Advocacy for HIV criminal law reform often emphasizes that such laws may deter HIV testing and weaken the public health response to HIV. However, there has been limited evidence to support the relationship between HIV criminal laws and decreased HIV testing. Research in this study on men who have sex with men (MSM) in Toronto, Canada showed that about 7% of HIV-negative participants were less likely to get tested due to fear of prosecution. While it may seem like a small proportion, the study demonstrated that a 7% decrease in HIV testing could increase overall HIV transmission potential by 18.5%. The findings suggest that even a minor decrease in testing due to fear of prosecution can have potentially significant population-level effects on transmission.
The researchers note the importance of individuals who are HIV-positive but not yet aware of their status as a significant driver of transmission, particularly in light of the role of ART as a preventative tool. The study has various limitations, including a geographically limited sample (Toronto, Canada) and reliance on mathematical modeling that may not identify all the possible variables that affect willingness to disclose serostatus and testing behaviors.