Wednesday, 14 July 2010

Obama, the National HIV/AIDS Strategy and the Role of Law

The White House published a new HIV/AIDS National Strategy yesterday. The gay media seem to have broadly welcomed the proposals as a campaign pledge follow through. My first glance at the report led me to think that this was a report that was not focusing upon the role of law in restricting HIV transmission. Then I looked a bit more at the detail. Page 15 of the report has an interesting paragraph on preventing HIV infection among 'gay, bisexual and transgender individuals', it states:

'Congress and State legislatures should consider the implementation of laws that promote public health practice and underscore the existing best evidence in HIV prevention for sexual minorities'.

Say what? What could these laws be? The sentence is as loose as can be. First off 'consider'. Well that is hardly a firm direction. Then we have the substance - as vague as can possibly be. It seems to both support states attempts to criminalise HIV transmission and at the same time appear to sit on the fence. Such were the hopes of the Obama Presidency that any lack of clear direction leaves the administration open to attacks from all directions.

It's therefore interesting to see the administration shuffle off the fence as the report progresses. The strategy makes reference to law as a positive force to ensure access to AIDS treatment and it also refers to the Affordable Care Act in the context of equality of access to treatment. On page 36 of the report, it talks of the importance of law in 'establishing an environment where people will feel safe in getting tested and seeking treatment'. That must surely mean a rejection of criminalising HIV transmission but we have that troubling paragraph on page 15. Later on page 36 we have a breakthrough section. It notes that at least 32 states have HIV related laws that criminalise HIV transmission but goes on to state that:

'Some laws criminalize consensual sexual activity between adults on the basis that one of the individuals is a person with HIV who failed to disclose their status to their partner. CDC data and other studies, however, tell us that intentional HIV transmission is atypical and uncommon.155 A recent research study also found that HIV-specific laws do not influence the behavior of people living with HIV in those states where these laws exist.156 While we understand the intent behind such laws, they may not have the desired effect and they may make people less willing to disclose their status by making people feel at even greater risk of discrimination. In some cases, it may be appropriate for legislators to reconsider whether existing laws continue to further the public interest and public health. In many instances, the continued existence and enforcement of these types of laws run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment'.

Hurrah - common sense. No fence - sitting. A firm, clear statement. So why the wishy-washy sentence early on? I think it goes as far as we could expect/hope the administration to do. It will be interesting to see how states respond and whether this aspect of the report will get picked up more. An interesting absence from the strategy was the subject of pornography and the representation of condom only butt-fucking. Again, this suggests a possible change in direction.

The full strategy can be read here.

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