We have come a long way in what we know about HIV treatment and transmission since the HIV/AIDS epidemic began 40 years ago. In terms of health, an HIV diagnosis today largely means continuing to lead an ordinary life with regular treatment and monitoring. With one pill a day, we can now reduce the level of HIV in a person’s bloodstream to such low levels that tests are unable to find copies of the virus. And when a person reaches this status, known as “undetectable,” we now know that the person is unable to transmit the virus to sexual partners, making testing and treatment an essential tool in ending the epidemic. We also have medications available, known as PrEP and PEP, that can prevent transmission either before or after an exposure. In short, we have the necessary tools to end the epidemic.
Yet, if you looked at Missouri’s criminal laws, you would never know that. In Missouri, if you are living with HIV and know your status, you can be charged with a Class B felony, punishable by 5 to 15 years in prison, for not disclosing your status before engaging in certain activities, some of which do not actually transmit the virus. It doesn’t matter if you had no intent to transmit HIV. It doesn’t matter if there wasn’t even a risk of transmission. If you cannot prove you told a sexual partner your status, you may be at risk of prosecution.
Missouri’s HIV-specific criminal laws harm all Missourians, whether living with HIV or not. One key problem with the law is that it creates a disincentive to getting tested because you can only be prosecuted if you know your status. This directly harms public health efforts to get people access to testing and treatment. Further, the singling out of HIV for harsh punitive treatment with a statute that isn’t based in science perpetuates stigma and fear of HIV which harms people living with HIV and again hurts public health efforts.
And then there is the problem with proving disclosure. Because it is often impossible to prove that you told someone your status, prosecutions often come down to one person’s word against another’s. And public fear, stigma, and ignorance about HIV mean that the deck is stacked against people living with HIV in these situations. For this reason, Missourians living with HIV are always at risk of a vindictive ex or an abusive partner using this law against them.
These problems aren’t merely theoretical. A report by the Williams Institute found that Missouri has one HIV-related arrest for every 60 people living with HIV in the state. And yet, Missouri does not have lower HIV transmission rates than other states without such harsh laws. There are no studies to show that these laws reduce transmission or increase disclosure. And there are a number of organizations that support ending HIV criminalization, including the U.S. Department of Justice, the American Medical Association, and many, many others.
Fortunately, there are legislative efforts in Missouri this session to take a step towards modernizing our HIV-specific criminal laws. Senator Holly Rehder is sponsoring SB 65 in the Senate and Representatives Phil Christofanelli and Tom Hannegan are sponsoring HB 755 in the House. These bills, if passed, would do a number of things to update Missouri’s HIV-specific laws, including removing specific references to HIV in the law, lowering the penalties, raising the level of intent necessary to be convicted, limiting the law to only cover activities that create a substantial risk of transmission, and protecting the privacy of accusers and the accused.
To be clear, these bills would be a substantial improvement on the current law, but they would not end HIV criminalization in Missouri, rather they are an important first step. The bills fall short, especially in two key areas. First, although the bills would increase the level of intent necessary to be charged with a felony, they would not require that a person actually intended to transmit the virus to be convicted, meaning someone who did not actually intend to harm anyone could still face prosecution. And these bills also do not address the fact that sex workers living with HIV can face penalties up to 30 times higher simply because of their HIV status. Though these bills are a step in the right direction, we will still need to continue organizing and advocating for better HIV policy in Missouri in the years to come.
Please contact your state senator and representative to let them know that you support modernizing Missouri’s HIV-specific criminal laws.
Missouri HIV Justice Coalition