The American Academy of HIV Medicine (AAHIVM) and its members are opposed to laws that distinguish HIV disease from other comparable diseases or that create disproportionate penalties for disclosure, exposure or transmission of HIV disease beyond normal public health ordinances. We support non-punitive prevention approaches to HIV centered on current scientific understanding and evidence-based research.
The criminalization of HIV transmission and exposure is a complex issue. Early in the history of the HIV epidemic, public fear of the disease led many states to pass laws that established criminal penalties for failing to disclose infection, for exposing others to the disease, and for transmitting the disease intentionally or unintentionally. In many cases, these laws apply regardless of protective measures the HIV-positive person may take.
At the time when many of these laws were passed the routes of HIV transmission, and methods of preventing the disease were not as well understood scientifically as they are today. In some cases, these laws reflect assumptions about the disease that are now known to be scientifically invalid. For example, some state laws criminalize biting or spitting by HIV-positive persons, even though saliva is not considered a probable transmission risk.
These laws are specific to HIV and the same standard is not applied to other diseases such as hepatitis C and hepatitis B which can also be transmitted via sexual activity.
Currently, 34 states and two U.S. territories have laws which criminalize behavior of HIV positive people. The laws are varied in detail, but many are harsh in nature with some having penalties, including incarceration, that are usually reserved for the most serious of crimes. Many of these laws are applicable whether or not actual harm has been demonstrated or caused. This seems to be disproportionate punishment that arises from hysteria and/or homophobia.
The subsequent prosecutions that have resulted from these laws, and the juridical policy that has been built upon on these laws are similarly flawed in their presuppositions, motives, and utility.
They also fail to take into account the major advances in HIV care and treatment that are now available to those who do become infected. HIV disease is in most cases today a manageable long-term condition. However, prosecutorial precedent still treats transmission of the disease as the equivalent of a death sentence, which represents a significant exaggeration in the current medical environment.
As medical professionals, our members support policies that encourage individuals to learn their HIV status, participate in regular medical care, and take measures to protect others against the spread of the disease without punitive sanctions.
Our members oppose public policies and laws that distinguish HIV disease from other comparable diseases and believe public health and juridical policy on HIV should be no different to that of other sexually transmitted or communicable diseases, such as tuberculosis, hepatitis, herpes or syphilis.
Public health policies, and laws (as well as possible prosecutions that might result from those laws) should take into account the most up-to-date scientific information about methods of transmission and prevention, as well as the great advances in care and treatment that are now available to those who do become infected with HIV, which in today’s world is usually a treatable long-term condition.
In some rare cases, there may be a role for legal redress against individuals who transmit the disease or expose others to the disease with malicious intent. There may also be a role for legal redress when an individual seeks to defraud another individual concerning their health status. However, pathways for such legal redress already exist in most states. Redundant laws focused on one disease are unnecessary, stigmatizing, harmful and unjust.
Policies on HIV should also take into account the high levels of stigma and prejudice still associated with the disease, and seek to protect individual privacy, rights, and freedom. Public policies, and laws around disease transmission should be evidence-based and non-discriminatory in nature. They should serve public health goals and promote public awareness.