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U.S. health policy promotes HIV testing and linkage to care (test-and-treat) with an emphasis on high risk groups such as convicted offenders. We sought to identify whether or not laws for mandatory HIV disclosure to sexual partners are a barrier to HIV testing among offenders under community supervision.

A total of 197 probationers and parolees were surveyed in a closed/item-open-ended item methodology on two reporting days in Alabama. Three main questions were asked: (1) What do offenders know about HIV? (2) What do they know about the law? (3) Do they support mandatory disclosure and HIV testing? Data for the quantitative items were analyzed with SPSS and matched with open-ended responses for explanatory purposes.

Testing and criminalization of non-disclosure were fully supported as key elements of HIV prevention. This support was framed by conceptions of HIV as a killer disease, of people with HIV as potential murderers, and by low self-awareness of HIV risk.

While the study involved only a single group of convicted offenders in a southern state, the results suggest that disclosure laws legitimize HIV stigma and undermine test-and-treat strategies among communities at risk.

The research is the first of its kind to investigate possible links between HIV criminalization and barriers to HIV prevention and care among convicted offenders.

This chapter provides both an introduction to the volume and a brief review of literature on education and other social factors and health beliefs in health care services.

Literature review.

The chapter argues for the importance of greater examination of education, other social factors, and health beliefs in the use of health care services.

Reviews the issues of education, social factors, and beliefs and previews this volume.