Is It A Crime? A Look At HIV Criminalization in U.S.

Brooklyn native Nushawn J. Williams was informed that he had HIV in 1996.  Despite this, he was determined by health officials to have had sex with up to 75 partners.  By his own unabashed admission, he actually slept with 300 women.  He did not use protection in these encounters and caused an outbreak of HIV in upstate New York. [i]  His youngest partner was 13 years old.[ii]  By 1998, two of his partners had given birth to HIV-positive children.[iii]     His case was one of the earliest involving HIV status disclosure and Nushawn became the poster child for HIV criminalization.

When you hear stories like this, the question of whether to criminalize HIV exposure seems like a no-brainer.  Legislators apparently agreed; Williams’ case was cited in a number legal proposals, including requiring states to keep registries of HIV-positive residents and making it a felony not to disclose one’s positive status to sexual partners.[iv]   

As of 2008, 34 states in the US have laws that allow prosecution for criminal HIV exposure.  The provisions of these laws vary widely by state and by the context of exposure.  In New Jersey, for example, someone who knows he or she is HIV-positive and has sex without a partner’s informed consent is guilty of a third-degree crime.  This offense can be punished by up to five years in prison and a fine of up to $15,000.  In states such as California and Alaska, being HIV-positive can be an aggravating factor in sexual offenses.[v]

Those who argue against HIV criminalization often claim that mandating disclosure for individuals with HIV violates their right to privacy.  Additionally, it can increase the stigma associated with the virus.  Such laws therefore infringe on the civil rights of the HIV-positive person.[vi]  

William Brawner was born with HIV and had developed AIDS by the time he was in college.  Described as a ladies’ man, he had unprotected sex with numerous girls before going public with his status and participating in a documentary on his journey with AIDS.  When asked in an interview with Loop 21 if he wished he had come clean sooner, Brawner responded in the negative.  He said, “I think everything happens in its time.  Everything has its time and has its purpose. It was just my time.”[i]

The obvious counter is that the right time would have been when Brawner first had unprotected sex.  The HIV-positive person’s right to privacy ends where he or she puts another person at risk.  What about the rights of this person?  You didn’t bother to tell me that if I have sex with you I may end up getting a horrible disease that changes my life and that’s ok because you have a right to privacy? Really?

 

While the high profile Williams and Brawner cases are cited here, there are many other cases that go unreported in the media.  Further, many are not as clear cut.  For legal purposes, it is difficult to prove which party originally had the virus, especially when multiple partners are involved.  The first person to get tested and find out his or her status may shoulder the blame, even if he or she was actually infected by someone else who was not diagnosed until later.  It also possible for people to use the legal system to seek revenge against former partners who are HIV-positive.[i] 

Laws that criminalize HIV exposure may have the paradoxical effect of increasing transmission.  Research does not support the idea that the law plays a role in anyone’s sexual behavior.  Sexual activity is often impulsive and laws based on rational analysis therefore have a very limited impact.  Getting tested for HIV, on the other hand, requires deliberation and effort.   Laws that impose obligations on those who know their HIV-positive status and make it possible for this status to be made public and used against them in prosecution may deter testing.[ii] 

While there should be legal options for extreme cases like Nushawn Williams, criminalization is not a very useful tool in the fight against HIV/AIDS.  We would hope that those with HIV do the right thing and be honest with their sexual partners.  However, legally mandating that they do so is not an effective prevention tactic.  At the end of the day, it is up to you to protect yourself. 

Here’s what you can do:

1.    Get tested

2.   Have your partner to do the same

3.   Always ask what someone’s status is before a sexual encounter

4.   Be honest about your own status

5.    Don’t go through with it if you don’t trust them to tell you the truth or you’re not willing to take the risk

6.   Use protection

To find an HIV testing site near you, please go to http://www.hivtest.org/

--Melanie Pino-Elliott

GET DOWN Youth Blogger

mpino@sas.upenn.edu

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[i] AVERT. http://www.avert.org/criminal-transmission.htm

[ii] Richard Elliott.  Criminal Law, Public Health, and HIV Transmission: A Policy Options Paper. http://data.unaids.org/publications/IRC-pub02/jc733-criminallaw_en.pdf

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[i] Darren Sands.  “25 to Life: In New Film, Man with AIDS Confesses Unprotected Past.” http://loop21.com/life/coming-clean-hiv-postive-man-confronts-lives-he-destroyed

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[i] Michael Cooper.  “Drifter Says He Had Sex with up to 300.” http://www.nytimes.com/1999/07/29/nyregion/drifter-says-he-had-sex-with-up-to-300.html

[ii] Jennifer Frey.  “Jamestown and the Story of 'Nushawn's Girls.'”  http://www.washingtonpost.com/wp-srv/style/features/jamestown0601.htm

[iii] Richard Perez-Pena.  “Two Births Lengthen List in One-Man HIV Spree.”  http://www.nytimes.com/1998/01/29/nyregion/two-births-lengthen-list-in-one-man-hiv-spree.html

[iv] Richard Perez-Pena. http://www.nytimes.com/1998/01/29/nyregion/two-births-lengthen-list-in-one-man-hiv-spree.html

[v] American Civil Liberties Union.  State Criminal Statutes on HIV Transmission—2008.  http://www.aclu.org/files/images/asset_upload_file292_35655.pdf

[vi] AVERT.  Criminal Transmission of HIV. http://www.avert.org/criminal-transmission.htm

C.R.E.A.M. Human Slavery Alive And Well in U.S.

At a marketing firm in a major U.S. city, there is a 28-year-old sales representative named Todd.  He works 9 to 5, drives a Hybrid, has a serious girlfriend, and spends holidays volunteering at a soup kitchen.  One Saturday night, Todd attends the bachelor party of his college friend Larry, who is getting married the following weekend.  The party is held at a local strip club.  Todd has no intention of cheating on his girlfriend and probably wouldn’t do anything sketchy like paying for sex anyway.  However, simply by paying his cover charge at the door, he unwittingly contributed to human slavery.

Sex trafficking—the illegal trade of human beings for sexual exploitation—is a global problem.  It is one of the word’s largest criminal enterprises, tied with the arms market and second only to the drug trade.[i]  You’ve probably heard about it.  It may not surprise you that large numbers of Burmese women and children are smuggled into Thailand to work in brothels.  Or that in the last few years roughly 100,000 Ukrainian women were exported into the sex trade in western Europe.  Or that related problems occur in other countries across Europe and Asia, as well as Africa, Australia, and Latin America.[ii]  However, sex trafficking is not the exclusively foreign problem that such statements would lead you to believe.  What may surprise you is just how big this problem is in the United States. 

Let us return to the strip club.  One of the girls working that night, Tina, is from South Bend, Indiana.  Her father was an angry, abusive man and her mother coped by drinking heavily.  When Tina was 13, she met a man named Jake.  He listened to her.  Unlike her parents, he seemed to care about her.  She quickly fell in love.  After a few months of being together, he convinced her to leave her miserable horrible home life and move with him to the "big city".   When they arrived, he got her a job at the club.  She became a stripper, believing him when he said it was the only way they could support themselves.

When he started insisting that she have sex with the patrons, she tried to resist.  He then beat her, raped her, and chained her to the wall for several days.  Both emotionally and physically under his control, she obeyed his orders.  Tina now has sex with several clients a night and gives the money to Jake.  She sees no way out of this life.  Jake has told her that if she goes to the police, she’ll be the one in trouble.  She is the prostitute, after all.

Though this story and its characters are fictional, they represent thousands of real situations across the country.  Because of the underground economy and the fear and coercion used to keep victims from coming forward, statistics on sex trafficking are difficult to come by.[i]  However, analysts estimate that between 100,000 and 300,000 children are sexually exploited in the US and that the average age of entry into the trade is 12 to 14 years old.[ii] 

It gets worse for the club patrons with fewer reservations than Todd.  Due to the nature of their work, sex trafficking victims have a comparatively high risk of HIV infection.  They are forced to sell sex, usually to multiple partners and may not be given access to condoms.  Additionally, the sex acts that occur are often of a riskier nature.  For example, injuries inflicted during violent sex may not allowed to heal properly before future encounters, increasing susceptibility to the virus.[iii] Those who solicit sexual services from the club dancers, therefore, put themselves at risk of contracting HIV. 

It is important to understand that human trafficking is very much tied to the legal sex trade.  Pimps frequently start their victims off in strip clubs, massage parlors, escort services, or pornography.  After progressing to prostitution, these venues provide a cover for the illegal activity.[i]  What many people would declare a harmless way for guys to blow off steam in fact feeds into one of the most evil institutions in the world.  Sex trafficking exists for one simple reason: it is profitable.  If there were no demand, there would be no market.  Patrons of the commercial sex industry, legal or illegal, are part of the demand that keeps this market alive. 

Every year in January, Human Rights Organizations bring attention to Sex Trafficking around Human Trafficking Awareness Day.  While the sex trade, and sale of woman and children is a global pandemic, the connection between the trade and HIV and overall sexual health must be part of the dialogue, especially in the United States. 

If you believe you or someone you know is a victim of human trafficking, please call the National Human Trafficking Resource Center at 1-888-3737-888 or visit http://www.polarisproject.org/what-we-do/national-human-trafficking-hotline/the-nhtrc/overview

To find out some of the warning signs that someone may be a trafficking victim, please see http://www.lightunderthebridge.com/Human_Trafficking.html

To learn more about human trafficking, check out http://www.polarisproject.org/human-trafficking/overview

--Melanie Pino-Elliott

GET DOWN Youth Blogger

mpino@sas.upenn.edu

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[i] Shared Hope International.  “Demand: A Comparative Examination of Sex Tourism and Trafficking in Jamaica, Japan, the Netherlands, and the United States.” http://www.sharedhope.org/Portals/0/Documents/DEMAND.pdf

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[i] PBS.  “Estimating the Numbers.” http://www.pbs.org/wgbh/pages/frontline/slaves/etc/stats.html

[ii] Neubauer, http://www.washingtontimes.com/news/2011/apr/23/sex-trafficking-us-called-epidemic/?page=all

[iii] Amanda Kloer.  “Sex Trafficking and HIV/AIDS A Deadly Junction for Women and Girls.” http://www.americanbar.org/publications/human_rights_magazine_home/irr_hr_spring10_kloer.html

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[i] Chuck Neubauer.  “Sex Trafficking in the U.S. Called ‘Epidemic.’” http://www.washingtontimes.com/news/2011/apr/23/sex-trafficking-us-called-epidemic/?page=all

[ii] Coalition Against Trafficking in Women.  http://www.catwinternational.org/factbook/index.php

Sex Education in Philadelphia Schools: An Ounce of Prevention

Every so often, along the brick pathways that go through the University of Pennsylvania campus, there are stone panels with quotes from Benjamin Franklin etched into them.  Every Tuesday, on my way to statistics class, I pass one that reads, “An ounce of prevention is worth a pound of cure.”  This idea is very important to the HIV/AIDS situation, especially here in Philadelphia.

Philadelphia’s HIV infection rate is five times the national average, affecting 1.3% of the population.[i]  Young adults are the most at risk of contracting Sexually Transmitted Infections (STIs) in general, and for HIV in particular, infections have increased by 40% over the last three years.[ii]  According to the National Institute of Allergy and Infectious Diseases, almost 18% of reported AIDS cases in the United States are people ages 20-29.  Because AIDS usually takes 10 years to develop after HIV infection, these young adults probably contracted the virus as teenagers.

Psychologists believe that the part of the brain responsible for evaluating long-term consequences is still immature during adolescence.[iii]  For this reason, teens often engage in risky behaviors such as becoming sexually active at an early age, using drugs, not using protection, or having sex with multiple partners,[iv] all of which make HIV infection more likely.

 

If you are a teenager living in the Philadelphia area, you face a major challenge in getting information and skills useful for prevention.  In Pennsylvania public schools, sexual health is rarely taught until high school, at which point you or your peers may already be sexually active; a 2009 survey from the CDC found that 15% of Philadelphia teens lose their virginity before age 13.[i] 

Public schools in Pennsylvania are required to teach STI and HIV transmission, but not as part of a comprehensive sex education curriculum.[ii]  Last year, the Healthy Youth Act (HB 1163), which would have made schools offer age-appropriate sex ed,  covering both abstinence and contraception, failed to pass.[iii]  Instead, individual districts are left to decide whether sex ed will be offered and what will be included in the curriculum.[iv] 

Many of the health classes that are taught are not very practical.  The trend seems to be focusing on anatomy and physiology rather than real-life applications and decision-making.  As Brenda Green, executive director of Concern for Health Options: Information, Care, and Education (CHOICE) said in a Philadelphia City Paper article, “When you’re 15 and someone is pressuring you into something you may not want to do, knowing what your fallopian tubes are won’t help.”

Some community-based programs have arisen to (partially) make up for these shortcomings. CHOICE is based in Philadelphia and provides services throughout Pennsylvania.  The organization teaches sexual health through formal presentations, local events and community outreach. They also operate a hotline where teens can call in with any questions about health, relationships, or related subjects [v] Another movement called Take Control Philly, which offers STI testing at health centers and allows teens ages 13-19 to pick up or order free condoms.[vi]

Factors other than education influence adolescent sexual behavior.  Some things that predict less sexual risk-taking are close relationships with parents, strong religious affiliations, and involvement in school and community activities.  On the other hand, riskier sexual behavior corresponds to sexually irresponsible parents, sexually active friends and peers, romantic relationships (particularly with older partners), alcohol and drug use, and gang involvement.[vii]

Ultimately, however, sexual responsibility is an individual choice.  Teens, your parents may not have been great role models to you.  Your school may not have educated you properly.  Your friends may be pressuring you.  But you still have the power to do what is right for you.  Becoming sexually active is a big decision that you shouldn’t rush into or make for the wrong reasons.  If you are sexually active, HIV (as well as pregnancy, and other STIs) can happen to you.  If you use protection consistently, the risk of HIV can be reduced by 80%.[viii]  You should know your partner, your partner’s sexual history, and you should both get tested for HIV.  Make sure your partner is someone you trust to tell you the truth and to support you if the worst should happen.  Respect yourself, protect yourself, and remember the words of Ben Franklin: “An ounce of prevention is worth a pound of cure.” 

For more advice on dealing with peer pressure and sex, go here: http://kidshealth.org/teen/sexual_health/girls/virginity.html?tracking=T_RelatedArticle

For more information on your body, sexual health, and relationships, check out http://www.choiceteens.org/ or call 1-800-84-TEENS

To find an HIV Testing Site near you, follow this link: http://www.hivtest.org/

--Melanie Pino-Elliott

GET DOWN Youth Blogger

mpino@sas.upenn.edu

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[i] Daniel Denvir, 2011.  Avoiding the Subject: Philadelphia Schools are Failing When It Come to Sex Education. http://www.citypaper.net/news/2011-10-20-philadelphia-schools-sex-education.html

[ii] Christina Long, 2011.  Urgent Need for Sex Education in Philly Schools. http://www.thenotebook.org/blog/113578/urgent-need-sex-education-philly-schools

[iii] Brian Wallace, 2010.  Bill Would Require Sex-Ed Classes in Public Schools. http://lancasteronline.com/article/local/253048_Bill-would-require-sex-ed-classes-in-public-schools.html

[iv] Christina Long, 2011.

[v] http://www.choiceteens.org/

[vi] http://www.takecontrolphilly.org/

[vii] Douglas Kiry & Gina Lepore, 2007.  Sexual Risk and Protective Factors. http://www.etr.org/recapp/documents/theories/RiskProtectiveFactors200712.pdf

[viii] World Health Organization, 2011.  Condom Effectiveness in Reducing Heterosexual HIV Transmission. http://apps.who.int/rhl/hiv_aids/dwcom/en/index.html

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[i] Nick Powell, 2010.  City Council Tackles HIV/AIDS epidemic in Philly. http://blogs.philadelphiaweekly.com/phillynow/2010/10/27/city-council-tackles-hivaids-epidemic-in-philly/

[ii] WHYY Radion, 2011. http://whyy.org/cms/radiotimes/2011/04/12/11025/

[iii] Salynn Boyles, 2007.  Teens Are Hard-Wired for Risky Behavior. http://www.webmd.com/parenting/news/20070413/teens-are-hardwired-for-risky-behavior

[iv] American Academy of Child & Adolescent Psychiatry, 2004.  Children, Adolescents, and HIV/AIDS. http://www.aacap.org/cs/root/facts_for_families/children_adolescents_and_hiv/aids

A Dangerous Liaison: Antifeminist Culture And The Spread Of HIV

Despite having made great strides toward gender equality, American society remains rather antifeminist.  Yes, women have the right to vote.  Yes, discrimination on the basis of sex is illegal.  However, these official mandates have not changed the cultural perception of women as the weaker sex. 

One illustration of this is violence against women, which presents a problem across the globe.  Sexual violence, in particular, can be used as a weapon in political conflict and is rampant in war-torn countries.  For instance, health centers in the South Kivu region of the Democratic Republic of the Congo estimate that 40 local women are raped every day.  Following a civil war in Liberia, 92% of 1,600 women surveyed reported being victims of sexual violence, including rape.  Meanwhile, in Darfur, women and girls live under the constant threat of rape by Sudanese Government soldiers, militia, and rebels.[i]

In addition to the global problem of sexual violence as a weapon of war, it is also a serious issue at the relationship level.  Surveys from the World Health Organization show that 15% of women in Japan and 70% of women in Ethiopia and Peru experienced physical and/or sexual violence from an intimate partner.[ii]  According to data from The United Nations Children’s Fund, 35% of women surveyed in Egypt were beaten by their husbands at some point in the marriage.  In Israel, 30% reported sexual coercion by their husbands in the previous year.[iii]

The United States is not much of an exception. The Rape, Abuse, and Incest National Network reports that approximately 17.7 million women in the country have been rape victims.  28% of rapes are committed by an intimate partner.[iv]

 

Intimate partner violence has important implications for the HIV/AIDS pandemic.  The sexual transmission of HIV occurs primarily through unprotected sex.[v]  Women in abusive relationships have limited ability to negotiate whether they have sex at all, much less whether condoms are used.  Additionally, the trauma and tearing experienced in forced encounters increases the risk of the virus’s transmission. [vi]

Currently, not much research has been done on the prevalence of AIDS resulting from sexual coercion in the United States.  According to the National Center For Victims, the Center for Disease Control and Prevention, the agency responsible for tracking the spread of AIDS, does not record cases by consensual and non-censual sex but mainly by age, gender, race and risk group.[vii]   However, this relationship has been noted in other countries.  In sub-Saharan Africa, for example, the high rate of sexual violence has been linked to the region’s high infection rates. [viii]

Despite troubling situations like this, gender inequality is not always acknowledged as a legitimate social problem.  For instance, I recently had a conversation with my friend Kristen, in which she expressed a desire for feminists to “stop harping.”

 

“Harping?” I replied incredulously.  “For equal rights?”

“We have equal rights.  And the spousal abuse rate is 50/50,” she said as if this settled the matter.

“There are other indicators of inequality,” I said slowly, taking a deep breath in an effort to avoid exploding and thus hurting my cause by living up to the hysterical woman stereotype—one I knew Kristen believed.  “Like the pay gap—women get 77 cents to the dollar for doing the same job as a man.”

“So what?” she said.  “I’m content.  Can’t we just leave it at that?”

I later discovered that Kristen’s statistic on spousal abuse was sorely mistaken.  The National Crime Victimization Survey reports that 85 % of cases feature female victims.  Of course, domestic violence comes in other forms as well—wives may abuse their husbands, women may abuse their female partners, and men may abuse their male partners.  Abuse also occurs in non-spousal relationships, particularly among young people.  A report from the Bureau of Justice found that 60 percent of a sample of 500 women ages 15 to 24 were currently in an abusive relationship, while all of them had experienced dating violence at some point in their lives.[ix]

Though there are many kinds of abuse, the typical battery case has a male aggressor and a female recipient.  One of the key causes of battering is a pathological need for control rooted in misogyny.  Abusive men see female partners as subordinates for whom they have the right to make decisions.  If the woman does not comply with his will, the abusive man will resort to violent behavior to punish her and regain control.[x]  This violence often includes sexual coercion. 

Abusive relationships are not only prone to an increased risk of HIV infection, but correspond to other risk factors as well.  Several studies show that women with histories of physical and sexual abuse are more likely to contract HIV.[xi]  Sexual assault victims often experience an enhanced need for intimacy and sexualization of affection, which lead to repeated sexual encounters.  They also may use drugs or alcohol to cope with the pain of abuse, impairing their judgment and prompting riskier sexual behavior.  Research documents these victims as being more likely to have casual sex, to engage with multiple partners, and not to use protection.

 

So no, Kristen, we cannot just leave it at that.  Feminism is not a redundant movement for an issue that the Constitution has already remedied.  It’s not just about harping for a 23-cent-to-the-dollar pay raise.  It is an effort to create a society that actually practices the values it claims to hold dear.  And sometimes—like in the case of sexually coercive relationships leading to the spread of HIV/AIDS—it is a matter of life and death.

 

As AIDS is a dangerous, life-altering disease with no cure and limited treatments, it is crucial to prevent infection by targeting the roots of the problem.  Where the problem can be attributed to a cultural promotion of domestic violence, we must begin by making a change in attitude.  Though domestic violence affects both men and women, both the victimization of women and the cultural degradation of women are more common.  Here are some things you as an individual can do to create an environment that promotes gender equality:

1.    The media plays a big part in shaping your worldviews.  Make informed choices about the movies and television you watch, the music you listen to, and the magazines you read.  Look for sources of entertainment that portray women respectfully.

2.   Watch your language.  Remove words like “bitch,” “slut,” and “whore,” from your vocabulary.  Even if you’re saying it jokingly to a friend, even if you’re talking about someone who will never hear you say it, these words make a statement about how you think women should be treated.

3.   When you come across these and other situations that reinforce female degradation, speak up.  Don’t pick fights, but start thoughtful conversations. 

4.   Help girls and women respect themselves for non-physical reasons.  Compliment your female friends on their intelligence, hard work, and accomplishments at least as often as you do on their appearance.

5.    Mentor the young people in your life.  Encourage girls to live up to their full potential and encourage boys to treat girls as equals.

Whether or not you personally know someone who has contracted or is in danger of contracting HIV from an abusive partner, this issue is relevant to all of us.  Everyone plays a part in the formation of our culture.  You can accept the dominant trend or you can take a stand, set a better example, and inspire others to do the same.  Make a difference within your own sphere of influence. 

If you have been victim of domestic violence, please call 1-800-799-SAFE (7233) or 1-800-787-3224 (TTY) for assistance.

For advice on counseling a friend or family member in an abusive relationship, follow this link: http://stoprelationshipabuse.org/educated/how-to-help-a-friend-who-is-being-abused/

If you think you may have recently been exposed to HIV/AIDS, there are treatment options available to help.  Consult your doctor immediately.

 

--Melanie Pino Elliott

GET DOWN Youth Blog Squad

mpino@sas.upenn.edu

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[i] Office of the High Commissioner for Human Rights.  Rape: Weapon of War. http://www.ohchr.org/en/newsevents/pages/rapeweaponwar.aspx

[ii] http://www.who.int/mediacentre/factsheets/fs239/en/

[iii] http://www.unicef-irc.org/publications/pdf/digest6e.pdf

[iv] http://www.rainn.org/statistics

[v] AVERT, 2011.  HIV Transmission—Frequently Asked Questions. http://www.avert.org/hiv-aids-transmission.htm

[vi] World Health Organization, 2004.  Intimate Partner Violence and HIV/AIDS.

[vii] The Centers for Disease Control and Prevetion, 2010.  HIV in the United States. http://www.cdc.gov/hiv/resources/factsheets/us.htm

[viii] Sexual Violence and HIV/AIDS Transmission.  Forced Migration Review, 2007. http://www.fmreview.org/FMRpdfs/FMR27/13.pdf 

[ix] ACADV.  Dating Violence. http://www.acadv.org/dating.html#statistics

[x] Lundy Bancroft, 2002. Why Does He Do That? Inside the Minds of Angry and Controlling Men.

[xi] The Well Project, 2011.  Domestic Violence and HIV. http://www.thewellproject.org/en_US/Womens_Center/Domestic_Violence_and_HIV.jsp

[xii] The Advocates for Human Rights, 2006.  Sexual Assault, HIV/AIDS and Other STIs. http://stopvaw.org/Sexual_Assault_HIV_AIDS_and_Other_STIs.html

Lundy Bancroft, 2002. Why Does He Do That? Inside the Minds of Angry and Controlling Men.

The Well Project, 2011.  Domestic Violence and HIV. http://www.thewellproject.org/en_US/Womens_Center/Domestic_Violence_and_HIV.jsp