Advocates support overturning Iowa’s criminal HIV law

Nine Iowa inmates sit behind bars for a crime that advocates say should no longer be on the books.

The men have been convicted of criminal transmission of HIV, a Class B felony that carries a sentence of up to 25 years in prison.

A group known as CHAIN - for Community HIV & Hepatitis Advocates of Iowa Network - is working to repeal that law.

“A lot of people have no idea that the criminal transmission laws even exist,” said Virginia Tonelli, CHAIN's advocacy coordinator. “It's not uniformly applied; it's not uniformly prosecuted. At the very least it needs to be reformed.”

According to CHAIN, the law undermines public health goals because it makes HIV-infected people less willing to get tested - you cannot be charged if you do not know your status - and less willing to disclose their HIV status to partners, out of fear of prosecution.

About 150 volunteers are members of CHAIN, which formed in 2005, including health care professionals who also advocate for funding for the AIDS drug assistance program and other issues.

The group this year promoted legislation to repeal the HIV law, but the bill died in subcommittee.

“It's a complex issue,” said Tonelli, adding that CHAIN will try again in the next legislative session. “Sometimes it's a difficult conversation to have. We had a lot more support than we expected.”

Since the law took effect in Iowa in 1998, 37 people have been charged with the crime and 26 of those were convicted.

Fred Scaletta, spokesman for the Iowa Department of Corrections, said besides the nine inmates, two people are on probation and one is on parole for criminal transmission of HIV.

Scaletta said the others likely were fined or finished their sentences and are no longer incarcerated.

The average cost to treat an Iowa prisoner with HIV ranges from $959 to $2,390 per month.

“That depends on the stage they're in and how many meds they're on,” Scaletta said. “They're getting whatever medical procedures are necessary.”

Add the annual cost of prison, at $31,500 per inmate, and each person convicted of the crime will cost Iowa taxpayers $1.38 million over the course of the full sentence, according to CHAIN.

Tonelli said those convicted also have to register as a sex offender, regardless of whether or not the act was consensual.

Under the law, a person aware of his or her own positive HIV status does not have to transmit HIV - the virus that causes AIDS - but only has to engage in intimate contact with another person.

Randy Mayer, chief of the Iowa Department of Public Health's HIV, STD and Hepatitis Bureau, said fewer Iowans are getting tested for HIV, but not necessarily because of the law.

The state saw a peak of nearly 24,000 tests at public sites in 1992, following basketball star Magic Johnson's announcement that he was HIV-positive.

Tests have gradually decreased at public sites to less than 6,000 last year.

Mayer said about 60 percent of positive tests now come from private medical offices.

Funding from the U.S. Centers for Disease Control and Prevention targets high-risk populations only, and with less funding there are fewer public sites offering those tests in Iowa, he said.

“A lot of it is HIV apathy,” Mayer said. “People are not hearing about the disease and so they're not getting tested as much.”

He noted that the national HIV/AIDS strategy encourages state legislatures to reconsider whether HIV-specific laws further the public interest and public health.

The strategy echoes the message from CHAIN, saying that in many instances, “the continued existence and enforcement of these types of laws run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment.”

Tonelli said CHAIN supports adding HIV transmission to another Iowa law that addresses the intentional spread of other infectious diseases.

She noted that Iowa is one of 34 states with a transmission law.

“Iowa is one of the harshest,” she said, referring to the 25-year sentence and lifelong sex offender status, a penalty that exceeds those of most other crimes, including manslaughter.

Still, Tonelli said Iowa is at the forefront of a shift in perspective.

“A lot of states are too scared to touch this,” she said. “Iowa is one of the first to actively try to have the law changed.”