When the patients started trickling in during the mid-1980s, I admit that I was afraid. I took every precaution that I could when treating my AIDS patients, but of course, I still treated them — it was my duty as a doctor. The medical community didn’t yet know what caused AIDS, much less how it was transmitted. I could feel my heart beat a little faster and the sweat on my brow when I arrived at work to see that I had an AIDS patient on the schedule for the day.
The fear that I felt, however, paled in comparison to the fear that my patients felt. In the 1980s and early ’90s, an AIDS diagnosis meant certain death. We didn’t have the medicine we needed to treat AIDS effectively, and our patients knew it. Their faces said it all.
Now we know that AIDS is caused by the HIV virus, and we know exactly how it is and how it is not transmitted. We know that when people living with HIV have access to treatment, they can live full, healthy, robust lives. They can have romantic relationships, and even have children with no complications for their partner or offspring. This is all thanks to a single pill that, when taken daily, makes it impossible to transmit HIV to others.
Despite these tremendous medical advances, in Missouri we punish people who know that they are HIV positive, even though knowing your status is the responsible thing to do. It does not matter if a person living with HIV uses a condom, or has successfully suppressed their viral load by taking their once-daily pill — if someone living with HIV cannot prove without a doubt that they have disclosed their HIV status with a sexual partner, they may be subject to Class A felony charges. Even more egregious, we punish people for behaviors that cannot transmit HIV according to decades of scientific research. Transmission need not occur in order to be prosecuted under Missouri state code.
A Class A felony is at the same level as pre-meditated murder. It is at the same level as severe child abuse. Staff at agencies that serve people living with HIV tell us how painful it is to communicate this law to their clients right after they share an HIV-positive diagnosis.
Prosecuting and imprisoning people for living their lives while HIV positive is not effective public health policy. It does not save lives. What saves lives is access to care and effective medical intervention. It is with these tools that we will end HIV/AIDS, not through criminalization.
In memory of my patients who died too soon during the early years of the AIDS epidemic, I am eager to support HB 166 and 167, pre-filed by Reps. Tracy McCreery, Democrat, and Holly Rehder, Republican, respectively. These bills would modernize our outdated, harmful state statutes, removing a barrier to being tested and treated, and moving our state toward an HIV-free future.