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Should we punish the sick?

The wrong approach to infectious disease control

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HIV, gay news, Washington Blade

HIV criminalized, transmission, Maryland HIV infection rate, leukemia, PrEP, Pre-Exposure Prophylaxis, HIV, gay news, Washington BladeWould you consider calling the police if a coworker showed up at work one day with the flu? As absurd as that may sound, recent developments suggest that the notion of punishing people who are ill is becoming more entrenched and pervasive in American society.

Although new laws have cropped up in several states targeting diseases as diverse as meningitis and hepatitis, no disease is more widely criminalized than HIV. This year, on World AIDS Day (observed annually on Dec. 1), many advocates and public health organizations will be celebrating the dramatic advances in decreasing the number of new infections made possible by successful treatment and prevention.

In major urban cities around the globe — including London, Sydney and San Francisco — health departments are implementing powerful new tools to stop HIV transmission that are working. These include pre-exposure prophylaxis, or PrEP, which can greatly reduce the risk of infection when taken daily. In addition, it has come to light that treating HIV with antiretroviral medications help prevent its spread by rendering people living with HIV virtually noninfectious.

But while these advances are certainly promising, they do not tell the whole story.

The problem is that laws written in response to the AIDS epidemic remain stuck in 1985. HIV-specific criminal laws passed in the 1980s and 1990s at the height of America’s AIDS scare remain on the books. Law enforcement and prosecutors continue to vigorously enforce them, despite their lack of medical knowledge and sometimes without any legal justification. These moves are simply reactionary, based on stigmatizing views of HIV that unfairly punish innocent individuals.

Many HIV-related statutes make it a crime for people living with HIV to engage in a wide range of behaviors without first disclosing their HIV status—regardless of whether HIV could have been plausibly transmitted through their actions. Sometimes mistakenly referred to as “HIV transmission laws,” they make no mention of transmitting the disease or even putting a partner at risk of infection. For example, in Michigan, the law criminalizes any “sexual penetration” without disclosing one’s status—an overly broad formulation that includes many behaviors that cannot transmit HIV. Most HIV-specific state laws are felonies with harsh penalties, ranging from several years to life in prison.

Some states have laws so broadly written that they can be also used to punish a range of harmless nonsexual behaviors. In Tennessee, for example prosecutors regularly charge people living with HIV who spit at or bite police officers.

To that point, a recent report coauthored by the Centers for Disease Control (CDC) and the Department of Justice found that 25 states criminalize one or more behaviors that pose a low or negligible risk for HIV transmission, such as biting or spitting.

Michigan’s law is so badly written that one creative prosecutor used it to convict a woman for giving a lap dance in 2009. A detective explained the incident to the court with a graphic depiction of the woman’s genitals touching the man’s nose. That no one has ever contracted HIV via nasal contact mattered little under Michigan’s questionable (to say the least) law.

In a dozen cases reviewed during research for my book, “Punishing Disease,” accusers falsely claimed that it would take many years to know if a defendant had infected them. But most conventional HIV tests have only a three-to-six month “window” after exposure before patients can receive definitive test results. Court testimony in many cases almost invariably came long after that time period had elapsed.

These inaccurate suppositions directly impact sentencing. In a 2004 case in Davidson County, Tenn., the accuser claimed she wouldn’t know whether the defendant infected her for 10 years. The judge accepted her ignorant claim, ordering the defendant to serve 10 years’ probation and to pay for the woman to be tested for HIV for the next 10 years.

While HIV was originally the singular target of such laws, legislators seeking to “modernize” these laws have begun broadening their scope to include additional diseases such as meningitis and hepatitis – suggesting that the criminalization of sickness is contagious.

Punishment is the wrong approach to infectious disease control. The war on drug’s failure to contain drug addiction should warn us to the pitfalls of punitive approaches to controlling medical problems. Blame and shame are not the tools to protect us from disease; they are instead the fuel that drives epidemics.

 

Trevor Hoppe, Ph.D. is the author of ‘Punishing Disease: HIV and the Criminalization of Sickness’ and co-editor of ‘The War on Sex.’ He is currently assistant professor of sociology at University at Albany (SUNY).

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3 Comments

3 Comments

  1. BigGaySteve

    November 26, 2017 at 12:06 pm

    How about honesty? 1 out of 8 US blacks have the gene for Sickle Cell that comes with lots of health problems. 30% of UK birth defects are Paki massively overrepresented because of EVOLUTION. East Asians & (non-Jewish)Whites have the lowest healthcare needs until older than the average lifespans of everyone else.

  2. Shirley

    November 28, 2017 at 6:11 am

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  3. Ken Pinkela

    November 28, 2017 at 8:42 am

    THank you to my dear friend Trevor Hoppe and the professional courage to speak out. The stigma that surrounds HIV has become almost culturally accepted with the wrongful use of our justice system. It has bred a generation in its allowing bigots and the ignorant a powerful venue to “attack” “blame” “point fingers” and “scapegoat” .. As Trevor knows, and so do many of my old friends in the DC Metro area, HIV Criminalization in the US military is like no other legal process…without evidence of any kind, without an investigation, without any sexual contact or known possible way to transmit or expose a person to HIV and without any elements of any defined crime…just the unfounded allegations… even in the presence of physical witnesses…a person can lose everything…even when the prosecution’s sole witness has the courage to speak out in a sworn statement describing lies and coercion that the entire case was fabricated…the STIGMA and FEAR of many in positions to morally step in to review and ensure the process, they too turn and hide…even openly gay men serving in groundbreaking positions like Secretary of the Army…they run and hide…HIV Criminalization is NOT about public health and its not about precluding any crime…Don’t misunderstand the position of many, if not all, advocates working to end HIV Criminalization…there are existing laws on the books that allow for the successful prosecution of acts of “criminal malicious intent” to do a person harm (i.e. the deliberate intent to infect a person)…HIV Criminalization is NOT that…it is a pure ignorance, hate and fear based action inflicted on people living with HIV…HIV IS NOT A CRIME

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Sondheim’s art will be with us for the ages

Iconic work explored sadness, rage, irony, and love of humanity

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Stephen Sondheim (Screen capture via CBS)

“The only regret I have in life is giving you birth,” his mother wrote in a letter to Stephen Sondheim.

The only regret so many of us feel now is that Sondheim, the iconic composer and lyricist, died on Nov. 26 at his Roxbury, Conn. home at age 91.

He is survived by Jeffrey Romley, whom he married in 2017, and Walter Sondheim, a half-brother.

F. Richard Pappas, his lawyer and friend, told the New York Times that the cause of death was unknown, and that Sondheim had died suddenly. The day before he passed away, Sondheim celebrated Thanksgiving with friends, Pappas told the Times.

“Every day a little death,” Sondheim wrote in “A Little Night Music.”

This isn’t the case with the passing of Sondheim. Whether you’re a Broadway star or a tone-deaf aficionado like me, you’ll sorely miss Sondheim, who the Times aptly called “one of Broadway history’s songwriting titans.”

Like multitudes of his fans, I don’t remember a time in my life when a song from a Sondheim musical hasn’t been in my head.

When I was a child, my parents repeatedly played the cast album of “Gypsy,” the 1959 musical with music by Jule Styne, lyrics by Sondheim and book by Arthur Laurents. My folks loved the story of the show, which was loosely based on the life of the burlesque artist Gypsy Rose Lee. You haven’t lived until you’ve heard Ethel Merman belt out “Everything’s Coming Up Roses!” When I need to jumpstart my creative juices, I remember that “You Gotta Get a Gimmick.”

In college, I felt that “Company,” the 1970 musical with music and lyrics by Sondheim and book by George Furth, spoke to my generation. 

As was the case with Sondheim’s musicals, “Company” didn’t have a conventional plot, happy ending, or tidy resolution. It takes place during Bobby’s 35th birthday party. Bobby, who is single, is celebrating with his friends (straight, married couples). Bobby likes having friends but doesn’t want to get married.

Sondheim didn’t come out as gay until he was 40. Yet, even in the 1970s, it was hard not to think that Bobby in “Company” wasn’t gay.

Once you’ve heard Elaine Stritch sing “The Ladies Who Lunch” from “Company,” it becomes indelibly etched in your brain.

Who else but Sondheim could have written, “And here’s to the girls who play/smart-/Aren’t they a gas/Rushing to their classes in optical art,/Wishing it would pass/Another long exhausting day/Another thousand dollars/A matinee, a Pinter play/Perhaps a piece of Mahler’s/I’ll drink to that/And one for Mahler!”

In September, I, along with legions of other theater lovers, were thrilled when Sondheim told Stephen Colbert on “The Late Show,” that he was working with David Ives on a new musical called “Square One.”

In his musicals from “Follies” to “Sweeney Todd” to “Sunday in the Park with George,” Sondheim, through his lyrics and music, revealed the internal depths of his characters and the sadness, tenderness, bitterness, rage, irony, wit, and love of humanity. Sondheim’s wordplay was so brilliant that he did crossword puzzles for New York magazine.

Over his decades-long career, Sondheim won every award imaginable from the Pulitzer Prize for “Sunday in the Park with George” to the Presidential Medal of Freedom (awarded to him by President Barack Obama in 2015). He received more than a dozen Tony Awards for his Broadway musicals and revivals as well as a Tony Award for lifetime achievement in 2008.

Thankfully, Sondheim’s art will be with us for the ages.

A remake of “West Side Story,” directed by Steven Spielberg with a screenplay by Tony Kushner, premieres this month.

Sondheim is a character in the Netflix film “tick, tick BOOM!,” directed by Lin-Manuel Miranda. The movie is based on an autobiographical posthumous Jonathan Larson (the composer of “Rent”) musical. Sondheim is supportive of Larson’s work.

Thank you Stephen, for your art! R.I.P.

Kathi Wolfe, a writer and poet, is a regular contributor to the Blade.

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Publish trans employment stats

Not enough corporations that march in Pride are hiring non-binary staff

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On Nov. 10, the top-tier consulting firm McKinsey published a report on discrimination toward trans people in the workplace. The report came out with numbers that we have all known true for a long time and lead to one conclusion: Trans people have a harder time finding jobs, holding them down, and advancing in their careers. 

Specifically, McKinsey cited the fact that cisgender people are twice as likely to be employed as trans people, and that more than half of trans employees are uncomfortable being out at work. Meanwhile, cisgender employees make 32% more than trans employees in the workplace, even if those trans employees hold the same positions or higher positions. 

On top of this, trans people are 2.4 times more likely to be working in the food and retail industries, which pay entry level wages that are much less than decent pay. 

These statistics are true based on a number of factors. For one, many trans people have a harder time passing at work, and people who don’t pass well face worse job prospects. (As a side note, on top of that, the study pointed to the fact that many trans people exert undue emotional and psychological energy into trying to pass really well and not be discriminated against, which takes a toll on their mental health.) 

So what is a concrete step that corporations can take to make the trans experience in the workplace better? It’s time that corporations step up their game by publishing and making transparent the number of trans employees that they actually hire. Such numbers can be published in any kind of company document: a pamphlet, online report, or even annual shareholder’s report. As it is, most corporations do not publish numbers on LGBT employees. 

“Rainbow capitalism” is a term we know all too well: major corporations and multinationals flaunting a rainbow and trans pride flag during the month of June, but seemingly doing little to hire more trans people or give back to the community during other months. 

Every corporation surely has the time and company-wide infrastructure to get statistics on their trans employees. All they need to do is implement a company-wide survey to new hires. This takes extremely little effort and time in the grand scheme of company workings. 

If major corporations like McKinsey, Bain, Deloitte, defense contractors, and hundreds of other huge companies published statistics on trans employees, they would be held accountable for their actions and words.

If these statistics were to be published today, we would probably find out that not enough corporations that march in Pride parades are hiring trans and gender nonconforming employees. 

Turning the numbers against corporations will ensure that these same corporations finally live up to their words about workplace inclusion and diversity. It won’t cure everything about the issue of being trans in the workplace, but it’s a step in the right direction. 

Isaac Amend (he/him/his) is a trans man and young professional in the D.C. area. He was featured on National Geographic’s ‘Gender Revolution’ in 2017 as a student at Yale University. Isaac is also on the board of the LGBT Democrats of Virginia. Find him on Instagram @isaacamend.

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Should we be scared of Omicron?

A reminder to stay vigilant against latest mutation

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It’s Sunday of Thanksgiving weekend when I sit down to write this column. The craziness in the world continues but other than the scare of the new COVID mutation, which has been named Omicron, there isn’t one headline to grab attention. Instead, there are many, including some manufactured by the news media to gain viewers or sell papers. Some like the car rampaging through the Christmas parade is frightening but incidents like this seem to be happening all too often.  

The stock market went down 1,000 points on Friday because market players freaked out about the new COVID mutation coming out of South Africa. However that didn’t seem to stop people from spending their money on Black Friday. Rep. Lauren Boebert (R-Colo.) was again on the attack this time against fellow Congresswoman Ilhan Omar (D-Minn.) accusing her of being a Muslim terrorist. She apologized, or pretended to, but again the Republican leadership wouldn’t condemn her statements. These things seemed to be grist for the news media with no one else unfortunately really voicing concern. 

Boebert’s comments were taken as old hat. They are disgusting, offensive, and dangerous, but as long as her constituents reelect her we will have to live with them. She is joined by Rep. Marjorie Taylor Greene (R-Ga.),  Madison Cawthorn (R-N.C.), and Paul Gosar  (R-Wyo.) who represent the worst in Congress and the worst of the American people. Yet again until their constituents throw them out we have to live with their stupidity and the absurdity of their being where they are. 

The new COVID mutation out of South Africa is potentially a game changer. But it will be important for scientists to look at this carefully to determine how quickly it spreads and whether or not the current vaccines will offer any protection against it. Countries around the world, including the United States, have quickly instituted travel bans for South Africans and those in countries surrounding it. The World Health Organization at this time has suggested this should not be done as it will have limited impact on its spreading and could have severe and detrimental economic impact on countries whose people are being banned. One thing we must learn from this is how important it is to ensure everyone all over the world has access to vaccines as we know the more people who are inoculated the harder it is for the virus to mutate. It is not time to panic yet and by Sunday there was some reporting this new mutation may not be any more difficult to deal with than the current ones and not lead to any more severe illness. The takeaway from all this is we need to keep vigilant, get vaccinated and get booster shots, and make sure we vaccinate our children. Continue to wear masks indoors and wash our hands. 

Now the other interesting stories last weekend were about what will happen in the Senate in the weeks leading up to the Christmas holidays. Remember the House of Representatives passed President Biden’s Build Back Better bill as a reconciliation measure, which means it can pass the Senate with a simple majority. That would mean every Democratic senator and the vice president. The focus is on two senators: Manchin (D-W.Va.) and Sinema (D-Ariz.). In reality we need to look at a number of others who will fight to either take out or put something into the bill the House passed. It is clear it will not pass in the current form and then it has to go back to the House again. 

Another issue that will be taken up is the debt ceiling. It may be a little easier than thought because as recently reported, “After taking a hard line and refusing to negotiate with Democrats during the last standoff over the debt limit, Senate Minority Leader Mitch McConnell (R-Ky.) is quietly looking for a way to get the issue resolved without another high-profile battle.” Then there is the budget and since none is passed Congress will have to pass another continuing resolution since the one they passed in September expires on Dec. 3. 

So for the next few weeks there will be a focus on the Senate to see what they do and how obstructionist Republicans want to be. Seems while things change, they somehow remain the same.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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