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Research Blog – HIV Criminalization Laws in the United States


Posted on March 27th, 2015 by Patrick in Featured, Research Blog. No Comments

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Photo Credit: bloomsberries, “gavel”, January 23, 2007

What Are HIV Criminalization Laws?

HIV criminalization laws penalize people who know they have HIV and engage in behaviors that could expose others to HIV. The most common restriction requires people to disclose their HIV status to partners before having sex. However, these laws vary and sometimes ban other acts with little risk of spreading HIV, such as spitting or biting [1].

HIV Criminalization Laws in the US

The number of states with these laws has grown considerably since the beginning of the HIV epidemic. Currently, 33 states have these laws, representing 67 pieces of legislation [1]. While most laws were passed in the 1980s and 90s before the development and widespread use of antiretroviral HIV treatment, the most recent law was passed in 2011. Of states with these laws, 33% criminalize behaviors that have little to no risk of spreading HIV. In addition, few laws account for activities that reduce the risk of transmitting HIV, such as condom use, antiretroviral treatment, and pre-exposure prophylaxis [1].

Evidence-Based Concerns about HIV Criminalization Laws

HIV criminalization laws are controversial, and experts have raised concerns about the effectiveness of this approach, as well as the potential for unanticipated negative effects [2].

Only a small number of studies have examined the effectiveness of these laws. However, they have found no evidence that these laws reduce the spread of HIV [1]. Reasons that these laws may not be effective include that many people are unaware of their HIV status [2], the level of knowledge about HIV laws among HIV-positive individuals is unclear [1], and few people are charged for violating these laws [1-2]. These laws contrast with other HIV prevention interventions that have shown to be effective such as condom use [3].

Given that HIV continues to be a stigmatized disease, these criminal penalties may further isolate individuals living with HIV. This could lead to reduced access to much needed healthcare resources in this group if HIV positive individuals choose not to seek care in effort to avoid stigma [4]. Given the lack of evidence supporting these laws and concerns about their negative side effects, a number of HIV researchers [1-2,5] have encouraged states with existing laws to reexamine these laws and to realign them with best practices for HIV prevention and other public health policies. For example, some experts suggest these laws should be abandoned entirely [2]. Others argue that, at a bare minimum, these laws should accurately differentiate behaviors that do and do not pose a risk for transmitting HIV [1].

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References:

[1] Lehman, J. S., Carr, M. H., Nichol, A. J., Ruisanchez, A., Knight, D. W., Langford, A. E., … & Mermin, J. H. (2014). Prevalence and public health implications of state laws that criminalize potential HIV exposure in the United States. AIDS and Behavior, 18(6), 997-1006. doi: 10.1007/s10461-014-0724-0

[2] Burris, S., & Cameron, E. (2008). The case against criminalization of HIV transmission. JAMA, 300(5), 578-581. doi:10.1001/jama.300.5.578.

[3] Vitinghoff, E., Douglas, J., Judon, F., McKiman, D., MacQueen, K., & Buchinder, S. P. (1999). Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology,150(3), 306-311. doi: 10.1093/oxfordjournals.aje.a010003

[4] UNAIDS. (2008). UNAIDS policy brief: criminalization of HIV transmission. Retrieved from http://data.unaids.org/pub/basedocument/2008/20080731_jc1513_policy_criminalization_en.pdf.

[5] Galletly, C. L., & Pinkerton, S. D. (2006). Conflicting messages: how criminal HIV disclosure laws undermine public health efforts to control the spread of HIV. AIDS and Behavior, 10(5), 451-461. doi: 10.1007/s10461-006-9117-3





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