Louisiana Upholds HIV Exposure Law as Other States Retreat – Governing

Report on Louisiana’s HIV Criminalization Law and its Conflict with Sustainable Development Goals

This report analyzes Louisiana’s law regarding “intentional exposure to HIV,” examining its divergence from national trends and its significant misalignment with key United Nations Sustainable Development Goals (SDGs). The state’s punitive approach undermines global public health objectives, exacerbates social inequalities, and obstructs justice for vulnerable populations.

H2: Contradiction with SDG 3: Good Health and Well-being

Louisiana’s continued enforcement of a harsh HIV criminalization law directly conflicts with the objectives of SDG 3, particularly Target 3.3, which aims to end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases by 2030. The state’s policy creates substantial barriers to achieving this goal.

H3: How the Law Undermines Public Health

• Discouraging Testing: Public health officials and AIDS experts assert that such laws deter individuals from getting tested for HIV. Criminal liability is often contingent on knowing one’s status, creating a clear disincentive to seek diagnosis and treatment. This directly impedes efforts to control and end the epidemic.
• Stigmatization: The law perpetuates stigma surrounding HIV, which is a known barrier to accessing healthcare, treatment, and support services. The case of Robert Smith, who faced social exclusion compounded by his conviction, exemplifies this challenge.
• Ignoring Scientific Advancement: The statute fails to account for modern medical science, such as the fact that an individual with an undetectable viral load due to effective treatment cannot transmit HIV. The law criminalizes behaviors with low or zero risk of transmission, basing enforcement on fear rather than evidence.
• Threatened Support Systems: The potential for federal funding cuts to programs like the Ryan White HIV/AIDS Program, which supports over half of diagnosed individuals in the U.S., further jeopardizes the health infrastructure necessary to achieve SDG 3.

H2: Exacerbation of Inequalities, Defying SDG 10 and SDG 16

The application of Louisiana’s HIV law disproportionately affects marginalized communities and highlights systemic failures in the justice system, running counter to SDG 10 (Reduced Inequalities) and SDG 16 (Peace, Justice and Strong Institutions).

H3: Disproportionate Impact and Systemic Injustice

1. Racial Disparity: A 2022 Williams Institute analysis revealed a significant racial bias in the law’s enforcement. Black individuals, particularly Black men, constituted nearly three-quarters of those convicted and placed on the sex offender registry, a rate disproportionate even to their representation in HIV diagnoses within the state. This perpetuates the systemic inequality that SDG 10 seeks to eliminate.
2. Vulnerability of Marginalized Groups: Nationally, data shows that women, sex workers, and the queer community are also disproportionately prosecuted under similar laws, compounding their marginalization.
3. Failure of Justice (SDG 16): The law places the burden of proof on the accused to demonstrate they disclosed their status. This, combined with the intimate nature of the alleged offenses, often leads to convictions based on conflicting testimonies with little evidence, undermining the principle of equal access to justice. The broad language of the law (“any means or contact”) allows for its misuse as a coercive tool in relationships, further compromising justice.

H2: Socio-Economic Consequences and Barriers to SDG 1 and SDG 8

A conviction under Louisiana’s law carries severe socio-economic penalties that create a cycle of poverty and exclusion, directly opposing SDG 1 (No Poverty) and SDG 8 (Decent Work and Economic Growth).

H3: The Impact of Sex Offender Registration

• Barriers to Employment and Housing: The mandatory registration as a sex offender, a requirement in only five states for this offense, creates insurmountable barriers. As seen in the case of Robert Smith, it severely restricts where an individual can live and work, making it difficult to secure stable employment and housing.
• Economic Hardship: The inability to find work and the fees associated with maintaining registry status push individuals toward poverty, contradicting the goals of ensuring decent work (SDG 8) and implementing social protection systems (SDG 1).

H2: The Case for Reform and Alignment with National Trends

While Louisiana maintains its punitive stance, a national movement is underway to modernize or repeal HIV criminalization laws to align them with science and public health principles. This reform is essential for the state to contribute to, rather than hinder, the achievement of the SDGs.

H3: Proposed Reforms

Advocacy groups, including the Louisiana Coalition on Criminalization and Health, have pushed for specific, evidence-based reforms to the law. These reforms are critical steps toward aligning state policy with human rights and public health imperatives.

1. Remove the requirement for sex offender registration.
2. Require that actual transmission of the virus occurred for a conviction.
3. Require clear and demonstrable intent to transmit the virus.

The failure of recent legislative efforts to pass such reforms, and the introduction of bills to expand criminalization to other STIs, indicates a significant disconnect between Louisiana’s legislature and the principles of effective, just, and health-focused governance embodied by the Sustainable Development Goals.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on Louisiana’s HIV exposure law touches upon several interconnected Sustainable Development Goals (SDGs). The primary issues of public health, discriminatory laws, social stigma, and inequality directly link to the following SDGs:

• SDG 3: Good Health and Well-being: The core of the article revolves around HIV, a major public health issue. It discusses the HIV/AIDS epidemic, access to treatment (antiviral pills), prevention strategies, and the negative impact of punitive laws on public health outcomes, such as deterring people from getting tested.
• SDG 10: Reduced Inequalities: The article explicitly highlights how the law disproportionately affects marginalized communities. It states that “Black people made up nearly three-quarters of the people convicted” under Louisiana’s law and that nationally, “women, sex workers, the queer community” are also disproportionately arrested. This directly addresses the goal of reducing inequalities based on race, gender, and health status.
• SDG 16: Peace, Justice and Strong Institutions: The article critiques a specific law (“intentional exposure to HIV”) and the justice system that enforces it. It discusses how the law is based on “fear, not science,” leads to unjust outcomes like placement on a sex offender registry for low-risk behavior, and places the burden of proof on the accused. This relates to promoting the rule of law and ensuring equal access to justice through non-discriminatory laws and policies.
• SDG 5: Gender Equality: The analysis in the article points out that “women, sex workers” are among the marginalized groups disproportionately arrested and prosecuted under HIV criminalization laws, connecting the issue to the broader goal of ending discrimination against women.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion, several specific SDG targets can be identified:

1. Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases… The article directly engages with this target by discussing how punitive laws “hurt efforts to end the HIV epidemic.” It explains that such laws “deter people from getting tested and treatment, undermining response to the epidemic.”
2. Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services and… medicines. The article mentions the importance of access to treatment, citing Robert Smith’s use of “daily antiviral pills” to become undetectable. It also highlights threats to healthcare access through potential federal funding cuts to “the Ryan White HIV/AIDS program” and “Medicaid,” which serves “40 percent of adults under 65 with HIV.”
3. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices… The central theme of the article is the call to reform or repeal Louisiana’s HIV exposure law, which is presented as a discriminatory policy. The nationwide effort to “update or repeal state laws that criminalize HIV” is a direct action toward this target.
4. Target 16.b: Promote and enforce non-discriminatory laws and policies for sustainable development. The article is a case study of a law that is argued to be discriminatory. Public health officials and experts state that “enforcement of such laws is often shaped by fear, not science,” and activists are pushing to amend the law to remove its most punitive and scientifically unsupported elements, directly aligning with the promotion of non-discriminatory laws.
5. Target 5.1: End all forms of discrimination against all women and girls everywhere. The article implies this target by noting that women and sex workers are disproportionately prosecuted under these laws, which constitutes a form of discrimination within the justice system based on gender and occupation.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

The article provides both direct and implied indicators that can be used to measure progress:

• For Target 3.3 (End AIDS epidemic):
  • HIV Testing Rates: The article implies this indicator by referencing a 2024 survey that found “after California updated its HIV criminalization law in 2018, respondents were more likely to get tested.” This suggests that changes in testing rates can be used to measure the public health impact of legal reforms.
  • Number of People on Treatment: The story of Robert Smith, who takes “daily antiviral pills” and is “undetectable,” points to the importance of treatment access. The mention that the Ryan White program “serves more than half of the people in the U.S. diagnosed with HIV” is a quantitative measure of treatment coverage.
• For Target 10.3 & 16.b (Eliminate Discriminatory Laws):
  • Number of Discriminatory Laws in Force: The article provides a baseline by stating “Louisiana is one of 30 states with criminal penalties related to exposing or transmitting HIV.” Progress could be measured by a reduction in this number. The fact that “a dozen states have changed their laws” and “four have gotten rid of them completely” serves as an indicator of progress.
  • Arrest and Conviction Data by Demographic Group: The article uses this as a key indicator of inequality. The statistic that “Black people made up nearly three-quarters of the people convicted and placed on the sex offender registry” in Louisiana is a powerful indicator of the law’s discriminatory outcome. Tracking this proportion over time would measure progress toward equality.

4. Summary Table of SDGs, Targets, and Indicators

Source: governing.com