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Criminalization of HIV
Brief History

The criminalization of HIV started in the 1980s when states enacted HIV exposure laws. It was until "the passage of the Ryan White Care Act in 1990 that marked an important milestone in the development of the U.S. HIV exposure laws". The Ryan White Care Act "required all U.S. states to certify that they had a legal mechanism to prosecute HIV-infected individuals who knowingly exposed others to HIV." The term exposure "refers to many behaviors, with the possibility of actual transmission resulting from the exposure being more or less remote—and in some cases virtually impossible such as spitting or biting." "In 1987, President Ronald Reagan formed the Presidential Commission on the Human Immunodeficiency Virus Epidemic." One of the recommendations that this Presidential Commission made was that it "encourge[d] continued state efforts to explore the use of the criminal law in the face of this epidemic".

Implications and factors influencing the criminalization of HIV

There have been studies done on the effects of the criminalization of HIV, stating that "the laws may increase HIV-related stigma and discrimination, thus making persons at risk for HIV less willing to be tested or fostering." Scholars in the policy and law environment have discussed the difficulty that comes with individual cases: "individuals who know they are at risk of having HIV but avoid testing; those who know they are HIV infected but occasionally have unprotected sex; and those who know they are HIV infected and regularly have sex without disclosing or taking precautions". Aside from having these factors to look at during the criminalization from judges, lawyers, and jury, we can see an "Unfair treatment of defendants" as a problem. "Judges and juries may consciously or unconsciously take into consideration the race, nationality, or social position of the accused".

Opposition to the criminalization of HIV/AIDs

There are many scholars that state that this criminalization of HIV is in a grey area. "Regulation of sex implicates rights of privacy, autonomy, and self-expression, not to be abridged without a compelling justification." While this idea stems from the idea of autonomy, there are other ways scholars in academia have been viewing this specific issue. One of the main points that are brought up in this conversation is that "Rather than introducing laws criminalizing HIV exposure and transmission, legislators must reform laws that stand in the way of HIV prevention and treatment". One of the ways that they see this play out is "removing legal barriers to condoms and comprehensive, age-appropriate sex education and sexual and reproductive health services, including post-exposure prophylaxis, needle and syringe programmes, effective drug dependence treatment (including opioid substitution therapy with methadone and buprenorphine) and other evidence-informed strategies designed to reduce HIV risk". More research is being done to determine the best way to have a reduction of criminalization of HIV/AIDs.

HIV-Related Stigma in Health Care Settings
Background

While there are many societal stigmas surrounding HIV/AIDS, healthcare providers can also be a source of this stigma as it pertains to treating and providing care to these patients. While there is no way to gauge what people really think, we consider this stigma to be perceived. Perceived stigma “refers to an individual’s anticipated fear of societal attitudes and potential discrimination they may experience because they are HIV positive”. This stigma can be seen in body language or the way that you are spoken to.

Research on stigma

Studies have found that "twenty-six percent of respondents reported at least 1 of the 4 types of perceived stigma from a health care provider at baseline". These perceived stigmas ranged from feeling inferior to providers feeling uncomfortable around them. There is also research that shows that “substantial prejudice toward PLHA and fear of providing direct care to known HIV infected persons by some nurses”. Another issue that may arise from provider stigma is “decreased HIV testing, condom use, PrEP uptake, medication adherence, linkage to care, and retention in care, which are all essential components of the HIV care continuum”. In a study done by Geter, Herron, and Sutton, there were three themes that contributed to HIV-related stigma by healthcare providers. The overarching themes were “(1) attitudes, beliefs, and behaviors, (2) quality of patient care, and (3) education and training”.