Theory, Analysis, Social Justice, and Criminalizing HIV Transmission: A Commentary on Lehman and Colleagues (2014)

Abstract

Since the start of the AIDS epidemic, the US government has attempted a number of interventions to protect the public health. Some, such as Congressional allocation of funds for HIV surveillance and research, or assistance to persons living with HIV such as subsidized treatment or housing, appear to have promoted this aim. Others such as the Helms amendment banning federal funds for AIDS education materials describing homosexuality, bans on Federal funding for syringe exchange, the US public health service travel ban on entry visas for people living with HIV, or the PEPFAR anti-prostitution pledge have probably undermined it. These mixed effects suggest that scientific data measuring the outcomes of policies proposed to protect the public health are not the deciding factor on whether such policies become federal law. State governments have also had a role, but until now it has been challenging to evaluate the scope of state-level HIV law in its entirety. In their article, Prevalence and Public Health Implications of State Laws that Criminalize Potential HIV Exposure in the United States, Lehman and colleagues [1] take stock and analyze state laws criminalizing HIV exposure. Their paper offers an excellent exploration of the differing ways states (1) define criminal HIV exposure; (2) classify it within the legal code; and (3) impose penalties on those it finds guilty. In this commentary, we expand upon the ideas put forth by Lehman and colleagues. We explore methodological challenges to the study of how law impacts individual HIV risk behavior and suggest theoretical frameworks and testable models to understand this phenomenon. We conclude with a consideration of how the principle of social justice joins this arena as a necessary research question in its own right.