Legal Barriers and Ethical Challenges in HIV Prevention and Care: A Case Study on the Criminalization of Sex Workers and Clients Living With HIV in China

Legal provisions, as a key component of social structures, have a significant impact on HIV prevention and control efforts. Article 12 of the "Interpretation of Law in Handling Criminal Cases on Organizing, Forcing, Luring, Sheltering, or Introducing Prostitution" [Prostitution Law], jointly issued by China's Supreme Court and Supreme Procuratorate in 2017, stipulates that sex workers and clients aware that they are living with HIV who engage in commercial sexual activities are to be heavily penalized for spreading sexually transmitted disease, regardless of their actual viral load or use of safety measures. Our study employs a case study methodology, aiming to explore the adverse impacts of the criminalizing provisions of China's Prostitution Law on HIV prevention efforts through the analysis of specific cases. An analysis of cases reveals that records of antiretroviral therapy for people living with HIV, intended to manage their illness and reduce transmission risk, have paradoxically been used as evidence for their convictions.