Guest Commentary

Bring Missouri’s HIV policies into the 21st century

Talk to your doctor about your sexual health

Talking about sex may not be a regular part of your doctor-patient relationship, but it should be. This can be especially true for adolescents and young adults who are disproportionately impacted by sexually transmitted diseases (STDs). Nearly hal
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Talking about sex may not be a regular part of your doctor-patient relationship, but it should be. This can be especially true for adolescents and young adults who are disproportionately impacted by sexually transmitted diseases (STDs). Nearly hal

Missouri’s HIV-specific criminal statutes are due for an update. Thirty years ago, at the height of the epidemic and with few treatment options, an HIV diagnosis was tantamount to a death sentence. Understanding of the virus and its mode of transmission was minimal, and, in response, governments enacted strict laws across the country that would penalize people living with HIV for engaging in sexual activity as a desperate means to combat the epidemic.

In Missouri that led to criminal penalties based on disclosure of status. If someone living with HIV cannot prove without a doubt that they have disclosed their HIV status to a sexual partner, they may be subject to Class A felony charges — the same as a first- or second-degree murder. Yet today, not a single study exists that shows any decline in transmission rates in states that have specific criminalization for HIV, as Missouri has.

With today’s antiretroviral therapies, people living with HIV who take HIV medications consistently can suppress the virus in their bloodstream, rendering the virus incapable of transmission to another person. People living with HIV are leading long, normal and productive lives without the fear of exposing loved ones to the virus. By virtue of thirty years of biomedical and epidemiological research, someone newly diagnosed with HIV may achieve viral suppression in a matter of about three months after starting treatment. In addition, pre-exposure prophylaxis, or PrEP, and condoms or other latex barriers are viable means of HIV prevention that unaffected partners can use to take control of their own risk of contracting the virus.

Persons living with HIV on antiretroviral therapy, using latex barriers, and keeping medical appointments with their doctor are doing all the right things to protect themselves and their partner. Yet this is not a consideration under Missouri’s current law. The HIV positive person can still face felony charges and receive up to 15 years of prison time, even when there is no transmission to a partner.

Contracting HIV is no longer a death sentence, but we certainly treat it like one. The stigma associated with HIV was built on top of misinformation during the 1980s, and has stubbornly solidified its place in the American consciousness in the time since. This has made it difficult to move public understanding and opinion, and therefore legislation to modernize HIV-specific criminal codes has stalled.

It is time for Missouri’s General Assembly to embrace public policy that is grounded in today’s medical realities, and fortunately a bipartisan team of lawmakers — Republican Rep. Holly Rehder and Democratic Rep. Tracy McCreery — are attempting to do just that. House Bill 167, sponsored by Rehder, would eliminate HIV-specific language from Missouri statutes, a step toward treating those living with HIV the same as their fellow Missourians. Punishment still exists for those who willingly and knowingly expose others to communicable diseases — but HIV is not singled out. House Bill 166, sponsored by McCreery, would change all of Missouri’s HIV-specific criminal codes, instead of being a partial fix like HB 167, and the penalties in HB 166 are more in line with what science now tells us about HIV.

We applaud the House Committee on Health and Mental Health for voting to move a House committee substitute for both bills forward on April 15. We urge Speaker of the House Elijah Haahr and Majority Floor Leader Rob Vescovo to schedule floor debate for HB 167 quickly and to allow time for amendments that would make the final version of the bill as comprehensive and modern as HB 166.

We thank both sponsors for working together in such a bipartisan and collaborative fashion, and we urge their colleagues to do the same. Now is the time to end the stigma and change the law.

LaTrischa Miles is a treatment adherence supervisor at KC Cares Health Center.

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