The North Carolina Commission for Public Health recently voted to modernize North Carolina’s HIV control measures, a series of statutes written into state law in 1988 to help protect people against HIV infection. The movement to modernize the law was spearheaded by the North Carolina AIDS Action Network.
The centerpiece of the original law made it a crime for a HIV-positive person to not disclose to a sexual partner that they were HIV-positive, or to engage in sexual intercourse without a condom. Public health still strongly encourages people to have open and honest conversations with partners about sexual history and risk, and to use condoms to prevent transmission of all sexually transmitted infections (STIs). However, the old criminal laws were counterproductive to public health. They were stigmatizing and discouraged people who might be infected with HIV to get tested or to disclose their status for fear of criminal prosecution.
Prior to the recent modernization, the North Carolina HIV control measures had not been revised since they were passed in 1988. Since then, much has changed in both medical science and in social attitudes surrounding HIV. For example, if a patient follows their prescribed regimen of anti-retroviral medications, they can often deplete the level of HIV in their body so much that they achieve “viral suppression”. A virally suppressed person is unable to transmit HIV during sex, whether or not a condom is used. The “U=U” movement (Undetectable Equals Untransmittable), which was recently validated by the Centers for Disease Control, informs the modernized control measures. The revised statute states that a person who has been virally suppressed for at least six months no longer has to inform their partners about their HIV status. Also, a person who is HIV-positive is no longer legally required to use a condom during sexual intercourse if:
- The person who is HIV-positive is virally suppressed
- Their partner is taking PrEP (Pre-Exposure Prophylaxis)
- Their partner is also HIV-positive.
People who are HIV-positive and not virally suppressed are still required by state law to disclose their status, even if their partner is on PrEP or HIV-positive.
The modernized control measures also allow HIV-positive individuals to donate organs to other HIV-positive individuals, which was not allowed under previous law. Additionally, the revised law de-stigmatizes some antiquated language, exchanging “a person infected with AIDS” to “a person living with HIV”.
Not only does the modernized language align more closely with scientific advances and decrease the stigma and discrimination of the original text, it also allows healthcare professionals to focus on people living with HIV who are not currently linked with medical care, and connect them to treatment so that they can achieve viral suppression.
The full text of the new North Carolina HIV control measures can be found here.