We're more than 30 years into the HIV epidemic, and despite countless media campaigns, educational forums, and outreach by thousands of HIV educators, the general public remains remarkably uninformed about the nature of HIV.
In part, because misinformation about HIV is still so prevalent, our laws continue to reflect myths about HIV that were scientifically disproved years ago. In particular, laws that seek to criminalize HIV status are in desperate need of modernization.
State and federal health officials, working with community organizations across the country, have invested many millions of dollars in outreach to get people tested for HIV. But you would be hard-pressed to find information that spells out, in understandable and blunt terms, the actual routes, relative risks and consequences of living with HIV in 2014.
Vague references to sexual contact, bodily fluids and “high risk” behavior have left a vast majority of the public with the perception that HIV is easily transmitted, that any kind of sex can produce transmission, that even spit is a transmission risk, and that HIV is a “death sentence.” None of these things are true.
Most sex does not result in HIV transmission. Spitting and biting are not HIV transmission routes. With proper medical care, people with HIV can expect to live long, relatively normal lives and can see their HIV levels drop to levels at which transmission risk is near zero. But despite dramatic improvements in HIV treatment over the last 15 years, the public’s understanding of HIV has remained rooted in the 1980s.
Much of the ignorance seems rooted in the silent treatment that sex gets in this country, and in persistent stigma attached to a sexually transmitted disease deeply associated with gay men. Rather than address the ignorance and misconceptions that inform negative reactions to individuals and groups who are disproportionately affected by HIV — LGBT, person of color, HIV-diagnosed — legislators have enacted criminal laws to control the imagined threats these "others" pose.
In most states, individuals living with HIV who engage in consensual sex can become convicted felons sentenced to years, even decades, in prison — in many cases, punishment more severe than that meted out for manslaughter. In 10 states, the punishment can include mandatory sex offender registration.
HIV status is also used as an aggravating factor in assault cases or as a basis for increasing charges and sentences imposed on sex workers. It is not surprising that roughly 1 in 7 individuals living with HIV passes through correctional facilities every year.
The HIV criminalization laws passed over the last 30 years are a response to fear and bias, not to scientific study or medical evidence. They cannot stop or even slow the spread of HIV. They put a government seal of approval on mob mentality, which can easily turn into several forms of violence — from physical assaults to the violence done to a person's life by discrimination, marginalization and imprisonment.
A felony conviction can deprive a person of access to public housing, student loans, and even the right to vote. Those who are placed on sex offender registries may be shut out of more than 90 percent of residential housing and denied unsupervised contact with minors, including their own children. Because HIV criminal laws target only those who know that they are HIV positive, they could serve as a powerful disincentive to get tested and into treatment.
A Roadmap for Change: Federal Policy Recommendations for Addressing the Criminalization of LGBT People and People Living with HIV, a new report published by Columbia University’s Center for Gender and Sexuality Law, offers policy makers and advocates a guide to modernizing the laws that have led to the overrepresentation of LGBT people and people living with HIV in the criminal justice system.
Coauthored by the Center for Gender and Sexuality Law, The Center for HIV Law and Policy, Streetwise and Safe and the Center for American Progress, it outlines practical ways to bring government policies into line with the tremendous strides in treatment and public health practices that have turned HIV into a manageable, chronic health condition.
Criminalization of HIV has done nothing to stop the spread of new infections. It’s time to drop the outdated stereotypes and bring HIV policy into the twenty-first century.
CATHERINE HANSSENS is the founder and executive director of The Center for HIV Law and Policy, a national resource and strategy center for people living with HIV and their advocates.