背景:2021年,中国法院,根据新颁布的民法典,由于配偶在婚前未能披露其艾滋病毒感染情况,首先吊销了结婚证。这个具有里程碑意义的案件引发了关于艾滋病毒感染者(PLHIV)是否有法律义务告知其配偶和性伴侣的新辩论。医学的进步已经部分隔离了性接触中的艾滋病毒传播,将披露义务的法律依据扩展到疾病预防之外。本研究调查了中国PLHIV在履行这一职责方面可能面临的一些不可预见的挑战,以及他们根据政府促进健康的目标做出的决定的结果。
方法:本研究旨在详细研究中国PLHIV中有关伴侣告知的法律规定和实践。2019年至2020年采用了混合方法研究方法,结合问卷调查,深入采访,参与式观察。通过在中国PLHIV在线平台上发布的问卷,共获得433份有效回复。在对问卷数据进行收集和随机编码之后,选择了40名艾滋病毒感染者进行深入访谈。随后,在金华市关爱家(爱心家园)进行了为期六个月的实地调查,以进一步探讨这一问题。
结果:相当比例的PLHIV对其配偶的披露率很高(近80%)。在性伴侣的背景下,56%的PLHIV表示他们的性伴侣知道他们的HIV感染。无论是已婚PLHIV向配偶披露,还是未婚/离婚PLHIV向性伴侣披露,然而,绝大多数人对披露可能导致的对他们关系的潜在破坏表示担忧。在婚外关系中的已婚PLHIV中观察到唯一的例外,在这种情况下,他们的关注程度略有下降。未披露的原因主要包括检测不到病毒载量和采取保护措施。
结论:这项研究表明,普遍存在的“艾滋病毒耻辱”阻碍了艾滋病毒感染者自愿履行《艾滋病毒/艾滋病预防和控制条例》第38条赋予的披露义务,新《民法典》不明确的法律规定在这方面发挥了重要作用。解决这一问题不仅需要提高社会对PLHIV的容忍度,减少社会排斥的情况,而且还需要将披露义务的法律基础从疾病预防转移到有关各方法律关系中的权利和义务。当涉及到披露的接受者时,例如,区分配偶和性伴侣至关重要。至于PLHIV未能履行披露职责,除了涉及间接通知的干预外,增加进一步的法律责任可能是不可取的。故意传播行为,另一方面,仍然应该受到严厉的惩罚。
背景:不适用。
BACKGROUND: In 2021, a Chinese court, based on the newly enacted Civil Code, first revoked a marriage license due to the spouse\'s failure to disclose their HIV infection before the marriage. This landmark case ignited a fresh debate on whether people living with HIV (PLHIV) have a legal duty to inform their spouses and sexual partners. Advances in medicine have partially isolated HIV transmission from sexual contact, extending the legal basis for the obligation to disclose beyond disease prevention. This
study investigates some possibly unforeseen challenges for PLHIV in China to fulfill this duty, and the outcomes of their decisions in light of the government\'s goal to promote health.
METHODS: This
study aims to provide a detailed examination of the legal provisions and practices concerning partner notification among PLHIV in China. A mixed-methods research approach was employed between 2019 and 2020, combining questionnaire surveys, in-depth interviews, and participatory observations. A total of 433 valid responses were obtained through a questionnaire posted on a Chinese online platform for PLHIV. Following the collection and random coding of the questionnaire data, 40 individuals living with HIV were selected for in-depth interviews. Subsequently, a six-month field investigation was conducted in Guan ai jia yuan (Caring Home) in Jinhua City to further explore this issue.
RESULTS: A considerable proportion of PLHIV exhibit a high rate of disclosure to their spouses (nearly 80%). In the context of sexual partners, 56% of PLHIV stated that their sexual partners were aware of their HIV infection. Whether married PLHIV disclosing to their spouses or unmarried/divorced PLHIV disclosing to sexual partners, however, a substantial majority expressed apprehension about the potential disruption to their relationships that the disclosure might cause. The sole exception was observed among married PLHIV in extramarital relationships who demonstrated a slightly diminished level of concern in this context. Reasons for non-disclosure predominantly included undetectable viral load and the adoption of protective measures.
CONCLUSIONS: This
study reveals that a prevailing \"HIV stigma\" hinders PLHIV from voluntarily fulfilling the disclosure duties bestowed by Article 38 of the Regulations on the Prevention and Control of HIV/AIDS, and the unclear legal provisions of the new Civil Code play a significant role in this regard. Addressing this issue necessitates not only increasing societal tolerance toward PLHIV and reducing instances of social exclusion but also shifting the legal basis of disclosure duties from disease prevention to rights and obligations within the legal relationships of the parties involved. When it comes to the recipients of disclosure, for instance, it is crucial to differentiate between spouses and sexual partners. As for PLHIV failing to fulfill their disclosure duties, apart from interventions involving indirect notifications, the addition of further legal responsibilities may not be advisable. Intentional transmission actions, on the other hand, should still be subject to severe penalties.
BACKGROUND: Not applicable.