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Thu, Apr. 15th, 2010, 03:44 am
Another Stupid Legal Response to HIV

Darren Chiacchia, an American equestrian athlete who won an Olympic medal in Athens in 2004, is on trial.

The charge? Exposing his partner to HIV in the state of Florida, where it is illegal for an HIV+ person to have sex with someone without disclosing HIV status. According to Chiacchia's bitter ex-lover, Chiacchia hid his status from his boyfriend for years. Chiacchia said he was afraid to tell his lover about his HIV status because he was afraid it would go public. His lover found out and made it public anyway. Chiacchia probably deserves that much.



I don't need to go into detail to explain that knowingly exposing someone to HIV is a shitty thing to do. I'm not going to talk about it - not because I don't think it's terrible - but because it is already obvious to everyone reading this and nothing needs to be added. There will be plenty who pile on Chiacchia for his actions.

But what I will say is that the situation has already been irredeemably mishandled, and that the law is bogus in the first place.

Laws criminalizing the transmission or HIV have been misused by ignorant prosecutors and public. In 2008, for example, a Dallas homeless man who is HIV+ was sent to prison for 30 years for spitting on a police officer. The jury, either unaware or indifferent to the fact that HIV is not transmitable through saliva, decided that the saliva was a "deadly weapon" before issuing a guilty verdict.

This is like charging someone with attempted murder for shooting somebody with a squirt gun.

It is hard to get HIV. There are two ways for adults outside a medical setting to get it: through sexual intercourse, and through injections. Inject HIV+ blood into your body, and you stand a good chance of getting HIV. Have unprotected sex with an HIV+ and you have chance of having HIV (between 1 in 50 and 1 in 200; have unprotected sex with an HIV+ person 100 times, as people in a new relationship may do over the course of a year, and your chance of having HIV is pretty high.) But getting HIV through tears, saliva, urine, feces or skin is impossible. Oxygen kills HIV. Nobody has ever gotten HIV through a cut or scratch; you can roll in a puddle of HIV+ blood on the floor, even with cuts on your body, and it's not going to infect you.

HIV needs to be injected fresh, without exposure to air, from one body directly into your body. This happens during IV drug usage and through sex, it happens through organ transplants, it can potentially happen when an infant drinks dozen gallons of her or his mother's infected breast milk over the course of a year, and can happen to an infant during childbirth if the mother is infected.


Source: Wikipedia: HIV Transmission

In the Florida case, too, there is much to question. It is more likely here that the two had sex, which can lead to transmission, but prosecutors have not said what risky behavior Chiacchia and his partner engaged in, or if protection was used. Chiacchia could have feasibly insisted on condoms knowing he was infected. Nor can anybody ever prove whether Chiacchia really lied about his HIV status; it is possible for any person in a relationship with an HIV+ person to claim not to have known about his partner's status to satisfy a vendetta. Chiacchia's partner has not become infected with HIV; the charge is that Chiacchia wrongly placed his partner at risk, though his partner has not been harmed.

The problems with criminalizing HIV transmission are numerous, but in my mind, the ultimate reason why I think the laws fail is because they do not prevent the spread of HIV - they actually promote it. I am more concerned with stopping a deadly disease than with some sentimental form of "justice" where people are locked up for selfish behavior. When the goals conflict, I side with the practical: with preserving human life and health is paramount. I do not allow innocent people to suffer to punish guilty people; that is not a good trade.

The reason criminalizing HIV is dangerous is explained:

Imagine you are a person who has engaged in some risky behavior; perhaps drug use, perhaps unprotected sex, and you are unsure of your HIV status. You think (as many hypochondriacs do) you might have it, but your mind waffles. You might wake up in the morning convinced you are going to die and go to bed at night feeling reassured, talking yourself out of it: "I felt great today," you might think; "I had so much energy!" You might panic every time you get a cold or allergies thinking it is an early sign of AIDS. Even without treatment you will probably live for 10 years as an HIV+ person - which is why many people procrastinate on getting tested. You can put it off for a few months. It is February: lets say you resolve to get tested before the end of December.

An added deterrent is that if you do get tested and the result is positive, it will suddenly become illegal for you to have sex, and you know this. Perhaps you are already in a relationship, perhaps there is someone you have your eye on. Sure, if you tell your partner or partners your status and they consent to having sex using protection, it would be safe and not illegal. But you are convinced no one would have sex with you if they find out you have HIV. You are scared and irrational, and still believe that the world ends when you find out you have HIV. You still think that everyone you love turns their back on you - and sometimes they do. You wake up each morning terrified. You talk yourself down during the day; you've had panics before, and in the past you got tested and everything turned out OK. Almost everyone has a false panic sooner or later. You go to bed convincing yourself that all is well.

In the midst of this, you have sex with several people. You go to a bar and get drunk, and in your intoxicated euphoria you don't even think about your risk; when drunk you decide that you are sure you don't have HIV, and you have sex. Your anxiety actually drives you to the bars more often, or to use other drugs that lead to unprotected sex.

Lets say for the sake of the scenario that you actually are unknowingly HIV+, and infect several other people.

This could have been avoided had you been tested, and told, through counseling that is often provided with the test, that you have a wide number of options available to you as an HIV+ person, that you are not likely to die anytime soon because medication works very well now, that it is still safe to have sex if you follow certain procedures, that HIV+ people continue to find and have romantic relationships and this is actually encouraged by their doctors, and that the first step to reducing the spread of the disease is knowledge.

Instead, you have unknowingly infected people with HIV (and this is not illegal, since you never knew you had it), because the law terrified you away from getting tested. Many will say that putting others at risk in this way is still selfish and wrong, and sure, that is true, but many, many many people do it, far more than would knowingly infect others with HIV. Many people alive and healthy and HIV- today have had sex while not knowing their status, and are all equally guilty of putting others at risk though they got lucky.

That is just one way that criminalizing HIV transmission leads to more transmissions. The other problem is that it gives the community a false sense of security; if you are in a high-risk group, you may think it's safe to have unprotected sex with strangers because they are required by law to tell the truth. You ask your partner or your acquaintance if he has HIV, he says no, so you decide not to use a condom. This is a common assumption. HIV activists fight to prevent it all costs and think it's wrong, wrong, wrong, but many people do it anyway.

The problem is, most HIV transmissions come from someone who didn't know her or his status in the first place. Your partner may say "I tested negative two months ago - I'm negative" and still infect you. You are most contagious when newly infected, which is ironically before you know you are contagious; it could be days after a test. The false sense of security encourages people to take more risks. The risks lead to more HIV transmission.

People who work full time to stop the spread of HIV know: the answer is to educate people to get over their fear, to encourage testing, openness, honesty, and to most of all, remove the stigma associated with HIV+ people. The view is that human beings are naturally good. They don't want to spread HIV around. Very, very few want to willingly infect others, especially when they are given positive support and hope. Remove the fear, and they will get tested, live openly and honestly, and take steps to protect those around them. Research has shown that people do this and it works.

I do think that Chiacchia's public trial will have a chilling effect on people considering getting tested in Florida. It will put unnecessary stigma on HIV+ people and it almost definitely will lead to more people getting HIV than would have otherwise. Is that a fair tradeoff in the District Attourney's mind?

That's up to the prosecutors, and apparently their answer is yes.

Thu, Apr. 15th, 2010 10:43 pm (UTC)
pizzuti

I know the risk doesn't change, but the probability changes because of the fact that, while any one of the 100 exposures could have infection, whether you are infected or not is binary. So you have to subtract the chance of being already infected from new risk.