Preventing HIV transmission via HIV exposure laws: applying logic and mathematical modeling to compare statutory approaches to penalizing undisclosed exposure to HIV

Twenty-four U.S. states have enacted HIV exposure laws that prohibit HIV-positive persons from engaging in sexual activities with partners to whom they have not disclosed their HIV status. There is little standardization among existing HIV exposure laws, which vary substantially with respect to the sexual activities that are prohibited without prior serostatus disclosure. Logical analysis and mathematical modeling were used to explore the HIV prevention effectiveness of two types of HIV exposure laws: "strict" laws that require HIV-positive persons to disclose their serostatus to prospective partners prior to any sexual activity and "flexible" laws that require seropositive status disclosure only prior to high-risk sex (e.g., unprotected anal or vaginal intercourse). These laws were compared relative to each other and to a no-law alternative. The results of these analyses indicate that, under most (though not necessarily all) circumstances, both strict and flexible exposure laws can be expected to reduce HIV transmission risk relative to the no-law alternative, with flexible exposure laws producing the greater reduction in risk. This study demonstrates how logical analysis and mathematical modeling techniques can make an important contribution to the construction of a rational basis for decisions about a highly contested public health policy issue.     

Communication and dialogue: what government websites might tell us about citizenship and governance

There are many ways to map and measure the links and spaces between the citizen and government. With the new models of governance available—where the government directs and the private sector along with a range of other actors implements—there are a whole number of questions that can be both examined in a qualitative manner but also may be examined in a quantitative manner. This paper looks at one quantitative approach (WAES—Website Attribute Evaluation System) and posit that it may be possible to develop from this further techniques—the development of e‐metrics—which will aid qualitative study of the citizenship and governance in the world of e‐government (E‐Gov).     

Criminal law and HIV transmission/exposure: two new cases

In a regular column, we review new developments in the area of criminal prosecutions for HIV transmissions or exposure. Since the last issue of the Review, two new Canadian cases have come to our attention. A Swedish case is reported in HIV/AIDS in the Courts - International.     

What has worked and what has not with Minnesota sex offenders: a review of the evidence

Abstract

Since the early 1990s, many states in the USA have attempted to control sexual offending and, more narrowly, sexual recidivism by implementing longer prison sentences for sex crimes, sex offender registration and notification, residency restrictions, involuntary civil commitment and lifetime probation and parole. The early 1990s also marked the beginning of a decline in official rates of sexual offending, including sexual recidivism. This study reviews recent research conducted on Minnesota sex offenders in an effort to identify which policies, programmes and practices might have contributed to the drop in sexual recidivism rates that have been observed over the last few decades. By assessing what has, and has not, worked with Minnesota sex offenders, this study discusses how lessons learned from the Minnesota experience may apply to broader efforts within the USA and abroad to control sexual offending.     

From global problems to international norms: what does the social construction of a global corruption problem tell us about the emergence of an international anti-corruption norm

This article examines the ontological contestation that is inherent to the emergence of an international anti-corruption norm. First, the article briefly analyses the compatibility of an agenda on the social construction of problems from sociology and the well-established study of norms in constructivist IR. It argues that an analytical shift from the study of norms to the social construction of problems can shed light on the power relations that underlie international norms, and corruption in particular. The article traces the emergence of a global corruption problem up to the early 2000s when scholars have traditionally placed the establishment of an international anti-corruption norm. It first shows the contestation of corruption as a global issue on the level of problem definition, and then, it shows the role of venue shopping and venue shifting in the diffusion of anti-corruption talks and the norm cascade of the 1990s. The article concludes with an analysis of how the social construction of problems challenges the conventional approach of the emergence of an international anti-corruption norm.     

Criminal law and HIV transmission/exposure: one new case. One-year sentence for spitting

In a regular column, we have reviewed new developments in the area of criminal prosecutions for HIV transmission or exposure. Since the last issue of the Review, one new Canadian case has come to our attention.     

Police response to domestic violence: making decisions about risk and risk management

Assessing and responding to risk are key elements in how police respond to domestic violence. However, relatively little is known about the way police make judgments about the risks associated with domestic violence and how these judgments influence their actions. This study examines police decisions about risk in domestic violence incidents when using a risk assessment instrument. Based on a sample of 501 risk assessments completed by police in Australia, this study shows that a limited number of items on the risk assessment instrument are important in police officers' decisions about risk. Statistical analyses show that the victim's level of fear contributes to police officers' judgment on the level of risk and their decisions on which risk management strategy should be used. These findings suggest that research on police responses to domestic violence needs to pay greater attention to situational dynamics and the task requirements of risk-based decision making.     

UNFCCC negotiations (pre-Kyoto to COP-9): what the process says about the politics of CDM-sinks

One of the most contentious issues in the negotiations aimed at operationalizing the Kyoto Protocol was the treatment of sinks and, particularly, the eligibility of sinks projects in the Clean Development Mechanism (CDM). This paper attempts to analyse the politics underlying these negotiations, drawing on methods of process tracing, key informant interviews, negotiating texts and secondary literature. Tracing the sinks debate and highlighting key lessons about the nature of global environmental agreements and their institutional arrangements is the first step to recounting the history of the politics of one of the major contemporary international environmental debates. The paper shows that the Kyoto Protocol negotiations on sinks and CDM-sinks were multilaterally supported as a practical solution, but went ‘off track’ due to actors’ interests and tradeoffs. As regards future negotiations on forest sinks in developing countries under the framework of the UNFCCC, the paper argues that these are likely to be influenced by similar constraints, and also by the conservation and development agenda of its supporters; as well as the experience gathered on the CDM and the interests and concerns of developing countries. We broadly frame the paper within the literature on global environmental politics.

Risk factors for potential occupational exposure to HIV: A study of correctional officers

This study examined social determinants that explain correctional officer exposure to blood/bodily fluids. Seasoned officers in five prisons were selected at random to complete an anonymous mail survey regarding situations which may have placed them at risk for exposure to HIV while at work. Institutional variables more strongly predicted officer chances of occupational exposure in a corrections setting than did perceptual and individual level variables, particularly the custody level of inmates supervised, length of time in the corrections career, and being in a position of rank. Years of experience increased the number of exposures to blood and bodily fluid, and increased officer apprehensiveness concerning uses of force with seropositive inmates. Knowledge about HIV and the frequency of use of personal protective equipment was not related to the likelihood of encounters with blood or bodily fluids.     

Gender, sexuality, and HIV/AIDS: the what, the why, and the how

The focus of Geeta Rao Gupta's plenary presentation of 12 July 2000 at the XIII International AIDS Conference is on the what, why, and how of gender, sexuality, and HIV/AIDS. Dr Rao Gupta discusses the factors associated with women's vulnerability to HIV; and the ways in which unequal power balance in gender relations increases not only women's, but also men's, vulnerability to HIV-despite, or rather because of, their greater power. She then addresses the question of how one is to overcome the seemingly insurmountable barriers of gender and sexual inequality. How can we change the cultural norms that create damaging, even fatal, gender disparities and roles? According to Dr Rao Gupta, an important first step is to recognize, understand, and publicly discuss the ways in which the power imbalance in gender and sexuality fuels the epidemic. She provides examples of sensitive, transformative, and empowering approaches to gender and sexuality and concludes that, in the final analysis, reducing the imbalance in power between women and men requires policies that are designed to empower women--policies that aim to decrease the gender gap in education, improve women's access to economic resources, increase women's political participation, and protect women from violence.