By Michelle
Andrews JUNE 19, 2018
Last
week, an Ohio man who has the hepatitis C virus was sentenced to 18 months in
prison for spitting at Cleveland police and medics.
Matthew
Wenzler, 27, was reportedly lying on a Cleveland street across from a
downtown casino in January. When police and emergency medical technicians tried
to put him on a stretcher to take him to a hospital, he spit saliva mixed
with blood repeatedly at them, hitting an officer in the eye.
In
Ohio, it’s a felony for people who know they have HIV, viral hepatitis or
tuberculosis to intentionally expose another person to their blood, semen,
urine, feces or other bodily substances such as saliva with the intent to
harass or threaten the person.
Advocates
for people living with diseases like hepatitis C and HIV say these laws add to
the stigma that patients already face and studies suggest the laws are not effective at stopping the spread
of disease.
“This
person is now facing a year and a half of incarceration for something that
didn’t harm anyone and didn’t pose a risk of harm to anyone,” said Kate
Boulton, a staff attorney at the Center for HIV Law and Policy.
Roughly
two-thirds of states, according to the Center for HIV Law and Policy, have laws
that make it a crime to knowingly expose others to HIV, the virus that causes
AIDS. Many of these laws were passed in the 1980s and 1990s when fear and
stigma about HIV were high and contracting the disease was considered a death
sentence.
In
recent years, about a dozen states have added hepatitis C to the list of
medical conditions for which people can face criminal prosecution if they
knowingly expose others by engaging in certain activities like sex without
disclosure, needle-sharing or organ donation.
Public
health officials say these provisions, which are sometimes tacked on to
existing HIV laws, are likely to be ineffective at stemming
transmission of the disease. They may even exacerbate the problem.
“If you
have to let people know that you are infected with HIV or hepatitis C before
you have sex with them, why would anyone in their right mind get themselves
tested and begin treatment?” said Dr. Anne Spaulding, an epidemiologist and
associate professor at Emory University’s public health school. She has worked
as a medical director in correction systems and published research on hepatitis
C among prisoners.
Yet,
among some lawmakers there is still interest in criminalizing actions they view
as spreading the disease. The increasing awareness of the opioid epidemic,
which is linked to the spread of hepatitis C through the use of dirty needles,
may play a role, some experts say.
“We’re
seeing this massive surge in opioid addiction,” said Boulton. “Whereas hepatitis
maybe wasn’t on the radar in the past, now it is.”
An
estimated 3.5 million people have
hepatitis C, a viral infection that causes inflammation of the liver that can
lead to scarring, liver cancer and death. It is typically passed from person to
person through blood. Today that happens often through sharing needles to
inject drugs, and, more rarely, through sex. But many older cases were caused
by blood transfusions before testing for the virus existed.
The
virus isn’t transmitted through urine, feces, semen or saliva, Spaulding said,
noting that although there have been some cases of the disease being spread
through blood hitting the eye, it is very rare and requires a great deal of
blood.
In
2016, the most recent figures available, nearly 3,000 cases were reported
to the federal Centers for Disease Control and Prevention, a 22 percent
increase from the previous year. But many cases go unreported, in part
because people don’t realize they carry the virus. The CDC estimates that
the full number of new cases in 2016 was 41,200.
“Hepatitis
C is still a very dangerous disease to contract,” said South Dakota Republican
State Sen. Stace Nelson, who sponsored a bill this year that would
have made it a felony for people who have been diagnosed with hepatitis C to expose
someone else to the disease. “These circumstances where someone knows that
they have it and intentionally or negligently infects someone else … it’s a
threat to society.”
Advocates
have been working to reform state laws that make it a crime to expose
people to HIV. In the process, they are increasingly working to head off
efforts to criminalize hepatitis C, including supporting local advocates
to help stop a bill in
Michigan in recent years, said Sean Strub, who in 1994 founded POZ
magazine, which is dedicated to issues about HIV. He is also executive
director of the Sero Project, an education and advocacy group that, among
other things, is working to end criminal penalties for exposing others to HIV.
“Now we
have this very robust and active movement combatting HIV criminalization,”
Strub said. “But we’re really combatting a whole range of conditions.”
Sometimes,
however, HIV reform has had negative consequences for people living with
hepatitis C.
Take
for example Iowa, which passed a law in 1998 that said people who were
found guilty of knowingly exposing others to HIV faced up to 25 years in prison
and had to register as sex offenders, even if they used a condom and
didn’t infect anyone. The burden of proof was on the accused to show that
they had disclosed their HIV status to their partner.
Advocates successfully pushed to replace that with
a law reducing the penalties and eliminating the sex offender registration
requirement. But one of their goals also was to reduce stigma by
no longer singling out HIV.
So
they added hepatitis, meningococcal
disease and tuberculosis to the medical conditions that people
could be prosecuted for if they exposed others to it.
People
who worked for the replacement law say they realized from the start that
it wasn’t an ideal solution.
But
outright repeal wasn’t an option politically, said Tami Haught, a community
organizer in Iowa who works as the training and organizing coordinator for the
Sero Project.
“It was
a tough decision that had to be made,” said Haught, who is HIV positive. She
noted that in some states without disease-specific exposure laws, prosecutors
have found a way to charge people under other general criminal laws in any
case.
On
balance, she said she believes it was the right way to go.
Michelle
Andrews: @mandrews110
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