1. Cecilia Chung and Laurel Sprague July 23, 2014 AIDS 2014 Melbourne, Victoria, Australia Intersections of Disclosure and Prosecution Transgender People in the US Respond to Criminal Laws Based on HIV Status

2. 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).

3. 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

4. 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

5. Transgender Respondents US respondents = 3034, 2% identified as transgender or third sex Transgender male1937% Transgender female1835% Third sex1427% Total51100% Transgender male Transgender female Third sex HIV-negative 74%28%46% Unknown HIV status 0% 15% HIV-positive 21%72%31% Prefer not to answer 5%0%8%

6. Enabling Legal Environment Disabling

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

8. 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%). HIV-positive respondents only

9. 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 ? HIV-positive respondents only

10. 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).

11. HIV Disclosure

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

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

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

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

16. 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

17. Next Steps  Research that people living with HIV need:  Violence related to disclosure  With specific questions for transgender people living with HIV

18. 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.