Barcelona 2013
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| Abstract #223 - Law and Ethics | ||||
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Session: 26.3: Law and Ethics (Parallel) on Tuesday @ 11.00-13.00 in Auditorio Chaired by David Dalmau, Vincent Douris Authors: Presenting Author: Dr Julia del Amo - National Center Epidemiology, ISCIII, Spain |
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| Additional Authors: Ms. Chen Zhang, Dr. Yan Hong, Ms. Shaobing Su , Dr. Yuejiao Zhou, | ||||
| Aim: To quantify and characterize existing legal complaints for the sexual transmission of HIV in Spain, describe temporal trends and consider whether advance of HIV scientific knowledge is reflected in charging decisions, judicial reasoning, and sentences. | ||||
| Method / Issue: All sentences and judicial decisions (autos*) dictated by Spanish penal and civil jurisdictions between 1981 - 2012 obtained through a systematic search of legal databases Cendoj, Aranzadi, El Derecho, and Tirant Lo Blanch. Sentences and decisions selected fulfilling the following inclusion criteria; (1) possible transmission of HIV is judged as an individual infraction, whether or not other infractions are involved (2) HIV is employed as a means to increase the sentence imposed due to other infractions. This second criteria will not be included in this abstract. Socio-demographic, clinic-epidemiological and juridical data were extracted and entered into a database. *Auto: motivated judicial resolution in which the judge decides on secondary or incidental issues such as the admission or dismissal of the complaint. | ||||
| Results / Comments: 16 sentences and 9 judicial decisions (autos*) belonging to 19 cases were included; 17 judged by penal jurisdiction and two by civil jurisdiction. The first sentence was pronounced in 1996 and between 1999 and 2000 there were 3 sentences/ sentences/judicial decisions, 4 between 2001-2005 and 18 between 2006-2012. Out of 19 cases, 8 were reported in Madrid, 3 in Andalucía, 3 in Catalonia, 2 in the Balearic Islands. In 10 (53%) of the cases there was an effective transmission of HIV, in 6 (32%) there was no transmission and in 3 (15%) directionality could not be determined. In 15 (79%) cases, the index case was a heterosexual male, in 13 of Spanish origin and 2 of foreign origin and one was an injecting drug use (IDU). In 3 out 15 cases, the persons were men who have sex with men (MSM) and there was one case in which the defendant was a heterosexual woman. In the 10 cases in which there was a transmission of HIV, the mechanism of the transmission was heterosexual sex and the index case was a male in 9 occasions. Disclosure of HIV status, use of condoms and its frequency, and its possible breaks were mentioned in some sentences/judicial decisions; in some cases the use of Antirretroviral Treatment (ART) was also referenced. In very few cases was there any mention to the plasma viral load (VL) of the index case, although there are incorrect mentions on HIV transmissibility. Two cases mention phylogenetic studies were performed. Only one 2012 sentence gathered the elements - VL levels, adherence to ART, CD4 lymphocyte levels, concomitant sexually transmitted infections and a reference to pertinent scientific literature. | ||||
| Discussion: The number of sentences/judicial decisions has increased in Spain since 2006 and it seems to be more frequent in Madrid. The defendant?s/accused?s profile - male, Spaniard and heterosexual - does not reflect the HIV epidemiology in our setting, with a larger presence of IDUs and MSMs. Although some recent sentences reflect the scientific advances in the HIV infection, it is not a generalized pattern. | ||||
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