In nearly half of all U.S. states, it is a felony for HIV-positive people to have sex without disclosing their status to their partners. In some places, this law, meant to promote public health, has become a tool of social control. Those who have—or are suspected of having—HIV or AIDS are essentially kept under surveillance and can be criminally sanctioned for various violations.

Trevor Hoppe (Social Problems, February 2013) interviewed 25 health officials responsible for managing “health threat” cases in Michigan, where the laws are particularly strenuous. When new HIV-positive individuals are identified, officials do extensive contact tracing. While surveillance technologies are officially about disease prevention, they are also used to aid law enforcement and to regulate the client’s sexual practices. If an individual is labeled a “health threat,” they may be forced to undergo testing, counseling, treatment, or be quarantined. HIV-positive individuals may not be allowed to have any unprotected sex, even if they have disclosed their status to their partner (and if they test positive for a secondary STI, that is taken as evidence of unprotected sex). The law also treats all types of sex as equally risky, criminalizing even those sexual acts that carry no risk of transmission.

The criminal punishment for non-disclosure also provides impetus for local rumor mills, often setting in motion a “witch hunt.” Community members can call in confidential third party reports accusing individuals they suspect are HIV positive of not disclosing. These accusations often come against already-stigmatized individuals and may be false reports, but they set investigations in motion.

The additional stigma and social costs attached to an HIV diagnosis in states with such legislation may now be reducing people’s willingness to be tested for STIs at all, thus rendering a public health effort bad for public health.