101–12 (Peterborough: Broadview Press, 2001); Wortley, S., “Hidden Intersections: Research on Race, Crime, and Criminal Justice in Canada,” Canadian Ethnic Studies 35, 3 (2003): 99117.

19 Owusu-Bempah, A. and Millar, P., “Revisiting the Collection of ‘Justice Statistics by Race’ in Canada,” Canadian Journal of Law and Society 25, 1 (2010): 97104,

20 Merminod, A., “The Deterrence Rationale in the Criminalization of HIV/AIDS,” Lex Electronica 13, 3 (2009): 234.

21 We defined as an HIV non-disclosure case any circumstance in which one or more Criminal Code charges were laid by police against a person based on alleged HIV nondisclosure in the context of sexual activity. We excluded situations in which police charged an HIV-positive person with assault—including sexual assault and aggravated sexual assault—when force, violence, or coercion was used to obtain sex. We also excluded criminal cases involving charges for biting or spitting. We treated as separate cases charges that were prosecuted in separate proceedings, either at the trial stage or on appeal. In 66 cases, defendants faced two or more criminal charges related to HIV non-disclosure.

22 Since at least 1989, the Canadian HIV/AIDS Legal Network has been tracking HIV non-disclosure criminal prosecutions in Canada, drawing on a variety of sources: media clipping services (including; Internet and hand searches of media reporting; electronic searches of legal databases (LexisNexis, Quicklaw, and CanLii); and information passed on by HIV/AIDS organizations, community members, and lawyers.

23 Eight individuals were each involved in two criminal cases.

24 Symington, A., “Criminalization Confusion and Concern: The Decade since the Cuerrier Decision,” HIV/AIDS Policy and Law Review 14, 1 (2009): 510; Grant, “The Boundaries of the Criminal Law.”

25 Elliott, R., “Criminalization Creep: Legal Developments and Community Responses to Criminal Prosecutions for HIV Exposure” (paper presented at OHTN Research Conference, Toronto, 2009).

26 Mallea, P., The Fear Factor: Stephen Harper's “Tough on Crime Agenda” (Ottawa: Canadian Centre for Policy Alternatives, 2010).

27 On positive prevention see Fisher, J., Smith, L., and Lenz, E., “Secondary Prevention of HIV in the United States: Past, Current and Future Perspectives,” Journal of Acquired Immune Deficiency Syndrome 55 (2010): S10615.

28 Mykhalovskiy, E., “Integrating HIV Treatment and Prevention: Shifts in Community-Based Organizing and Biopofitics in the Canadian Context,” in HIV Treatment and Prevention Technologies in International Perspective, ed. Davis, M. and Squire, C., 6186 (Basingstoke, UK: Palgrave Macmillan, 2010).

29 In R v Williams, [2003] 2 SCC 41 at para 28, the Supreme Court of Canada suggested that once an individual becomes aware that he or she has faced a risk of contracting HIV, and hence that his or her partner's consent has become an issue, the individual is obliged to disclose that awareness to his or her sexual partner.

30 Mykhalovskiy and Sanders, “‘There Is No Excuse.’”

31 Our analysis focuses on men because the number of women (11) prosecuted from 1989 to 2010 does not lend itself to the identification of trends and patterns. Of course, the impact of criminalization on HIV-positive women is not a simple function of the number of cases involving female defendants; it is also important to recognize gender differences in the experience of criminalization based on such factors as degrees of social marginalization and power dynamics in interpersonal relationships. For a discussion see Allard, P., Kazatchkine, C., and Symington, A., “Criminal Prosecutions for HIV Non-disclosure: Protecting Women from Infection or Threatening Prevention Efforts?” in Women and HIV Prevention in Canada: The Past, the Present and the Future—Implications for Research, Policy and Practice, ed. Gahagan, J. (Toronto: Canadian Scholars Press, forthcoming).

32 For the purposes of our research, we designated the accused's sexual orientation on the basis of the gender of the complainant.

33 Adam, B. et al. , “Circuits, Networks, and HIV Risk Management,” AIDS Education and Prevention 20 (2008): 420–35.

34 In a recent paper drawing on a range of drug-using cohorts in the Vancouver area, Marshall and colleagues report an HIV prevalence rate of 21.2% among male heterosexual drug users. Marshall, B. et al. , “Pathways to HIV Risk and Vulnerability among Lesbian, Gay, Bisexual, and Transgendered Methamphetamine Users: A Multi-cohort Gender-Based Analysis,” BMC Public Health 11, 20 (2011).

35 Miller, J., “African Immigrant Damnation Syndrome: The Case of Charles Ssenyonga,” Sexuality Research and Social Policy 2, 2 (2005): 3150; African and Caribbean Council on HIV/AIDS in Ontario (ACCHO), Criminals and Victims? Race, law and HIV Exposure in Ontario (Toronto, 2010).

36 Wortley, S. and Tanner, J., “Data, Denials and Confusion: The Racial Profiling Debate in Toronto,” Canadian Journal of Criminology and Criminal Justice 45 (2003): 367–89,; Janoff, D.V., Pink Blood: Homophobic Violence in Canada (Toronto: University of Toronto Press, 2005).

37 Adam, B., “What Do HIV-Positive People Think about the Criminalization of HIV Transmission? Results from the Positive Spaces Healthy Places Survey” (paper presented at the OHTN Research Conference, November 2010).

38 ACCHO, Criminals and Victims.

39 See, e.g., Roberts, J. and Doob, A., “Race, Ethnicity, and Criminal Justice in Canada,” in Ethnicity, Crime and Immigration: Comparative and Cross-National Perspectives, vol. 21, ed. Tonry, M., 469522 (Chicago: University of Chicago Press, 1997).

40 We received two widely different estimates of the proportion of HIV-positive men in Ontario who are Black. The Ontario HIV Epidemiological Monitoring Unit's estimate of 57.8% was based on modelled HIV prevalence using 2007 surveillance data; a second estimate of 22.6% from the OHTN was based on data from the Ontario Cohort Study.

41 ACCHO, Criminals and Victims.

42 Commission on Systemic Racism, Report of the Commission on Systemic Racism in the Ontario Criminal Justice System (Toronto: Queen's Printer for Ontario, 1995).

43 An examination of Toronto Star coverage (March 1990–July 2010) found that 64% (134/208) of news stories on criminal HIV non-disclosure cases focused on cases involving Black male defendants. E. Mykhalovskiy, unpublished data.

44 Wortley, “Hidden Intersections.”

45 The outcome data from 1989 to the end of 2010 represent the information we had at the time of writing, which may not reflect the final outcome of a case. We treated cases as “unknown” when we were aware of charges' being laid but were unable to obtain any information about the outcome(s) as of the time of writing.

46 Mykhalovskiy et al., HIV Non-disclosure and the Criminal Law.

47 Grant, I., “The Prosecution of HIV Non-disclosure in Canada: Time to Rethink CuerrierMcGill Journal of Law and Health 5, 1 (2011): 759.

48 Burris and Cameron, “The Case against Criminalization.”

1 We thank Cecile Kazatchkine for assistance with the demographic data presented in this article. We also thank the anonymous reviewers for their helpful comments on the manuscript. This research was supported by a grant from the Ontario HIV Treatment Network. Eric Mykhalovskiy is supported by a Canadian Institutes of Health Research New Investigator Award.

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