On Iowa, HIV Criminalization, and Cautious Optimism

When I want to remember the date that I tested HIV-positive, I Google “Ingmar Bergman’s Death.” My exposure to Bergman’s films as a youngster jump-started my devotion to unconventional, distinctively articulated filmmaking. For this, he will always remain dear to me. On July 30, 2007, he passed away and I learned I had HIV. On the bright side, the double whammy of loss did offer the minor consolation of a mnemonic device to handily recall the anniversary of my sero-conversion. Though not an optimist by nature, and despite the bad news, after the initial smoke of the bad news cleared, I remember advising myself to feel unbelievably lucky.

And I was lucky. This was 2007, not 1987; I would be fine, mostly. Not fine were my two gay neighbors, who died of AIDS-related complications when I was ten and living in a small, quiet town outside Wilkes-Barre, Pennsylvania. Because of them, Eddie and John, that is, I likely possessed a more acute awareness of HIV/AIDS than most others of my generation who came of age just after the advent of sustainable medical treatment for HIV infections. I learned of my sero-conversion while in Pennsylvania. My nine years living in New York City had just ended and I was soon off to Iowa City, where I would begin my doctoral studies. I realized having HIV might be tougher in Iowa than in New York, but I had decided to move to a quieter locale for a number of reasons and those remained in place.

What I did not know then was that living in Iowa entailed existing within a legal jurisdiction particularly fraught for HIV-positive people. I learned this on my first visit to an infectious disease clinic at the University of Iowa Hospital and Clinics. With the disinterested and rehearsed tone of a flight attendant reviewing safety protocol, my nurse practitioner informed me of Iowa’s HIV-criminalization law. In short, an HIV-positive person aware of his or her sero-status could be convicted of a felony if they did not disclose their status to a partner before engaging in any sexual contact whatsoever, including sex with a condom and even kissing. In 2007, thirty-two states in the United States had laws specific to criminalizing HIV, and all fifty states had some sort of law, however general, that was potentially applicable. Iowa’s was the harshest. Another revelation in a medical office and suddenly the two states of transition I found myself in (having HIV and moving to Iowa) felt insuperable and luckless.

I came to learn a significant amount about HIV criminalization. I even made a film about it in 2010 called Red Red Red. Yet, at the time, and despite my knowledge about HIV/AIDS, both its history and the pragmatic aspects, I knew little about criminalization. I was abstractly aware that people were prosecuted for HIV-related crimes, but I thought these cases only involved people who willingly tried to infect multiple partners. What my nurse practitioner described was a beast of an altogether different nature, one more prosaic, closer to home, and far more likely. Though Iowa finalized the wording of its law in 1998, after the advent of antiretroviral treatment that curbed the progress of HIV infection, the law itself was grounded in the many draconian state laws that required mandatory testing and quarantine throughout the 1980s.

Perhaps the most convincing argument against HIV criminalization is the fact that these laws may actually increase infection. Those who are HIV-positive, but unaware of their HIV status, are safe from being charged under these laws. If one believes oneself at risk for HIV infection, yet values these risk-bearing experiences as an integral part of one’s quality of life, that person may not want to be aware of their possible positive sero-status. Present treatments for HIV dramatically reduce the quantity of the virus in the blood, making infection far less apt to occur. If they avoid HIV testing to avoid the possibility of prosecution and are HIV-positive...