Iowa's Ignorance and HIV

In 1998, Iowa politicians enacted a law that criminalized potential HIV transmission as a Class B felony. The sentence designates the ‘carrier’ as a felon, imposes a sentence of up to 25 years in prison, and assigns him lifelong sex-offender status, even if the contact was consensual. Under the law, a person aware of his or her positive HIV status does not actually have to transmit the HIV virus, they only have to engage in intimate contact with another person.

The penalty exceeds that for manslaughter.

Since the law was enacted, 26 people have been convicted under the law; nine people currently sit behind bars. The cost to taxpayers is an estimated annual cost of $31,500 per inmate, plus medical costs of $24,000 annually per inmate.

The cost to the incarcerated is the destruction of their life for the crime of being human and having an illness.

Last year, the Iowa legislature defeated an effort to repeal the law, considered the most backwards and punitive (I would add ‘medieval’) in the country. Of course, this is Iowa, a state where right-wing fundamentalists are well-organized in the electoral processes and have handed presidential caucus victories to Pat Robertson in 1988 and Mike Huckabee just four years ago. Reason and Science need not apply...

Supporters of the law have a well-honed mantra that follows this general pattern:

“HIV/AIDs is a deadly disease that is a death sentence. When you know you have it and you are intimate with someone, you are infecting them, and committing an assault on them that is as dangerous as any other form of slow murder.”

In reality, much of the support for this law comes from those who look down on all sexual activity in general, and consider homosexuality in particular to be an abomination. Puritanical theology is the root of their desire to punish these people, not health. Nonetheless, in the battle of legislative processes, and insuring under the US Constitution that no excessive punishments be imposed for ‘crimes,’ it is important to address their stated reasoning above…and certainly time to educate the legislators and the public. I have been wanting to post this for a while, and the Iowa law was the tipping point.

1. HIV is not AIDs. Say that out loud. Again. HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, as do thousands of viruses. The HIV virus may lead to AIDs as a long-term complication of the viral attack, but HIV is not AIDs any more than blindness or neuropathy is the same thing as diabetes. One may cause the other, but they are not the same thing.

2. HIV is not a death sentence. Gay activists often (appropriately) refer to the 1980s as a health holocaust, as entire neighborhoods were decimated. But times have changed significantly, and thousands of men and women live normal healthy lives for decades with the HIV virus under control. In other words, HIV is now a manageable medical condition, not the end of life.

3. As viruses go, transmission of the HIV virus is very, very difficult. It is not transmitted by close contact, or sharing food or drinking glasses, or by breathing on each other, or by kissing (unlike many other viruses). It is not transmitted through saliva, sweat, or urine. Unlike many prevalent STDs such as syphilis, gonorrhea, herpes, HPV, and genital warts (none of which carry the penalties imposed in Iowa), it is not transmitted through oral sex.

Repeat: in the 30+ year history of HIV, there is not one single scientific case study that has documented transmission via fellatio. Period. In order to be on the ‘safe side,’ many doctors and government-funded clinics will publicly state that this is a ‘hypothetical’ route of transmission. But as for documenting a single case – it doesn’t exist…and privately, the medical community knows this. In July 2002 a study was concluded in Spain of serodiscordant couples (one HIV positive, One HIV Negative), where they evaluated for risks of HIV transmission through unprotected oral sex. In over 19,000 unprotected oral-genital contacts with HIV-infected partners, there was not a single case of seroconversion to HIV. (http://hivinsite.ucsf.edu/insite?page=pr-rr-05)

Even vaginal and anal transmission of the virus is unlikely. According to the Guidelines for the Management and Post Exposure Prophylaxis of Individuals who Sustain Nonoccupational Exposure to HIV, ANCAHRD/CTARC Bulletin, February 2001, the risk of transmission as a result of receptive anal sex is approximately three per cent. Other experts place the risk as low as 1 in 1300. (http://aids.about.com/od/hivaidsstats/f/infectionrisk.htm)

4. HIV positive individuals who have their virus controlled with medication can not transmit the HIV virus. (http://www.aidsmap.com/page/1429357/)

“…Swiss HIV experts have produced the first-ever consensus statement to say that HIV-positive individuals on effective antiretroviral therapy…are sexually non-infectious… After review of the medical literature and extensive discussion [the] Swiss Federal Commission for HIV / AIDS resolves that, “An HIV-infected person on antiretroviral therapy with completely suppressed viraemia (“effective ART”) is not sexually infectious, i.e. cannot transmit HIV through sexual contact.”

The statement officially defines a ‘suppressed viraemia’ (or “Undetectable Viral Load,” the common US parlance) as a viral load that has been suppressed to less than < 40 copies/ml for at least six months. (For comparison, someone not controlled on medication may have a viral load of 500,000 to over 1 million copies/ml). At the time this statement was made, that was the most sensitive that HIV tests could detect; today, these tests can detect viral loads of only 20 copies/ml, which means someone declared to have an Undetectable Viral Load has even fewer copies of the virus in their system than the limit established by the original Swiss statement. Finally, the Commission specifically stated that “courts will have to take into account the fact that HIV-positive people on antiretroviral treatment…cannot transmit HIV sexually in criminal HIV exposure and transmission cases….Unprotected sex between a positive person on antiretroviral treatment…and an HIV-negative person, does not comply with the criteria for an “attempt at propagation of a dangerous disease” according to section 231 of the Swiss penal code nor for “an attempt to engender grievous bodily harm” according to section122, 123 or 125.”

Iowa politicians, take note.

The current law in Iowa, then, locks someone up in a cage for up to 25 years and brands them a sex offender for engaging in normal human activity that has no chance of endangering someone else…simply because of their ‘status’ as a branded individual. The law is not based in science or humanity or health, but expresses a punitive, uneducated, and fearful attitude towards what they do not wish to understand.