HIV, disclosure, rasicm, criminal records

[NecCat]

I don't even know where to start with this

http://www.buzzfeed.com/steventhrash...20c#.ge2zYZwjP

I was ready to get all indignant about this article, based on the title. I was expecting to get very upset that a man was held in solitary confinement, a known cause of extreme stress and mental damage, based solely on his medical status. Then I read the whole thing.

"Johnson's is perhaps the most racially charged HIV case since..."
I can't think of a case that could be less decided on race. How his race, the race of his victims, the race of the doctors, lawyers, judge or jury could affect the outcome of this I don't understand at all. He doesn't seem (from this article) to be denying that he had sex with people who didn't know that he was HIV positive. Either that is illegal or it isn't, with no room for interpretation based on race.


"Johnson’s highly publicized arrest made him the modern face of what activists call “HIV criminalization,” laws that make it a crime for anyone who knows they are HIV-positive to expose another person to the virus without disclosing their status."
I didn't know that there were activists fighting against this law. Now that I do, it makes me angry. Anyone with a disease that is highly contagious (in whatever circumstances) and also typically fatal should be required to do that. Laws requiring people to disclose HIV status before sex, blood transfusions, receiving first aid if they are bleeding, or before invasive medical treatments does not criminalize HIV, nor does it criminalize the people who have it. It serves the best interest of the whole of society. The fact that people are embarrassed to have a disease that is still considered a fault of bad behaviour doesn't outweigh actual physical danger to other people.

Thirty-three states have “laws explicitly focused on persons living with HIV,” according to the federal Centers for Disease Control and Prevention. Many of those laws were passed when there was no effective treatment for HIV. Today, taking antiretroviral drugs has been shown to reduce the risk of transmitting HIV by more than 90%. And people who are uninfected can also sharply reduce the odds of acquiring HIV by taking medication
So the best practise if you have been exposed requires taking medication, but we should fight against being required to tell people they have been exposed? I'm also curious how only 33 states have laws about this. Is it just because no one has had to file a complaint in the rest of the states?

“The demonization of Mr. Johnson not only has destroyed his life, it is providing ample evidence that the best way to avoid prosecution is to avoid ever getting tested or treated for HIV,” as part of a letter sent to the prosecuting attorney to try to reform the laws that are causing the "destruction of this young mans life" Which is slightly ridiculous. Any responsible adult with an active sex life will want to be tested for all std's. Any responsible drug users who share needles probably don't exist, but if they get clean they should want to be tested. Do the people who are against this 'criminalization of HIV' really suspect that this is the message being sent. It's better to die of AIDS early then know if you have HIV in time for effective life lengthening and quality of life increasing treatment. Also the characterization of 'demonizing' Mr Johnson is a bit misleading when we are talking about the arrest, indictment and holding until trial someone who is accused of a crime that causes physical damage to another. The destruction of his life will be if he is found guilty and sentenced to serve a long jail sentence, not because he has a disease, but because of his breaking the law and his disregard for the lives of his victims.

I don't know about all of Canada, but I know there was a woman charged with knowingly infecting men without informing them of her status in Ontario, and I remember reading about a case in either Saskatchewan or Alberta of a man being charged for the same a few years ago, so there are laws here that make it illegal to expose someone without their knowledge. I fervently hope that there are not activists in Canada fighting for the expulsion of these laws.

I admit to having very little personal experience with HIV or AIDS. I have only known one person (that I know of) with AIDS. He passed away 18 years ago, so there are more things known about AIDS now, but he always took what precautions he could. He was very upfront about it, he was very contentious of making sure others were safe around him. His apartment always smelled strongly of bleach, if there was a chance he was bleeding or had cut himself somewhere he would scrub it super well with bleach. He kept a small pack of bandaids and a small bottle of bleach on him when he went out. If he did get a cut he would instantly wrap it so he wouldn't bleed on anything, and then bleach anything he did bleed on. Even then it was not known for sure how long the disease could live outside of the human body, but it was known that bleach would kill it. Due either to the disease or the drugs he would get cut and bleed quite easily, he thought that was his responsibility to others to keep them safe. And he told every potential sexual partner his status as soon as it was a possibility so they could make an informed choice.

My friend also didn't work, because he couldn't afford the drugs needed to prolong his life which were about $1600/month (then). On welfare his prescriptions were covered by the province, if he got a job he would be 3-12 months without a health plan before there was a possibility of his medications being covered. I don't know for sure, but I would think in the states the chance of a person without good health coverage or an independently wealthy person would have less chance of paying for the medicine. That would make prevention even more important for the average American.

About the only things in the article that made me mad for the reasons I expected:
He has been in solitary confinement for the last few months. The reason is either because he threatened someone with an attempt to infect them, because he refused to take a plea bargain, or for a reason not disclosed. Unless there is more to the story, he should not be in solitary, and I hope his lawyers keep working to change that.
There are laws that criminalize an HIV positive person spitting on another person. As far as I know spitting on someone is assault, which is a criminal offence, so why there would be a separate law based on the HIV status of the offender is a bit of a head scratcher.

[Tama]

Going 3-12 months without the drugs is asking for trouble. HIV drugs need to be taken religiously, because if you miss even ONE dose, it can throw everything off and then you would need to see the doctor AGAIN to get evaluated AGAIN to get on a new regimen.

Just thought I'd let you know about that, with your friend. He probably had it under decent control and didn't want to risk upsetting anything in his system.

[Panacea]

Part of the reason these draconian laws were passed is because there were people who were deliberately infecting as many people as they could; they took their rage at the diagnosis out on the world. Those people should still go to prison.

However, the laws do need reform. AIDS isn't the death sentence it used to be, and while not telling your partner IS reprehensible, good safe sexual practices (always using a condom) does a LOT to protect you.

HIV lives less than 30 seconds outside the human body; once the blood dries, the virus is dead. It's best to be used to clean surfaces, but not the skin as it is very irritating to the skin; the injury could lead to a weeping wound that would make transmission more likely, not less. Soap and water for the skin is all you need. Or a good alcohol gel.

Hep C is more worrisome to me than HIV. It can live 3 days on surfaces, and is transmitted MUCH more easily than HIV.

I don't blame the OP's friend for his situation with his meds. They are still very expensive, and any change in your meds can make that particular drug useless. We have people in prison who have committed crimes deliberately just so they could get their meds: the prison system has to provide them for free.

I have no doubt this guy is in isolation because of his HIV status. There is no need for it. I knew many HIV positive inmates when I worked in corrections. They did just fine in general population and their status was often common knowledge. But correctional officers . . . I've known many to be just plain vindictive.

The jail officials are lying through their teeth when they claim to have no "hole," but administrative segregation. That's what administrative segregation IS: 23 hr lockdown. Those guys are full of crap. It's torture, nothing less.

[Tama]

I realized that it could cause resistance, or cause the need for reevaluation of med regimens, but going AWOL briefly causing that drug to be USELESS?! Wow.

[Greenday]

I understand why it's a crime and I agree with it. As for segregation, it should only be used in extreme cases and ended ASAP. It shouldn't be used as punishment and not in the insanely long terms it is used right now.

It's hard to tell which story is true. On the one hand, we have a prison system well known for mistreating prisoners for no reason other than kicks. On the other hand, we have a guy who willingly infected other people with a deadly disease so it's not like he has tons of credibility.

[Gravekeeper]

On the other hand, we have a guy who willingly infected other people with a deadly disease so it's not like he has tons of credibility.

and on the third, mutant hand growing out of our back, we have the fact this is an almost entirely anonymously sourced story from the bastion of investigative journalism that is....Buzzfeed?

The only real points I can offer on this are that A) Solitary confinement pretty much is torture and B) I fail to see how race plays into this specifically. You're already more likely to be convicted and receive a harsher sentence if you're black to begin with ( sadly ). So I don't see how this particular crime is different from the norm.

[HYHYBT]

Please at least look at the other side of HIV disclosure laws. Aside from (though tightly related to) stigma, there's a serious practical problem with them. Think this through.

1) Whether such laws exist or not, you cannot rely on your partner telling you if they're HIV+. Even if they're honest, they may not know themselves. So what you're really getting out of a disclosure law even just up to this point is mainly a false sense of safety. This discourages people from taking precautions and from getting themselves tested regularly.

2) The urge for sex is pretty strong, and people rationalize. Add to that the tendency for potential mates to vanish when they find out someone is positive and a requirement for people who test positive to disclose their status, what you're doing is providing a strong incentive not to get tested. After all, you can't be expected to tell what you don't know yourself.

3) Treatment, done correctly, not only leads to a longer and healthier life for the infected person, but also, if I understand correctly, decreases the chance of transmission.

Put all that together and you get a law that, while it sounds right, and while it surely benefits some individuals, is going to lead, overall, to infected people being both more numerous and less healthy.

[Panacea]

I realized that it could cause resistance, or cause the need for reevaluation of med regimens, but going AWOL briefly causing that drug to be USELESS?! Wow.

HIV is notoriously nimble. It mutates and develops resistance quickly. That's why the triple cocktail is so effective; it counters the adaptability of the virus . . . as long as the regimen is followed. Many HIV patients carry timers to make sure they take their meds precisely on time.

The good thing is these cocktails drive viral loads down to undetectable levels.

Between vastly improved treatments and a high level of safe sex practices among homosexual men, infection rates dropped dramatically by the early 21st century. They are starting to rise again, in part because younger homosexual men did not witness the horrors of the early AIDS epidemic, and because of unsafe practices among IV drug users.

It's hard to tell which story is true. On the one hand, we have a prison system well known for mistreating prisoners for no reason other than kicks. On the other hand, we have a guy who willingly infected other people with a deadly disease so it's not like he has tons of credibility.

There's a difference between intent and negligence. We haven't had a real case of malicious infection in decades. I'm not seeing any intent in his actions, just immaturity and poor safe sex practices, something that is becoming more common as the horror of the 1980's recedes in the minds of todays young population.

I really don't see how enforcing such draconian laws is helpful to the problem.

and on the third, mutant hand growing out of our back, we have the fact this is an almost entirely anonymously sourced story from the bastion of investigative journalism that is....Buzzfeed?

The only real points I can offer on this are that A) Solitary confinement pretty much is torture and B) I fail to see how race plays into this specifically. You're already more likely to be convicted and receive a harsher sentence if you're black to begin with ( sadly ). So I don't see how this particular crime is different from the norm.

Racial bias is a huge problem in our criminal justice system. Our system is broken, and we're criminalizing stupidity.

[Aragarthiel]

Please at least look at the other side of HIV disclosure laws.

/snip

Put all that together and you get a law that, while it sounds right, and while it surely benefits some individuals, is going to lead, overall, to infected people being both more numerous and less healthy.

The laws are both good and bad. Even with the meds, there is still a chance of transmission, and I personally would not appreciate finding out I have an incurable, possibly fatal disease that requires terribly expensive meds to keep under control. On the other hand, not having the laws would help make people more aware of who they're sleeping with. Anyone responsible about their HIV would be up front about it to begin with, so really, the laws seem a bit unnecessary (except, of course, for medical purposes).

[Gravekeeper]

Put all that together and you get a law that, while it sounds right, and while it surely benefits some individuals, is going to lead, overall, to infected people being both more numerous and less healthy.

We really have zero evidence that this is the case. Its just conjecture. HIV infection rates have always risen and fallen with public awareness and access to protective contraception. Thus it is inevitably tied to wealth and education more than anything else. Criminal prosecution for malicious infection with HIV is also pretty rare. Some countries and states have specific laws, while for others its simply folded into existing criminal offences.

Furthermore, the law wouldn't exist if the crime didn't exist and, unfortunately, the crime does exist. One of the most prominent examples occurred here in Canada with a man who knowingly transmitted the virus which resulted in two of his partners dying from AIDS.

Though in Canadian law there is not a separate law for this but rather failure to disclose is considered fraud and thus the partner cannot legally give consent under deception. Meaning its aggravated sexual assault.

[Panacea]

The laws are both good and bad. Even with the meds, there is still a chance of transmission, and I personally would not appreciate finding out I have an incurable, possibly fatal disease that requires terribly expensive meds to keep under control. On the other hand, not having the laws would help make people more aware of who they're sleeping with. Anyone responsible about their HIV would be up front about it to begin with, so really, the laws seem a bit unnecessary (except, of course, for medical purposes).

HIV is the most politicized disease in history. All kinds of special laws regarding it were passed in the 1980's and 90's, many of them in response to pressure from gay activists.

For example, the Public Health department collects and reports all STD infections to the CDC. This is done partly for statistical purposes (to track infection rates) and partly to contact all possible partners to get them tested and treated. HIV was exempted from some of those requirements by Federal law. Public health agencies could report new infections, but no identifying information and no effort to track down partners was made (that's starting to change in some parts of the country but not all).

In addition, for decades you had to get informed consent to test someone for HIV. That's never happened for any other disease; if your physician suspects a disease, he just orders the test and it gets done.

This was a big problem when something happened, and the health of a health care worker was at stake. For example, my manager on a step down unit was helping a surgeon insert a central line one day. After he was done, she was cleaning up all the trash he left in the bed. When she grabbed what she thought was just the paper drapes (this is a sterile procedure), she stuck herself with a needle the surgeon hand tossed into the bed instead of onto the bedside table on the surgical tray.

The patient in question's husband was known to be HIV positive, and they were both known to be IV drug users (that's why she needed the central line in the first place). The patient refused to be tested for HIV. So my manager had to be tested (which she would have been anyway), and take AZT for 6 months before being retested. Had the patient agreed to be tested and been negative, the AZT could have been stopped much earlier.

What we need in regards to HIV is sensible laws. Malicious infection should be a criminal act. Negligence, no. The only people we need to be locking up are the ones who refuse to disclose their status but insist on having unprotected sex, which is actually a small portion of the population.

[Shangri-laschild]

The problem is, while the risk of infecting someone may be low and advancements have been made, it's not risk free because he did infect someone. And now that person has to spend the rest of their life making sure they take drugs at certain times and managing this. Now they have to deal with whether or not to inform anyone they have sex with. The rest of their life and health has been changed by all of this because he didn't inform them. And yeah, maybe they still would have had sex with him. That would have been their informed choice though. I don't know if I agree to laws with this level of penalty but I don't really disagree with the laws in general.

[Panacea]

The problem is, while the risk of infecting someone may be low and advancements have been made, it's not risk free because he did infect someone. And now that person has to spend the rest of their life making sure they take drugs at certain times and managing this. Now they have to deal with whether or not to inform anyone they have sex with. The rest of their life and health has been changed by all of this because he didn't inform them. And yeah, maybe they still would have had sex with him. That would have been their informed choice though. I don't know if I agree to laws with this level of penalty but I don't really disagree with the laws in general.

The same thing is true for Hepatitis C, which is also sexually transmitted, but we don't hold it to the same standard.

HIV is still seen as the "gay disease" and that's the real, unspoken issue here.

[KabeRinnaul]

HIV is still seen as the "gay disease" and that's the real, unspoken issue here.

I don't think that's the biggest part of it. Sure, some people might still make that association, but I think it more comes from how pop culture and scare-education treated the danger of HIV when we were growing up (particularly for children of the 80s and 90s). No matter how much new developments change things about it, I still think of HIV/AIDS as a highly-contagious and -infectious death sentence — that a positive diagnosis is basically life-ending.

It's not that we secretly hate them for catching "teh ghey". It's that we (as individuals, not as a whole) don't actually know all that much about the disease and fall back to the "unstoppable incurable doom-plague" concept of it we grew up with.

[Gravekeeper]

The same thing is true for Hepatitis C, which is also sexually transmitted, but we don't hold it to the same standard.

Well, two things here. A) You're wrong, people do get charged with malicious infection of Hep C and B) HIV and Hep C are worlds apart.

Hep C is extremely low risk for sexual transmission. In fact its actually HIV that increases the risk of sexual transmission of Hep C, unfortunately. Being charged with malicious infection of Hep C is usually the result of intentionally biting/spitting/attacking someone in such a manner as to risk transmission.

But HIV has over twice the morality rate of Hep C, spreads easier and is incurable. Whereas Hep C is curable in most cases and is harder to spread. So there's no real reason to hold Hep C to the same standard. There was never a Hep C epidemic that decimated millions.