The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.
Medical professionals and health advocates are seeing progress in a longstanding effort to remove Ohio laws that they say unduly target those with HIV.
The laws, many of which were created in the 1990s, are in need of reform because of the evolution of the science and medical treatment for HIV, according to members of the Ohio Health Modernization Movement, a coalition which has been working for years to update the laws. Not only does current legislation rely on outdated science, but it also furthers stigma surrounding the disease, the group says.
“What people really lose is the humanity of it, in that these are individuals who sometimes don’t have control over their situation,” said Nate Albright, an infectious disease nurse practitioner, predoctoral fellow at The Ohio State University and a director-at-large for the Association of Nurses in AIDS Care.
People also lose sight of the discriminatory aspects of laws related to HIV diagnosis, Albright said. In an article he wrote for the Center for HIV Law and Policy, he found that Black Ohioans represented 44% of those arrested for “allegations of HIV-related offenses,” despite only accounting for 13% of the total state population.
A report from the Equality Ohio Education Fund and OHMM found that between 2014 and 2020, Ohio had at least 214 HIV-related prosecutions, with 56% of cases charged under the state’s “harassment with a bodily substance” law, and 36% charged under felonious assault laws. No prosecutions were reported under the state’s blood donation law, according to the report.
That report also identified a “significant racial disparity between individuals charged under HIV criminalization statutes when compared to the general populace.”
“The disparate enforcement and impact of charges under these laws evidence a compelling need to modernize these laws so that they reflect accurate science regarding the routes and risks of transmission of HIV,” researchers stated in the study.
Evolving science
When Albright was young, he saw a family member eat off of a cheese plate, and, because that family member was known to have HIV, Albright was told to avoid sharing from the same plate.
“It was fear that is not evidence-based or based in science,” he said.
The laws that are currently on the books in Ohio stem from that same fear, advocates say, which is why reform needs to be based in the newest science, which includes treatments that can render HIV undetectable and lower risk of transmission significantly.
It took until the mid-1990s for the medical community to recognize the need to combine medications into a “cocktail” to lower the amount of HIV in a person’s body, but since then, medications have been developed that are safer, more effective and easier to use, according to Dr. Carl Fichtenbaum, professor of infectious disease at the University of Cincinnati’s college of medicine, and president of the Infectious Disease Society of Ohio.
“We have more than 50 different medications that have been approved by the FDA since 1987,” Fichtenbaum told the Capital Journal. “What we have demonstrated is that when you are effectively treated, you can not transmit HIV to another person.”
HIV tests can be obtained at low or no cost from public health and other medical facilities across Ohio.
Laws that aren’t updated create hesitation in getting tested or treated.
“If you call an infection a crime … of course people are going to feel stigmatized or worried,” Fichtenbaum said.
The fact that the world recently dealt with a virus called COVID-19 should be an example of how to use science, not laws, to deal with medical problems, according to Fichtenbaum.
“It’s one thing to say that we should quarantine someone for a period of time, it’s another thing to lock them up or make them pay a price,” he said.
Legislative reforms
Two Republican-led bills have been introduced to change criminal definitions that target those with HIV and remove penalties for individuals who attempt to donate blood or plasma and may have HIV.
House Bill 498 and House Bill 513 were recently introduced with the support of the OHMM.
HB 498 would “remove the criminal offense related to donating blood when the donor is a carrier of the virus that causes AIDS,” according to the language of the bill. Tracy Jones, executive director of the AIDS Taskforce of Greater Cleveland expressed support of the bill, and said the current law “serves no practical purpose for protecting the blood supply, as every donation is rigorously screened for HIV.”
The change in law wouldn’t change the process by which blood donations are accepted or impact the supply. When blood is donated, samples of the blood are taken and screened for pathogens, and any blood found with those pathogens, like HIV or hepatitis B and C, are removed from the supply.
HB 513 is broader with its changes to criminal definitions, along with screening processes and HIV testing requirements.
Some of the changes made in the more than 400-page bill include changing the definition of “conduct that poses a substantial risk of the transmission of HIV” to mean “vaginal intercourse, anal intercourse or sharing a hypodermic needle or syringe in a manner that poses a substantial risk of the transmission of HIV.”
The bill would also remove a requirement in the section of Ohio law regarding disclosure of HIV test results or diagnosis that an individual receiving a positive HIV result or AIDS diagnosis “disclose this information to any other person with whom the individual intends to make common use of a hypodermic needle or engage in sexual conduct.”
Language would be removed for felony charges of “engaging in solicitation after a positive HIV test,” “loitering to engage in solicitation after a positive HIV test” and “engaging in prostitution after a positive HIV test.”
With the Republican support of the bills, they have more of a chance to succeed in the GOP supermajority that makes up the Ohio House and Senate. Both bills have been referred to the House Criminal Justice Committee for public hearings.
