Knowingly giving someone HIV could now become only a misdemeanor in California

[OutHouse]

Maybe because HIV is the first and only criminalized disease in history? Maybe because this criminalization has a clearly documented adverse effect on testing and treatment and drives people into denial and secrecy?

Or maybe, just maybe, the criminalization has done nothing to stop the spread anymore than the criminalization of drugs stopped drug abuse?

Education and treatment are the only real solutions to this. People who are on antiretroviral drugs and undetectable have a 0% chance of infecting others.

Criminalization is all about revenge. Nothing more, nothing less.

or maybe, just maybe the state is tired of spending money on HIV drug cocktails for the prisoners?

 

[interchange]

or maybe, just maybe the state is tired of spending money on HIV drug cocktails for the prisoners?

I'd really love to know how many people have been convicted under the old statue. I'm guessing very few, and if so the law's practical purpose is as a deterrent. Sounds like evidence shows it does the opposite.

 

[Amused]

I'd really love to know how many people have been convicted under the old statue. I'm guessing very few, and if so the law's practical purpose is as a deterrent. Sounds like evidence shows it does the opposite.

Over 800.

https://williamsinstitute.law.ucla....minalization-California-Updated-June-2016.pdf

 

[Zorba]

So someone who has no viral load because of modern medicine should be put in prison?

If they don't tell their partener, and that partener gets the disease, yes. It is absolutely no different than randomly firing a gun. I think Hep C should be in the same boat as well.

I don't really see it as any different than stealthing, which a lot of people are pushing to be considered rape.

 

[interchange]

Over 800.

https://williamsinstitute.law.ucla....minalization-California-Updated-June-2016.pdf

Thanks for the data. Certainly crossed the threshold I had in my imagination. I suppose you would have to weigh the value of punishing these criminals vs it's lack of public health benefit to do so. I'm still solidly in the camp against it, but I don't fault someone for feeling otherwise so long as it is an informed opinion (e.g. not equating HIV to a death sentence or expecting tougher penalties to be effective as a deterrent).

 

[JSt0rm]

if they have no viral load their partner cant get it.

 

[edcoolio]

if they have no viral load their partner cant get it.

Therefore, there should be no issue telling their "partner" they should not worry about their disease status.

Regardless, there is plenty of hedging when it comes to the so-called "viral load". The best that can be said is that a low viral load means you are significantly LESS infectious (maybe even very close to 0), but you are still infected.

At an absolute minimum, the risk (no matter how small) of that decision should be decided by the uninfected partner(s).

 

[Zorba]

if they have no viral load their partner cant get it.

And the only people that don't tell their partner they have HIV are people with zero viral load. Regardless, it is completely wrong to lie about having chronic, very major communicable disease, in order to have sex with someone. And I think people that do should be held criminally responsible, especially if the other person gets the disease.

Although HIV isn't the death sentence it used to be, it is still a major life change, and crazy expensive to treat for the rest of your life.

 

[tommo123]

HIV infection is no longer a fatal infection. If a HIV infected person takes their antiretrovirals, they will now have the same life expectancy as an HIV uninfected patient. Yes it sucks having to take medications, but HIV is not like HIV of the 80's/90's.

so someone infected on purpose is still capable of having unprotected sex? on drugs your viral count could be lowered substantially and make infection less likely but it's still a risk. what about if you don't have the money to afford those drugs?

give someone a poison that will kill them but not for a decade or 2 and force them to pay through the nose for drugs to keep it from ravaging their body. yea, no punishment for that

 

[abj13]

so someone infected on purpose is still capable of having unprotected sex? on drugs your viral count could be lowered substantially and make infection less likely but it's still a risk. what about if you don't have the money to afford those drugs?

give someone a poison that will kill them but not for a decade or 2 and force them to pay through the nose for drugs to keep it from ravaging their body. yea, no punishment for that

Did you even bother to read what I posted? At no point did I say whether knowingly spreading HIV should not be criminalized. I agree with everyone who has also posted that if it is to be criminalized, it should be on par with other communicable diseases like hepatitis B or C. What should we do about conditions like HPV? Spreading HPV can result in cancer. What about Zika?

Furthermore, I suggest you try to learn about HIV treatment in the US. There are several programs that are specifically setup to aide in the care and treatment of underserved and underinsured patients. For example, the Ryan White Program funded by the US government already puts aside over 2 billion dollars a year to help provide care to these populations, including paying for medication costs. Then there is Medicaid. Thankfully we have agreed as a society to help those infected with HIV to get the therapy they need.

 

[Moonbeam]

An interesting issue. I see the same issue regarding punishing pedophilia and have argued that only drives people who have such a mental orientation to hide it with self preserving cunning, whereas, if the condition could only be understood as one that if you have it requires that you seek help in not ever acting out on it because of the damage such actions would have on children and by doing so one received moral attribution for such confessions rather than moral approbation. The problem seems to be that the desire to punish seems to go hand in hand with ones personal moral outrage rather than what might be best in the long run for civilization.

This raises the question as to whether the suppression of moral outrage in those who feel it by handing moral judgment over to a presumably less biased judgment via the law, results in a more positive or negative outcome. Here, for example if say such an event happened to a loved family member by some selfish swine interested only in his or her personal lust, condemning my loved one to a life long unasked for burden, how am I supposed to live with the feeling such a person gets to walk away with his or her life unchanged? That person robbed a loved one of innocence and robbed be of mine in the process. How many people with the feeling I would have would you want walking around on the streets? What are we asking of people to suggest they forego vengeance? For what purpose did vengeance evolve? Can it ever be said that consciously engaging in sexual behavior while aware one has a potentially deadly disease can ever be other than objectively evil? How much of a cross must we bear before we break?

 

[interchange]

This raises the question as to whether the suppression of moral outrage in those who feel it by handing moral judgment over to a presumably less biased judgment via the law, results in a more positive or negative outcome. Here, for example if say such an event happened to a loved family member by some selfish swine interested only in his or her personal lust, condemning my loved one to a life long unasked for burden, how am I supposed to live with the feeling such a person gets to walk away with his or her life unchanged? That person robbed a loved one of innocence and robbed be of mine in the process. How many people with the feeling I would have would you want walking around on the streets? What are we asking of people to suggest they forego vengeance? For what purpose did vengeance evolve? Can it ever be said that consciously engaging in sexual behavior while aware one has a potentially deadly disease can ever be other than objectively evil? How much of a cross must we bear before we break?

If we go on your theory that all hate is self hate, then moral outrage is self outrage -- perhaps an unconscious recognition that we all have similar drives as which motivates unacceptable behavior.

And so, outrage represents the morality of the weakest of us. If we can condemn something with simple disgust instead, we might be better off.

 

[Moonbeam]

If we go on your theory that all hate is self hate, then moral outrage is self outrage -- perhaps an unconscious recognition that we all have similar drives as which motivates unacceptable behavior.

And so, outrage represents the morality of the weakest of us. If we can condemn something with simple disgust instead, we might be better off.

I have long suspected that moral revulsion is a conditioned response made possible by the transmission from one person to another via language of ideas that have no actual reality, say, like eating using your fingers because of the ridiculous conventional pressure to use a fork, etc. In this way the mind can trigger, via ideation, a a far more fundamental and non rational response, vomiting when having eaten some that is in the process of making you sick. This, I think, is the evolutionary value of disgust.

It seems to me, therefore, that revenge based on moral outrage at anti social behavior is a social primate's way of disgorging sociopathic individuals from the social compact, reducing the possibility that such a disease, if hereditary, can be purged from the social system. This would also explain why conservatives who are the ones whose moral system includes group loyalty and respect for authority will persist in any primate grouping. It has evolutionary value that requires no intellectual underpinnings to maintain.

So basically, I believe that this whole matter is based on disgust and what is unconsious is how disgust comes to be connected to assumptions that have no reality. I believe, then that moral outrage and disgust are basically the same thing and one is not better than the other, and further, that both exist because they have survival value for out non-thinking ancestors and are a deep part of our nature. The answer, then, it seems to me has to do with self acceptance, that we are an animal aflicted with a nature that can't be eliminated by any form of rationalizations, but can be understood for what it. It is understanding and self acceptance, it seems to me, that allow the mind to transcend one's basic nature. One is what one is but the mind, conscious self awareness adds something much more. We are more than the sum of our parts. We are capable of love and one can't really love others if one hates oneself.

When the mind creates standards that are unnatural in the form of concepts and ideas and applies them to oneself, the self becomes divided into a self that fails to live up to those ideas, and a self that pretends it does. The self in such a state is at war within itself.

 

[Sunburn74]

Yeah, I disagree completely with Sen. Wiener on this one. It might be given harsh treatment, because it's a fatal (not to mention life changing) disease, very easily spread through a (relatively) common occurrence.

Fatal is a bit much. I think incurable and fraught with complications even with treatment is more right.

However, I think I would agree with you that it should be a felony to knowingly do so and a misdemeanor to unknowingly do so. However, I would require that documented transmission is necessary to get the felony charge, rather than just the act. The act of sex without disclosure without transmission should probably be a misdemeanor.

Simply put, in this day and age, there really is no excuse to have HIV and not know about it with how easy it is to get either over the counter testing or even free testing. Thats why I disagree with the Senator claiming its just like any other illness. Its not. Most sexually communicable diseases are not as aggressively screened for as HIV and don't have the lifelong impact either. If you're a homeless guy, you can very easily be screened for HIV in almost any major city. Many publically run hospitals, emergency centers, clinics and even jails screen everyone for HIV who passes through their doors. On the other hand, its pretty hard to get yourself screened for syphilis or trichomonas or chlamydia and etc even though those disorders are more common and are curable. In part, screening is less aggressive because they are highly treatable, their screening methods are a bit more cumbersome (may require urine, throat swabs, and other less readily accessible fluids as opposed to a simple blood test as with HIV) and the person is generally symptomatic at some point whilst with HIV prevention is by far the strategy with the best outcomes.

 

[[DHT]Osiris]

Fatal is a bit much. I think incurable and fraught with complications even with treatment is more right.

However, I think I would agree with you that it should be a felony to knowingly do so and a misdemeanor to unknowingly do so. However, I would require that documented transmission is necessary to get the felony charge, rather than just the act. The act of sex without disclosure without transmission should probably be a misdemeanor.

Simply put, in this day and age, there really is no excuse to have HIV and not know about it with how easy it is to get either over the counter testing or even free testing. Thats why I disagree with the Senator claiming its just like any other illness. Its not. Most sexually communicable diseases are not as aggressively screened for as HIV and don't have the lifelong impact either. If you're a homeless guy, you can very easily be screened for HIV in almost any major city. Many publically run hospitals, emergency centers, clinics and even jails screen everyone for HIV who passes through their doors. On the other hand, its pretty hard to get yourself screened for syphilis or trichomonas or chlamydia and etc even though those disorders are more common and are curable. In part, screening is less aggressive because they are highly treatable, their screening methods are a bit more cumbersome (may require urine, throat swabs, and other less readily accessible fluids as opposed to a simple blood test as with HIV) and the person is generally symptomatic at some point whilst with HIV prevention is by far the strategy with the best outcomes.

I'd say documented transmission shouldn't be necessary, although proof of everything should be to prevent people from diming out others with a felony charge. But first degree attempted murder (requires premeditation, which I think most would agree 'i have HIV and I'm gonna have sex with you' constitutes) is a felony charge, and so even if 'unsuccessful' at transmission of HIV it should still be a felony. I know I wouldn't feel better about having sex with someone without them disclosing HIV and me being on the receiving end, so to speak.

Also, the whole point of this is speaking about criminalization of an act, it's not like having a 'willingly disclose vs unwillingly disclose' even factors into the equation for someone willingly committing a known, and rather, horrible crime (transmitting HIV to someone knowingly). It should be a misdemeanor if they didn't know they had HIV when they transmitted it, frankly. Accidental homicide still has penalties (in fact, it's still a felony) so this shouldn't get a pass imo.

I do understand that HIV isn't the 1-5yr death sentence it once was if you're in a first world nation, but without medical care for the remainder of your life (and very probably a shitload of money) it'll still kill you, and at minimum it's a life changing event, probably on par with being paralyzed. As a note, that would be aggravated assault which is *also* a felony.

 

[interchange]

I do understand that HIV isn't the 1-5yr death sentence it once was if you're in a first world nation, but without medical care for the remainder of your life (and very probably a shitload of money) it'll still kill you, and at minimum it's a life changing event, probably on par with being paralyzed. As a note, that would be aggravated assault which is *also* a felony.

This is very far off from reality. A typical person who is adherent to care faces very little morbidity. Thanks to the Ryan White program, those without access to care can get high quality treatment for free. Yes, there are many potential caveats. But, for reference, I joked with a colleague about a year ago that I wished many of my patients would get HIV. Of course I don't, but the rationale there was because it would enable them access to a whole variety of high quality services they need in their lives, and likely the HIV would have little negative consequence in return.

Additionally, I'm going to do more research on transmissibility of HIV, but as framed here, vaginal intercourse without comorbid active STD and someone on treatment -- this is an extremely difficult environment to transmit HIV. I wonder if it is possible to come up with a set of reasonable circumstances where it is practically impossible.

Anyway, the preponderance of inaccurate information and stigma here is really telling of why, regardless of actual risk, people with the illness would be so reticent to inform partners or get tested themselves.

 

[[DHT]Osiris]

This is very far off from reality. A typical person who is adherent to care faces very little morbidity. Thanks to the Ryan White program, those without access to care can get high quality treatment for free. Yes, there are many potential caveats. But, for reference, I joked with a colleague about a year ago that I wished many of my patients would get HIV. Of course I don't, but the rationale there was because it would enable them access to a whole variety of high quality services they need in their lives, and likely the HIV would have little negative consequence in return.

Additionally, I'm going to do more research on transmissibility of HIV, but as framed here, vaginal intercourse without comorbid active STD and someone on treatment -- this is an extremely difficult environment to transmit HIV. I wonder if it is possible to come up with a set of reasonable circumstances where it is practically impossible.

Anyway, the preponderance of inaccurate information and stigma here is really telling of why, regardless of actual risk, people with the illness would be so reticent to inform partners or get tested themselves.

Fair enough, some of my thoughts on it may be reactionary and outdated. It's still a little silly though to say 'because we have treatment for it, we shouldn't consider it bad enough to issue a felony charge'. Again, I'd relate it to an accident that results in someone being severely maimed, like losing a leg. We have great prosthetics, but does that mean that the crime should be given a pass? Or a less severe punishment?

If all this knowledge is inaccurate, and a stigma exists, there needs to be some kind of 'state of the union' from the medical community regarding the current status of HIV (and potentially other diseases). If someone who tends to read a lot about a lot of topics (me) isn't even passingly aware of how things are beyond 'they have some treatments that have been developed in the last three decades' then what about your average Joe Football?

 

[abj13]

Additionally, I'm going to do more research on transmissibility of HIV, but as framed here, vaginal intercourse without comorbid active STD and someone on treatment -- this is an extremely difficult environment to transmit HIV. I wonder if it is possible to come up with a set of reasonable circumstances where it is practically impossible.

HIV is a poorly transmitted virus. For example, in needlestick situations with known HIV positive blood and detectable viral load, the risk of transmission is 0.3%. Similarly, the risk for transmission of Hepatitis C is about 2%, and Hepatitis B transmission can be as high as 30% in unvaccinated individuals.

There's been multiple studies examining your question, but one of the best well done study is the following:

https://www.ncbi.nlm.nih.gov/pubmed/27404185

They followed over a thousand couples in which one partner was HIV positive and the other was negative. The HIV positive person had to be on anti-retrovirals. They then followed them for several years and the couples were freely open to disclosing intercourse with persons that are not their partner. There were 11 episodes of HIV transmission, but when they tested the HIV virus to determine if there was transmission, there were zero cases of HIV transmission within a couple. All of the newly HIV positive partners got their virus from someone else. I can't remember if they also tested the compliance of the HIV positive individuals, it might be another study in which they tested the antiretroviral level in the blood.

 

[interchange]

Fair enough, some of my thoughts on it may be reactionary and outdated. It's still a little silly though to say 'because we have treatment for it, we shouldn't consider it bad enough to issue a felony charge'. Again, I'd relate it to an accident that results in someone being severely maimed, like losing a leg. We have great prosthetics, but does that mean that the crime should be given a pass? Or a less severe punishment?

Note that it is still criminal (misdemeanor), and in my first post here I did state that I felt it was also criminal and there is value in punishing criminals in a just manner.

If all this knowledge is inaccurate, and a stigma exists, there needs to be some kind of 'state of the union' from the medical community regarding the current status of HIV (and potentially other diseases). If someone who tends to read a lot about a lot of topics (me) isn't even passingly aware of how things are beyond 'they have some treatments that have been developed in the last three decades' then what about your average Joe Football?

I think this is a really helpful intervention and should be part of our funding. I think it will have limited efficacy, but help. Not sure to what degree this kind of education is already being funded and happening also.

Perhaps this will help us:
In punishing this criminal behavior, what outcomes are you most interested in? Recidivism? HIV infection rate? HIV stigma? Simply feeling like you haven't given someone a free pass?

 

[[DHT]Osiris]

I think this is a really helpful intervention and should be part of our funding. I think it will have limited efficacy, but help. Not sure to what degree this kind of education is already being funded and happening also.

Perhaps this will help us:
In punishing this criminal behavior, what outcomes are you most interested in? Recidivism? HIV infection rate? HIV stigma? Simply feeling like you haven't given someone a free pass?

Agreed, it should be part of our funding. It'd probably be a slow-burn, something that increases awareness over time (generations, likely).

I guess the outcome I'm most interested in would be to reduce infection spread rates among those flippant enough to think it's no big deal (probably small numbers) as well as to normalize punishments for crimes (attempted murder is felony no matter how 'creative' you get with it). Note that this isn't getting into crime and punishment fairness, I could do a whole thread on that alone, just that it seems incongruent with other punishments. I'd say also, to feel as though the victim has some measure of closure in at least knowing that the person won't likely harm others. It's a small victory but it is a victory.

 

[madoka]

He should have committed his crime in CA where braindead liberals would protect him.

http://nypost.com/2017/06/07/man-with-hiv-charged-with-murder-after-girlfriend-dies-of-aids/0/

A married man accused of not telling his longtime girlfriend that he was HIV-positive was charged with murder after the woman died of AIDS.

A judge on Tuesday set bond at $1.5 million for Ronald Murdock, who was indicted last week in the February death of 51-year-old Kimberly Klempner.

Murdock, 51, of Toledo, who also is charged with felonious assault. A message seeking comment on the accusations was left with his attorney.

Murdock and Klempner had unprotected sex when he knew he was HIV positive, but he did not tell her, the indictment said. They were involved in a five-year relationship, Klempner’s son said.

A police report said Murdock’s wife discovered that Murdock and Klempner were having an affair and told Klempner that Murdock was HIV positive.

“By the time she found out and by the time everything was said and done, it was way too late,” said Josh Klempner.

His mother’s death certificate listed the cause of death as AIDS.

“She would have done anything for that man,” Josh Klempner said. “And for him not to come out in the beginning and tell her what was going on was not right.”

 

[highland145]

Maybe because HIV is the first and only criminalized disease in history? Maybe because this criminalization has a clearly documented adverse effect on testing and treatment and drives people into denial and secrecy?

Or maybe, just maybe, the criminalization has done nothing to stop the spread anymore than the criminalization of drugs stopped drug abuse?

Education and treatment are the only real solutions to this. People who are on antiretroviral drugs and undetectable have a 0% chance of infecting others.

Criminalization is all about revenge. Nothing more, nothing less.

Cool. Let's slip it to your family.

 

[highland145]

HIV infection is no longer a fatal infection. If a HIV infected person takes their antiretrovirals, they will now have the same life expectancy as an HIV uninfected patient. Yes it sucks having to take medications, but HIV is not like HIV of the 80's/90's.

Hey, another person up for the cause before they had HIV.

 

[momeNt]

Now that HIV is permanently treatable, this law is technically a big pharma subsidy. Pharm lobbies just securing future streams of revenue. Ideally we all would have HIV so that way we can remove the laws concerning disclosure about it entirely.

 

[JSt0rm]

Now that HIV is permanently treatable, this law is technically a big pharma subsidy. Pharm lobbies just securing future streams of revenue. Ideally we all would have HIV so that way we can remove the laws concerning disclosure about it entirely.

what if there was less transmission because of this then before? Would you go with the science or would you stick your head in the sand because your sensibilities about justice come first?