(PLWHA: People Living With HIV and AIDS)
Es mejor saber. It is better to know.
By Adesina
A Hispanic man beams a Colgate smile from the photograph with this tattooed on his muscular arm. It is an ad campaign for HIV testing. My first thought? I didn’t look nearly that happy when I found out my positive status.
Es mejor saber. It is better to know.
My second thought: Is it? Have we made it so?
HIV/AIDS “prevention” has turned a dark corner, to criminalization. Many states have disclosure laws that mandate PLWHAs disclose their status prior to sexual activity or other possible exposures, or risk jail if they fail to do so, even when protection was used or transmission failed to occur. Your name, physical address, and HIV status can be placed on sex offender registries in some states, becoming accessible to anyone with an iPhone application, putting already stigmatized PLWHAs at further risk for hate crimes.
Rather than allocating more funds toward media campaigns and education in schools and other social spheres conducted by PLWHAs, which would make them more visible, reduce fear around disclosure, and make testing a more likely choice for others, CDC resources are used to teach PLWHAs about safe sex and how to disclose, Yet this very disclosure might put us at risk for discrimination or violence if societal attitudes about PLWHAs are not simultaneously targeted in prevention efforts. This emphasis on educating PLWHAs assumes that people who know their status are responsible for the continued spread of the virus, rather than those not tested. This same assumption fuels “Test and Treat” public health approaches. Yet statistics demonstrate that the majority of transmissions occur between two people who did not know their status.
With criminalization and stigma, people who do not know their status are deterred from getting tested. Once you test positive, the burden of prevention is placed on you, and you alone, to stop the spread of the virus. You are targeted and further stigmatized by the law. You are banned from travel or immigration in multiple countries. You may face discrimination in housing, employment, access to insurance and quality health care. Some HIV+ people get their sexual partners to sign a release stating they were informed of their status, to avoid future prosecution. An HIV+ Michigan man was recently charged under anti-terrorism laws for using a biological weapon, because he bit his neighbor during a fight (the rate of transmission due to biting is .000000001 percent). In this case, we are not just considered criminals, but terrorists, our bodies the weapon. An HIV+ man in Texas is charged for spitting in the direction of a police officer, even though HIV is not transmitted via saliva. A Toledo sex worker is charged for soliciting undercover officers after she received a positive result in a women’s shelter. She faces five years in prison. Never mind her already criminalized occupation that created obstacles to accessing preventive care and education in the first place, or the race, class and gender inequities she confronts every day in her attempt to feed and house herself. Never mind men paying for sex are not equally criminalized, and can hand over all responsibility for protecting themselves from HIV to the woman they solicit. HIV+ children living on the streets often sell their bodies also, as a means to survival. Shall we lock them up too? Where is our humanity? And an HIV diagnosis itself impacts one’s inability to secure employment and housing, disproportionately leading to poverty, homelessness, and power dynamics in relationships. Economic justice for people living with and vulnerable to acquiring HIV is imperative to effective prevention measures.
Headlines on HIV prosecutions appear in the same papers with testing campaigns claiming it is better to know one’s status. We must examine this double message, and scrutinize the efficacy of fear-based criminalization as a prevention measure. The truth is, criminalization may actually contribute to the spread of the virus, rather then preventing it. This virus travels on stigma. Destigmatization should be our primary focus, not criminalization. We, as a culture, must squarely face our collective sexual shame. This virus will only be prevented when it is welcomed into the light of day. We must create a safe and compassionate culture within which PLWHAs can disclose their status, without fear. The responsibility for prevention must be shared by everyone, not just shouldered by those of us who know our status.
In my experience, PLWHAs take seriously our responsibility to protect others. Yet I also know the stigma and hatred that PLWHAs can face when disclosing, as well as the shock and denial accompanying this diagnosis. Some of us have more coping skills and support to come to terms with our status, than others. This is not to rationalize knowingly transmitting the virus, but to consider a more complex and layered picture, with all the human variables that make disclosure difficult, all of which coalesce around stigma and inequality.
Criminalization laws claim to protect women. Yet women are often the first in a partnership to learn of their positive status through prenatal testing, so are often blamed for ‘bringing HIV home’ to the partner. HIV+ women may fear partner violence with disclosure, and are statistically at far greater risk of gendered violence then their HIV- counterparts. This sometimes puts us in a position to not disclose or negotiate condom use within a sexual relationship with a power imbalance. Shall we jail women in this situation? Or attempt to correct the imbalance, making it safe for HIV+ women to disclose, as well as to demand condom use? Don’t believe women are being prosecuted? Just search the sex offender registries available online.
Criminalization dehumanizes PLWHAs, attempting prevention through strong-armed authoritarian fear, rather then education, destigmatization, and by addressing race, class, and gender inequities. The bottom line is that criminalization is not working. It is helping this preventable disease travel further and faster– in silence, in ignorance, in fear.
Es mejor saber. It is better to know.
May we make it truly so for all PLWHAs, and for those that approach getting tested. Otherwise, this statement is pure rhetoric. When PLWHAs are provided dignity and human rights, finding out you’re one of us will not be so feared. Getting tested will be a safe and likely option for those who don’t know their status, disclosure will be easier and safer, and the virus can be truly prevented as our common humanity is both acknowledged and restored.
Bio:
Addy is a woman in her late 30s, living positively with HIV. She is a writer, a performer, a gardener, and an activist with a human rights focus. She hopes to continue to use her writing and performance to educate and inform the public on the experiences and issues faced by people living with HIV and AIDS.