Earlier this summer, my office brought together nearly 50 prosecutors, public health officials, and legal and infectious disease experts at the White House to discuss HIV-specific criminal laws and the prosecution of people living with HIV. Our goal was to ensure that state and local officials were aware of the latest scientific evidence about HIV transmission risk. This meeting was part of ONAP’s work to implement the National HIV/AIDS Strategy’s call to repeal and reform outdated state HIV criminalization laws to reduce HIV-related stigma and discrimination. We know that HIV-related stigma and discrimination present complex obstacles to accessing HIV services for people with or who experience risk for HIV.

During the meeting, public health experts explained how HIV is and is not transmitted and discussed the effectiveness of today’s HIV treatment to suppress a person’s HIV viral load to undetectable levels, which protects the health of the person with HIV and prevents transmission of the virus to sexual partners. They also briefed participants on the effectiveness of HIV prevention methods now available, such as pre-exposure prophylaxis (PrEP), which is medicine people at risk for HIV take to prevent getting HIV from sex.

In his presentation, Dr. Jonathan Mermin, Director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, reviewed the history of HIV criminalization laws, noting that most were passed early in the HIV epidemic, at a time when little was known about HIV, especially how HIV was confidently not transmitted, and well before HIV treatment and PrEP were available. But today, after more than 30 years of HIV research and significant biomedical advancements to treat and prevent HIV, most HIV criminalization laws do not reflect current scientific and medical evidence. Dr. Mermin shared that CDC analysis has found no association between HIV diagnosis rates and criminal exposure laws across states over time. In addition, these laws are not associated with increased disclosure of HIV status and they exacerbate HIV disparities. Thus, there is no evidence of a public health benefit from these laws. He added that CDC is developing an objective assessment tool to assist jurisdictions in evaluating their laws and regulations to ensure they align with current scientific and medical evidence.

Mr. Brad Sears, JD, Executive Director of UCLA’s Williams Institute, reviewed findings from studies of arrests and convictions under these laws in seven states. These included that enforcement of these laws isn’t decreasing over time; Black people, women, and sex workers are over-represented in arrests and convictions; most enforcement actions are in a limited number of jurisdictions, driven by local practices and prosecutors; and the vast majority of people are arrested and convicted when there is no HIV transmission, intent to transmit HIV, or conduct that could transmit HIV.

Throughout the full-day dialogue, prosecutors asked questions to clarify their understanding
about HIV and address myths circulating in law enforcement and the criminal legal system about HIV and its transmission. Prosecutors also shared examples from their experience that others may find useful to adopt or adapt. Examples included guidance issued by the New Jersey attorney general to local prosecutors on enforcement of the state’s HIV criminalization statute in light of advancements in treatment for HIV and a fact sheetExit Disclaimer developed for New York County prosecutors and law enforcement professionals about the routes, risks, and realities of infectious disease transmission, prevention, and care. As one prosecutor observed, “to achieve maximum public safety, I have to be concerned about public health,” reinforcing that health and safety are inextricably intertwined.

Participants identified opportunities for collaborations between public health and public safety at the state and local levels to better serve communities as well as actions that could be taken within individual agencies. Many of the prosecutors who participated represent jurisdictions prioritized in the Ending the HIV Epidemic in the U.S. initiative. So, they will find many willing partners in their communities who are already working to innovate and strengthen HIV services and policies.

ONAP collaborated with the Center for HIV Law & PolicyExit Disclaimer and the Association of Prosecuting AttorneysExit Disclaimer to convene the meeting.

Many participants shared that they were leaving the meeting with new insights and connections to continue this dialogue locally. I am encouraged by reports from several participants in the months since the meeting regarding follow up meetings that have been held and information dissemination that has taken place in their jurisdictions. I am grateful for the concern all the participants demonstrated about this issue and their openness to strengthening partnerships between law enforcement and public health to better serve their communities and improve the lives of and outcomes for people living with HIV.