HIV Criminalization, Stigma and the Implementation of PrEP

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By Eric Brus

The American Psychological Association (APA) recently adopted a resolution opposing HIV criminalization and recommending the repeal or reform of HIV laws that still remain in effect in many U.S. states.

Specifically, APA urges the appeal of laws that:

  • target persons living with HIV (PLHIV) and engender harsher sentencing;
  • increase likelihood of incarceration for PLHIV;
  • undermine national HIV prevention efforts;
  • increase the control of, and risk of intimate partner violence to, women and vulnerable people with HIV;
  • specifically target and criminalize PLHIV; and
  • discriminate and stigmatize against PLHIV.

    The APA resolution also recommends that "laws that criminalize behaviors posing low or negligible risk for HIV transmission should be repealed or reformed and better aligned with contemporary scientific evidence regarding HIV transmission probabilities for specific behaviors and the efficacy of risk-reduction activities."

    The APA resolution follows similar recommendations by the U.S. Department of Justice, CDC, National Alliance of State and Territorial AIDS Directors, HIV Medicine Association, Positive Justice Project, and a range of other government, professional, and advocacy groups.

    Summary of March White House Meeting on HIV Stigma

    In a recent post on blog.AIDS.gov, Amy Lansky, acting director of the Office of National AIDS Policy (ONAP), summarized key findings and discussion points from the March White House Meeting on HIV Stigma: Research for a Robust Response, cohosted by ONAP and the National Institutes of Health.

    In her post, Lansky notes that, "As we approach the 35th anniversary of the first case reports of what would later come to be known as HIV/AIDS, we can rightfully celebrate that we now have an array of effective tools to prevent new infections, diagnose them, and care for people living with HIV. Yet the great effectiveness of these tools is too often blunted due to persistent HIV-related stigma and discrimination. We know from studies as well as countless personal stories that HIV-related stigma inhibits far too many people from accessing HIV prevention, testing, and care, even today. Clearly, in order to end the epidemic, we must combat stigma and discrimination."

    AVAC Introduces PrEP Implementation and Access Resources

    The HIV prevention advocacy group AVAC has developed a new section of its PrEP Watch clearinghouse that focuses on ongoing and planned initiatives to roll out and increase access to HIV pre-exposure prophylaxis (PrEP) at various sites worldwide.

    Their Implementation Initiatives page currently includes information about PrEP demonstration and introduction efforts in sub-Saharan Africa, including five projects supported by the U.S. Agency for International Development and the DREAMS Initiative, a partnership to reduce new HIV infections among adolescent girls and young women in 10 countries.

    The PrEP Watch site also includes detailed summaries of research and demonstration projects and PrEP roll-out activities in specific countries, including Kenya, South Africa and Zimbabwe. AVAC plans to compile additional country summaries as PrEP is evaluated and implemented out in other nations.

    Eric Brus is the Director of Health Information at AIDS Action Committee. This report is produced by the Health Library of the AIDS Action Committee in collaboration with the New England AIDS Education and Training Center Minority AIDS Initiative Project. The full version is available here.


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