HIV Criminalization and Stigma

Enough is enough.

We have seen the horrid consequences of stigma and demonization of those persons with the smallest voice since the beginning of the AIDS epidemic. The founder of one of the leading organizations battling against the spread of HIV, the Foundation for AIDS Research (amfAR), Dr. Mathilde Krim, recognized before all others that this battle would not be about curing a virus. It would be about the creation of new pariahs, new vectors of disease, new excuses to systematically dehumanize large swaths of people. When asked why she founded amfAR, Dr. Krim stated "that I would never tolerate injustice and would speak up whenever I saw it" so she dedicated her career to AIDS research and educating the world on how to beat it.

Some of us are old enough to remember when HIV was called GRID (Gay-Related Immune Deficiency) or even Gay Cancer. Those were the original names for the virus. It was originally thought that this virus primarily targeted gay and bisexual men. What came next was an unprecedented, coordinated social attack on gays in America. The newly politically emboldened Christian Right used fear and misinformation about HIV as tools to demonize homosexuality, stating that God had delivered AIDS to this population as punishment for sexual impurity.

The consequences were harsh and swift. Public health departments worked to close social venues frequented by gays. A witch hunt on suspected gays and lesbians began throughout the military, only stopped by the problematic "Don't Ask Don't Tell" policy during the Clinton years that hoped to stop the witch hunt by making it illegal for sexuality to be discussed. For the first time in modern American history, lawmakers scrambled to isolate, and thereby stigmatize, people living with a particular disease. These inappropriate and appalling laws were developed during the initial AIDS panic and often remained on the books long after public health officials demonstrated that the ineffectiveness of these measures in preventing the spread of HIV. For example, foreign people living with HIV/AIDS could not gain a visa to enter the United States despite the scant demonstrable risk to public health caused by their entry. Decades passed until the George W. Bush and Obama Administrations ended the ban.

The most egregious actions taken against those living with the virus that causes AIDS are HIV Criminalization laws. These restrictions stipulate that a person living with HIV/AIDS must disclose their status to a partner prior to sexual relations and/or can be punished for exposing another person to any of their bodily fluids. The latter provision includes saliva, urine, and feces. This is simply false as it is impossible for those fluids to transmit the virus. The former provision is tantamount to regulation of sexual activity which is a legacy to the power that the Christian Right held during the initial AIDS panic.

We know that it is imperative for each person to be tested for HIV and, if positive, early treatment and care post-infection can help ensure that that person lives a healthy and productive life. Yet simply being HIV-positive still carries a scarlet letter. Most people have heard anecdotal stories of families turning their backs on their sons or daughters, children being ostracized by entire communities, and even people going to prison -- simply for disclosing their HIV-positive status. Our loved ones far too often do not receive the same compassion and care that another person living with a chronic condition receives; evidenced by the fact that HIV Criminalization laws remain in 34 states across America.

The headlines often show these laws at their worst. Currently, a woman in northern Georgia has just been sentenced to two years in jail for failing to disclose her HIV status to her former husband (who remains uninfected). A man received a 32-year prison sentence for failing to disclose his HIV status to partners in Ohio. In case after case, people living with HIV/AIDS are punished more severely than if they had physically attacked someone. In some cases, our criminal justice system has treated HIV-positive people more harshly than murderers. The Ohio man admitted to the court that he did not feel comfortable nor know how to discuss his HIV status because of "how judgmental and uneducated society is." As a society we must create an environment that encourages honest conversation and finally puts an end to this witch hunt.

One simply needs to take a step back and look objectively at how the general public responds to other infectious diseases. In just about every other case, level heads prevail. For instance, the CDC estimates that the seasonal flu is associated with up to 49,000 deaths during a bad season. Additionally, hepatitis can lead to the development of a variety of chronic conditions and potentially even causing liver cancer. Hepatitis C is responsible for over 16,000 deaths per year. Due to continual advances in health, HIV is not a death sentence. Currently approximately 15,000 people die with an AIDS diagnosis in the States each year. Yet, only persons living with HIV/AIDS are treated so callously and so strongly stigmatized in our community.

We must end HIV stigma. It is one of the largest barriers -- if not the largest -- to ending the AIDS epidemic in our lifetimes. President Obama declared, "Few could have imagined that we'd be talking about the real possibility of an AIDS-free generation. But that's what we're talking about [now]." Science, public health, and even our elected officials have laid the initial groundwork. As U.S. Representative Barbara Lee (D-CA) stated after announcing a bill to require the Attorney General to review these laws: "HIV Criminalization laws breed discrimination, distrust and hatred. These laws are based on fear, not science. This is an important first step in ensuring that our laws reflect current scientific understanding of HIV." NOW is the time to end HIV. We must base prevention and treatment efforts in sustainable endeavors that encourage education about, prevention, and treatment of HIV. Criminalizing those infected by HIV is not one of them.

Enough is enough.