JEFFERSON CITY, Mo. - A bill that went into effect over the weekend makes the first reforms to Missouri's HIV criminalization laws since they were passed in the 1980s.
Among other measures related to prosecutors and police, the bill requires prosecutors to prove someone knowingly exposed someone else who contracted HIV before getting a felony conviction, and reduces the minimum sentence from 10 to three years.
Rico Bush, communications director at Empower Missouri, said research shows HIV criminalization laws do not reduce the spread of HIV, but they do increase stigma and discourage people from getting tested - if they worry knowing their status could leave them vulnerable to conviction.
"It actually was deterring from people getting tested and actually knowing their true status," said Bush. "And then once you know your status, then you can get the help that's needed. We really want people to be educated about how HIV is passed, and also to get rid of the stigma surrounding HIV."
Bush said while there's more to be done, these reforms are an important step. He added that Empower Missouri and other advocates for reducing the stigma around HIV are working to educate people about medications they can take to curb the spread.
More than 13,000 Missourians currently live with HIV. Bush added there also are disparities in enforcement of criminalization laws.
"Since 1990, we know that more than 100 people in Missouri have been convicted of, you know, an HIV crime," said Bush. "And Black men account for half of HIV crime arrests and convictions in the state, of course, this despite being only 5.5% of the state population."
A bill introduced in Congress would incentivize states to eliminate their HIV criminalization laws, the REPEAL HIV Discrimination Act.
Earlier this year, Missouri became the third state to allow pharmacists to dispense HIV medication, like PrEP and PEP, without a prescription from a doctor.
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Today is National HIV Testing Day. First observed in the U.S. in 1995, anyone who is sexually active is urged to get tested to know their HIV status.
The federal government underscores the importance of testing to show self-value, compassion and respect. According to the Centers for Disease Control and Prevention, almost 14,000 Hoosiers are living with HIV, the virus that causes AIDS.
Alan Witchey, president and CEO of the Damien Center, an HIV/AIDS resource in Indianapolis, said the blood test is free and confidential, and insurance is not required.
"Nobody has to know that you're coming, and you can either make an appointment or you can just walk in," Witchey explained. "It's just a quick finger prick; you will have your results in 20 minutes."
He added testing for other sexually transmitted diseases can be performed at the same time. A positive test result will alert the Damien Center staff to connect the person to support services and the clinic. For a negative result, medication is available for HIV prevention. The services are available at little to no cost.
The Centers for Disease Control and Prevention said 100,000 cases of AIDS, the condition which mutates from an HIV diagnosis, were reported in the U.S. between 1981 -- the first reported case -- and 1989. Since then, the invention of life-extending medications has lessened the public's urgency to get tested.
Witchey emphasized HIV is still growing and spreading, even as other epidemics have evolved.
"Even though you don't hear about HIV as much anymore, it is still here," Witchey pointed out. "And a lot of people still have this misconception that HIV is a death sentence, or they won't be able to afford the medications even if they are HIV-positive."
"Ending the HIV Epidemic in the U.S." is a federal program with the aim of lowering new HIV infections nationwide by 75% by next year and at least 90% by 2030. Funding will be used to zero in on locations with the most frequent HIV transmission.
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New Mexico activists are tapping today's World AIDS Day, Dec. 1, to announce they'll ask the State Legislature to provide more money for treatment and prevention.
Equality New Mexico Executive Director Marshall Martinez voiced concern that many primary care providers fail to prescribe treatments known as PrEP and PEP, perhaps worried that they are specialized and complex. His group will ask lawmakers to provide more funding to the Department of Health to initiate educational outreach.
Marshall said the treatments significantly reduce risk and the effects of AIDS: "Since the beginning of the epidemic in the '80s, we've never had as powerful of a preventive tool as we have in PrEP."
According to Martinez, the New Mexico Department of Health reports there are between 3,000 and 4,000 people in the state living with HIV.
Federal data show American Indians and Alaska Natives have over twice the rate of HIV infection as their white counterparts. They also are more likely to die from HIV infection.
Nonetheless, Martinez noted the majority of those taking preventive medications are cisgender, white men. He stressed this demonstrates how important it is for the state to reach Indigenous and immigrant communities, starting with funds to train medical providers.
"And then public messaging in those sort-of non-traditional communities and from non-traditional messengers to say, 'Hey, there's this drug called PrEP - it would prevent HIV - you should ask your doctor about it,'" he explained.
It is estimated that since 1981, more than 40 million people have died from AIDS; in some countries, it is still the leading cause of death. Currently, almost 30 million people are using therapies to inhibit HIV and prevent AIDS.
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Today is National Gay Men's HIV/AIDS Awareness Day, and Nevada is one of the 10 states with the highest HIV infection rates.
In 2021, more than 11,000 Nevadans were living with HIV. Recent data show nearly 70% of all new HIV diagnoses in the U.S. are among gay and bisexual men.
Dr. Laura Cheever, associate administrator of the HIV/AIDS Bureau for the Health Resources and Services Administration, said despite progress in care and treatment, there are still many who do not realize they have the disease. HIV today is what she called a "manageable, chronic disease," which can be treated with antiretroviral therapy leading to viral suppression and have no risk of transmitting HIV sexually to someone else.
"In order to live a near normal life span, a person with HIV needs to get on medication and stay on them," Cheever explained. "A lot of people just don't want to deal with the fact that they may have HIV because there is so much stigma still around the HIV diagnosis as well as other issues including homophobia and racism."
Cheever advised getting tested is the first step. For those who test negative, there are ways to prevent future infections. She noted pre-exposure prophylaxis, commonly known as "PrEP," is a great option. According to the Centers for Disease Control, PrEP reduces the risk of getting HIV from sex by 99% when taken as prescribed.
Cheever pointed out like other chronic diseases, HIV disproportionately affects those who are part of minority populations. She added for those looking to receive care or treatment for HIV at low or no cost, you can visit hiv.gov. You can also visit takemehome.org, and enter your ZIP code to see if you are eligible to receive a free, at-home HIV testing kit.
Cheever stressed it is important to realize HIV does not solely affect men who have sex with men.
"It can be transmitted between any two people having sex," Cheever cautioned. "It is disproportionate in the population of gay men in this country which is largely based on sort of historically how it entered this country, but anyone who is sexually active is potentially at risk for HIV."
Cheever added access to health care, education and prevention efforts are all contributing factors in decreasing the rates of HIV.
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