A Black Body On Trial: The Conviction of HIV Positive "Tiger Mandingo"
December 1, 2015 9:50 AM Subscribe
"In his final arguments to the jurors, Groenweghe called Johnson’s accusers “promiscuous.” Hands in his pockets, eyes downcast, he told the members of the jury that these young gay men “have a lifestyle I don’t understand, that many of us don’t understand. But, he said that HIV criminalization laws weren’t put on the books by legislators just to protect them, but to protect the public health — including the health of the jurors."
It's Time to End Bad HIV Laws!: In more than 30 states, people living with HIV can be tried and imprisoned simply because a partner accuses them of hiding their HIV status.
It's Time to End Bad HIV Laws!: In more than 30 states, people living with HIV can be tried and imprisoned simply because a partner accuses them of hiding their HIV status.
So I was reading this story and thinking: boy, was it shitty to be a gay man in the 90s and early aughts. But then it got to the bit about Johnson's Instagram and I realized that this happened in 2015. WTF?
posted by sparklemotion at 11:04 AM on December 1, 2015 [1 favorite]
posted by sparklemotion at 11:04 AM on December 1, 2015 [1 favorite]
1) If you're going around knowingly infecting people with incurable diseases, you should probably go to jail.
2) That trial was absolutely disgusting.
posted by pan at 11:10 AM on December 1, 2015
2) That trial was absolutely disgusting.
posted by pan at 11:10 AM on December 1, 2015
If you're going around knowingly infecting people with incurable diseases, you should probably go to jail.
And yet we don't prosecute unvaccinated children (or their parents) for spreading deadly diseases. HIV, treated correctly, is no longer a deadly disease.
posted by roomthreeseventeen at 11:12 AM on December 1, 2015 [23 favorites]
And yet we don't prosecute unvaccinated children (or their parents) for spreading deadly diseases. HIV, treated correctly, is no longer a deadly disease.
posted by roomthreeseventeen at 11:12 AM on December 1, 2015 [23 favorites]
1) If you're going around knowingly infecting people with incurable diseases, you should probably go to jail.
This isn't how most US public health law works. Quarantine laws are an exception, but they are typically applied to easily spreadable diseases in which the person who got infected doesn't really have a choice about engaging in the acts that might lead to infection and the manner in which those acts progress.
People support this in the case of HIV because they are fundamentally anti-sex moralists, and are frequently specifically homophobic.
posted by OmieWise at 11:17 AM on December 1, 2015 [13 favorites]
This isn't how most US public health law works. Quarantine laws are an exception, but they are typically applied to easily spreadable diseases in which the person who got infected doesn't really have a choice about engaging in the acts that might lead to infection and the manner in which those acts progress.
People support this in the case of HIV because they are fundamentally anti-sex moralists, and are frequently specifically homophobic.
posted by OmieWise at 11:17 AM on December 1, 2015 [13 favorites]
Good journalism from BuzzFeed? What's the world coming to?
posted by fordiebianco at 11:25 AM on December 1, 2015
posted by fordiebianco at 11:25 AM on December 1, 2015
I'm sure most of them mean well and try their best, but this story really paints public defenders in a bad light. For a lot of poor (read black) defendants, this is their only option for representation and too often it just sets them at an even greater disadvantage.
As a result, Johnson's case was decided during jury selection and the prosecutor basically ran the entire exercise. I hope that he gets a different lawyer to represent him through the appeal (the article wasn't clear as to whether this was the case or not).
posted by tommasz at 11:29 AM on December 1, 2015
As a result, Johnson's case was decided during jury selection and the prosecutor basically ran the entire exercise. I hope that he gets a different lawyer to represent him through the appeal (the article wasn't clear as to whether this was the case or not).
posted by tommasz at 11:29 AM on December 1, 2015
Good journalism from BuzzFeed? What's the world coming to?
Where have you been? The best investigative journalism in the world right now is coming from Buzzfeed and Cracked. Let that sink in for a second.
posted by Talez at 11:31 AM on December 1, 2015 [30 favorites]
Where have you been? The best investigative journalism in the world right now is coming from Buzzfeed and Cracked. Let that sink in for a second.
posted by Talez at 11:31 AM on December 1, 2015 [30 favorites]
The best investigative journalism in the world right now is coming from Buzzfeed and Cracked. Let that sink in for a second.
I was aware that VICE was really making headway in that department, but BuzzFeed? I must have been asleep on the wheel.
posted by fordiebianco at 11:33 AM on December 1, 2015 [2 favorites]
I was aware that VICE was really making headway in that department, but BuzzFeed? I must have been asleep on the wheel.
posted by fordiebianco at 11:33 AM on December 1, 2015 [2 favorites]
I was aware that VICE was really making headway in that department, but BuzzFeed? I must have been asleep on the wheel.
You must have missed the traffic fines/debtor prison story they did a little while ago.
posted by Talez at 11:38 AM on December 1, 2015 [2 favorites]
You must have missed the traffic fines/debtor prison story they did a little while ago.
posted by Talez at 11:38 AM on December 1, 2015 [2 favorites]
Total fucking travesty of justice.
"The soft-spoken former university student had shown up to court in a blue shirt and a bright red tie, but standing trial was his black, ejaculating, HIV-positive penis."
HIV criminalization needs to stop.
posted by Sophie1 at 11:41 AM on December 1, 2015 [4 favorites]
"The soft-spoken former university student had shown up to court in a blue shirt and a bright red tie, but standing trial was his black, ejaculating, HIV-positive penis."
HIV criminalization needs to stop.
posted by Sophie1 at 11:41 AM on December 1, 2015 [4 favorites]
1) If you're going around knowingly infecting people with incurable diseases, you should probably go to jail.
Regardless of any personal feelings with respect to an ethical obligation to disclose, growing evidence shows that legal obligations via HIV disclosure laws have been less than effective. These laws are predicated upon the assumption that the HIV+ person knows about their status, so if you're worried about prosecution, an easy workaround is to simply not get tested, thereby deliberately keeping yourself in the dark and pleading ignorance if someone else accuses you. I don't care for implying that the virus is no longer a big deal because it can be managed with "just a pill a day," but you are safer having sex with an HIV+ person with an undetectable viral load on PrEP than someone who doesn't know their status at all. So these disclosure laws are presumably making the HIV epidemic worse. This screams for reform at the very least. But then you have people digging in their heels and saying we can't let HIV+ people who don't disclose "get away with it," essentially putting self-righteous desire ahead of good public policy.
And yet we don't prosecute unvaccinated children (or their parents) for spreading deadly diseases.
I would totally be on board with prosecuting parents who fail to vaccinate their children (barring medical exemptions) if it causes an outbreak. But I'm not sure if that'd be good public policy or not, this is my lazily vengeful id speaking...
posted by imnotasquirrel at 11:52 AM on December 1, 2015 [12 favorites]
Regardless of any personal feelings with respect to an ethical obligation to disclose, growing evidence shows that legal obligations via HIV disclosure laws have been less than effective. These laws are predicated upon the assumption that the HIV+ person knows about their status, so if you're worried about prosecution, an easy workaround is to simply not get tested, thereby deliberately keeping yourself in the dark and pleading ignorance if someone else accuses you. I don't care for implying that the virus is no longer a big deal because it can be managed with "just a pill a day," but you are safer having sex with an HIV+ person with an undetectable viral load on PrEP than someone who doesn't know their status at all. So these disclosure laws are presumably making the HIV epidemic worse. This screams for reform at the very least. But then you have people digging in their heels and saying we can't let HIV+ people who don't disclose "get away with it," essentially putting self-righteous desire ahead of good public policy.
And yet we don't prosecute unvaccinated children (or their parents) for spreading deadly diseases.
I would totally be on board with prosecuting parents who fail to vaccinate their children (barring medical exemptions) if it causes an outbreak. But I'm not sure if that'd be good public policy or not, this is my lazily vengeful id speaking...
posted by imnotasquirrel at 11:52 AM on December 1, 2015 [12 favorites]
I'm not sure quite how I feel about the underlying issue. HIV is no longer an automatic death sentence, but it remains a very serious health concern. No one should have to wear a HELLO I AM HIV+ badge at all times once diagnosed, but if he did in fact actively lie about his status before engaging in unprotected sex repeatedly, that is unspeakably reckless. It's a shame that the trial was such a Mongolian clusterfuck, from these reports, that we may never know the whole truth as to who knew what and when.
Knock down the DEATH SENTENCE stigma of HIV/AIDS and is it then within reason for those who lie about major STD status to be prosecutable / subject to lawsuits? It's not unprecedented.
posted by delfin at 12:11 PM on December 1, 2015 [1 favorite]
Knock down the DEATH SENTENCE stigma of HIV/AIDS and is it then within reason for those who lie about major STD status to be prosecutable / subject to lawsuits? It's not unprecedented.
posted by delfin at 12:11 PM on December 1, 2015 [1 favorite]
The idea that it is good public policy to assume that disclosure laws make things worse is simply speculation.
On the other hand, we know for a fact that getting patients to adhere to 100% compliance is impossible: HIV will always exist because people will never stop contributing to the spread of HIV. And people aren't going to demand their partner take an HIV test before consenting to sex, even higher risk sex. The syphilis epidemic of the pre-antibiotics era shows us that the threat of disfigurement and death will not stop people from endangering themselves.
At best, jailing malefactors who knowingly place others at risk without informing them of that risk keeps them out of the general population where they would continue to do so, as well as making public their status. That may be helpful for stopping "patient 0" types who serve as hubs in an outbreak.
posted by deanc at 12:11 PM on December 1, 2015 [1 favorite]
On the other hand, we know for a fact that getting patients to adhere to 100% compliance is impossible: HIV will always exist because people will never stop contributing to the spread of HIV. And people aren't going to demand their partner take an HIV test before consenting to sex, even higher risk sex. The syphilis epidemic of the pre-antibiotics era shows us that the threat of disfigurement and death will not stop people from endangering themselves.
At best, jailing malefactors who knowingly place others at risk without informing them of that risk keeps them out of the general population where they would continue to do so, as well as making public their status. That may be helpful for stopping "patient 0" types who serve as hubs in an outbreak.
posted by deanc at 12:11 PM on December 1, 2015 [1 favorite]
Although the facts are lurid, this is what most felony trials are. A defendant facing overwhelming evidence against him who is completely delusional about his ability to sway a juror or two ... which results in a confident-seeming prosecutor and a weak-seeming defense attorney (not because she's a bad lawyer, but because you can't do anything with nothing) ... with the judge imposing the maximum as is the default for unrepentant crooks who go to trial and lose.
posted by MattD at 12:15 PM on December 1, 2015
posted by MattD at 12:15 PM on December 1, 2015
against him who is completely delusional about his ability to sway a juror or two
FTA: Of the 51 potential jurors, only one appeared to be nonwhite — a female, African-American retired nurse — and all identified as straight. Most looked to be in their fifties or older. During questioning, about half of the would-be jurors said being gay was a “choice.” Only a third agreed that being gay was “not a sin.” No potential juror acknowledged having HIV. All said they believed HIV-positive people who do not tell their sexual partners that they have the virus should be prosecuted. When asked, not a single person said they had any distrust of the police.
That's not delusion, that's having the deck stacked against you.
posted by roomthreeseventeen at 12:17 PM on December 1, 2015 [20 favorites]
FTA: Of the 51 potential jurors, only one appeared to be nonwhite — a female, African-American retired nurse — and all identified as straight. Most looked to be in their fifties or older. During questioning, about half of the would-be jurors said being gay was a “choice.” Only a third agreed that being gay was “not a sin.” No potential juror acknowledged having HIV. All said they believed HIV-positive people who do not tell their sexual partners that they have the virus should be prosecuted. When asked, not a single person said they had any distrust of the police.
That's not delusion, that's having the deck stacked against you.
posted by roomthreeseventeen at 12:17 PM on December 1, 2015 [20 favorites]
> The idea that it is good public policy to assume that disclosure laws make things worse is simply speculation.
There is no evidence that such laws actually make people disclose, or refrain from sexual activity.
> That may be helpful for stopping "patient 0" types who serve as hubs in an outbreak.
No evidence for that, either.
You know what served as a hub for one of the worst HIV outbreaks in recent US history? Indiana's lack of syringe exchanges and their appallingly terrible public health access and education. But try making *that* a criminal offense.
posted by rtha at 12:22 PM on December 1, 2015 [27 favorites]
There is no evidence that such laws actually make people disclose, or refrain from sexual activity.
> That may be helpful for stopping "patient 0" types who serve as hubs in an outbreak.
No evidence for that, either.
You know what served as a hub for one of the worst HIV outbreaks in recent US history? Indiana's lack of syringe exchanges and their appallingly terrible public health access and education. But try making *that* a criminal offense.
posted by rtha at 12:22 PM on December 1, 2015 [27 favorites]
It's quite clearly and demonstrably not about the disease. If it were, we'd have similar laws for infectious hepatitis. It's just bigotry.
posted by KathrynT at 12:32 PM on December 1, 2015 [16 favorites]
posted by KathrynT at 12:32 PM on December 1, 2015 [16 favorites]
And yet we don't prosecute unvaccinated children (or their parents) for spreading deadly diseases.
Well, A. we probably should, or at least quarantine unvaccinated children so they can't wreak havoc on herd immunity, and B. most of the diseases that are vaccinated against are curable and transient. If my kid gets measles because you don't vaccinate your kid, I think you should at minimum be on the hook for the medical expenses, but my kid will probably survive and get over measles. You can't really get over HIV. You can manage it with treatment, but that comes with caveats. Specifically:
HIV, treated correctly, is no longer a deadly disease.
"treated correctly" is a pretty big caveat to when treatment can run $36,000 per year.
I think the trial was disgusting for many of the standard reasons that trials in our criminal justice system are disgusting, including the jury selection and the weak defense offered by a probably-heavily-overworked-and-stressed PD, and the severity of the sentence was appalling, and that sentencing laws in general are out of control. But I also think that deceiving sexual partners about your health status for any STD should be a crime.
posted by protocoach at 12:34 PM on December 1, 2015 [3 favorites]
Well, A. we probably should, or at least quarantine unvaccinated children so they can't wreak havoc on herd immunity, and B. most of the diseases that are vaccinated against are curable and transient. If my kid gets measles because you don't vaccinate your kid, I think you should at minimum be on the hook for the medical expenses, but my kid will probably survive and get over measles. You can't really get over HIV. You can manage it with treatment, but that comes with caveats. Specifically:
HIV, treated correctly, is no longer a deadly disease.
"treated correctly" is a pretty big caveat to when treatment can run $36,000 per year.
I think the trial was disgusting for many of the standard reasons that trials in our criminal justice system are disgusting, including the jury selection and the weak defense offered by a probably-heavily-overworked-and-stressed PD, and the severity of the sentence was appalling, and that sentencing laws in general are out of control. But I also think that deceiving sexual partners about your health status for any STD should be a crime.
posted by protocoach at 12:34 PM on December 1, 2015 [3 favorites]
But I also think that deceiving sexual partners about your health status for any STD should be a crime.
it's not just a crime, it's a form of sexual assault - consent is informed consent
posted by pyramid termite at 12:39 PM on December 1, 2015 [9 favorites]
it's not just a crime, it's a form of sexual assault - consent is informed consent
posted by pyramid termite at 12:39 PM on December 1, 2015 [9 favorites]
But I also think that deceiving sexual partners about your health status for any STD should be a crime.
Why only sexual partners? Why only STDs? If your kid bites my kid on the playground when they're 18 months old and my kid gets chronic Hep B as a result, setting her up for a lifetime of terrible health consequences and expensive treatment, why is that different than if those same two kids have an encounter of a different kind that leaves one with HIV?
posted by KathrynT at 12:39 PM on December 1, 2015 [4 favorites]
Why only sexual partners? Why only STDs? If your kid bites my kid on the playground when they're 18 months old and my kid gets chronic Hep B as a result, setting her up for a lifetime of terrible health consequences and expensive treatment, why is that different than if those same two kids have an encounter of a different kind that leaves one with HIV?
posted by KathrynT at 12:39 PM on December 1, 2015 [4 favorites]
I'm not knowledgeable about the science, but I do remember from research* that the whole idea of identifying "patient zero" individuals who were powerful vectors for the spread of HIV turned out to be such bullshit, and contributed to fearmongering around AIDS and stigmatizing gay/MSM sexuality. HIV spread sporadically and inconsistently for a number of years before a major outbreak that probably had more to do with social and cultural changes in Kinshasa and elsewhere than with particularly promiscuous people. This myth is what leads to the idea that people like Michael L. Johnson should be regarded as major menaces to public health, rather than as people acting out what is most convenient for them.
*(wanted to write on a particular early AIDS case; might still get around to it someday)
posted by thetortoise at 12:39 PM on December 1, 2015 [6 favorites]
*(wanted to write on a particular early AIDS case; might still get around to it someday)
posted by thetortoise at 12:39 PM on December 1, 2015 [6 favorites]
In a previous discussion, there was no evidence provided that criminalization had any positive effect. There were, however, signs that it could have a negative one. For example:
Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial
Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial
People who lived in a state with a criminal law explicitly regulating sexual behavior of the HIV-infected were little different in their self-reported sexual behavior from people in a state without such a law. People who believed the law required the infected to practice safer sex or disclose their status reported being just as risky in their sexual behavior as those who did not. Our data do not support the proposition that passing a law prohibiting unsafe sex or requiring disclosure of infection influences people's normative beliefs about risky sex. Most people in our study believed that it was wrong to expose others to the virus and right to disclose infection to their sexual partners. These convictions were not influenced by the respondents' beliefs about the law or whether they lived in a state with such a law or not. Because law was not significantly influencing sexual behavior, our results also undermine the claim that such laws drive people with and or at risk of HIV away from health services and interventions.Oslo Declaration on HIV Criminalization (PDF)
We failed to refute the null hypothesis that criminal law has no influence on sexual risk behavior. Criminal law is not a clearly useful intervention for promoting disclosure by HIV+ people to their sex partners. Given concerns about possible negative effects of criminal law, such as stigmatization or reluctance to cooperate with health authorities, our findings suggest caution in deploying criminal law as a behavior change intervention for seropositives.
1. A growing body of evidence suggests that the criminalisation of HIV non-disclosure, potential exposure and non-intentional transmission is doing more harm than good in terms of its impact on public health and human rights.posted by zombieflanders at 12:42 PM on December 1, 2015 [13 favorites]
2. A better alternative to the use of the criminal law are measures that create an environment that enables people to seek testing, support and timely treatment, and to safely disclose their HIV status.
3. Although there may be a limited role for criminal law in rare cases in which people transmit HIV with malicious intent, we prefer to see people living with HIV supported and empowered from the moment of diagnosis, so that even these rare cases may be prevented. This requires a non-punitive, non-criminal HIV prevention approach centred within communities, where expertise about, and understanding of, HIV issues is best found.
4. Existing HIV-specific criminal laws should be repealed, in accordance with UNAIDS recommendations. If, following a thorough evidence-informed national review, HIV-related prosecutions are still deemed to be necessary they should be based on principles of proportionality, foreseeability, intent, causality and non-discrimination; informed by the most up-to-date HIV-related science and medical information; harm-based, rather than risk-of-harm based; and be consistent with both public health goals and international human rights obligations.
5. Where the general law can be, or is being, used for HIV-related prosecutions, the exact nature of the rights and responsibilities of people living with HIV under the law should be clarified, ideally through prosecutorial and police guidelines, produced in consultation with all key stakeholders, to ensure that police investigations are appropriate and to ensure that people with HIV have adequate access to justice.
They could simply make it a strict liability crime, meaning that you don't have to know that you have HIV to be liable for spreading it. But that would be a really serious restriction on people with HIV who wanted to have protected sex with consenting partners.
If disclosure or lack of knowledge were part of the liability (i.e., the expectation that someone would take "reasonable precautions" by being tested), then this does not strike me as a "serious" restriction. The basis of a lot of these public health initiatives is that it is basically impossible to get people to change their behavior, so we need to rely on behavior changes as little as possible and simply treat HIV as something that everyone is at risk of. At the same time, HIV prevention policies assume that we can convince the masses to use condoms regularly and adhere to a PrEP regimen.
And we already have legal frameworks to make people liable for the results of sex, namely child support. But civil liability does not provide any protection for the poor, who likely have equally poor partners that have no assets that can be seized by courts if they're found liable.
posted by deanc at 12:43 PM on December 1, 2015
If disclosure or lack of knowledge were part of the liability (i.e., the expectation that someone would take "reasonable precautions" by being tested), then this does not strike me as a "serious" restriction. The basis of a lot of these public health initiatives is that it is basically impossible to get people to change their behavior, so we need to rely on behavior changes as little as possible and simply treat HIV as something that everyone is at risk of. At the same time, HIV prevention policies assume that we can convince the masses to use condoms regularly and adhere to a PrEP regimen.
And we already have legal frameworks to make people liable for the results of sex, namely child support. But civil liability does not provide any protection for the poor, who likely have equally poor partners that have no assets that can be seized by courts if they're found liable.
posted by deanc at 12:43 PM on December 1, 2015
And more here:
Criminalisation of HIV Exposure and Transmission: A Global Review (PDF)
Criminalisation of HIV Exposure and Transmission: A Global Review (PDF)
11.7 Fifth, criminalisation is insidious in its effects, whether or not the criminal law is enforced extensively (as in highincome countries) or not (as in Africa). Testimony for the High-Income Countries Dialogue (from North America in particular) demonstrates the racialised dimensions of criminalisation, where a disproportionate number of people from minority ethnic communities are prosecuted, thus reinforcing negative and harmful stereotypes so fuelling HIV-related discrimination and prejudice. The Africa Regional Dialogue, in contrast, drew attention to the ways in which the position and treatment of women are adversely impacted by laws framed ostensibly at protecting people living with HIV. The Caribbean and Latin America Regional Dialogues provided evidence, too, of the ways in which people living with HIV who fall foul of criminal law in ways not related directly to HIV transmission and exposure, may be affected where prisons fail to provide the means of minimising risk (through, for example, the provision of condoms), thereby increasing the likelihood of criminal liability where sex takes place.posted by zombieflanders at 12:45 PM on December 1, 2015 [9 favorites]
11.8 Sixth, the paper has shown how – in the absence of decriminalisation – prosecution guidance and education of criminal justice personnel can have a beneficial impact in terms of limiting, or restricting, prosecutions to the most egregious and clear-cut cases. Such guidance (as that which has been developed by the CPS, in collaboration with national HIV/AIDS NGOs and others) may not only serve as an educative tool, but – by increasing understanding of the significance of viral load and the limitations of phylogenetic analysis evidence – may serve to reduce the number of potential miscarriages of justice (arising, for example, from guilty pleas by those against whom the evidence is in fact insufficient to meet the criminal standard of proof ).
(I wasn't claiming that a "patient 0" actually existed and was responsible for HIV, but rather that some people in any STI outbreak end up serving as a significant hub, as one would expect in a situation that lends itself to the 80/20 rules)
posted by deanc at 12:46 PM on December 1, 2015
posted by deanc at 12:46 PM on December 1, 2015
No-one with an undetectable viral load, gay or heterosexual, transmits HIV in first two years of PARTNER study.
Folks who know they are HIV positive and are medicated for it aren't the problem. It's the people who DON'T know they're HIV-positive who have detectable viral loads in their system who can easily spread the disease, and criminalizing nondisclosure is a hell of an incentive to not get tested. Also,
There’s a Drug That Prevents HIV. Let’s Use It. PreP basically eliminates the possibility of contracting HIV, so why is risky behavior only the responsibility of the person who has the disease, and not the person who is at risk? There is medication you can take to keep yourself from getting this disease. If you want to engage in risky sexual activities, it should also be on your shoulders to protect yourself.
posted by xingcat at 12:57 PM on December 1, 2015 [9 favorites]
Folks who know they are HIV positive and are medicated for it aren't the problem. It's the people who DON'T know they're HIV-positive who have detectable viral loads in their system who can easily spread the disease, and criminalizing nondisclosure is a hell of an incentive to not get tested. Also,
There’s a Drug That Prevents HIV. Let’s Use It. PreP basically eliminates the possibility of contracting HIV, so why is risky behavior only the responsibility of the person who has the disease, and not the person who is at risk? There is medication you can take to keep yourself from getting this disease. If you want to engage in risky sexual activities, it should also be on your shoulders to protect yourself.
posted by xingcat at 12:57 PM on December 1, 2015 [9 favorites]
(I wasn't claiming that a "patient 0" actually existed and was responsible for HIV, but rather that some people in any STI outbreak end up serving as a significant hub, as one would expect in a situation that lends itself to the 80/20 rules)
But that's the point I'm trying to make, if rather awkwardly: that who these "hubs" (individuals with undisclosed status and large number of partners) are doesn't matter much for the spread of disease, and, regardless of how you feel about the ethics, trying to identify and punish them is counterproductive from a public health standpoint. That's the history of AIDS, anyway.
posted by thetortoise at 12:57 PM on December 1, 2015
But that's the point I'm trying to make, if rather awkwardly: that who these "hubs" (individuals with undisclosed status and large number of partners) are doesn't matter much for the spread of disease, and, regardless of how you feel about the ethics, trying to identify and punish them is counterproductive from a public health standpoint. That's the history of AIDS, anyway.
posted by thetortoise at 12:57 PM on December 1, 2015
But I also think that deceiving sexual partners about your health status for any STD should be a crime.
it's not just a crime, it's a form of sexual assault - consent is informed consent
No. It's not.
I've been raped. My husband is HIV+. Not disclosing STIs is NOTHING like rape or sexual assault.
posted by Sophie1 at 12:57 PM on December 1, 2015 [17 favorites]
it's not just a crime, it's a form of sexual assault - consent is informed consent
No. It's not.
I've been raped. My husband is HIV+. Not disclosing STIs is NOTHING like rape or sexual assault.
posted by Sophie1 at 12:57 PM on December 1, 2015 [17 favorites]
Between this article, and comments and links here on Metafilter, I'm convinced that criminalization of non-disclosure is ineffective. However, what about criminalization of lying about status or test results?
Like, it's one thing if a partner doesn't ask, or if a partner asks and the answer is "I haven't been tested recently." But if someone asks if you have any STIs, and you claim recent tests came back negative, and that's a lie, surely that should be criminal, right? Like, that isn't what they're claiming the defendant did here, but there's got to be a line where it crosses from unethical to actively harmful, no?
posted by explosion at 1:10 PM on December 1, 2015
Like, it's one thing if a partner doesn't ask, or if a partner asks and the answer is "I haven't been tested recently." But if someone asks if you have any STIs, and you claim recent tests came back negative, and that's a lie, surely that should be criminal, right? Like, that isn't what they're claiming the defendant did here, but there's got to be a line where it crosses from unethical to actively harmful, no?
posted by explosion at 1:10 PM on December 1, 2015
(Argh, I explained that poorly. But anybody who happens to want more detail on how the "patient zero" narrative has affected how we criminalize HIV and has damaged understanding of how epidemics spread should look into Richard McKay's work, e.g. Carry on.)
posted by thetortoise at 1:12 PM on December 1, 2015
posted by thetortoise at 1:12 PM on December 1, 2015
But that's the point I'm trying to make, if rather awkwardly: that who these "hubs" (individuals with undisclosed status and large number of partners) are doesn't matter much for the spread of disease, and, regardless of how you feel about the ethics, trying to identify and punish them is counterproductive from a public health standpoint. That's the history of AIDS, anyway.
I'd like to see the studies on that, because I know that anecdotally, when I worked at a first-line STD clinic, and worked closely with field epidemiologists, we were able to stop outbreaks of both syphilis and HIV by network analysis and treatment of particular sex workers.
posted by OmieWise at 1:13 PM on December 1, 2015
I'd like to see the studies on that, because I know that anecdotally, when I worked at a first-line STD clinic, and worked closely with field epidemiologists, we were able to stop outbreaks of both syphilis and HIV by network analysis and treatment of particular sex workers.
posted by OmieWise at 1:13 PM on December 1, 2015
If people who don't disclose STIs should be prosecuted, then every fucker who goes to work with the signs of the flu should be prosecuted. Every parent who chooses not to vaccinate their children should be prosecuted. Every person who hasn't been to the doctor despite that discharge should be prosecuted. Every person who comes back to the U.S. with Ebola should be prosecuted. Every person who travels to Yosemite and picks up bubonic plague needs to be prosecuted. Let's just start prosecuting everyone who transmits a disease.
OmieWise - there is a gigantic difference between identification and treatment and identification and punishment.
This is obviously a very personal issue for me and pardons if I'm a little worked up.
posted by Sophie1 at 1:15 PM on December 1, 2015 [15 favorites]
OmieWise - there is a gigantic difference between identification and treatment and identification and punishment.
This is obviously a very personal issue for me and pardons if I'm a little worked up.
posted by Sophie1 at 1:15 PM on December 1, 2015 [15 favorites]
But if someone asks if you have any STIs, and you claim recent tests came back negative, and that's a lie, surely that should be criminal, right?
But why? I mean, maybe I'm in the generation that grew up with HIV, where we were told that protection was everyone's responsibility.
posted by roomthreeseventeen at 1:18 PM on December 1, 2015 [2 favorites]
But why? I mean, maybe I'm in the generation that grew up with HIV, where we were told that protection was everyone's responsibility.
posted by roomthreeseventeen at 1:18 PM on December 1, 2015 [2 favorites]
Fantastic comment Sophie1
posted by biggreenplant at 1:19 PM on December 1, 2015 [1 favorite]
posted by biggreenplant at 1:19 PM on December 1, 2015 [1 favorite]
Let's just start prosecuting everyone who transmits a disease.
Not all diseases are the same, and while HIV isn't an automatic death sentence, treatment is no walk in the park, either.
posted by a lungful of dragon at 1:20 PM on December 1, 2015 [4 favorites]
Not all diseases are the same, and while HIV isn't an automatic death sentence, treatment is no walk in the park, either.
posted by a lungful of dragon at 1:20 PM on December 1, 2015 [4 favorites]
OmieWise - there is a gigantic difference between identification and treatment and identification and punishment.
Absolutely, and I think the punishment people are very wrong. I just think that at least anecdotally, the epidemiology does support the notion that there are network hubs who are more likely to be vectors of transmission than people who are not a hub.
I am firmly a test and treater.
posted by OmieWise at 1:21 PM on December 1, 2015 [4 favorites]
Absolutely, and I think the punishment people are very wrong. I just think that at least anecdotally, the epidemiology does support the notion that there are network hubs who are more likely to be vectors of transmission than people who are not a hub.
I am firmly a test and treater.
posted by OmieWise at 1:21 PM on December 1, 2015 [4 favorites]
If any of you arguing for criminalization of HIV are against the U.S.'s War on Drugs, you may want to stop and think about how many of the reasons the War on Drugs is horrible would apply equally to a Criminal War on HIV.
posted by jaguar at 1:35 PM on December 1, 2015 [5 favorites]
posted by jaguar at 1:35 PM on December 1, 2015 [5 favorites]
But why? I mean, maybe I'm in the generation that grew up with HIV, where we were told that protection was everyone's responsibility.
How about this: If you tell me you are allergic to peanuts and ask if there are peanuts in the cookies I baked and I tell you there are no peanuts despite knowing with certainly that this is a lie and you eat a cookie and end up in the hospital that would be criminal, yes? This seems like the same thing. Lying about it, I mean. Not simply being unethical and not disclosing.
posted by Justinian at 1:36 PM on December 1, 2015 [4 favorites]
How about this: If you tell me you are allergic to peanuts and ask if there are peanuts in the cookies I baked and I tell you there are no peanuts despite knowing with certainly that this is a lie and you eat a cookie and end up in the hospital that would be criminal, yes? This seems like the same thing. Lying about it, I mean. Not simply being unethical and not disclosing.
posted by Justinian at 1:36 PM on December 1, 2015 [4 favorites]
I'd like to share my husband's treatment regimen. Every morning he gets up and pops 7 pills. Four are for HIV. One is for herpes, two are Vitamin A capsules for a chronic skin rash that may or may not be HIV related.
Now I'd like to share my treatment regimen. Every morning I get up and pop 9 pills. Six are for chronic depression (in remission, thank Maude). One is for PCOS, 1 is for allergies and 1 is for anemia.
I'm not crying for his difficult regimen and he's not crying for mine. We all get dealt a hand. HIV is a hand. It is not a deadly hand, if treated. Depression is a hand. It is sometimes a deadly hand, even when treated.
posted by Sophie1 at 1:37 PM on December 1, 2015 [7 favorites]
Now I'd like to share my treatment regimen. Every morning I get up and pop 9 pills. Six are for chronic depression (in remission, thank Maude). One is for PCOS, 1 is for allergies and 1 is for anemia.
I'm not crying for his difficult regimen and he's not crying for mine. We all get dealt a hand. HIV is a hand. It is not a deadly hand, if treated. Depression is a hand. It is sometimes a deadly hand, even when treated.
posted by Sophie1 at 1:37 PM on December 1, 2015 [7 favorites]
If you tell me you are allergic to peanuts and ask if there are peanuts in the cookies I baked and I tell you there are no peanuts despite knowing with certainly that this is a lie and you eat a cookie and end up in the hospital that would be criminal, yes?
That's not a good analogy. Nor do I think it's criminal.
posted by roomthreeseventeen at 1:38 PM on December 1, 2015 [4 favorites]
That's not a good analogy. Nor do I think it's criminal.
posted by roomthreeseventeen at 1:38 PM on December 1, 2015 [4 favorites]
Also, a lungful of dragon, if I ever had the choice, knowing everything I know about HIV, I'd rather have HIV than about a billion other diseases and conditions that are less well-investigated and less treatable. I'd rather have HIV than almost any cancer that I can think of at this point, save basal cell carcinoma.
posted by Sophie1 at 1:45 PM on December 1, 2015 [2 favorites]
posted by Sophie1 at 1:45 PM on December 1, 2015 [2 favorites]
As several people have pointed out, there's plenty of empirical evidence that criminalization doesn't work from a public health perspective. It does, however, work as a discriminatory tactic to give DA's another way to punish people. Having said that...
It's a difficult question. People do not make rational choices when they are filled with hormones. Let's let it play out this way: you're a reasonable smart person, you're really into someone, things get started, they tell you they're HIV+, and push back about continuing any unsafe activity. You push forward because ... HORMONES == not thinking rationally ... and here you are, making a poor choice, even given the information.
And you get the results, and you're positive. And shame pours over you, and you say "he never disclosed". Maybe you even believe it. Maybe you say it because too many of your friends blame you, and you need a scape goat.
This is the problem. Human beings are irrational creatures.
I say this as someone who was in a serodiscordant relationship with someone HIV+. I can tell you that even with many years of knowledge and time spent educating others, there were a couple occasions where poor decisions ALMOST happened. ALMOST. You want to tell me everyone is going to behave perfectly? Everyone uses condoms 100%?
You need to find a new species to talk about.
posted by petrilli at 1:49 PM on December 1, 2015 [4 favorites]
It's a difficult question. People do not make rational choices when they are filled with hormones. Let's let it play out this way: you're a reasonable smart person, you're really into someone, things get started, they tell you they're HIV+, and push back about continuing any unsafe activity. You push forward because ... HORMONES == not thinking rationally ... and here you are, making a poor choice, even given the information.
And you get the results, and you're positive. And shame pours over you, and you say "he never disclosed". Maybe you even believe it. Maybe you say it because too many of your friends blame you, and you need a scape goat.
This is the problem. Human beings are irrational creatures.
I say this as someone who was in a serodiscordant relationship with someone HIV+. I can tell you that even with many years of knowledge and time spent educating others, there were a couple occasions where poor decisions ALMOST happened. ALMOST. You want to tell me everyone is going to behave perfectly? Everyone uses condoms 100%?
You need to find a new species to talk about.
posted by petrilli at 1:49 PM on December 1, 2015 [4 favorites]
If any of you arguing for criminalization of HIV are against the U.S.'s War on Drugs, you may want to stop and think about how many of the reasons the War on Drugs is horrible would apply equally to a Criminal War on HIV.
Obviously, the same racial and socioeconomic inequities that exist throughout our justice system will arise anywhere the justice system interacts with people. I don't think that means we should get rid of our justice system, I think it means we should improve it. Also separating STD transmission from drug use is that drug use harms, at most, the person taking the drug. HIV harms you and the person you are exposing to it, and if you harm somebody else without their consent (and sometimes even with or despite their consent, although that's a much murkier legal area), that is usually something that laws are formulated to prevent.
We all get dealt a hand. HIV is a hand. It is not a deadly hand, if treated. Depression is a hand. It is sometimes a deadly hand, even when treated.
Except HIV is something that is infectiously transmitted from another person. I can't say "I got depression from Jim." I can say "I got HIV from Jim." How far are we taking this "everybody gets dealt a hand that we just have to cope with" logic, anyway? If Jim robs me, is that just the hand I'm dealt? If he cuts off my arm, is that just the hand I'm dealt? I can live without my stuff. I can live without an arm, or even without both arms. Life without my stuff, or life without my arm(s), is likely to be worse, Jim has caused me harm in both cases, but I'm alive. I would certainly choose life without my arm over terminal cancer. I'm not sure "I would choose X over cancer" is a great metric, though.
posted by protocoach at 1:52 PM on December 1, 2015
Obviously, the same racial and socioeconomic inequities that exist throughout our justice system will arise anywhere the justice system interacts with people. I don't think that means we should get rid of our justice system, I think it means we should improve it. Also separating STD transmission from drug use is that drug use harms, at most, the person taking the drug. HIV harms you and the person you are exposing to it, and if you harm somebody else without their consent (and sometimes even with or despite their consent, although that's a much murkier legal area), that is usually something that laws are formulated to prevent.
We all get dealt a hand. HIV is a hand. It is not a deadly hand, if treated. Depression is a hand. It is sometimes a deadly hand, even when treated.
Except HIV is something that is infectiously transmitted from another person. I can't say "I got depression from Jim." I can say "I got HIV from Jim." How far are we taking this "everybody gets dealt a hand that we just have to cope with" logic, anyway? If Jim robs me, is that just the hand I'm dealt? If he cuts off my arm, is that just the hand I'm dealt? I can live without my stuff. I can live without an arm, or even without both arms. Life without my stuff, or life without my arm(s), is likely to be worse, Jim has caused me harm in both cases, but I'm alive. I would certainly choose life without my arm over terminal cancer. I'm not sure "I would choose X over cancer" is a great metric, though.
posted by protocoach at 1:52 PM on December 1, 2015
I suspect the difference between those arguing for criminalization and those arguing against is the number of actual HIV+ people they know.
posted by petrilli at 1:57 PM on December 1, 2015 [5 favorites]
posted by petrilli at 1:57 PM on December 1, 2015 [5 favorites]
Most cancers, with specific exceptions, are not known to be transmissible in the ways that HIV spreads, but are the result of some event that causes aberrant cell division, most often caused by genetics or environmental exposure to carcinogens. I'm not sure cancer is a useful comparison. If anything, really, laws against dumping cancer-causing chemicals into the sewer are useful, important, and not some kind of weird infringement on the rights of polluters to pollute.
I'm not for criminalization of HIV status, and I'd agree 100% that this individual was put on trial and convicted by a straight jury for having gay sex, but I'm not for the premise that being infected with HIV is like having a three-day run of the sniffles, either, or that discussing your status with partners should be optional in a modern society. It's a serious disease for the afflicted and also for the public health system fighting to control the spread of that disease.
posted by a lungful of dragon at 1:58 PM on December 1, 2015 [3 favorites]
I'm not for criminalization of HIV status, and I'd agree 100% that this individual was put on trial and convicted by a straight jury for having gay sex, but I'm not for the premise that being infected with HIV is like having a three-day run of the sniffles, either, or that discussing your status with partners should be optional in a modern society. It's a serious disease for the afflicted and also for the public health system fighting to control the spread of that disease.
posted by a lungful of dragon at 1:58 PM on December 1, 2015 [3 favorites]
It seems to me we're arguing for the conviction of someone over a he-said/he-said trial. At that point, the trial is not about truth, but about prejudice. I bet if you were talking about a white man accused of infecting a black man, the outcome would not have been the same.
posted by petrilli at 1:59 PM on December 1, 2015
posted by petrilli at 1:59 PM on December 1, 2015
It seems to me we're arguing for the conviction of someone over a he-said/he-said trial. At that point, the trial is not about truth, but about prejudice. I bet if you were talking about a white man accused of infecting a black man, the outcome would not have been the same.
I agree with you regarding the specific trial in the story, and as far as I can tell, no one is arguing that this was a fair trial and all the people here who support laws requiring disclosure believe this trial was shady.
That said, your contributions so far have been implying, with zero evidence, that no one supporting disclosure laws knows people with HIV, and offering up a scenario describing how someone could falsely accuse someone else of failing to disclose, where you explain away those interactions as people getting carried away by hormones and regretting it later. That's victim-blaming, it's extremely similar to how people frequently try to discredit rape victims, and I suspect it's just as inaccurate here as it is in those situations.
posted by protocoach at 2:08 PM on December 1, 2015 [1 favorite]
I agree with you regarding the specific trial in the story, and as far as I can tell, no one is arguing that this was a fair trial and all the people here who support laws requiring disclosure believe this trial was shady.
That said, your contributions so far have been implying, with zero evidence, that no one supporting disclosure laws knows people with HIV, and offering up a scenario describing how someone could falsely accuse someone else of failing to disclose, where you explain away those interactions as people getting carried away by hormones and regretting it later. That's victim-blaming, it's extremely similar to how people frequently try to discredit rape victims, and I suspect it's just as inaccurate here as it is in those situations.
posted by protocoach at 2:08 PM on December 1, 2015 [1 favorite]
So, do you support prosecution of people with the flu who travel on subways or airplanes?
posted by Sophie1 at 2:12 PM on December 1, 2015 [1 favorite]
posted by Sophie1 at 2:12 PM on December 1, 2015 [1 favorite]
That's not a good analogy. Nor do I think it's criminal.
I'm no expert but I'd be surprised to learn that intentionally inducing anaphylactic shock in a person, and against their wishes, is an act that would result and, if I understand you right, should result in no legal sanction. Can you elaborate?
posted by mrbigmuscles at 2:12 PM on December 1, 2015
I'm no expert but I'd be surprised to learn that intentionally inducing anaphylactic shock in a person, and against their wishes, is an act that would result and, if I understand you right, should result in no legal sanction. Can you elaborate?
posted by mrbigmuscles at 2:12 PM on December 1, 2015
I understand you right
Sorry, I meant I don't think it is currently illegal.
posted by roomthreeseventeen at 2:15 PM on December 1, 2015 [1 favorite]
Sorry, I meant I don't think it is currently illegal.
posted by roomthreeseventeen at 2:15 PM on December 1, 2015 [1 favorite]
> Except HIV is something that is infectiously transmitted from another person.
Like HPV, some strains of which can cause cervical cancer. But surely everyone here who has sex with women knows their own HPV status, and what strain(s) they may be carrying, and always inform their partners.
posted by rtha at 2:17 PM on December 1, 2015 [5 favorites]
Like HPV, some strains of which can cause cervical cancer. But surely everyone here who has sex with women knows their own HPV status, and what strain(s) they may be carrying, and always inform their partners.
posted by rtha at 2:17 PM on December 1, 2015 [5 favorites]
Fair enough, my bad.
posted by mrbigmuscles at 2:26 PM on December 1, 2015
posted by mrbigmuscles at 2:26 PM on December 1, 2015
So, do you support prosecution of people with the flu who travel on subways or airplanes?
Flu and HIV are not equivalent, so, no.
Sorry, I meant I don't think it is currently illegal.
There isn't much data out there about it, but I believe it would be illegal. Here's a case where a 19 year old was convicted of simple assault after smearing peanut butter on the face of someone he knew had a peanut allergy.
That doesn't make it just to send him to prison for 30 years.
I agree. Sentencing in this country is out of control and inhumane.
posted by protocoach at 2:27 PM on December 1, 2015
Flu and HIV are not equivalent, so, no.
Sorry, I meant I don't think it is currently illegal.
There isn't much data out there about it, but I believe it would be illegal. Here's a case where a 19 year old was convicted of simple assault after smearing peanut butter on the face of someone he knew had a peanut allergy.
That doesn't make it just to send him to prison for 30 years.
I agree. Sentencing in this country is out of control and inhumane.
posted by protocoach at 2:27 PM on December 1, 2015
Mod note: A few comments deleted. MattD, that just looks like picking a fight, please don't, it's already a difficult enough topic for people here. roomthreeseventeen, please take a step back and don't respond to every little thing in your own thread.
posted by LobsterMitten (staff) at 2:29 PM on December 1, 2015
posted by LobsterMitten (staff) at 2:29 PM on December 1, 2015
That's victim-blaming, it's extremely similar to how people frequently try to discredit rape victims, and I suspect it's just as inaccurate here as it is in those situations.
It isn't victim blaming. It is people taking responsibility for their own decisions. Rape is a completely different scenario, and the conflation of the two belies a lack of understanding of consent. I realize that the idea that people might "misremember" discussions seems similar, however.
Choosing to have unprotected sex with someone, whether they claim to be negative or not, represents an acceptance of some amount of risk (the actual amount depends on too many variables), but given the roles described in the case, any bottom who decides to have unprotected sex with someone is accepting some amount of risk. They are doing so willingly. They may be accepting more, or less depending on honesty, but it is never zero v 100%. Unprotected sex with someone who is HIV+ and untreated is not a guaranteed infection. Protected sex with someone who says they're HIV- is not 100% safe.
I had a long conversation with a public health person in DC managing a program on adherence to medication for HIV+ individuals. The summation, statistically, is that it was safer to have unprotected sex with someone who was HIV+, but on HAART, than it was to have unprotected sex with someone who said they were negative. This is a result of the unique situation DC finds itself in.
Remember this: the only person absolutely telling the truth is the person who says they're positive. Everyone else may be lying or may not even be aware. When you choose to have sex with someone, you own that decision. You must calculate those risks based on that reality, and not on some fantasy you think exists in the world.
posted by petrilli at 2:37 PM on December 1, 2015 [7 favorites]
It isn't victim blaming. It is people taking responsibility for their own decisions. Rape is a completely different scenario, and the conflation of the two belies a lack of understanding of consent. I realize that the idea that people might "misremember" discussions seems similar, however.
Choosing to have unprotected sex with someone, whether they claim to be negative or not, represents an acceptance of some amount of risk (the actual amount depends on too many variables), but given the roles described in the case, any bottom who decides to have unprotected sex with someone is accepting some amount of risk. They are doing so willingly. They may be accepting more, or less depending on honesty, but it is never zero v 100%. Unprotected sex with someone who is HIV+ and untreated is not a guaranteed infection. Protected sex with someone who says they're HIV- is not 100% safe.
I had a long conversation with a public health person in DC managing a program on adherence to medication for HIV+ individuals. The summation, statistically, is that it was safer to have unprotected sex with someone who was HIV+, but on HAART, than it was to have unprotected sex with someone who said they were negative. This is a result of the unique situation DC finds itself in.
Remember this: the only person absolutely telling the truth is the person who says they're positive. Everyone else may be lying or may not even be aware. When you choose to have sex with someone, you own that decision. You must calculate those risks based on that reality, and not on some fantasy you think exists in the world.
posted by petrilli at 2:37 PM on December 1, 2015 [7 favorites]
So, do you support prosecution of people with the flu who travel on subways or airplanes?
I don't even support prosecution of people with HIV, but I'll answer your question.
If a "superflu" influenza strain arrives that is more virulent or leads to higher mortality rates, I would support potentially involuntary measures that isolate carriers from larger populations and quarantine exposed populations, in order to keep the spread of disease under control. Our president already directs his cabinet to do this for communicable respiratory diseases like SARS and MERS.
But, again, HIV is not like these diseases: it is disease that is largely avoidable through reasonable measures, like using condoms or cleaning needles, and by communicating status. It doesn't spread through airborne mechanisms, and it isn't as virulent as the common flu. Again, I really don't think it makes much sense to call HIV infection just another disease, or to treat it like it's just a case of the sniffles.
posted by a lungful of dragon at 2:43 PM on December 1, 2015 [7 favorites]
I don't even support prosecution of people with HIV, but I'll answer your question.
If a "superflu" influenza strain arrives that is more virulent or leads to higher mortality rates, I would support potentially involuntary measures that isolate carriers from larger populations and quarantine exposed populations, in order to keep the spread of disease under control. Our president already directs his cabinet to do this for communicable respiratory diseases like SARS and MERS.
But, again, HIV is not like these diseases: it is disease that is largely avoidable through reasonable measures, like using condoms or cleaning needles, and by communicating status. It doesn't spread through airborne mechanisms, and it isn't as virulent as the common flu. Again, I really don't think it makes much sense to call HIV infection just another disease, or to treat it like it's just a case of the sniffles.
posted by a lungful of dragon at 2:43 PM on December 1, 2015 [7 favorites]
Like HPV, some strains of which can cause cervical cancer. But surely everyone here who has sex with women knows their own HPV status, and what strain(s) they may be carrying, and always inform their partners.
I was unaware that a reliable blood test for HPV (or herpes) was developed in the past decade.
posted by MikeKD at 3:04 PM on December 1, 2015
I was unaware that a reliable blood test for HPV (or herpes) was developed in the past decade.
posted by MikeKD at 3:04 PM on December 1, 2015
Mod note: One comment deleted. Please drop the "this is like rape" analogy, seriously.
posted by LobsterMitten (staff) at 3:06 PM on December 1, 2015 [4 favorites]
posted by LobsterMitten (staff) at 3:06 PM on December 1, 2015 [4 favorites]
I'm no expert but I'd be surprised to learn that intentionally inducing anaphylactic shock in a person, and against their wishes, is an act that would result and, if I understand you right, should result in no legal sanction. Can you elaborate?
roomthreeseventeen is wrong. Well, he/she (sorry I don't know which is correct!) may be right about it being a poor analogy (though I disagree) but it most certain is criminal.
posted by Justinian at 3:15 PM on December 1, 2015 [1 favorite]
roomthreeseventeen is wrong. Well, he/she (sorry I don't know which is correct!) may be right about it being a poor analogy (though I disagree) but it most certain is criminal.
posted by Justinian at 3:15 PM on December 1, 2015 [1 favorite]
it most certain is criminal
In what jurisdiction? I'm certainly willing to believe its criminal in some places, but I doubt its criminal worldwide. The specific example also said that the person knowingly lied about peanuts being in there, but did not clarify if the person "intentionally induced anaphylactic shock". Those are VERY different claims.
The original statement:
If you tell me you are allergic to peanuts and ask if there are peanuts in the cookies I baked and I tell you there are no peanuts despite knowing with certainly that this is a lie and you eat a cookie and end up in the hospital that would be criminal, yes?
So lying about the presence of allergens is itself criminal? Intentionally inducing anaphylactic shock is a more serious charge than simply lying about allergens, which _might_ cause that but is not the same as intentionally causing that (like degrees of murder).
posted by thefoxgod at 3:31 PM on December 1, 2015 [1 favorite]
In what jurisdiction? I'm certainly willing to believe its criminal in some places, but I doubt its criminal worldwide. The specific example also said that the person knowingly lied about peanuts being in there, but did not clarify if the person "intentionally induced anaphylactic shock". Those are VERY different claims.
The original statement:
If you tell me you are allergic to peanuts and ask if there are peanuts in the cookies I baked and I tell you there are no peanuts despite knowing with certainly that this is a lie and you eat a cookie and end up in the hospital that would be criminal, yes?
So lying about the presence of allergens is itself criminal? Intentionally inducing anaphylactic shock is a more serious charge than simply lying about allergens, which _might_ cause that but is not the same as intentionally causing that (like degrees of murder).
posted by thefoxgod at 3:31 PM on December 1, 2015 [1 favorite]
That article made me mad just reading it, that trial was a train-wreck in so many different ways. One part of the buzzfeed article I found disappointing was how it dealt with why criminalizing HIV transmission is bad, or more specifically how it kind of didn't?
The article, and this thread really, got really hung up on HIV no longer being the death sentence it used to be. Which speaks to how the world has changed from when the laws were created (plus bigotry of course), but I don't think is terribly relevant in explaining why a law shouldn't exist any more. There are lots of things that are illegal but also won't kill you (for a silly example, if I punch some stranger in the face it is illegal but definitely not fatal), it just isn't a very good argument by itself. I feel like that whole line of reasoning is just a distraction and will never be all that compelling to the people who approve of the law. In the context of the trial, most of that was overruled or dismissed, but I also can't see it having really worked in the first place, because the relative harm of having HIV wasn't on trial.
There are lots of good reasons why those laws should not be on the books, and I just wanted to vent my disappointment with the otherwise good Buzzfeed article not using any of them.
posted by selenized at 3:35 PM on December 1, 2015 [4 favorites]
The article, and this thread really, got really hung up on HIV no longer being the death sentence it used to be. Which speaks to how the world has changed from when the laws were created (plus bigotry of course), but I don't think is terribly relevant in explaining why a law shouldn't exist any more. There are lots of things that are illegal but also won't kill you (for a silly example, if I punch some stranger in the face it is illegal but definitely not fatal), it just isn't a very good argument by itself. I feel like that whole line of reasoning is just a distraction and will never be all that compelling to the people who approve of the law. In the context of the trial, most of that was overruled or dismissed, but I also can't see it having really worked in the first place, because the relative harm of having HIV wasn't on trial.
There are lots of good reasons why those laws should not be on the books, and I just wanted to vent my disappointment with the otherwise good Buzzfeed article not using any of them.
posted by selenized at 3:35 PM on December 1, 2015 [4 favorites]
petrilli: "The summation, statistically, is that it was safer to have unprotected sex with someone who was HIV+, but on HAART, than it was to have unprotected sex with someone who said they were negative. This is a result of the unique situation DC finds itself in."
And the really shitty thing is that the FDA won't step forward and state this publicly, for all of the good that it would do.
Ditto for the ridiculous claims that HIV cannot be reliably detected until 6 months after infection -- a timespan that does not appear to have any presently-valid scientific backing whatsoever.
I'll also drop a link to a recent comment that I made offhand in another thread, which turned out to be one of the most-favorited things I've ever posted to this site.
To summarize:
HIV doesn't deserve a stigma, but there's still so much bad or outdated information out there. We need to be shouting the latest advances from the rooftops, because even if .
posted by schmod at 3:44 PM on December 1, 2015 [10 favorites]
And the really shitty thing is that the FDA won't step forward and state this publicly, for all of the good that it would do.
Ditto for the ridiculous claims that HIV cannot be reliably detected until 6 months after infection -- a timespan that does not appear to have any presently-valid scientific backing whatsoever.
I'll also drop a link to a recent comment that I made offhand in another thread, which turned out to be one of the most-favorited things I've ever posted to this site.
To summarize:
- HIV is no longer a death sentence.
- You probably still don't want it.
- HIV is easily detectable, especially with modern testing procedures. Nobody seems to want to commit to a statistic about how much better the new tests are.
- HIV is harder to transmit than you probably think it is (albeit not odds that you'd want to bet against)
- HIV is treatable.
- If you are being treated, you are significantly less likely to transmit the disease. Nobody wants to commit to a statistic on how much this likelihood decreases.
- HIV transmission can be prevented. Conventional safe sex is a good start, and PrEP reduces the odds much further. If you think you might be at risk, talk to your doctor about PrEP.
- Based on the previous few points, "serocompatibility" is bullshit in 2015. You can be HIV-, have an HIV+ partner, and reliably stay HIV- by taking some fairly basic and noninvasive precautions (without having to sacrifice a "normal" sex life)
- PrEP doesn't lead to risky behaviors any more than airbags lead to reckless driving. Anybody who argues otherwise is being disingenuous.
- The initial numbers on PrEP are very good. After a very long and conspicuous silence, this is now also the official position of the CDC.
- An HIV infection can be stopped even after the initial exposure, thanks to PEP. If you think you have been exposed for any reason, go to an emergency room immediately. You are experiencing an urgent, but treatable medical emergency. Call 911 if necessary.
HIV doesn't deserve a stigma, but there's still so much bad or outdated information out there. We need to be shouting the latest advances from the rooftops, because even if .
posted by schmod at 3:44 PM on December 1, 2015 [10 favorites]
If you noticed a trend here, the FDA and CDC have been incredibly cautious about the information that they release, to the point where it's arguably causing real harm.
It's because everything you describe assumes a land of milk and honey where there's a perfect health system with good insurance coverage which is far from what the United States actually is. People with HIV lack health insurance at rates far higher than the general population even post-ACA. This is amplified by states who didn't expand medicaid insurance. Many patients come to rely on Ryan White treatment and they don't receive any inpatient care and they have a far lower life expectancy due to the policy of starting treatment only when T-cell counts drop below 350. Hell, even a yearly course of PrEP runs $13K.
Let's not kid ourselves, this disease ravages under-resourced communities and they don't want to encourage any measure of reckless behavior on the false belief that they're safe.
posted by Talez at 4:18 PM on December 1, 2015
It's because everything you describe assumes a land of milk and honey where there's a perfect health system with good insurance coverage which is far from what the United States actually is. People with HIV lack health insurance at rates far higher than the general population even post-ACA. This is amplified by states who didn't expand medicaid insurance. Many patients come to rely on Ryan White treatment and they don't receive any inpatient care and they have a far lower life expectancy due to the policy of starting treatment only when T-cell counts drop below 350. Hell, even a yearly course of PrEP runs $13K.
Let's not kid ourselves, this disease ravages under-resourced communities and they don't want to encourage any measure of reckless behavior on the false belief that they're safe.
posted by Talez at 4:18 PM on December 1, 2015
Not true Talez. Ryan White covers treatment upon diagnosis no matter the T-cell count. PrEP is covered by insurance and co-pays under $300 are covered by Gilead. Over $300, there is a need based program.
posted by Sophie1 at 4:23 PM on December 1, 2015
posted by Sophie1 at 4:23 PM on December 1, 2015
That is not to say that communities with fewer resources aren't fucked, but Ryan White requirements aren't the reason.
posted by Sophie1 at 4:25 PM on December 1, 2015
posted by Sophie1 at 4:25 PM on December 1, 2015
This website tracks people's experiences with PrEP and insurance.
posted by roomthreeseventeen at 4:27 PM on December 1, 2015 [3 favorites]
posted by roomthreeseventeen at 4:27 PM on December 1, 2015 [3 favorites]
It's not like people haven't been dividing people with HIV into the "deserving" and the "guilty" since the beginning. As Diseased Piriah News Used to say "Together for Eternity: Roy Cohn and Kimberly Bergalis"
posted by GenjiandProust at 5:22 PM on December 1, 2015 [8 favorites]
posted by GenjiandProust at 5:22 PM on December 1, 2015 [8 favorites]
There's also the small issue that it's virtually impossible to prove in 99% of cases.
The other 1% are probably egregious enough that you'd be able to find another law to prosecute.
posted by schmod at 7:00 PM on December 1, 2015 [2 favorites]
The other 1% are probably egregious enough that you'd be able to find another law to prosecute.
posted by schmod at 7:00 PM on December 1, 2015 [2 favorites]
For those who want to discuss criminalization, it may be important to look at how it operates in practice. From a UCLA Law School study released today. Today. Here's some points:
- Black people and Latino/as make up two-thirds (67 percent) of those who came into contact based on charges of these crimes.
- Across all HIV-related crimes, white men were significantly more likely to be released and not charged (in 60 percent of their HIV-specific criminal incidents) than expected. Black men (36 percent), black women (43 percent) and white women (39 percent) were significantly less likely to be released and not charged.
PDF of the report. "The vast majority (95%) of all HIV-specific criminal incidents impacted people engaged in sex work or individuals suspected of engaging in sex work" - they're mostly being charged with solicitation while HIV-positive, a penalty enhancement, which suggests to me (so very NAL, have only skimmed the report, sorry if I get this wrong) they are probably being charged with the state as the complainant, not any putatively affected individual. I wasn't able to tell from my skim what's going on with charges under Cal. Health and Safety Code § 120291, which is the nondisclosure law but which is limited to people who have a specific intention to transmit - it's only rarely been used since its establishment in 1998, probably because proving intent is tricky (30 people, 37 cases, 8 convictions).
(More here on what states have what kinds of laws.)(For everyone who has said "but we don't do that for flu!" - California's had law on the books since 1934 banning willfully exposing anyone to your case of "any contagious, infectious, or communicable disease", but it is very selectively used (sadly, I think probably chicken pox parties don't fall under this, because the criminal is the person with the disease, not their horrible parents.))
More to the point - criminalization of HIV nondisclosure is not useful. I'm out-of-date on the literature but my understanding from when I worked in HIV epidemiology some years ago is that punishments for non-disclosure drive people at high risk away from testing, which increases the risk for everyone because untested-but-positive folk neither take additional precautions nor are they treated, unlike their positive-testing counterparts. I can't think of any reason any of that would have changed.
posted by gingerest at 11:44 PM on December 1, 2015 [5 favorites]
(More here on what states have what kinds of laws.)(For everyone who has said "but we don't do that for flu!" - California's had law on the books since 1934 banning willfully exposing anyone to your case of "any contagious, infectious, or communicable disease", but it is very selectively used (sadly, I think probably chicken pox parties don't fall under this, because the criminal is the person with the disease, not their horrible parents.))
More to the point - criminalization of HIV nondisclosure is not useful. I'm out-of-date on the literature but my understanding from when I worked in HIV epidemiology some years ago is that punishments for non-disclosure drive people at high risk away from testing, which increases the risk for everyone because untested-but-positive folk neither take additional precautions nor are they treated, unlike their positive-testing counterparts. I can't think of any reason any of that would have changed.
posted by gingerest at 11:44 PM on December 1, 2015 [5 favorites]
Folks who know they are HIV positive and are medicated for it aren't the problem. It's the people who DON'T know they're HIV-positive who have detectable viral loads in their system who can easily spread the disease
Yes. I'd add that this is not only because people can't know their status definitively during the window period: there is also good evidence that people with HIV are actually most potentially infectious during the acute phase, before they have developed anti-HIV antibodies that can be detected by a test (viral loads peak during this time).
posted by en forme de poire at 11:48 PM on December 1, 2015 [1 favorite]
Yes. I'd add that this is not only because people can't know their status definitively during the window period: there is also good evidence that people with HIV are actually most potentially infectious during the acute phase, before they have developed anti-HIV antibodies that can be detected by a test (viral loads peak during this time).
posted by en forme de poire at 11:48 PM on December 1, 2015 [1 favorite]
Why only sexual partners? Why only STDs? If your kid bites my kid on the playground when they're 18 months old and my kid gets chronic Hep B as a result, setting her up for a lifetime of terrible health consequences and expensive treatment, why is that different than if those same two kids have an encounter of a different kind that leaves one with HIV?
Two differences there would be - (1) very young children are involved rather than (presumably) consenting adults and (2) that's a result of an assault, which is already a crime (although a toddler biting another would not likely reach the criminal courts)
posted by theorique at 3:35 AM on December 2, 2015
Two differences there would be - (1) very young children are involved rather than (presumably) consenting adults and (2) that's a result of an assault, which is already a crime (although a toddler biting another would not likely reach the criminal courts)
posted by theorique at 3:35 AM on December 2, 2015
Like HPV, some strains of which can cause cervical cancer. But surely everyone here who has sex with women knows their own HPV status, and what strain(s) they may be carrying, and always inform their partners.
I'm learning a lot from the discussion, and my starting point was that it should be criminal to knowingly lie about your HIV status when asked by a partner and then go ahead and engage in unprotected sex with them. And I'm still convinced by posts from folks like protocoach. It's posts like this one quoted above that that are unhelpful. Maybe it is just a stylistic thing. I really dislike bombast.
The question as I understand it isn't if someone unwittingly has HIV and infected someone, it is if someone knowingly infecting a partner. The HPV analogy only makes sense if the person has knowledge of their HPV status and does not inform a partner. Also, nearly all sexually active Americans will get HPV at some point in their lives (until more people get the vaccine before the become sexually active) and the consequence of infection are usually fleeting as I understand it.
posted by Cassford at 7:29 AM on December 2, 2015
I'm learning a lot from the discussion, and my starting point was that it should be criminal to knowingly lie about your HIV status when asked by a partner and then go ahead and engage in unprotected sex with them. And I'm still convinced by posts from folks like protocoach. It's posts like this one quoted above that that are unhelpful. Maybe it is just a stylistic thing. I really dislike bombast.
The question as I understand it isn't if someone unwittingly has HIV and infected someone, it is if someone knowingly infecting a partner. The HPV analogy only makes sense if the person has knowledge of their HPV status and does not inform a partner. Also, nearly all sexually active Americans will get HPV at some point in their lives (until more people get the vaccine before the become sexually active) and the consequence of infection are usually fleeting as I understand it.
posted by Cassford at 7:29 AM on December 2, 2015
Yes, but why does HIV have a special status among communicable diseases?
Deliberately transmitting a disease is a really shitty thing to do, but it's virtually impossible to prove intent or non-consent, and I'm not convinced that there's any reason why HIV is more egregious than some other communicable diseases.
Also, I'll add my +1 to the earlier points that these laws provide an incentive to not know your status.
posted by schmod at 10:30 AM on December 2, 2015 [4 favorites]
Deliberately transmitting a disease is a really shitty thing to do, but it's virtually impossible to prove intent or non-consent, and I'm not convinced that there's any reason why HIV is more egregious than some other communicable diseases.
Also, I'll add my +1 to the earlier points that these laws provide an incentive to not know your status.
posted by schmod at 10:30 AM on December 2, 2015 [4 favorites]
Schmod, I think that the idea is that, as George W. Bush said (in the documentary I watched last night), "It’s one of the few diseases where behavior matters. I once called on somebody, 'change your behavior: if the behavior you’re using is prone to cause AIDS, change the behavior!'" Of course, this victim-blaming bullshit has been used to justify all sorts of inhumane behavior about health care in the US and elsewhere, because of course we can all think of plenty of diseases, communicable and not, "where behavior matters". It's a vacuous argument made by a bad person with a lot of blood on his hands. But I digress.
HIV is exceptionally lethal. There are very few diseases with a case fatality rate as high as that of *untreated* HIV (even after factoring in long-term nonprogressors, it's north of 99%). Even Ebola doesn't kill people the way HIV does. But we do have effective treatment now, and HIV isn't especially transmissible, even as bloodborne pathogens go, so the whole idea that exposing someone to HIV is vastly worse than exposing them to any other pathogen is seriously out of date. We still need a vaccine, and we still need to make sure that treatment is accessible to everyone, and neither of these is an easy goal. But criminalizing nondisclosure doesn't bring either of them any closer.
posted by gingerest at 7:49 PM on December 2, 2015 [2 favorites]
HIV is exceptionally lethal. There are very few diseases with a case fatality rate as high as that of *untreated* HIV (even after factoring in long-term nonprogressors, it's north of 99%). Even Ebola doesn't kill people the way HIV does. But we do have effective treatment now, and HIV isn't especially transmissible, even as bloodborne pathogens go, so the whole idea that exposing someone to HIV is vastly worse than exposing them to any other pathogen is seriously out of date. We still need a vaccine, and we still need to make sure that treatment is accessible to everyone, and neither of these is an easy goal. But criminalizing nondisclosure doesn't bring either of them any closer.
posted by gingerest at 7:49 PM on December 2, 2015 [2 favorites]
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Written by a friend: Charlie Sheen and Celebrity (HIV) Statusposted by rtha at 10:15 AM on December 1, 2015 [13 favorites]