CHLP_AMA

Actually, we do a lot of work on HIV criminal laws. And the answer depends on the state where you live, since each state has its own way of handling this. Unfortunately (in my view), 32 states and 2 US territories have criminal laws that single out HIV for punishment without requiring proof of intent to harm -- which is what the criminal law otherwise requires in any other type of situation. In other words, if you get tested for HIV, and engage in conduct that would be legal if you didn't test positive for HIV, and then can't prove that you disclosed, in many states you can be guilty of a serious felony.

Keep in mind: HIV is not an easy virus to transmit, different types of sex pose little or no risk, and if someone doesn't have a high viral load they probably aren't putting their partner at risk of transmission anyway.

Thanks for a great question!

One fact that a surprising number of people think is untrue, including medical professionals, is that HIV is not an easy virus to transmit. Multiple studies have suggested that the riskiest type of sex -- being the receptive partner, or the "bottom", in condomless anal sex -- on average causes HIV transmission less than 2 out of every 100 acts. And that is without factoring in the reduction in transmission risk that being on effective HIV treatment, and/or using a condom, provides.

Another great question! It's hard for me to pick one, so bear with me if I pick a couple, okay?

The first is the adoption in the US of the Americans With Disabilities Act in 1990, which provided for the first time a way to sue private businesses across the country who refused to hire, or fired, or refused to insure, or refused to admit to schools, men, women and children living with HIV.

A second is the National AIDS Strategy, and the very first time our federal government called out HIV discrimination, and in particular HIV criminalization, as a factor in the disparities that people of color and others without social/economic capital experience in access to quality HIV care and prevention.

The biggest challenge in this work -- and the common denominator to every case of HIV discrimination I have handled over the last 30 years -- is a profound lack of knowledge about the routes, risks and realities of HIV transmission.

The larger issue is the widespread lack of sexual health literacy. We should be insisting on our children's sexual health literacy as an essential part of their well being as adolescents and adults. Sexual health should be as routine as dental hygiene! Instead, we allow our elected officials to put "ignorance is bliss" policies into place in our schools, detention centers, prisons and jails.

I'm hopeful that our new-ish Surgeon General will take this issue on.

Two key parts of the ACA have a particular importance for people living with HIV/AIDS: the expansion of Medicaid eligibility and the creation of new Health Insurance Marketplaces where individuals can purchase private coverage. A significant percentage of PLWHA are persons with low incomes, so the ACA means coverage for many more thousands of people living with HIV.