CLEVELAND — Naimah O’Neal has lived with HIV for 30 years. She was diagnosed in 1992 at the age of 29. She said she believes she either got the virus from her husband, who was using substances, or from receiving blood after she broke her arm in her 20s.
What You Need To Know
- There are more than 1.2 million people living with HIV in the United States
- About 25,000 people live with HIV in Ohio
- During the early years of the HIV epidemic, many states implemented HIV-specific criminal exposure laws designed to discourage behavior that might lead to transmission
- The laws were passed at a time when very little was known about HIV, including how it’s transmitted
- Organizations around Ohio and the nation are working to modernize HIV laws to reflect our current understanding of the virus
“I never even thought that as a heterosexual woman that I had to deal with HIV,” said O’Neal, who is a medical social worker for Circle Health and an advocate for people living with HIV. “It's not about how many partners you have, you could have one partner and be HIV positive. What it is, is not protecting yourself.”
HIV is a virus that attacks the body's immune system. Today, it's known that it can affect anyone regardless of sexual orientation, race, ethnicity, gender or age.
“As long as you're having sex and you're not using a condom or you're not protecting yourself with what they have now, PREP, then you're at risk,” said O’Neal. “You have some kids who were born with it. And they acquired it from their mothers who gave it to them, so it doesn't care.”
Science has come a long way. Being HIV-positive used to be considered a death sentence. Medical advancements have helped turn HIV from a fatal infection into a manageable chronic condition.
The Centers For Disease Control and Prevention said if people take their HIV medicine as prescribed, the amount of HIV in their blood can become undetectable and studies have shown that undetectable means untransmittable. Not everyone taking HIV medicine is undetectable, but the CDC said by taking medicine daily, as prescribed, most people can get an undetectable viral load within six months. The only way to know if someone is undetectable is by visiting their provider regularly.
Despite the advancements in medicine, the laws haven't caught up.
In Ohio, six laws add or enhance criminal penalties based on HIV status. A person may be charged with a second-degree felony charge if they know they are HIV positive and engage in “sexual conduct” without disclosing thier status.
“If you happen to be a person living with HIV, what would have been a misdemeanor becomes a felony automatically just because you're living with HIV,” said Kim Welter, facilitator of the Ohio Health Modernization Movement. “We also have a lot of stories from people who've been blackmailed under the laws. So hey, if you don't give me $500 right now, I'm going to go to the cops and tell them we had sex and that you didn't tell me that you were HIV positive. We have people in domestic violence situations where if you leave me, or if you kick me out, I'm going to go to the cops and tell them you didn't tell me you were HIV positive."
Kim Welter who works for Equality Ohio said most people have a 1980s understanding of HIV. The law criminalizes behaviors that can’t transmit HIV – such as spitting – and apply regardless of actual transmission or intent.
“It makes sense, people should disclose their health status,” said Welter. “The problem is that you then also have to prove it. And that's what becomes problematic for a lot of people. Well, how am I going to prove that I told somebody?”
O’Neal said it feels like people living with HIV are guilty until proven innocent when it should be innocent until proven guilty.
“No matter if I take my medicine, no matter if I use a condom, if I don't tell you out of my mouth that I'm HIV positive, then I can be prosecuted under the law and go to jail for a significant amount of time,” said O’Neal. “A lot of us live alone, we live in fear, a lot of us, because we could be prosecuted. We could be made to feel like we've done something wrong when we haven’t. And the fact that we're living with HIV should not be a reason that we be prosecuted.”
She said the current laws promote stigma, prevent progress and discourage people from getting tested and knowing their status. Through her work as an advocate for people living with HIV, she tries to debunk misconceptions about the virus.
“Ignorance is fueling the laws in Ohio right now, ignorance and fear,” said O’Neal. “You can’t spread [HIV] through saliva, you can't spread it through spit, you can’t spread it through sweat. You can spread it through blood, vaginal fluids and semen.”
National and state organizations are pushing to modernize HIV laws to match the current science, including the Elizabeth Taylor AIDS Foundation, Sero Project, Equality Ohio, Equitas Health, the Ohio Health Modernization Movement and others. February 28 is the first HIV is Not a Crime Awareness Day. At least nine states, including California, Colorado, Illinois, Iowa, Michigan, Missouri, Nevada, North Carolina and Virginia have modernized their laws.
Welter said the laws that were intended to stop the spread of HIV may now be doing the opposite. According to the CDC, 1 in 7 people with HIV don't even know they have the virus. Under the current laws, she said ignorance is bliss. Some people avoid testing all together as they don’t want to be subject to the law.
“If you don't know your status, you cannot be prosecuted under these laws,” said Welter. “So the logic that follows is that you're safer not knowing your status. Which is unfortunate because that's where most transmissions take place are amongst people who don't know their status. From a public health perspective, we want everybody to get tested.”
Welter said modernizing the laws would make it harder for prosecutors to convict a person solely because they’re HIV-positive. The organizations are trying to reduce the criminal penalty for failing to notify sexual partners of positive HIV status from a felony to a misdemeanor, bringing the charges to be consistent across all communicable diseases.
“We need to bring it up to modern standards, we need to make it so that people will want to get tested,” said O’Neal. “Because until we find everyone who's positive, and get them into treatment, and everyone who's negative, and keep them negative, we're always gonna have this conversation. We want to make it so that the science saying that they're undetectable, the fact that they may have used the condom can all be placed in evidence.”
O’Neal and Welter said people may either treat the virus, or criminalize it, and to end the HIV epidemic, treatment is the answer.
“If you want to end the epidemic, the way you end the epidemic is you end the stigma,” said Welter. “Part of ending the stigma is to get rid of the criminalization and you get people tested, into care and then we can end the epidemic. It’s the only way.”
O'Neal agreed ending the stigma is a must.
“Until we deal with fear and stigma, and all the misconceptions as a community, then we're not going to ever get a handle on HIV and AIDS in my lifetime or in my grandkids' lifetime,” said O’Neal.