Punishing Disease: HIV and the Criminalization of Sickness by Trevor Hoppe (review)

Trevor Hoppe breaks down misconceptions and moral judgments that lead to criminalization and seeks to educate readers and normalize HIV in his book, Punishing Disease. Hoppe divides the book into two sections to help answer the question, should criminal punishment be used to address a public health problem like infectious disease? Part I is a historical analysis of punitive criminal and health policies aimed toward disease control. Part II is an in-depth investigation into how HIV became criminalized by disclosure laws and who is mainly affected by these laws. Hoppe takes readers through the history of infectious diseases and details how sickness turned to "badness" (157) in the interplay between the criminal justice system and public health policy. Punishing Disease provides readers with a much-needed call to action to destigmatize HIV by calling upon individual, community and institutional prevention efforts.

Chapter 1 explores the history of infectious diseases such as the plague, typhoid, and tuberculosis. Hoppe uses sociological perspectives of social control to delineate the politics of coercive and punitive approaches to infectious disease control. Under the guise of protecting public health, Hoppe argues that punitive repercussions such as invasive surveillance, quarantine, and jail have a long history of predominantly affecting marginalized groups. Chapter 2 focuses on the history of HIV prevention strategy. Hoppe chronicles advances in medicine that changed HIV from a terminal disease to a manageable disease through antiretroviral treatment. He effectively argues that this shift created a paradigm of personal responsibility, likening HIV prevention to an individual's actions, which have been represented as such in public health campaigns. Hoppe's argument is potent as he identifies how the chasm between scientific research and prevention efforts continues to (mis)inform policy makers with antiquated beliefs regarding condom use and abstinence. Hoppe takes the discussion to a larger framework by criticizing public health campaigns' failures to comment on how structural conditions such as racism and poverty affect HIV prevention. Chapter 3 unpacks how positive prevention, a prevention strategy geared toward empowering HIV-positive individuals to self disclose their HIV-positive status, ended up nurturing a culture of surveillance to support and simultaneously punish HIV-positive individuals. Hoppe highlights how health officials and law enforcement work hand-in-hand to police bodies and sex, and limit civil liberties. Hoppe ends the section strongly by illuminating the difference between individual and institutional responsibility and whether disclosure is a reasonable prevention method if science contends there is almost a zero percent chance of HIV transmission if adhering to medication (61).

Chapter 4 characterizes the criminalization of HIV and how the disease differs from infectious disease epidemics in the past. Hoppe argues that there are four aspects that drive criminalization: social stigma, sensational media reports, moral entrepreneurs, and interest-group lobbying (131). Hoppe cites morality and judgments against homosexuality as the underlying catalyst for stigmatizing HIV discourse and policymaking therefore invoking disclosure of HIV-positive status prior to sex as a morally correct choice by individuals to protect the public. Chapter 5 connects history and policy to the courtroom and details the application of law. Hoppe illustrates how stigmatizing rhetoric and biases allow judges and prosecutors to convict HIV-positive defendants, even though their bases for conviction contradict scientific literature. Hoppe demonstrates that the underlying offense in these cases is simply being HIV-positive, which leads to his most salient point: punishment does not effectively handle sociomedical problems.

Chapter 6 reveals that the victim or "complainant" in an HIV-related crime may have great influence on how the courts punish HIV-positive defendants. Hoppe engages with sociolegal scholars to suggest that the process of legal action is most affected by the respective gender of a male defendant and female complainant. Hoppe contends that judges' and prosecutors' underlying sexist attitudes toward women and their perceived vulnerability result in higher incarceration rates for straight male defendants compared to gay male defendants in HIV-related crimes. Hoppe believes...