August 31, 2009
This blog previously appeared on The Center for HIV Law and Policy's Web site and has been reprinted with permission.
Nearly three decades after the identification of the first cases of AIDS, our national dialogue continues to fail those living with HIV by failing to put human rights at the center of AIDS prevention and treatment.
Stigma, discrimination, poverty, homophobia, racism, sexism, and misinformation continue to fuel the spread of HIV and hurt those living with it in very real ways. These terms routinely are recited in our collective litanies of what needs to be addressed, but far less frequently made concrete and specific in policy plans and prevention strategies. As a community, we need to consistently insist that government officials commit to a long-term response to HIV that treats human rights as a central theme rather than an isolated issue that can be bargained away when politics get in the way. Until all approaches -- whether legal, medical, or political -- are grounded in respect for the dignity of those individuals they purport to help, they will fail those individuals.
A compelling example is the issue of the criminal prosecution and incarceration of people with HIV who dare to have sex without proof of HIV notification to their partners. Where are all the government health officials on this issue? Imagine where HIV-positive people serving time for spitting or having sex might be if the energy, advocacy and considerable funding invested in changing state HIV testing laws to eliminate informed consent had instead focused on the 30-plus state laws that make criminals of people with HIV for consensual sex, even when no transmission occurs? These policies reflect and perpetuate the stigma and misinformation that keeps HIV thriving, and scare people with or at risk of HIV a lot more than signing a consent form for testing. As government-created and enforced discrimination, they are a particularly toxic manifestation of AIDS-related stigma.
It's true that gains have been made recently in action that demonstrates that ONAP and other members of the Obama administration understand the importance of human rights in addressing the AIDS crisis. Last month, in response to advocacy by a group of advocates including the Center for HIV Law and Policy, the ACLU, Lambda Legal and GLAD, the U.S. Department of Justice issued a directive making it clear that state licensing boards and agencies that interpret their infectious/communicable disease clearance requirements to exclude people with HIV/AIDS from trades such as massage therapy, barbering, home health care, or physician's assistant are in violation of federal disability antidiscrimination law. The DOJ's action removes long-standing employment barriers for people with HIV or AIDS in the many states across the country that have prohibited their pursuit of a career on the mistaken belief that their HIV made them too dangerous for their chosen professions. And the ACLU, representing an army veteran who was fired from his job with a State Department contractor because he is HIV-positive, also just secured an important settlement in which the State Department agreed to end the automatic exclusion of people with HIV from working under State Department contracts.
These are important victories, empowering potentially thousands of people with HIV through access to meaningful employment, and hopefully sparing scarce and under-funded legal advocates the resources required to challenge past exclusions. They also are HIV prevention; there are multiple studies that demonstrate the connection between job options, the ability to earn a living and the inclination to engage in risk-taking behavior. Of course tests and drugs are critically important, but so are self-sufficiency, respect, dignity, and self-worth. Most of us rate these things as indispensable to our quality of life. Why is it so hard for policy-makers to see these as central to effective HIV prevention policy as well?