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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World AIDS Day is Dec. 1, dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV.
Thousands of people live with H-I-V/Aids in Arizona. More than 80% of those who were diagnosed with the virus in 2020 were linked to care, according to the Arizona Department of Health Services.
Anthony Petro, associate professor of religion and women's, gender and sexuality studies at Boston University, cited progress in how to medically treat the disease and noted how we speak about it has also changed. Petro said some diseases, such as HIV/AIDS, take on a set of political and moral meanings which can affect societal and even scientific views.
"When you think about public health itself, it is the application of medicine to a public and that depends upon us knowing who the public is that we care about," Petro explained.
Petro noted the early years of the AIDS epidemic brought questions about whether the imagined "American public" included certain groups such as queer people, sex workers and IV drug users. He recalled in the absence of "state support," local activists helped advance the movement. He contended it was only when medical researchers decided it was a virus, it gained a level of "prestige" and funding started to flow.
Petro added today, access to reproductive and transgender health care are issues currently walking that moral-political line.
President-elect Donald Trump has picked Robert F. Kennedy Jr. to lead the Department of Health and Human Services. Petro acknowledged Trump's selection has concerned public health experts as Kennedy has expressed a level of suspicion about whether HIV truly causes AIDS. He has instead suggested recreational drugs called "poppers" could be the real reason, which the medical community said is false.
Petro, like others, stressed a lot of work is still needed, related to HIV prevention and treatment.
"To hear someone today in 2024, thinking about those kinds of conspiracy theory approaches to thinking about HIV and AIDS, is certainly troubling, but it is not new," Petro outlined. "And I think we do have a very good infrastructure for HIV/AIDS care."
Petro reminded people about pre-exposure prophylaxis, or PrEP, which is the use of antiretroviral medication to prevent HIV. Most private insurance and Medicaid programs are required to cover PrEP services without co-pays or deductibles, according to the Centers for Disease Control and Prevention.
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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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