Leigh Alon received her BA from University of Chicago and currently works in HIV prevention at the Chicago Center for HIV Elimination
As the HIV epidemic began sweeping the United States in the 1980s, panic about the new virus led states to pass laws criminalizing the spreading of HIV. In 34 states, various forms of these laws remain on the books, writing into law the stigma, fear, and ignorance about HIV which originated 30 years ago, but continues to plague individuals living with HIV and communities that have been disproportionally affected. Between 2008 and 2016 there have been 279 prosecution cases based on state laws criminalizing the transmission of HIV.
The laws are not consistent with current scientific knowledge about how HIV spreads. Whether an individual actually contracts HIV based on the incident in question, or whether transmission was even likely, is not taken into consideration. For example, an HIV positive man was sentenced to 35 years in prison for spitting on a police officer arresting him for public intoxication, yet there have been zero documented cases of HIV spreading via saliva. Additionally, with the antiretroviral therapy available to people living with HIV today, those who are virally suppressed below a threshold cannot transmit the virus. Nonetheless, under existing laws, they are required to disclose their status.
These laws have also been used in a retaliatory fashion, punishing people for safe, consensual sex. In Iowa, a 34-year-old gay man on anti-retroviral therapy had sex, using a condom, with a man he met online. His partner later pressed charges after having found out his status, leading to a sentence of 25 years in prison and a lifetime as a registered sex offender. A man in Ohio is serving 40 years for failing to disclose his status to an ex-girlfriend. He claims she knew and retaliated after he ended their relationship.
Many public health officials have stated that HIV criminalization laws actually lead to worse health outcomes, by discouraging people from getting tested and learning their status. Diagnosing individuals early is key to controlling the spread of the virus, since those undergoing treatment are no longer contagious. The Prevention Action Campaign, which has been taken on by major cities across the country, utilizes the slogan “Undetectable equals Untransmittable” or “U=U” to educate the public about this idea.
Under these laws, however, African American men and sex workers have been disproportionally targeted. There are no laws around disclosure of human papilloma virus (HPV), which causes a number of cancers, including cervical, rectal, and anal-genital cancers, which claim thousands of lives annually. HPV, unlike HIV, is not associated with marginalized racial and sexual groups.
The Obama administration’s 2010 HIV strategy called for major reforms in these laws. Most recently, California has taken a step in the right direction: starting in 2018, knowingly transmitting HIV will be classified as a misdemeanor, down from a felony, significantly lowering the associated maximum jail time. There remains a long road ahead, however, towards truly modernizing discriminatory laws that serve as roadblocks for individuals seeking healthcare and for eliminating HIV in vulnerable communities.