National Youth HIV & AIDS Awareness Day (NYHAAD) is commemorated annually on April 10th and is a day to educate the public about the impact of HIV and AIDS on young people. The day also highlights the HIV prevention, treatment, and care campaigns of young people in the United States, according to Advocates for Youth, which leads the awareness day efforts.
Apart from promoting sexual health education, the policy goal of the organizers this year is focused on decriminalization because state and federal criminal law does not currently reflect the four decades of medical advances and discoveries made regarding transmission and treatment of HIV/AIDS.
Advocates for Youth asserts that that laws “should not place a unique or additional burden on individuals solely as a result of their HIV status” and that those “living with HIV are still treated differently under the law in so many states and communities.”
They advocate for passage of the REPEAL HIV Discrimination Act. The law, according to their website, should “reflect evidence-based, medically accurate understandings of HIV transmission, health implications, and treatment.” The bill currently has 74 co-sponsors, all Democrats, except for one Republican co-sponsor, Puerto Rico’s Resident Commissioner Jenniffer González-Colón.
The bill would require strong transparency with stakeholders and the public. It would require the attorney general, secretary of health & human services, and the secretary of defense review current HIV criminalization laws, share information with congress, and make the information publicly available.
REPEAL HIV Discrimination stands for “Repeal Existing Policies that Encourage and Allow Legal” HIV Discrimination. Congressmember Barbara Lee (D-Oakland) is the bill’s original sponsor and has introduced a version of the bill multiple times since 2015.
In the findings of the bill, the following key facts are stated:
- In 28 states, HIV criminal laws are classified as felonies.
- In 32 states and two territories, criminal statutes are based on perceived exposure to HIV, rather than behaviors motivated by an intent to harm.
- In 11 states, HIV-specific laws make spitting or biting a felony, even though you cannot transmit HIV via saliva.
- In 24 states, HIV disclosure to sexual partners is required, even if non-infectious.
- In 25 states, one or more behaviors that pose a low or negligible risk for HIV transmission are criminalized.
Not only are there vastly inconsistent and medically misinformed statutes across the states, but the range of punishments is also strikingly and devasting. Five states impose sentences greater than 20 years; for seven states, it’s between eleven and 20 years; and eighteen states impose sentences of up to ten years per violation; seven impose sentences between eleven and 20 years; and five impose sentences of greater than 20 years.
How these laws impact the lives of people living with HIV is little known, partly because the number of prosecutions, arrests, and instances where HIV-based charges are used to induce plea agreements is unknown. Most State HIV-specific laws and prosecutions do not treat the use of a condom during sexual intercourse or adherence to PrEP as a mitigating factor or evidence that the defendant did not intend to transmit HIV.
Although HIV, and even AIDS, currently is viewed as a treatable, chronic, medical condition, people living with HIV have been charged under aggravated assault, attempted murder, and even bioterrorism statutes because prosecutors, courts, and legislators have failed to update their incorrect views and demonize the blood, semen, and saliva of people living with HIV as a deadly weapon. In fact, individuals who are convicted after an HIV-based prosecution often must register as sex offenders in at least six States for consensual sexual behavior.
This failure to act is unacceptable in the face of multiple peer-reviewed studies that demonstrate these laws do not reduce risk-taking behavior or increase disclosure by people living with HIV. Worse, there is increasing evidence that they reduce the willingness to get tested.
In many instances, the continued existence and enforcement of these types of laws runs counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment, according to the National HIV Strategy.
In February 2019, the Department of Health and Human Services (HHS) launched the Ending the HIV Epidemic: A Plan for America, a new initiative with an ambitious goal to end the domestic HIV epidemic in ten years. The stated goals include reducing new HIV cases by 75 percent by 2025 and by 90 percent by 2030.
In this plan, HHS recognizes that stigma is debilitating barrier preventing people living with, or at risk for, HIV from receiving the health care, services, and respect they need and deserve.
Many of the jurisdictions identified as a priority for the first five years of the plan are in states that have stigma-based criminal statutes for perceived exposure to HIV. These statutes run counter to the goals of this new initiative and stand in the way of ending the domestic HIV epidemic.
A public health announcement: All people are responsible for practicing behaviors that protect themselves from HIV and other sexually transmitted infections.
So, laws that place the legal responsibility for preventing the transmission of HIV exclusively on people who have been diagnosed clearly undermines this public health message intended to shift risk-taking behavior and increase HIV and STI testing.
A list of San Diego County HIV prevention, treatment and care service providers is available online through the County of San Diego’s website.
