Stigma Topics: Modernization of HIV Laws and Policies

Since the beginning of the epidemic in the 1980s, HIV laws and policies were established throughout the U.S. and globally with the objective to reduce the number of new infections but were reflective of limited knowledge surrounding HIV transmission. 

Progress has been slow and vastly overdue to update these laws and policies based on new practices, current evidence including the inability of those virally suppressed to transmit HIV sexually.  

Inclusively, according to the global coalition HIV Justice Worldwide, these outdated criminalization laws mitigate HIV-related stigma and social disadvantage, create barriers to testing, and make prevention and healthcare more difficult.

Increasing evidence suggests there is no association between HIV or AIDS diagnosis rates and criminal exposure laws. Research also suggests HIV laws and policies are unevenly enforced based on race and sex. In California, Black and Latino people make up half of the population of people living with HIV but two thirds of defendants in HIV-criminalization cases.

According to the Centers for Disease Control and Prevention, as of 2018, in the United States:

• 26 states had laws that criminalize HIV exposure
• 19 states have laws that require persons who are aware that they have HIV to disclose their status to sexual partners
• 12 states require disclosure to needle-sharing partners
• Several states have a maximum sentence length as high as up to life in prison for violating an HIV-specific statute, others have maximum sentence lengths that are less than 10 years

In the video featured above we discuss how, on January 1, 2018, North Carolina’s HIV Control Measures were amended to exempt individuals who are in care and have been virally suppressed for at least six months from disclosing their status or using condoms; to recognize the effectiveness of PrEP and remove stigmatizing language from the law; and brought North Carolina into compliance with the federal HIV Organ Policy Equity (HOPE) Act. The modernization of North Carolina’s HIV Control Measures was a result of a task force of people living with HIV, medical providers, and advocates, convened by North Carolina AIDS Action Network and the Southern HIV/AIDS Strategy Initiative. The task force worked with the North Carolina Department of Health and Human Services to draft the recommendations, incorporating evidence, including U=U and jointly built community support.

Additional Resources

Consensus Statement on HIV "Treatment as Prevention" in Criminal Law Reform
The consensus statement is a collaborative document that “grew out of the recognition of a need for guidance on how the science of HIV treatment and prevention tools relates to the reform of HIV criminal laws.”

Expert Consensus Statement on the Science of HIV in the Context of Criminal Law
Published in the Journal of the International AIDS Society in 2018, the consensus statement is a “detailed analysis of the best available scientific and medical research data on HIV transmission, treatment effectiveness, and forensic phylogenetic evidence”

Prevention Access Campaign and Undetectable = Untransmittable
U=U is a health equity initiative to end the dual epidemics of HIV and HIV-related stigma by empowering people with and vulnerable to HIV with accurate and meaningful information about their social, sexual, and reproductive health.

HIV Legal Assessment Program
The Centers for Disease Control and Prevention’s  HIV Legal Assessment Program is a collection and assessment of statutory and regulatory frameworks with the objective to determine if they act as barriers or facilitators to effective HIV prevention.

The Sero Project
According to their website, “Sero is a network of people with HIV and allies fighting for freedom from stigma and injustice. Sero is particularly focused on ending inappropriate criminal prosecutions of people with HIV, including for non-disclosure of their HIV status, potential or perceived HIV exposure or HIV transmission.”

The Center for HIV Law and Policy
The Center for HIV Law and Policy is an independent project of the National Center for Civic Innovation, “challenges barriers to the rights and health of people affected by HIV through legal advocacy, high-impact policy initiatives, and creation of cross-issue partnerships, networks and resources.”

HIV Justice Worldwide
HIV Justice Worldwide coalition works to shape the discourse on HIV criminalization including a campaign to “abolish criminal and similar laws, policies and practices that regulate, control and punish people living with HIV based on their HIV-positive status.” Access to their Toolkit focused on advocating for decriminalizing HIV transmission can be found here.