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BY BTL CONTRIBUTOR
State health officials are using the newest science to address the HIV epidemic Michigan and to curb its growth.
The new science certainly has the potential to reshape how we identify new HIV cases, getting those recently infected into care and quickly suppressing their virus. That, in turn, could help reduce the number of transmissions from that person. Specifically, health officials are using genetic data, collected from people living with HIV as part of their medical care, to identify related infections. Those related infections create clusters of people, and those clusters reveal groupings which may be involved in more transmissions or visiting and socializing in areas where that particular virus is quietly passing from one person to another. Disrupting these secret networks is good public health.
That’s a laudable move. But this is not a lab where pure science devoid of the social and human impact can be accepted.
As long as Michigan continues to criminalize people living with HIV for engaging in sexual behavior that may not even transmit the virus, the genetic clustering work could be abused by zealous prosecutors. Perhaps those prosecutors believe they are working to stop HIV transmissions. Perhaps they are driven by animus against certain at-risk populations. Indeed, an analysis of prosecutions in the state done by sociologist Trevor Hoppe found there was a disparity among those charged under Michigan’s felony law: while black men who have sex with women represent a small percentage of those living with HIV in the state, they represented nearly 44 percent of the prosecutions. The analysis did not include data from Wayne county or Detroit specifically.
Let’s be clear: genotype studies do not, and cannot, prove the directionality of transmission. However, with the lack of basic understanding of HIV science in America today, combined with a near worship of science as evidence in criminal cases by juries; make this genotype data attractive for law enforcement.
Add on top of this the request for expansive investigatory powers and data collection by the state and you have a recipe for an oppressive, invasive nanny state. That nanny state will undermine prevention and care services. That will result in more cases of HIV, not fewer.
The legislature has the opportunity in this lame duck session to reject this expansion. They can refuse to pass the legislative reforms before them if Rep. Jon Hoadley’s HIV criminalization modernization legislation is not included. They can also, as the GOP does not believe in government interference in the private lives of citizens, reject the whole reform package sitting in the Senate today. Why? Because the reforms would dramatically reshape how HIV cases are investigated and would remove autonomy for many people living with HIV.
And finally, lawmakers must act to end the use of genotype data without receiving informed consent from persons living with HIV for their participation. Any move to approve the use of genotype data by the legislature should first be vetted not by case workers and hand-selected persons living with HIV who are married to state health officials, but through large community gatherings held throughout the state for people living with HIV.
Early in the epidemic, activists screamed “Nothing about us, without us.” Unfortunately, that message has been lost in the flurry of exciting scientific advances. Until state health officials realign with that message, seeking the broad input from many people living with HIV, not just those who are hand selected to serve on state committees, these initiatives will become invasive, authoritarian and result in sex policing by the government.