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February28, 2024
For Immediate Release
Today, onFebruary 28th, the US People Living with HIV Caucus commemorates the Global HIVIs Not A Crime (HINAC) Awareness Day. In reflecting on this year’s theme – “You care about ending HIV criminalization, you just don’t know it yet” – we are reminded that the surveillance, policing and criminalization of HIV in the U.S.are not neutral practices. They are rooted in racist, xenophobic, misogynistic, and anti-LGBTQ ideologies that harm the health and wellbeing of our communities.
We have been told for years that our concerns about molecular HIV surveillance(MHS)being used as a tool for HIV criminalization are overblown. We do not just fear that technology might eventually be able to determine directionality of HIV transmission (i.e. proving that person A transmitted HIV to person B), science is actively working in that direction. In a preprint of a paper from October 2023, which is not yet peer-reviewed, researchers were able to support inferences of directionality in88.3% to 92.2% of cases, depending on the granularity of the genetic information being analyzed. In simple terms, HIV directionality inferences are coming and may already be here.
Moreover, whether or not science can prove directionality beyond a reasonable doubt is, for practical matters, besides the point. Police, prosecutors, judges and juries are not the best arbiters of forensic evidence based on science they often do not understand. The technology behind MHS (phylogenetic analysis) has been used as evidence to show direction of transmission in HIV criminalization cases around the world. Moreover, dubious scientific theories and techniques, otherwise known as “junk science,” have found their way into every facet of our criminal legal system. Anyone paying attention should be concerned.
Today and every day, the US People Living with HIV Caucus stands against carceral systems, especially in public health practices. We stand for the leadership, health, safety and dignity of people living with HIV, especially those most impacted by systems that perpetuate anti-Black, anti-LGBTQ+ surveillance, policing and criminalization.
“Why is the directionality research [mentioned above] being done? This research is a perfect example of why the meaningful involvement of people living with HIV is necessary at every level of HIV research, response, and implementation,” said Ronald Johnson,Chair of the US People Living with HIV Caucus. “Communities of people living with HIV are not served by determining directional transmission. Instead this kind of research makes us more vulnerable to stigma, criminalization, and discrimination.”
“The practice of molecular HIV surveillance is connected to a system that continues to oppress and further marginalize Black communities.” said Kamaria Laffrey, Co-Executive Director of the Sero Project. “I am told that I shouldn't be in fear of this surveillance practice. However, it is my HIV genetic information that is kept in databases indefinitely without my consent. I have witnessed HIV criminalization be weaponized against people living with HIV; I have seen people arrested for behaviors that cannot transmit HIV. Even the threat of HIV criminalization is terrifying. We need a pause on MHS until there are guarantees that our health information cannot be used against us in criminal, civil or immigration proceedings.”
“MHS does not happen exclusively in laboratories and databases; it happens within the context of power, politics and policies that already stigmatize, target and criminalize communities most impacted by HIV.,”said Naina Khanna, Co-Founder and outgoing Co-Executive Director of Positive Women’s Network-USA. “WhenMHS is used in a country like the United States that actively criminalizes HIV, there can be a number of consequences, including and not limited to increased medical mistrust, alienation from care, reluctance to disclose contacts, or refusal of resistance testing.”
“The possibility of misuse and abuse of HIV data and phylogenetic analysis should not be under appreciated, especially considering that the communities most impacted by HIV are the same communities that have been, and continue to be, subject to anti-Black state violence, marginalization, under-resourcing, over-surveillance and over-criminalization,”said Venita Ray, Treasurer for the US PLHIVCaucus . “MHS fits into the US’s carceral public health approach, and this has a real-life impact on care for people living with, and communities most impacted with, HIV.”
“The article by Zhao and colleagues [mentioned above] demonstrates that HIV-TRACE, the method currently used by the CDC for cluster detection and response, can identify with a high level of precision two individuals for whom direct HIV transmission has occurred,” said Diana Marie Tordoff, Postdoctoral Scholar at Stanford University School of Medicine. “Although this technology cannot determine who transmitted to whom, these types of analyses can be misrepresented in criminal and legal contexts and pose a significant risk to people living withHIV in the context of HIV criminalization.”
“Care for individuals with HIV is based on compassion and maintenance of hope for a normal life,” said Michael Fingerhood, professor at the Johns Hopkins University School of Medicine,Division Director of Addiction Medicine at Johns Hopkins Bayview Medical Center and Chair of the American Academy of HIV Medicine, Mid-Atlantic Chapter.“There is no benefit to assigning blame or criminality by trying to assess the origin of HIV transmission, and such efforts are likely to be fallible.”
