The question has arisen in some blogs as to why I would choose the title “Viral Apartheid” for this blog. There are a couple of answers for this.
Check out the definition of apartheid on dictionary.com:
“2. any system or practice that separates people according to race, caste, etc.”
Let’s face it — HIV is treated differently than any other infection in America.
When was the last time a person was arrested for a felony for having the flu and spitting at a cop? And when was the last time a family was charged with failing to disclose their child was infected with rotovirus when they sent the child to daycare? Do we expect a person with the flu to disclose that infection to their intimate partners?
You are welcome to bury your head in the sand and pretend that HIV-positive people are not subjected to separation based on their viral status, but it doesn’t make it any less true. And the truth is, we treat people with HIV differently than we do other illnesses or health conditions — including in most states STIs.
Beyond the obvious, here are the other reasons I have titled this blog Viral Apartheid:
First, and foremost, this is the title of a book I am writing in relation to HIV and criminal laws. The book is tentatively titled “Viral Apartheid: The Rise of HIV Exceptionalism and the Erosion of American Privacy.” The book, and the lectures I have delivered on the topic, explore how HIV became a health issue turned into a felony infection and how that movement has in some instances eroded our privacy.
For instance, in Michigan, if you test for HIV through a state funded program and you opt for anonymous testing, the state directs the testing facility to offer you something other than confidential testing. Confidential testing means the testing location knows your name, date of birth and other information about. Anonymous is exactly what it sounds like. So why do they want this? Because they require the information collected for confidential testing to be reported and recorded in the states HIV Event System — a massive database of three quarters of a million entries of people who have tested for the virus, whether they are negative or positive. The state doesn’t tell confidential testers that their information will be reported to this database, where it remains “indefinitely” regardless of their status.
No such database of persons testing — regardless of whether they are infected or not — for gonorrhea, syphilis or other reportable STIs exists in Michigan.
Second, HIV remains an infection subjected to massive stigma. Those of us living with the virus are referred to as “unclean.” We are treated as vectors of disease by AIDS Service Organization, public health and governments — not to mention our own communities. Millions of prevention dollars are spent on getting us to prevent transmission to our partners (while ignoring the 20 percent of Americans infected with HIV who do not know they are infected but are 3.5 times more likely to transmit the virus).
In spite of the fact the epidemic has been around for over 30 years, the vast majority of Americans are simply ignorant about the disease, and this exceptionalism feeds this ignorance.
How ignorant? When I speak to local colleges and universities, I often ask the question, “What is the percent probability of being infected from a one time sexual encounter with a person with HIV?” The responses range from the low end of about 20 percent to the high end of about 90 percent.
The real answer, according to the CDC? The highest probability of sexual transmission of HIV from unprotected sex occurs for the bottom (or passive or receptive) partner in unprotected anal intercourse. The percentage probability of infection? .5 percent. This number does not account for viral suppression of HIV with medications or condom use (96 percent reduction and an 80 percent reduction, respectively).
The 2012 Kaiser Family Foundation Survey reports that 27 percent of Americans thought you could get HIV from sharing a drinking glass, 17 percent thought one could get infected touching a toilet seat and 11 percent thought HIV could be transmitted by sharing a swimming pool with a person with HIV. (And for those who don’t know, NO none of those are transmission routes for HIV.)
Third, HIV discrimination remains — both overt and covert. One need only look at the incident involving a woman with HIV and a Dearborn Police Officer to know that ignorance fuels discrimination.
Fourth, many public health advocates want the public to see HIV as just another disease — you know, just like diabetes. The problem is, that just isn’t true. First, diabetes is not subjected to criminal penalties. Second, when a person says they have diabetes, it does not lead to trumped up charges when they get in a scuffle with cops or others (you know like the so-called bio-terrorist in the Detroit area who was charged with bio-terrorism for biting an assailant during a gay bashing incident). Thirdly, being diagnosed with diabetes does not result in people being thrown out of homes, or dis-invited from family meals because they are sloppy eaters.
And let me be clear, this is not about whether or not a person chooses to have sex with a person who acknowledges they are HIV-positive. (Although I will note that a recent study has found that sero-sorting is the least effective prevention method). This is about treating those with the virus, and frankly, the virus itself, differently than any other disease in America.