Nick Rhoades, a gay man convicted of criminal transmission of HIV in Iowa and sentenced to 25 years in prison, despite the virus not being transmitted, talks to activists at the national HIV is Not a Crime Conference held in Grinnell, Iowa in June. BTL photo: Todd A. Heywood
HIV continues to disproportionately impact men who have sex with men – nationally and in Michigan. Here are the top HIV-related stories of 2014
First International Conference To End HIV Criminalization
For the first time, nearly two hundred national and international advocates to eradicate HIV criminalization gathered to create a strategy to address the growing use of criminal laws as a way to address the HIV epidemic. The gathering was held in June in Grinnell, Iowa and was organized by The Sero Project. Sero Project was founded by HIV activist and founding publisher of POZ Magazine, Sean Strub.
The gathering happened just days after the Iowa legislature became the first state in the nation to revamp its state law. In a special ceremony, Nick Rhoades, who had been convicted under Iowa's law for a one night stand in which he did not transmit HIV and took many actions to prevent such a transmission, had his GPS tracking ankle bracelet cut off with garden shears by openly gay Iowa State Sen. Matt McCoy. In addition to Rhoades having his bracelet removed, Donald Bogardus also had his bracelet removed. Bogardus had also been convicted under Iowa's law for failing to disclose his HIV status to a sexual partner.
Shortly after the gathering, Rhoades' conviction was overturned by the Iowa State Supreme Court based on an appeal challenging the law and arguing that it required proof of intent to transmit – something the prosecution failed to prove.
Michigan was well represented at the conference. Among those in attendance was Jon Hoadley, now a representative elect to the state house for Kalamazoo.
"Michigan is engaging in cutting edge advocacy on HIV criminalization reform, and I was proud to be a first in the country conference to learn from success in other states," Hoadley said.
Michigan continues to be a leader in prosecutions of people living with HIV.
Feds Call On States To Revamp HIV Criminal Laws
Shortly after the June gathering of anti-criminalization advocates in Iowa, the federal Department of Justice released a guide for states to modernize HIV criminal laws and prosecutions.
"The majority of these laws were enacted at a time when far less was known about risk, likelihood and mode of transmission of the virus and at a time when the quality of life and lifespan of an individual with the virus was vastly different than it is currently," the guide says. "As a result, certain of these laws do not accurately reflect the current science of transmission, do not account for risk reduction behaviors and medical protocols that greatly reduce transmission risk and do not reflect that, with testing and treatment, HIV may be a manageable medical condition."
Among the recommendations, the DOJ guide noted states should remove HIV-specific criminal laws, and rely instead on traditional criminal laws for prosecution of persons with HIV for rape related crimes and crimes where it can be proven the person living with HIV intended to transmit the infection. If states want to keep HIV specific laws, the report continued, states should amend the laws to reflect the current knowledge of HIV transmission, risk and health of persons infected.
Advocates hailed the move.
"The DOJ's recommendations are an important step towards reforming these outdated and problematic laws. As I found in Michigan, many of the criminal cases brought under such laws involve sexual behavior that is not actually blameworthy," says Trevor Hoppe, who graduated this spring with a doctorate in sociology from the University of Michigan. His dissertation evaluated criminal prosecutions under Michigan's law in the past two decades. "In Michigan, I could not find a case in which it was clear that the defendant maliciously intended to infect their partners. While defenders of HIV-specific criminal statutes often invoke stories of malicious offenders who wreak havoc by attempting to infect as many innocent, unwitting partners as possible, this narrative does not accurately reflect the cases brought under these laws. The HIV-positive monster in many people's minds is a product of stigma and has no basis in reality."
The Michigan Department of Community Health was working on researching whether or not to repeal Michigan's law but suspended the process in November 2012. Internal drafts of reports and recommendations show state health officials were prepared to recommend lawmakers amend the law to require proof of intent to transmit the infection. MDCH officials did not explain why the process was suspended.
CDC Expands Clinical Recommendations For PrEP
In May, the CDC released a new clinical guidance for prescribing Pre-Exposure Prophylaxis (PrEP). The new guidance, the New York Times estimated, could extend prescriptions of the once-a-day HIV prevention to 500,000 men who have sex with men. The intervention was approved by the FDA in July 2012 but was slow to be taken up as a prevention option, despite having been shown in clinical studies to be at least 92 percent effective in preventing an HIV negative person from being infected with the virus. A National Institutes of Health (NIH) study found that the intervention could actually be 99 percent effective in preventing infections.
"While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the U.S. HIV epidemic today," a press release from the CDC quoted Jonathan Mermin, M.D., M.P.H., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, as saying. "These guidelines represent an important step toward fully realizing the promise of PrEP. We should add to this momentum, working to ensure that PrEP is used by the right people, in the right way, in the right circumstances."
The Michigan Department of Community Health, which had been resisting adoption of PrEP as a prevention option since its adoption by the FDA, announced the week after the CDC guidance was released that it would adopt the CDC guidance in whole. Prior to that, while the state had no clear PrEP policy, the state's Medicaid program – health insurance for low income residents – could have the drug covered. The state in December is holding two trainings for HIV test counselors – one in Detroit and one in Lansing – on how to discuss PrEP with HIV test subjects.
HIV In Men Who Have Sex With Men Fraught With Racial Disparities
In November, a new study found significant racial disparities among men who have sex with men. While only eight percent of all white men in the U.S. who have sex with men were infected, 32 percent of all black men in the U.S. who have sex with men were infected. The disparity didn't stop there. The study found access to care and treatment was also poorer for black men who have sex with men.
The study also represents the epidemic issues in Michigan, the Michigan Department of Community Health said.
For Curtis Lipscomb, executive director of KICK, the study shows that HIV education programming has to be scaled up "right now," and LGBT organizations have a significant role to play. "We have seen the dominate issue of marriage equality front and center in our movement. Although marriage is important to the stability of households, it is one of many issues we must organize around – such as poverty, housing and employment," Lipscomb says. "The LGBT organizations must challenge significant racial disparities in HIV. To read that the prevalence will likely persist for decades due to an alarmingly high concentration of HIV in black gay men frightens me. It suggests a further disappearance of my population and the return of the 80s scare of homosexual men – a time when someone died daily and despair took over emotional wellbeing."
"If black, gay and bi men continue to die disproportionately, matrimony will mean nothing. This impacts all of us," Lipscomb continues. "How can we move together if one of our segmented community is disengaged? Marriage will then only become a luxury ‘for those that can afford it.'"
