For the first time since enacting HIV laws in the 1980s, Missouri will update its laws that make it a crime to expose a person to the virus. Gov. Mike Parson on Wednesday signed a bill that reduces the charges a person faces for transmitting the virus.
Missouri joins a number of states that have passed such legislation this year. Legislatures around the country are moving to correct HIV laws that were based on false assumptions about how the virus is transmitted.
Advocacy groups and politicians in Missouri successfully lobbied for SB 53, a sweeping measure affecting police and prosecutors, to include changes to the state’s HIV laws after years of attempts to pass similar legislation. Public health professionals say laws criminalizing HIV have not reduced transmission of the virus.
Under the new law, prosecutors must prove someone “knowingly” exposed a person to the virus to obtain a felony conviction. The measure also reduces the minimum sentence from 10 years to 3 years, if the person contracts HIV. A previous law made it a felony crime in Missouri to “recklessly” expose another person to HIV, which is harder to defend in court.
Missouri’s updated law goes into effect on Aug. 28.
While the Missouri HIV Justice Coalition wants state lawmakers to eliminate laws against transmitting the virus, some advocates say the law lessening penalties is still a victory for the more than 13,000 people in Missouri who live with HIV.
“We still feel like it's a really strong step in the right direction, to make sure that the laws are medically accurate and are charging people at an appropriate level,” said Mallory Rusch, executive director for Empower Missouri, an advocacy group within the HIV Justice Coalition that lobbied for the bill’s passage.
Advocates argued the old law was outdated, since modern medication can reduce people’s viral load to undetectable levels. People who are consistently on HIV treatment for at least six months cannot transmit HIV to others.
The former law treated all HIV-positive people as if they were a public health risk, Rusch said. The new law updates language to correct misconceptions about how HIV is transmitted. HIV transmission doesn’t occur through saliva or touching. It’s very rarely transmitted through biting or oral sex.
“[The old laws] were based on faulty assumptions about science, and it's no fault of the legislature at the time, it's just all they knew,” said Rep. Phil Christofanelli, R-St. Peters, who filed the bill in the House. “Back in the ‘70s and ‘80s, when HIV entered the public consciousness, the legislators at the time first thought it was a death sentence.”
Public health professionals say they still feel the consequences of faulty science and outdated laws.
“It put people living with HIV in a position to where, number one, they're criminalized unfairly, but two propagated the stigma and the shame that still persists around people living with HIV,” said Dr. Matifadza Hlatshwayo Davis, an infectious disease specialist at Washington University School of Medicine.
Davis, who has treated people with HIV for more than a decade, said laws that penalized HIV transmission discouraged people from getting tested because if people didn’t know their HIV status, they couldn’t be charged.
But that also led to people forgoing necessary treatment.
“If people don't see this big fear about being criminalized, they may be more willing to take a test to find out what their status is,” said Erise Williams Jr., CEO of Williams and Associates, a public health agency in St. Louis that has a robust HIV program.
Since 1990, more than 100 people in Missouri have been convicted of an HIV crime, according to the Williams Institute, a think tank at UCLA Law.
The institute found Black men account for half of HIV crime arrests and convictions in the state, despite being only 5.5% of the state’s population.
In St. Charles County, a Black student at Lindenwood University made national headlines in 2015 when a judge sentenced him to 30 years in prison after a jury found him guilty of infecting one partner with HIV and endangering four others. An appeals court later ruled that Michael L. Johnson’s trial was “fundamentally unfair” and granted him parole after he had served five years.
Public health professionals say Johnson’s and other high-profile cases of alleged intentional HIV transmission have distorted the public’s view that this is a common occurrence and have instead undermined efforts to prevent infections.
That’s led lawmakers in Nevada, Illinois and Oregon to change their HIV laws this year, either adjusting punishments for transmission or expanding access to HIV medication.
Illinois' legislature recently passed a bill to completely decriminalize HIV, which would make it only the second state to do so, after Texas. Illinois Gov. J.B. Pritzker has yet to sign the bill into law.
Missouri expands access to HIV preventive medication
Missouri's Republican-controlled legislature also passed a bill during the 2021 session to allow pharmacists to dispense HIV medication. Parson signed the bill into law last month, making Missouri the fourth state to do so.
Pharmacists must be trained by a doctor before they can give someone post-exposure prophylaxis.
If the medication is started within 72 hours of an HIV exposure, it can greatly decrease chances of contracting the virus. But getting the pill during that crucial window can be difficult in rural areas with few health care providers.
The Centers for Disease Control and Prevention found that 13 mostly rural counties in Missouri are at risk for an HIV outbreak.
Rep. Christofanelli co-sponsored the bill to make the drug more accessible. Medicaid and Medicare both cover PEP.
“I think public health issues cross party boundaries,” he said. “HIV is something that's affecting this entire state whether you live in a rural area community or an urban or suburban community, like mine. And Missouri has continued to come up on national news stories for the prevalence of spread of HIV across our state.”
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