Iowa Scraps Harsh HIV Criminalization Law in Historic Vote

Image: HIV Exposure Law

Leslie Flaggs stands in the street in front of her daughter's house in Jackon, Miss. Ms. Flaggs' conviction for having sex with a man while being HIV positive has followed her for years: She has been called "HIV bitch" and was forced to register as a sex offender in every state she has lived. William Widmer / Getty Images for NBC News

Iowa lawmakers voted early Thursday to repeal one of the nation’s toughest laws punishing perceived exposure to HIV and replace it with one that reflects the latest scientific understanding of how the disease is transmitted. The state is one of the first to revise its decades-old statutes since the AIDS epidemic began.

Lawmakers unanimously approved the legislation, which is headed to the desk of Gov. Terry Branstad. He hasn’t indicated yet if he will sign the bill, which the state’s attorney general helped to draft and on which the public health department consulted.

HIV/AIDS advocates have long been fighting for such changes to the more than 30 state laws nationwide, but they’ve often met resistance. Advocates in Iowa had fought for several years to ease the law, which now will allow for a tiered-sentencing system – a range of felonies and misdemeanors, depending on exposure and transmission of the disease - rather than a flat 25-year prison term. Those convicted under the law will no longer have to register as sex offenders, and those who had been forced to do so in the past will have their record expunged.

“This is incredible for people living with HIV. I’m speechless,” said Tami Haught, a community organizer at the nonprofit, Community HIV/Hepatitis Advocates of Iowa Network. “Getting unanimous passage through both houses just shows – and I hope will show the nation – that it’s the right thing to do. It’s time to modernize these laws. It’s time to end the stigma associated with being HIV positive. It’s a disease. It doesn’t define who we are. It is a disease that we have.”

Leslie Flaggs, who received a 25-year suspended sentence under the old law, can now get her name removed from the sex offender registry after six years. The change means she can go to parks, swimming pools and walk freely in her community in northwest Iowa. Before, she had difficulty finding work far enough away from areas where she wasn't allowed under the registry requirements, such as schools.

"It's so good," she said of the bill passing, breaking into tears. "I prayed to him (God) and I talked to him every day. I said, 'Lord remove this stuff from us. We're only human beings. We're only people.'"

Like many other states, Iowa passed its HIV criminal transmission law after Congress approved the federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act in 1990. A provision of that law, which funds essential medical and support services to people with HIV, required every state to certify that its criminal laws were sufficient to prosecute any HIV-infected individual who knowingly exposed another person to the disease – even if they didn’t transmit it -- at the height of the epidemic.

But with more understanding of HIV and improved drugs and care management options, the disease is no longer the death sentence it once was. And often, there is less risk of exposure. An HIV-positive person with undetectable levels of the virus in their blood -- common these days thanks to treatment that was in its early stages of use and was unproven when Iowa’s law was passed -- isn’t likely to transmit it to anyone else. Criminal exposure statutes should be changed to take the modern realities of living with HIV into account, advocates say.

The federal government has agreed: The U.S. government’s Office of National AIDS Policy said studies show that intentional transmission is “atypical and uncommon” and has called on states to re-consider their statutes. The Presidential Advisory Council on HIV/AIDS, has weighed in, too, issuing a resolution in 2013 calling for an end to the HIV-specific statutes.

Most of the state laws were passed before studies showed that antiretroviral therapy reduces the risk of HIV transmission, according to a recent article by the Centers for Disease Control and Prevention and the Justice Department. The laws also don't consider effective prevention measures, such as condoms.

“I’m delighted. It just shows how effective it is when people with HIV work in partnership with public health professionals and other advocates,” Sean Strub, executive director of the Sero Project, a network of people with HIV fighting to change the criminal transmission laws, said of the Iowa legislation. “We’ve improved public health. We’ve brought greater justice to people with HIV and taken an important step towards reducing stigma.”

The Center for HIV Law and Policy welcomed the changes to the state’s “draconian” HIV law but cautioned that it was “not model legislation” and urged other states to “recognize the shortcomings” – including adding the transmission of other infectious diseases, such as tuberculosis and hepatitis, to the new statute.

"In this case, an improvement for people living with HIV in Iowa represents a substantial worsening of the treatment of meningococcal disease, hepatitis and tuberculosis, and would represent a significant setback in many states,” the Center said in a statement.