Canadians shouldn't have to disclose HIV to lovers: doctor
Many say drugs have turned what was once a fatal disease into a chronic illness.
Andrew Weichel, ctvbc.ca
Published Monday, December 19, 2011 3:47PM PST
HIV-positive Canadians shouldn't be legally required to reveal their status to sexual partners, according to a B.C. doctor globally recognized for his work treating the disease.
Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS, says current treatments can make the risk of spreading HIV through sex negligible -- even without condoms.
"The science doesn't suggest that a person who has HIV with an undetectable viral load or is practicing safe sex, or both, is actually a risk to anybody," Montaner said.
Montaner was a lead investigator in the development of the highly active antiretroviral therapy (HAART), a drug cocktail introduced in 1996 that has become the global standard of care.
In an article he co-authored in the current issue of the Canadian Medical Association Journal, Montaner boasts of a randomized trial that saw a 96-per-cent decrease in transmission risk for patients using the therapy.
"It is time to embrace the scientific evidence, recognize the ability of HAART to virtually eliminate the transmission of HIV, and do away with criminal prosecutions for HIV nondisclosure," the article reads.
Yet the number of such cases tried in Canada is rising, Montaner wrote, and the country ranks as a world leader in prosecutions.
The doctor says he is frequently contacted by Crown prosecutors and RCMP investigators about cases involving patients who have already managed their risk of transmission through treatment and didn't transmit the disease.
"[HAART] is going to render them potentially non-infectious -- so why are you putting them in jail?" he said.
But his proposal may be a tough sell for the general public, particularly in the wake of several shocking cases of nondisclosure that led to HIV transmission or even death.
Johnson Aziga made national headlines in 2009 becoming the first Canadian convicted of murder for infecting two unsuspecting women, both of whom eventually contracted AIDS and died of related cancers.
Apart from what were dubbed the "HIV transmission murders," Aziga was convicted of 10 counts of aggravated sexual assault and one count of attempted sexual assault for keeping almost a dozen partners in the dark.
Even those who have not transmitted the disease can face sex assault charges in Canada; according to legal precedent, one cannot consent to sex if unaware of their partner's HIV status.
But despite how disturbing the most sensational stories may be, Montaner says they shouldn't skew the public's perception about HIV transmission – and the doctor insists there is nothing to fear about those who are properly managing their risk.
"I am totally for people having responsible sexual lives, don't get me wrong," Montaner said. "That doesn't mean that you necessarily need people to disclose their HIV status if they're undetectable."
There would still be plenty of room to prosecute those with detectable HIV who choose not to inform their partners maliciously, he added.
And the law as it stands may even increase infection rates. Montaner argues that if sexually active Canadians think they will be forced to disclose their HIV status to every partner, even while dealing with the risk of transmission responsibly, they could be less likely to get tested for the disease in the first place.
Finally, Montaner argues HIV-positive Canadians are already stigmatized in society, and shouldn't suffer under a "Draconian" law that discriminates against them based on their illness.
"What this is creating is an unfair burden on people affected with HIV… people whose only crime is being HIV positive," he said. "This is unreasonable."
Have your say: Should people with undetectable viral loads be forced to reveal their HIV to sexual partners?