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Criminalizing disease is an ineffective public health strategy

Letter to the editor

In response to Darcy Keenan's Oct. 31 op-ed, "Efforts to Decriminalize Spreading of HIV Are Wrong," we write to offer an alternative perspective.

On Oct. 26, the Ohio Supreme Court voted unanimously to uphold statutes that criminalize the nondisclosure of an HIV positive status as a felony, punishable with up to 180 days in jail and $1,000 in fines.

Ohio's Revised Code S S 2903.11(B) refers specifically to HIV, however, other sections are vague enough to bring assault charges for the transmission of infections such as chlamydia, gonorrhea, syphilis, hepatitis and herpes. Transmitting any STD after hooking up with someone at Brick Street could land you in a courtroom by the next weekend.

Knowing your HIV and STI status is key to reducing transmission and prolonging life. A painless, 20-minute test is all it takes. HIV can be transmitted through contact with blood, semen, breast milk, vaginal secretions, sharing needles, vertical transmission and contaminated blood products.

Even though new HIV diagnoses are falling nationwide, there are still approximately 1.1 million US citizens living with HIV.

Closer to home, health departments along the Northern Kentucky-Cincinnati-Dayton corridor predict thousands of new infections, primarily from injection drug use and sharing contaminated drug paraphernalia.

Further criminalizing HIV will continue to increase infections. According to Raymond Faller, a public defender in an ongoing HIV nondisclosure trial in Columbus, "The targeting of HIV and no other chronic illnesses reinforces the notion that HIV is a death sentence, which does not reflect the medical reality of HIV." Criminalization of HIV transmission is out of step with modern medicine.

HIV is now a chronic, incurable, but highly treatable infection. In fact, on Sept. 27, the CDC confirmed that medication-adherent people who are "undetectable" (fewer than 200 HIV virus copies/ml of blood) cannot transmit HIV to intimate partners. When coupled with safer-sex techniques, pre-exposure medications, and needle exchange/clean works programs, transmission is virtually impossible.

Access to testing, treatment and preventative services and accurate HIV/AIDS information is often blocked by federal and state legislation. Testing centers, non-profits, and other organizations lose funding when moral panic seeps into rational public discussion of public health issues. These defunding efforts disproportionately impact rural, poor and minority communities who otherwise lack medical access.

The CDC estimates for lifetime cost of treating HIV range from $300,000 to 500,000. Without insurance, life-saving treatment can exceed $3,000 a month. More than 30 percent of people with HIV are uninsured, while, an estimated 50 percent do not receive regular treatment. Federal programs like the Ryan White Comprehensive AIDS Resources Emergency Act (CARE) help offset the costs.

The Joint United Nations Program on HIV/AIDS (UNAIDS) suggests that the best way to promote public health is not a punitive approach. Instead, governments should increase prevention efforts, and improve access to testing and treatment. The HIV Justice Network recommends achieving these goals by eliminating criminalization laws, promoting needle exchange programs, protecting privacy, and disseminating accurate information.

Open discussion about treatment and prevention is vital to destigmatizing HIV. Pre-exposure prophylaxis (PrEP) is a daily pill for HIV-negative individuals that prevents infection. According to the CDC, PrEP reduces HIV transmission through sex by more than 90 percent and more than 70 percent through injection drug use. PrEP is covered by Miami's student health insurance, and when combined with Gilead's co-pay assistance voucher it is free.

World AIDS Day is Dec. 1. Early detection, early treatment, safer sex, PrEP and lifelong adherence to medication are essential for the health of everyone. Confidential, free HIV testing will be available in the Women*s & LGBTQ* Center located in 3012 Armstrong.

There will also be an informational table on slant walk on World AIDS Day.

Knowledge, not inflammatory rhetoric and misinformation, is the power with which we will end isolation, end stigma and end HIV transmission.

Students in WGS 370: HIV/AIDS and the Media: Alex Apicella, Laura Caudill, Elisabeth Dodd, Meg Jackson, Joshua Jones, Abigail Karr, Glynis Lonnemann, Haley Miller, Flavia Stanton, YeFan Wang, Mackey Willis, Lauren Zell, Mackenzie Zellner; Matthew Jones, WGS; Jane Goettsch, Women*s Center; Rhonda Jackson, Women*s Center; Hannah Thompson, LGBTQ* Servicesa