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Why the criminalization of HIV transmission doesn’t work

Why the criminalization of HIV transmission doesn’t work

HIV-positive gay men in the Czech Republic are being investigated for allegedly having sex without condoms

Thirty gay men living with HIV are currently facing criminal investigation in Prague because they attended a sexual health clinic.

Each of the men had been diagnosed with an STI, which the authorities took to indicate that they had unprotected sex. Under the Czech Criminal Code any condomless sex act, including oral sex, by a person with HIV can be prosecuted, due to the potential to spread infectious disease.

In this case there are no individual complainants. Nothing has so far come to light to indicate that any of these men’s partners have been infected.

According to the Czech AIDS Society, most of the men have an undetectable viral load, which means that it is extremely unlikely they would be able to transmit the virus.

On top of this, reports indicate that some of the men had only engaged in sero-concordant sex (sex with people who share the same HIV status).

This particularly heavy-handed application of the law can only serve to discourage people with HIV from attending sexual health services in the Czech Republic, which may result in STIs going undiagnosed and untreated, and thereby facilitate their spread.

The story illustrates how blunt and ineffective criminalization is as a method of preventing new HIV infections. Dumb and ineffective laws around HIV transmission aren’t confined to the Czech Republic.

A recent US study compared rates of unprotected sex among gay men and found little variation between those states that criminalize HIV transmission and those that don’t.

In fact, the study found that those men who lived in a state which criminalized transmission were slightly more likely to have sex without a condom than those who didn’t.

As a means of changing behavior, criminalization just doesn’t work.

Criminalization of HIV transmission usually only applies to those who are aware that they are living with the virus, which in itself does nothing to encourage testing. Furthermore, it may lead individuals who are uninfected or undiagnosed to believe that the law will somehow protect them from infection and, as a result, take fewer precautions.

It isn’t helpful to place all of the responsibility for preventing transmission on the shoulders of the partner living with HIV, even if they have been diagnosed.

Such a strategy also doesn’t reflect the way that the virus is usually passed on. The majority of infections among gay men are as a result of sex with men who have not been diagnosed and are unaware that they are living with HIV.

But then, criminalization of HIV in many countries and states bears little relationship to the reality of HIV transmission. We have increasing confidence that someone who is undetectable on treatment poses no risk of transmitting the virus.

The preventative impact of successful HIV treatment is greater than the efficacy of condom use as a strategy for stopping HIV transmission. But all too often whether something is actually risky bears little relationship to the way that laws are framed.

HIV can’t practically be transmitted through saliva but still in some US states spitting, if you are living with HIV, is criminalized. This is just daft.

HIV is now very treatable and someone who is diagnosed promptly, with access to treatment, has every prospect of living a long and healthy life. Many of the greatest challenges that those of us who live with HIV face relate to the stigmatization of the virus, attitudes that bad laws, such as those that criminalize HIV transmission, only serve to compound.

We need to have an effective response to prevent new HIV infections. We will only achieve that by encouraging people to access testing and, if diagnosed, HIV treatment.

We will make progress when people are educated about the actual risks of transmission, rather than distortions and disinformation that only serve to isolate people with HIV.

Criminalization of HIV transmission doesn’t prevent new infections. On a global level, we need to agitate for a rational and efficient response to this epidemic and leave these outdated, prejudicial and ineffective laws behind.

Matthew Hodson (@Matthew_Hodson) is the Chief Executive of GMFA. This article is Matthew’s own opinion and not necessarily the view of GMFA as an organization. GMFA publishes FS Magazine. FS relies upon funds from the community. To support FS, visit www.gmfa.org.uk/donate, or, if you’re in the UK, text FSFS15 £5 to 70070 to donate £5 (or £10, if you can).

Matthew Hodson, Chief Executive of GMFA
Matthew Hodson, Chief Executive of GMFA