KHN contributing columnist Michelle Andrews writes the sequence Insuring Your Health, which explores well being care protection and prices.
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Last week, an Ohio man who has the hepatitis C virus was sentenced to 18 months in jail for spitting at Cleveland police and medics.
Matthew Wenzler, 27, was reportedly mendacity on a Cleveland road throughout from a downtown on line casino in January. When police and emergency medical technicians tried to place him on a stretcher to take him to a hospital, he spit saliva combined with blood repeatedly at them, hitting an officer within the eye.
In Ohio, it’s a felony for individuals who know they’ve HIV, viral hepatitis or tuberculosis to deliberately expose one other individual to their blood, semen, urine, feces or different bodily substances comparable to saliva with the intent to harass or threaten the individual.
Advocates for folks residing with illnesses like hepatitis C and HIV say these legal guidelines add to the stigma that sufferers already face and research counsel the legal guidelines are not effective at stopping the unfold of illness.
“This person is now facing a year and a half of incarceration for something that didn’t harm anyone and didn’t pose a risk of harm to anyone,” mentioned Kate Boulton, a employees lawyer on the Center for HIV Law and Policy.
Roughly two-thirds of states, in keeping with the Center for HIV Law and Policy, have legal guidelines that make it against the law to knowingly expose others to HIV, the virus that causes AIDS. Many of those legal guidelines had been handed within the 1980s and 1990s when worry and stigma about HIV had been excessive and contracting the illness was thought-about a dying sentence.
In current years, a couple of dozen states have added hepatitis C to the checklist of medical circumstances for which individuals can face prison prosecution in the event that they knowingly expose others by partaking in sure actions like intercourse with out disclosure, needle-sharing or organ donation.
Public well being officers say these provisions, that are typically tacked on to present HIV legal guidelines, are more likely to be ineffective at stemming transmission of the illness. They might even exacerbate the issue.
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“If you have to let people know that you are infected with HIV or hepatitis C before you have sex with them, why would anyone in their right mind get themselves tested and begin treatment?” mentioned Dr. Anne Spaulding, an epidemiologist and affiliate professor at Emory University’s public well being faculty. She has labored as a medical director in correction programs and revealed analysis on hepatitis C amongst prisoners.
Yet, amongst some lawmakers there’s nonetheless curiosity in criminalizing actions they view as spreading the illness. The growing consciousness of the opioid epidemic, which is linked to the unfold of hepatitis C by means of the usage of soiled needles, might play a task, some specialists say.
“We’re seeing this massive surge in opioid addiction,” mentioned Boulton. “Whereas hepatitis maybe wasn’t on the radar in the past, now it is.”
An estimated 3.5 million people have hepatitis C, a viral an infection that causes irritation of the liver that may result in scarring, liver most cancers and dying. It is often handed from individual to individual by means of blood. Today that occurs usually by means of sharing needles to inject medicine, and, extra not often, by means of intercourse. But many older instances had been brought on by blood transfusions earlier than testing for the virus existed.
The virus isn’t transmitted by means of urine, feces, semen or saliva, Spaulding mentioned, noting that though there have been some instances of the illness being unfold by means of blood hitting the attention, it is vitally uncommon and requires a substantial amount of blood.
In 2016, the newest figures obtainable, practically three,000 instances had been reported to the federal Centers for Disease Control and Prevention, a 22 % enhance from the earlier yr. But many instances go unreported, partially as a result of folks don’t notice they carry the virus. The CDC estimates that the complete variety of new instances in 2016 was 41,200.
“Hepatitis C is still a very dangerous disease to contract,” mentioned South Dakota Republican State Sen. Stace Nelson, who sponsored a bill this yr that will have made it a felony for individuals who have been recognized with hepatitis C to show another person to the illness. “These circumstances where someone knows that they have it and intentionally or negligently infects someone else … it’s a threat to society.”
Advocates have been working to reform state legal guidelines that make it against the law to show folks to HIV. In the method, they’re more and more working to move off efforts to criminalize hepatitis C, together with supporting native advocates to assist stop a bill in Michigan lately, mentioned Sean Strub, who in 1994 based POZ journal, which is devoted to points about HIV. He can also be government director of the Sero Project, an training and advocacy group that, amongst different issues, is working to finish prison penalties for exposing others to HIV.
“Now we have this very robust and active movement combatting HIV criminalization,” Strub mentioned. “But we’re really combatting a whole range of conditions.”
Sometimes, nevertheless, HIV reform has had unfavorable penalties for folks residing with hepatitis C.
Take for instance Iowa, which handed a legislation in 1998 that mentioned individuals who had been discovered responsible of knowingly exposing others to HIV confronted as much as 25 years in jail and needed to register as intercourse offenders, even when they used a condom and didn’t infect anybody. The burden of proof was on the accused to indicate that they’d disclosed their HIV standing to their accomplice.
Advocates successfully pushed to replace that with a legislation decreasing the penalties and eliminating the intercourse offender registration requirement. But certainly one of their targets additionally was to cut back stigma by now not singling out HIV.
So they added hepatitis, meningococcal disease and tuberculosis to the medical circumstances that individuals could possibly be prosecuted for in the event that they uncovered others to it.
People who labored for the substitute legislation say they realized from the beginning that it wasn’t a perfect resolution.
But outright repeal wasn’t an possibility politically, mentioned Tami Haught, a neighborhood organizer in Iowa who works because the coaching and organizing coordinator for the Sero Project.
“It was a tough decision that had to be made,” mentioned Haught, who’s HIV constructive. She famous that in some states with out disease-specific publicity legal guidelines, prosecutors have discovered a option to cost folks below different normal prison legal guidelines in any case.
On steadiness, she mentioned she believes it was the appropriate option to go.
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Michelle Andrews: @mandrews110
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