In May 2014, Iowa Governor Terry Branstad signed into law Iowa's revised version of its former criminal HIV Transmission Law. The new law repealed the former Chapter 709C and replaced it with new Chapter 709D, Contagious or Infectious Disease Transmission Act. The law ended mandatory sex offender registration of individuals convicted of intentional exposure of another to HIV, but kept felony status for intentional or reckless transmission as well as intent to transmit without infection, and added hepatitis, meningococcal disease, and tuberculosis to the law', which previously targeted only individuals diagnosed with HIV.
In addition to eliminating mandatory sex offender registration, the new law's positive features include a defense for people living with HIV, TB, Hepatitis A, B or C, or meningococcal disease who take "practical means to prevent transmission;" strengthening the prior law’s standard for determining “intent to transmit;" and reduction of penalties in cases where there is no evidence of HIV transmission.
Unfortunately, Iowa Chapter 709D still classifies intentional transmission of HIV as a class B felony. It also, for the first time, opens the door for prosecutions of people living with all forms of hepatitis, meningococcal disease, and tuberculosis as a class B felony punishable by up to 25 years imprisonment. The creation of new felony offenses for these other poorly understood, stigmatized conditions is likely to have a disproportionate impact on marginalized communities with limited political capital, particularly immigrants who represent most cases of TB in the United States.
Under the new law, Intent to transmit any of these diseases despite lack of transmission is treated as a class D felony punishable by up to 5 years imprisonment.
Finally, while the old HIV criminal law punished only “intentional exposure,” Iowa's new criminal transmission law now adds the crime of “reckless” transmission or exposure, which is easier for a prosecutor to establish.
Dialogue on difficult policy decisions must include representatives of all communities affected by these decisions, and space for disagreement rooted in careful consideration of the facts. This dialogue, as with any involving HIV and stigmatized infectious disease, also must include a racial and economic justice analysis. In this case, an improvement for people living with HIV in Iowa represents a substantial worsening of the treatment of hepatitis, tuberculosis and meningitis, and would represent a significant setback in many states were other jurisdictions to use Iowa's law as a model. Immigrants, who bear much of the burden of tuberculosis in this country, should not have to confront the additional specter of criminalization of an airborne disease that disproportionately affects them.
The Iowa law should serve as a catalyst for deeper dialogue on ways to secure more justice in the criminal justice system for PLWH that considers the interests of all communities routinely targeted on the basis of stigmatized identity.