Prison term for spreading HIV, applies to escorts too?

[ZhenXBear]

I know someone with that exact attitude. He once actually told me,"It's no big deal. If I get HIV I'll just take meds."

 

Yikes. Precisely as I speculated.

 

As you're assessing risks with four different potential sex partners, discussing things maturely and "honestly" this is what you know:

 

What are the odds that your friend who got shot in the eye would have been protected by disclosure? What are the odds that his masturbation partner was knowingly positive? Was it, "if only he'd told me?" or "if only he knew to tell me"?

 

I'd be afraid that the concept of mandatory disclosure would discourage testing and increase our undiagnosed rates. If someone tests positive he has to disclose, and he's likely to have to reduce his dating pool to bug chasers, safe-playing HIV+ guys, and the few guys who view HIV+ and unknown status as equal risk. If someone prefers not to disclose then not knowing his status is the best defense.

 

In my many discussions with him, I don't believe he would have had sex with him had he had known he was HIV positive. The guy actually did show him his HIV results from the County health department, but lied about the meaning of the words "Indeterminate" for the Western Blot. Negative Western Blot results mean that there are no bands of protein present representing HIV. Indeterminate means there are some but not all protein bands present associated with the virus. Based on the progression of the protein band formations, this person was likely in the initial serological conversion process at the time the assay was performed. He would have been instructed to come back in about 8 weeks for a repeat Western Blood and at that time, the remainder of the bands would have been present. Typically at this time, viral loads of untreated patients are also exceptionally high.

 

I do agree with your fears about mandatory disclosure, but I'm hopeful that with the many "at home" HIV kits that exist today, people may chose that route for testing. What's alarming is that "reducing the dating pool" is even something a person would be concerned about. Seems pretty narcissistic.

[Steven_Draker]

... If someone prefers not to disclose then not knowing his status is the best defense.

 

And that would put us how many years backwards ...?

http://www.workplace-communication.com/image-files/aids_logo_know_your_status.png

[Nvr2Thick]

And that would put us how many years backwards ...?

http://www.workplace-communication.com/image-files/aids_logo_know_your_status.png

Based on the stats some folks have quoted about undiagnosed cases I'd say it puts us about zero years backwards, but it locks us there. The benefits to knowing your own status are profound, but if we create negative consequences to knowing those benefits can be undone.

[doitb4ugo]

Perhaps legally requiring branding or visible tattoos would be a good method to reduce the good guys (non-HIV+) "dating pool". We poz guys would also benefit by making it easier to spot our own kind as we search for meaningless sex with strangers. Sounds like a Win-Win.

[Nvr2Thick]

Perhaps legally requiring branding or visible tattoos would be a good method to reduce the good guys (non-HIV+) "dating pool". We poz guys would also benefit by making it easier to spot our own kind as we search for meaningless sex with strangers. Sounds like a Win-Win.

 

I think it would be best to brand everyone.

[Amoco]

For a professional escort, or a client who frequently has unprotected sex, ignorance should not be a legally viable defense. If you kill someone going 150 mph, you can't use ignorance of the speed limit as an excuse. So those escorts who choose to not get tested should be put in jail, too.

 

That said, I do agree that each of us has a responsibility to protect ourselves. But the idea that that relieves the escort of his responsibility is absurd.

[Michael Wayne]

Amoco sir I believe what I posted is a fact and a driving factor in the bareback epidemic. You cannot assail my logic sir...with all due respect. that having been said a poz guy should always disclose....... but IF THEY DON'T then condoms do protect much of the time. It is still a crime but it most likely will not result in seroconversion. Amoco I know u do not like me much these days but please don't confuse your obvious dislike of me with the solid facts of my reporting. thanks

[Guest ChrisW]

There is something NONE of you seem to have covered that is quite pertinent. Was the "victims" strain genotyped and tied to the guy who is being charged?

[ZhenXBear]

There is something NONE of you seem to have covered that is quite pertinent. Was the "victims" strain genotyped and tied to the guy who is being charged?

 

An interesting question indeed, Chris. Since genotyping is primarily used to determine drug resistance to the various medications within the classes used to treat the virus (e.g. Protease Inhibitor, nucleoside RT inhibitors, etc.) one would think that samples collected from both that had matching mutations would lead to the conclusion that they came specifically from the source patient.

 

I'm by no means an expert in virology but I think that there is weak probability this would stand in court. For the following reasons:

 

If the new victim had resistance mutations for medications they'd never received for their HIV, then one presumes that the mutation was present in their initial infection. But not all mutations are transmissible necessarily; there's research that indicates that mutations affect how well the virus can be transmitted, so they aren't necessarily passed onto the next person.

 

Therefore Person A could infect person B and some of those drug mutation strains not be present because those specific strains "were not fit enough" to be passed on to person B. So the genotyping would likely be different and thus not provide conclusive information, considering the medications used to treat HIV are limited and this creates statistically more common mutations that are passed forward.

 

Even genetic sequencing of the virus itself would only determine that they both came from the same natural variation of the virus and those typically are regional. The only caveat would be that if person A had an atypical subtype, like one usually present Africa/Middle East, it might lend to the court case but wouldn't be a smoking gun.

 

Unfortunately it's not as clear cut as paternity testing where you can provide significantly higher odds of certainty.

[Guest ChrisW]

You can test to see if someone gave HIV to someone else but it requires extra testing. I just consulted an HIV specialist and he sent me a link to the HTPN 052 study.

 

http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748/

 

"The results

The main news is that in PARTNER so far there have been no transmissions within couples from a partner with an undetectable viral load, in what was estimated as 16,400 occasions of sex in the gay men and 28,000 in the heterosexuals.

 

Although some of the HIV-negative partners became HIV positive (exactly how many will be revealed in later analyses), genetic testing of the HIV revealed that in all cases the virus came from someone other than the main partner."

 

http://www.avert.org/criminal-transmission-hiv.htm

 

"Firstly it needs to be proven that the accused (let's call them A) was definitely the source of the accuser's (B) HIV. This would involve a range of evidence including sexual history, testing history and scientific evidence in the form of phylogenetics. This compares the DNA of the virus that A and B are infected with (see the Richard D. Schmidt case study, below, for application in US courts). If they are completely different then it means B almost certainly did not acquire HIV from A, and the case would probably be thrown out. If the strains are very similar, however, it is possible, though not conclusive, that A infected B. Phylogenetics cannot reliably estimate the direction of transmission and therefore it is possible that B infected A. Furthermore, both could have been infected by the same third party, or different third parties who shared similar strains of HIV. Due to its shortcomings, advocates recommend phylogenetic evidence should only be considered in the context of all other evidence. "

 

Claiming ignorance is no excuse not to protect yourself. If you don't want to put yourself at risk of HIV don't have sex or share needles. If you want to minimize your risk use condoms/and or prep. Monogamous relationships provide the illusion of safety for STI's but thats all it is, an illusion. Knowledge is the best way to protect yourself against sti's folks know what your risks are. There are other sti's out there such as HPV and HSV that you can get from skin to skin contact. Your partner may not even know they have something and condoms won't always protect against those.

[rvwnsd]

There is something NONE of you seem to have covered that is quite pertinent. Was the "victims" strain genotyped and tied to the guy who is being charged?

 

None of the stories I read or heard addressed genotyping. Doesn't mean it wasn't done, just that they did not mention it in the story.

[ZhenXBear]

You can test to see if someone gave HIV to someone else but it requires extra testing. I just consulted an HIV specialist and he sent me a link to the HTPN 052 study.

 

http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748/

 

"The results

The main news is that in PARTNER so far there have been no transmissions within couples from a partner with an undetectable viral load, in what was estimated as 16,400 occasions of sex in the gay men and 28,000 in the heterosexuals.

 

Although some of the HIV-negative partners became HIV positive (exactly how many will be revealed in later analyses), genetic testing of the HIV revealed that in all cases the virus came from someone other than the main partner."

 

http://www.avert.org/criminal-transmission-hiv.htm

 

"Firstly it needs to be proven that the accused (let's call them A) was definitely the source of the accuser's (B) HIV. This would involve a range of evidence including sexual history, testing history and scientific evidence in the form of phylogenetics. This compares the DNA of the virus that A and B are infected with (see the Richard D. Schmidt case study, below, for application in US courts). If they are completely different then it means B almost certainly did not acquire HIV from A, and the case would probably be thrown out. If the strains are very similar, however, it is possible, though not conclusive, that A infected B. Phylogenetics cannot reliably estimate the direction of transmission and therefore it is possible that B infected A. Furthermore, both could have been infected by the same third party, or different third parties who shared similar strains of HIV. Due to its shortcomings, advocates recommend phylogenetic evidence should only be considered in the context of all other evidence. "

 

Claiming ignorance is no excuse not to protect yourself. If you don't want to put yourself at risk of HIV don't have sex or share needles. If you want to minimize your risk use condoms/and or prep. Monogamous relationships provide the illusion of safety for STI's but thats all it is, an illusion. Knowledge is the best way to protect yourself against sti's folks know what your risks are. There are other sti's out there such as HPV and HSV that you can get from skin to skin contact. Your partner may not even know they have something and condoms won't always protect against those.

 

 

Definitely a good read! The final paragraph is what I was also saying. While phylogenetics (sequencing) can be used to determine the phylum (subclass) of the virus it can't be used to definitively prove a specific person gave it to a specific person only to prove they have the same subtype. Of course the vast majority of people in specific regions of the world have the same subtype so while it could be used to support a case in court the Defense would likely use the points we've discussed to negate its importance or at the very least instill a reasonable doubt in a jury.