Criminal transmission of HIV

Criminal transmission of HIV is a series of laws criminalizing the intentional spread of HIV. This also includes not telling a sexual partner that you have HIV. HIV is a deadly infection transmitted by bodily fluids such as blood and semen, though blood has a 90% transmission rate. The United States Centers for Disease Control and Prevention documents laws relating to intentional spread of infection and or not disclosing HIV diagnosis to a sexual partner.

State laws
Laws relating to criminal transmission of HIV are always changing and may not be 100% accurate. Comprehensive sexual education does help in preventing the spread of STI's such as the use of condoms, though laws will still criminalize those that use controls including condoms and even if HIV is unsuccessfully transmitted.

Now an example of HIV laws in the state of Michigan:

Informed Consent Required: No

Pre-Test Counseling: Yes

Post-Test Counseling for All Who Test: Yes

Anonymous Testing Available: Yes

Testing must be available anonymously

Partner Notification Required: Yes

Notification to sexual partners of possible HIV exposure is required.

Updated laws on HIV consent would certainly would help reduce the spread of infection. Now Colorado has more in-depth laws preventing the spread of HIV infection. Here is a good example:

Informed Consent Required: Yes

Pre-Test Counseling: Yes

Counseling and testing sites must provide pre-test prevention and risk-reduction counseling.

Post-Test Counseling for All Who Test: Yes

Counseling and testing sites must provide post-test prevention and risk-reduction counseling. Post-test counseling is required for HIV positive test results. Counseling must be offered in the case of healthcare worker exposure.

Anonymous Testing Available: Yes

Testing must be made available anonymously. Anonymous testing is available at designated anonymous testing sites.

Partner Notification Required: No

Just HIV?
There are a number of very deadly diseases where limiting exposure to others could save lives. There are no laws forbidding MRSA patients from touching others, even though the disease has a very few treatment paths and a ~20% mortality rate. Influenza A-H5N1 has a 60% fatality rate in humans, but no laws forbid having the disease and knowingly propagating it. Or Ebola, with a 85% mortality rate. Maybe the very limited transmission vectors make people think about the ethics differently. More likely there's something icky about HIV, that scares people more than is warranted. There are however laws that mandate quarantining people with contagious diseases (e.g., tuberculosis), particularly during epidemics.

Problems and questionable effectiveness
On July 25th, 2017 at the International AIDS Society conference in Paris, France, new evidence was provided on the effectiveness of HIV treatments in curtailing transmission of the virus in serodiscordant couples—this time among gay male couples, building on similar effectiveness in heterosexual couples. These study results come on the heals of a conference held on June 30th, when the United States Centers for Disease Control and Prevention gathered leaders in HIV prevention for a momentous discussion on the impact that treatment has had on the sexual transmission of the HIV. Mounting empirical evidence since 2010 demonstrates that it is impossible for an HIV-positive individual, who is on treatment and completely suppressed the virus, to transmit the pathogen to their sexual partners — even in the absence of any other forms of protection. However, this growing body of scientific evidence, and current federal guidelines for the management of HIV, namely testing and treating, all run counter to outdated and discriminatory HIV criminalization laws, which continue to exist in the United States.

Given the historical belief that HIV was a primarily a homosexuality issue, the laws that criminalize transmission of HIV may have an unintended side effect of stigmatizing homosexuals, racial minorities (blacks, Hispanics, and intravenous drug users are more likely to have HIV), and women, though it further stigmatizes people with HIV in general. Additionally, these laws in the United States fail to decrease transmissions of HIV. According to the ProPublica analysis of 19 states, there have been at least 541 cases of people being prosecuted for not disclosing they are HIV-positive. One problem is that the laws fail to account for those that attempted to reduce the risk of transmitting the virus, even close to zero, yet they still become sentenced to several years in prison, even if the partner has not contracted the disease. Even methods that do not transmit HIV, such as spitting and scratching, or transmit in only extremely rare cases (biting) is enough for prosecution. Due to the disproportionate punishment and the "blame the victim" mentality that imposes a burden on the already-stigmatized people with HIV, major and harmful problem consequence is that discourage people from getting tested for HIV; if they do not know if they have HIV, they cannot be prosecuted. Indeed, a third of transmissions are from people who do not realize they have HIV, which is 30.2% of the approximately 45,000 new cases in 2009. Finally, the laws may not be necessary: even if someone is intentionally trying to spread HIV, they can be prosecuted under factors including statuary rape and reckless endangerment.

Taking problems into account, research suggests that the law is ineffective at reducing transmission rates; there is no relationship between these laws and HIV or AIDS diagnosis rates, and these laws fail to account for other major factors that spread HIV: lack of education, urban living, and proper care for those with HIV. In fact, a whopping 61.3% of the cases in 2009 came from those not in medical care, which prompted researchers for improvements in the care continuum. The fall of HIV in men in Britain is attributed to frequent testing and rapid developments in care such as anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) program. PrEP is available on the NHS but not everyone qualifies for it to be prescribed so some people in Britain source PrEP online to access the medicine, Similarly, France, Norway, and Belgium include it in their National Health System.