'It's not as good as the face-to-face contact': A sociomaterialist analysis of the use of virtual care among Canadian gay, bisexual and queer men during the COVID-19 pandemic.

The COVID-19 pandemic led to the widespread adoption of virtual care-the use of communication technologies to receive health care at home. We explored the differential impacts of the rapid transition to virtual care during the COVID-19 pandemic on health-care access and delivery for gay, bisexual and queer men (GBQM), a population that disproportionately experiences sexual and mental health disparities in Canada. Adopting a sociomaterial theoretical perspective, we analysed 93 semi-structured interviews with GBQM (n = 93) in Montreal, Toronto and Vancouver, Canada, conducted between November 2020 and February 2021 (n = 42) and June-October 2021 (n = 51). We focused on explicating how the dynamic relations of humans and non-humans in everyday virtual care practices have opened or foreclosed different care capacities for GBQM. Our analysis revealed that the rapid expansion and implementation of virtual care during the COVID-19 pandemic enacted disruptions and challenges while providing benefits to health-care access among some GBQM. Further, virtual care required participants to change their sociomaterial practices to receive health care effectively, including learning new ways of communicating with providers. Our sociomaterial analysis provides a framework that helps identify what works and what needs to be improved when delivering virtual care to meet the health needs of GBQM and other diverse populations.

'I did not have sex outside of our bubble': changes in sexual practices and risk reduction strategies among sexual minority men in Canada during the COVID-19 pandemic.

In efforts to prevent the spread of COVID-19, jurisdictions across the globe, including Canada, enacted containment measures that affected intimacy and sexual relations. This article examines how public health measures during COVID-19 impacted the sexual practices of sexual minority men- gay, bisexual, queer and other men who have sex with men-and how they adopted and modified guidelines to prevent the transmission of COVID-19, HIV and other sexually transmitted infections (STIs). We conducted 93 semi-structured interviews with men (n = 93) in Montreal, Toronto and Vancouver, Canada, between November 2020 to February 2021 (n = 42) and June to October 2021 (n = 51). Across jurisdictions, participants reported changes to sexual practices in response to public health measures and shifting pandemic contexts. Many men indicated that they applied their HIV/STI risk mitigation experiences and adapted COVID-19 prevention strategies to continue engaging in casual sexual behaviours and ensure sexual safety. 'Social bubbles' were changed to 'sex bubbles'. Masks were turned into 'safer' sex tools. 'Outdoor gathering' and 'physical distancing' were transformed into 'outdoor sex' and 'voyeuristic masturbation'. These strategies are examined in connection to the notion of 'reflexive mediation' to illustrate how sexual minority men are simultaneously self-responsibilising and resistant, self-monitoring and creative.

The relevance of communal altruism for sexual minority men in contemporary contexts.

There are many reasons why individuals engage in prosocial behavior; communal sexual altruism is based on the notion that some practice safer sex in the interest of promoting the well-being of their community/in-group. Given that definitions of what constitutes "safer sex" have changed with advances in human immunodeficiency virus (HIV) prevention, we investigated the importance of communal sexual altruism (herein "altruism") among urban gay, bisexual, and other sexual minority men (GBM) in the contemporary context. Using a sample of 2449 GBM we examined the association of both safer-sex-related attitudes (e.g., HIV treatment optimism-skepticism) and behaviors (e.g., condomless anal sex [CAS]) with altruism scores. Higher altruism scores were associated with a lower likelihood of CAS and a greater frequency of discussing HIV status with new partners. These findings demonstrate that many GBM are motivated to engage in several kinds of behaviors that improve the well-being of their in-group (i.e., the GBM community).

A mixed methods investigation of the relationship between blood donor policy, interest in donation, and willingness to donate among gay, bisexual, and other men who have sex with men in Ontario, Canada.

BACKGROUND: As of 2019, men who have sex with men (MSM) in Canada are ineligible to donate blood if they have had oral or anal sex with another man in the last 3 months. Deferral policies targeting MSM are largely interpreted as unjust by gay, bisexual, and other men who have sex with men (GBMSM) - shaping their desire to donate blood and engage with blood operators. This mixed methods study explores interest in blood donation among GBMSM as well as willingness (and eligibility) to donate under four different deferral policies. METHODS: We surveyed 447 GBMSM who were recruited from the Ontario-wide #iCruise study. Participants were asked whether they were interested in blood donation and if they were willing to donate under each of our four deferral policies. We also completed interviews with 31 of these GBMSM. Participants were asked to describe their feelings about blood donation, their views on our different deferral policies, the impact of a policy change, as well as other means of redress. RESULTS: Most participants (69%) indicated that they were interested in donating blood. Despite this, an interpretation of the MSM deferral policy as discriminatory was common among all participants. Our mixed methods findings indicate that, among those who were interested in blood donation, the adoption of one of the alternative policies presented in this study (specifically Policy 2 or Policy 3) would significantly increase the number of participants willing to donate and be viewed as "a step in the right direction." However, many participants who were not interested in blood donation argued that a gender-neutral deferral policy would need to be implemented for them to donate. Participants recommended that blood operators consider efforts to repair relations with GBMSM beyond policy change, including pop-up clinics in predominantly queer areas and diversity sensitivity training for staff. CONCLUSION: We argue that the most impactful policy shift would be the implementation of an individual risk-based deferral policy that is applied to all donors regardless of sexual orientation or gender identity. However, given MSM's historical exclusion from blood donations, blood operators should pair this policy shift with community relationship-building efforts.

Measures of HIV Pre-exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Men Who Have Sex with Men in Canada and Demographic Disparities Among Those at Elevated Likelihood for HIV Acquisition.

HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool being scaled up in Canada. We describe PrEP uptake and identify demographic correlates of uptake among gay, bisexual, and other men who have sex with men (gbMSM) at elevated HIV risk using data from an online survey of gbMSM residing in Canada between Oct 2017 and Jan 2018. Among the 969 participants at elevated HIV risk who had recently tested for HIV, 96.0%, 83.3%, 72.6%, and 39.7% reported awareness, knowledge, acceptability, and pursuit of PrEP, respectively; 27.1% had ever and 24.6% were currently taking PrEP. The strongest correlate of PrEP uptake was living in a city of ≥ 500,000 inhabitants; others included being out to all or almost all family, friends, and colleagues regarding sexual attraction to men, greater financial coping, and being 30-49 years of age. Improved upscaling of PrEP in Canada may be accomplished through consideration of these disparities.

Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men's perspectives on plasma donation policy in Canada.

BACKGROUND: Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. METHODS: We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. RESULTS: Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants' perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a "stepping stone" to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as "second-class" donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture-a gulf between the critical importance of plasma donation from the perspective of Canada's blood operators and patients and the feelings of many GBM who understood this form of donation as less important. CONCLUSIONS: Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.

Mental health and structural harm: a qualitative study of sexual minority men's experiences of mental healthcare in Toronto, Canada.

Compared to the general population, sexual minority men report poorer mental health outcomes and higher mental healthcare utilisation. However, they also report more unmet mental health needs. To better understand this phenomenon, we conducted qualitative interviews with 24 sexual minority men to explore the structural factors shaping their encounters with mental healthcare in Toronto, Canada. Interviews were analysed using grounded theory. Many participants struggled to access mental healthcare and felt more marginalised and distressed because of two interrelated sets of barriers. The first were general barriers, hurdles to mental healthcare not exclusive to sexual minorities. These included financial and logistical obstacles, the prominence of psychiatry and the biomedical model, and unsatisfactory provider encounters. The second were sexual minority barriers, obstacles explicitly rooted in heterosexism and homophobia sometimes intersecting with other forms of marginality. These included experiencing discrimination and distrust, and limited sexual minority affirming options. Discussions of general barriers outweighed those of sexual minority barriers, demonstrating the health consequences of structural harms in the absence of overt structural stigma. Healthcare inaccessibility, income insecurity and the high cost of living are fostering poor mental health among sexual minority men. Research must consider the upstream policy changes necessary to counteract these harms.

Measuring Adverse Childhood Experiences: Comparing Individual, Composite, Score-based and Latent Profile-based Scoring Schemas Among Gay, Bisexual, and Other Men Who Have Sex with Men.

Adverse childhood experiences (ACEs; e.g., neglect, sexual abuse) among gay, bisexual, and other men who have sex with men (GBM) may not occur in isolation, but may be connected and occur in clusters. Most studies have measured ACEs individually, hierarchically, additively, or in a binary fashion (presence or absence of ACEs), rather than treating them as connected and clustered. This study examined these competing approaches of scoring ACEs and their relative power at predicting health outcomes. We examined abuse (sexual, physical, and emotional) and neglect (physical and emotional) experiences among a non-random sample of 470 Toronto GBM using the Childhood Trauma Questionnaire Short Form subscales. We compared five scoring schemas: (1) five individual scores for each form of maltreatment; (2) a composite score summing all of the maltreatment scores; (3) a hierarchical regression model with sexual abuse entered first then followed by physical abuse, emotional abuse, physical neglect, and emotional neglect; (4) a severity-based categorization; and (5) a latent profile-based categorization. Experiences of abuse and neglect were not uncommon (22-33%) and some participants experienced multiple forms of abuse and neglect (r = .33-.65, df = 464-467; p < .001; shared variance, r2 = 11-43%). Results show the dose-response effects of ACEs and highlight the importance of examining ACEs in clusters rather than individually. Latent profile analysis identified GBM who experienced multiple and frequent ACEs, and also identified the types of ACEs they experienced: crucial information that was obscured in score-based or severity-based approaches.

It's in Me to Give: Canadian Gay, Bisexual, and Queer Men's Willingness to Donate Blood If Eligible Despite Feelings of Policy Discrimination.

Blood donation policies governing men who have sex with men have shifted significantly over time in Canada-from an initial lifetime ban in the wake of the AIDS crisis to successive phases of time-based deferment requiring periods of sexual abstinence (5 years to 1 year to 3 months). We interviewed 39 HIV-negative gay, bisexual, queer, and other sexual minority men (GBM) in Vancouver, Toronto, and Montreal to understand their willingness to donate blood if eligible. Transcripts were coded following inductive thematic analysis. We found interrelated and competing expressions of biological and sexual citizenship. Most participants said they were "safe"/"low risk" and "willing" donors and would gain satisfaction and civic pride from donation. Conversely, a smaller group neither prioritized the collectivizing biological citizenship goals associated with expanding blood donation access nor saw this as part of sexual citizenship priorities. Considerable repair work is required by Canada's blood operators to build trust with diverse GBM communities.

Gay and bisexual men's views on reforming blood donation policy in Canada: a qualitative study.

BACKGROUND: Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor. As of June 3, 2019, this deferral period was reduced to 3 months. METHODS: To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada's three largest cities: Vancouver, (n = 17), Toronto (n = 15), and Montreal (n = 15). Interviews were coded in NVivo 11 following an inductive thematic analysis. We focus on men's preferred policy directions and their opinions about a policy change proposed by Canada's blood operators: a 3-month deferral for all sexual activity between men. We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada. RESULTS: Most participants were opposed to any deferral period in relation to MSM-specific sexual activity. A fair and safe policy was one that was the "same for everyone" and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Participants believed that multiple "gender blind" and HIV testing-related strategies could be integrated into the blood donation process. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction; (2) ambivalence and uncertainty; and (3) not an improvement. CONCLUSION: A predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing.

Is HIV prevention creating new biosocialities among gay men? Treatment as prevention and pre-exposure prophylaxis in Canada.

The advancements of "treatment as prevention" (TasP), "undetectable viral load" (UVL) and "pre-exposure prophylaxis" (PrEP) are redefining HIV prevention standards. Relying on the concept of biosociality, this article explores how gay men rally around, debate, and sometimes disagree about these emerging HIV prevention technologies. This article is based on data from the Resonance Project, a Canadian community-based research project. Twelve focus groups (totalling 86 gay and bisexual men) were held in three Canadian cities (Montreal, Toronto, Vancouver) in 2013-2014. Respondents view UVL and PrEP through the prism of their generational experience of HIV prevention. In this respect, biosocialities highlight an experiential dimension that is tied to the context of the HIV epidemic. The biosocialities of HIV prevention are also built around serological identities. However, our study shows the diversity of these positions. Analysis grounded in biosocialities is useful for better understanding how scientific information circulates, is made sense of, and generates debate among gay men.

A tale of two epidemics: gay men's mental health and the biomedicalisation of HIV prevention and care in Toronto.

There is mounting urgency regarding the mental health of gay, bisexual and other men who have sex with men (GBM). We examined how GBM are understanding the relationship between HIV and their mental health given the increasing biomedicalisation of HIV prevention and care. Our Grounded Theory analysis derived from qualitative interviews with 24 GBM living in Toronto, Canada, including both HIV-negative and HIV-positive men. Participants understood biomedical advances, such as undetectable viral load and pre-exposure prophylaxis (PrEP), as providing some relief from HIV-related distress. However, they offered ambivalent perspectives on the biomedicalisation of HIV. Some considered non-HIV-specific stressors (e.g. unemployment, racial discrimination) more significant than HIV-related concerns. These men expressed HIV-related distress as being under control due to biomedical advances or as always negligible when compared to non-HIV-specific stressors. Others emphasised the ongoing mental health implications of HIV (e.g. enduring risk and stigma). We describe a tension between optimistic responses to biomedicine's ability to ease the psychosocial burdens associated with HIV and the inability for biomedicine to address the social and economic determinants driving the dual epidemics of HIV and mental distress amongst GBM. We argue for more socio-material analysis over further sexual behavioural analysis of GBM mental health disparities.

HIV Risk and Protective Factors in the Context of Alcohol and Substance Use During Pride.

This investigation sought to identify HIV-risk and -protective factors among men-who-have-sex-with-men (MSM) who engaged in anal sex following alcohol or substance use during an international Pride Festival. MSM attending World Pride were surveyed regarding (1) alcohol, substance use, and sex during the past 24 h; and (2) HIV-risk and -protective factors. Valid data were provided by 1123 MSM. Anal sex was reported by 195 MSM, among whom the majority (n = 105) consumed alcohol or substances prior to sex. Among MSM aware of their HIV status who consumed alcohol or substances prior to sex (n = 99), those who engaged in serodiscordant condomless anal sex (n = 22) were more likely to be HIV+ (AOR = 10.14, 95% CI 1.48-69.35); report multiple sex partners (AOR = 9.05, 95% CI 1.70-48.12); and possess lower condom efficacy (AOR = 0.47, 95% CI 0.23-0.93) and social support (AOR = 0.08, 95% CI 0.01-0.46). Bolstering condom negotiation skills and social support could potentially reduce HIV acquisition/transmission-risk behavior, even when under the influence of alcohol or substances.

Correction: Number of Psychosocial Strengths Predicts Reduced HIV Sexual Risk Behaviors Above and Beyond Syndemic Problems Among Gay and Bisexual Men.

The original version of this article unfortunately contained a mistake. In the section, "Data Collection Procedure", the last sentence was incorrect.

Scenes as Micro-Cultures: Examining Heterogeneity of HIV Risk Behavior Among Gay, Bisexual, and Other Men Who Have Sex with Men in Toronto, Canada.

Using latent class analysis (LCA), we examined patterns of participation in multiple scenes, how sexual risk practices vary by scene, and psychosocial factors associated with these patterns among 470 gay, bisexual, and other men who have sex with men (GBM) recruited from Toronto. We calculated posterior probability of being in a class from participation in nine separate scenes. We used Entropy, the Bayesian information criterion and the Lo-Mendel-Rubin likelihood ratio test to identify the best fit model. Fit indices suggested a four-class solution. Half (50%) of the GBM reported no or minimal participation in any scene, 28% reported participating in the dance club scene, 16% reported participating in the BDSM, bear, and leather scenes, and 6% reported participating in circuit, party and play, and sex party scenes. Compared to GBM who did not participate in scenes, GBM participating in the BDSM-Bear-Leather scene were more likely to be older, white, to report higher sexual self-esteem, and to engage in condomless anal sex; Party and Play scene members were more likely to be of Asian origin, and to use drugs before and during sex, whereas Dance Club scene members were more likely to be younger and to report lower self-esteem but higher hope. LCA allowed us to identify distinct social niches or micro-cultures and factors characterizing these micro-cultures. GBM differ in their risk for HIV and STIs according to characteristics associated with participation in distinct micro-cultures associated with scenes. Tailored interventions may be needed that focus on reducing HIV risk and promoting sexual health in specific contexts such as the BDSM-Bear-Leather and Party and Play.

Number of Psychosocial Strengths Predicts Reduced HIV Sexual Risk Behaviors Above and Beyond Syndemic Problems Among Gay and Bisexual Men.

Syndemics research shows the additive effect of psychosocial problems on high-risk sexual behavior among gay and bisexual men (GBM). Psychosocial strengths may predict less engagement in high-risk sexual behavior. In a study of 470 ethnically diverse HIV-negative GBM, regression models were computed using number of syndemic psychosocial problems, number of psychosocial strengths, and serodiscordant condomless anal sex (CAS). The number of syndemic psychosocial problems correlated with serodiscordant CAS (RR = 1.51, 95% CI 1.18-1.92; p = 0.001). When adding the number of psychosocial strengths to the model, the effect of syndemic psychosocial problems became non-significant, but the number of strengths-based factors remained significant (RR = 0.67, 95% CI 0.53-0.86; p = 0.002). Psychosocial strengths may operate additively in the same way as syndemic psychosocial problems, but in the opposite direction. Consistent with theories of resilience, psychosocial strengths may be an important set of variables predicting sexual risk behavior that is largely missing from the current HIV behavioral literature.

HIV-related syndemic pathways and risk subjectivities among gay and bisexual men: a qualitative investigation.

Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathway whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use; (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration; and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into three high-risk modes: active and frequent engagement in condomless sex; unassertive deferment to a partner's initiation of condomless sex; and episodic risk combined with a risk reduction strategy. Three low risk modes were also identified: no recent condomlessness but multiple risk history in interview; a trajectory over time from high to low risk; and consistent low risk practice. These different modes of syndemic experience and risk management may have implications for identification of the effective HIV prevention tools that work best for different sets of men.

Promoting HIV Testing for Gay and Bisexual Men: An Evaluation of the 2011-2012 Campaign in Toronto and Ottawa.

This article reports on a social marketing campaign directed toward high-risk men who have sex with men in Toronto and Ottawa to encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and postcampaign survey of sexually active men who have sex with men and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an IP address in Toronto or Ottawa. Laboratory data showed a 20% increase in HIV testing in Toronto over the campaign compared to the previous year. The overall rate of HIV-positive tests remained relatively constant. Knowledge levels about seroconversion symptoms, sexually transmitted infection and HIV transmission, and the HIV window period were significantly better among postcampaign survey respondents aware of the campaign compared to postcampaign respondents who were not aware and compared to precampaign respondents.

Everyday moral reasoning in the governmentality of HIV risk.

Drawing on the sociology of morality, this article analyses the social contexts, discourses and ethno-methods of everyday life that shape real-world decisions of gay men around HIV prevention. Through an analysis of the predominant narratives in an online public forum created for an HIV prevention campaign, this article explores the ways in which homosexually active men engage in everyday moral reasoning and challenge a neoliberal moral order of risk and responsibility. The article concludes that gay and bisexual men engage in forms of practical morality with their sexual partners and imagine larger communities of interest, love, companionship and pleasure. At the same time, they draw heavily from discourses on individual and rational responsibility, as well as narratives of romance and community, that shape forms of moral selfhood. Risk management techniques that are grounded in notions of rational choice and that are insensitive to the emotional worlds that these men inhabit create situations of risk avoidance but also inadvertently open them to new forms of vulnerability.

Criminal Code reform of HIV non-disclosure is urgently needed: Social science perspectives on the harms of HIV criminalization in Canada.

The criminalization of HIV non-disclosure represents a significant issue of concern among people living with HIV, those working across the HIV sector, public health practitioners, and health and human rights advocates around the world. Recently, the government of Canada began a review of the criminal law regarding HIV non-disclosure and invited feedback from the public about potential reforms to the Criminal Code. In light of this public consultation, this commentary examines social science research from Canadian scholars that documents the intersecting damaging effects of HIV criminalization. Canadian social scientists and other researchers have shown that HIV criminalization is applied in uneven and discriminatory ways, impedes HIV prevention efforts, perpetuates HIV stigma, and has a damaging impact on the daily lives of people living with HIV. We argue that there is an urgent need for reforms that will significantly restrict how the criminal law is applied to HIV non-disclosure.

RéSUMé: La criminalisation de la non-divulgation du VIH est une question très préoccupante pour les personnes vivant avec le VIH, celles qui travaillent dans le secteur du VIH, les praticiens et praticiennes de la santé publique et les porte-parole de la santé et des droits de la personne du monde entier. Récemment, le gouvernement du Canada a amorcé un examen du droit criminel portant sur la non-divulgation du VIH et a invité le public à commenter d'éventuelles réformes du Code criminel. À la lumière de cette consultation publique, notre commentaire porte sur les études en sciences sociales menées au Canada qui font état des effets croisés préjudiciables de la criminalisation du VIH. Des spécialistes des sciences sociales et d'autres chercheuses et chercheurs canadiens ont montré que la criminalisation du VIH est appliquée de façon inégale et discriminatoire, qu'elle nuit aux efforts de prévention du VIH, qu'elle perpétue la stigmatisation liée au VIH et qu'elle a des effets dommageables sur la vie quotidienne des personnes vivant avec le VIH. Nous soutenons qu'il existe un besoin urgent de réformes pour restreindre de façon appréciable l'application du droit criminel à la non-divulgation du VIH.