June 27th was National HIV Testing Day, but in reality it is what we do 365 days of the year that will end the epidemic. Yet despite a vast wealth of knowledge on how to end the spread of HIV, stigmatization, misinformation and criminalization of HIV and AIDS continue to perpetuate an epidemic we could otherwise end.
HIV testing represents one of the most potent weapons in the fight against HIV. Yet too many individuals who may be at risk of infection continue to avoid testing. This reluctance to test is driven in part by the pervasiveness of HIV stigma.
Despite claims to the contrary, HIV stigma remains virtually omnipresent. People living with HIV and AIDS (PLWHA) encounter stigma in all arenas of daily life: at work (23 percent of people report discomfort with an HIV positive colleague), school (35 percent of parents express discomfort with HIV positive teachers); home life (42 percent of people would not be comfortable with an HIV positive roommate), and in commercial interactions (51 percent of people distrust a meal prepared by an HIV-positive person).
If lawmakers are serious about seeing an end to HIV and AIDS in this country and around the world, then attacking HIV stigma head-on is an imperative of the first order. The U.S. is home to widespread government-sponsored discrimination, based on fear and ignorance of the science of HIV transmission. Many states have laws on their books that exclude people living with HIV and/or AIDS from certain types of licensed work, including cosmetology, massage therapy, and barbering, despite the fact that transmission in these contexts is virtually inconceivable. Though HIV is not transmitted via the sorts of casual contact characteristic of a shared home life, some states bar PLWHA from serving as foster or adoptive parents. And at last count, thirty-four states have laws on their books that criminalize HIV transmission or exposure. HIV criminalization statutes are often so vague that spitting, coughing, or sneezing could be considered criminal conduct, despite all scientific evidence that the bodily fluids involved do not carry HIV. These laws demonize people living with HIV/AIDS, dehumanize them by reducing them to vectors of disease, and punish them out of all proportion to any offending act.
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Some defend criminalization laws and other forms of government-sponsored discrimination as a means to deter HIV transmission. However, these laws fail over and over again to meet that goal. In fact, they undermine prevention efforts by discouraging testing. If knowledge of an individual’s HIV status could open him or her to liability for exposure or transmission, better, so the logic goes, not to get tested. Criminalization of HIV has therefore made HIV testing newly frightening and newly dangerous, and as a result people are more likely to refrain from testing. But people who don’t know their HIV status are more likely to transmit the virus to others. Criminalization, ironically, serves as an ally to the virus it is intended to combat.
Criminalization and other laws premised on ignorance and fear are true barriers to the fight against HIV/AIDS. The federal government should urge states to eliminate those laws that treat people living with HIV/AIDS as walking missiles of contagion. HIV stigma must be met at every level, and the government ought to take the lead by making state-sponsored stigma a relic of the past.
 2009 Survey of Americans on HIV/AIDS: Summary of Findings on the Domestic Epidemic, Kaiser Family Foundation, April 2009, http://www.kff.org/kaiserpolls/upload/7889.pdf.