When Michael Johnson, a young Black college athlete in Missouri, was sentenced to 30 years in prison in 2015, it wasn’t for violence or theft—it was for allegedly transmitting HIV to a white partner and exposing four others.

A college wrestler with no criminal record, Johnson received a sentence greater than the statewide average for second degree murder. His stint in jail often left him isolated, spending 23 hours a day in solitary confinement due to his HIV.

An Appeals Court later reversed his conviction, citing prosecutorial misconduct and the “grossly disproportionate” sentence. Prosecutors presented no genetic evidence that Johnson had actually transmitted the disease. Later the county’s lead prosecutor said the laws governing such cases were outdated and scientifically inaccurate.  

Johnson’s case shows how cruel and wrong-headed HIV criminalization can be. Americans don’t get jailed for spreading diseases like measles or COVID-19, but they do for HIV, say Louis L. Listerud, research project manager of Eidos LGBTQ+ Health Initiative at Penn Nursing and LDI Senior Fellow Stephen Bonett. Their team detailed the history of these laws and called for their abolition in a new analytical essay in the American Journal of Public Health.  

More than 30 states have laws that criminalize the transmission of the virus that causes AIDS. Those measures date from the 1980s when the disease emerged as a death sentence and no treatment existed. Over the year, legislators expanded the reach of these laws, criminalizing such behavior as spitting and biting even though research shows those actions cannot transmit HIV.       

With the rise of effective treatments, HIV became a treatable disease, and many people with detectable viral loads now are poor and lack access to care. About 40 percent of HIV patients are Black even though they comprise 12 percent of the population.

These laws now serve to imprison people of color while targeting sex workers and the LGBTQ community at large, say Listerud and Bonett. They were never a good idea, because they failed to stop the spread of the disease and now prey on vulnerable groups. Once touted as a public health measure, these laws accomplish the opposite by stigmatizing the condition, making it harder to get tested and treated. They will make it impossible to meet the CDC’s goal of reducing new HIV infections by 90% in 2030.

Only total repeal should be considered, Listerud said, because “when you criminalize HIV, it’s like criminalizing poverty.”  Read more below from Listerud and Bonett:        

What are the basic problems with criminalizing HIV? Why is it wrong?

Listerud: Firstly, HIV criminalization statutes were supposedly implemented as a public health measure to stop the spread of HIV at a time when there was no treatment and the epidemic was quickly escalating. There are several problems with this logic as these laws: 1) did not stop the spread of HIV inside or outside of prisons; 2) further stigmatized HIV as a disease rooted in “morality” and “choice”; and 3) were disproportionately applied to already marginalized communities living at various intersections of Blackness, queer/transness, and sex work. Beyond the laws not fulfilling their intended purpose, criminalization of a disease rooted in the social determinants of health not only worsens profound racial disparities rooted in the legacy of slavery and segregation but churns individuals seen as disposable into the capitalist and violent system that is the prison industrial complex where they are exploited and can be branded as felons or sex offenders for the rest of their lives. Prison is a dehumanizing institution that in reality does not repair the harms an individual may have caused but rather inflicts harm as a form of punishment, not ‘rehabilitation’ or true healing justice.  

What are some examples of HIV laws that are out of date?

Listerud: Depending on the state, people living with HIV may be charged with bioterrorism, attempted murder, and aggravated assault even in cases where HIV was not transmitted or not willfully transmitted. People in these scenarios can receive more severe charges, longer sentences, or be added to the sex offender registry even in cases where they may have an undetectable viral load. They may also be convicted for actions that have been repeatedly shown by the evidence base to not in fact transmit HIV, like spitting, biting, or throwing of bodily fluids. These actions when inflicted upon police officers, a violent extension of the prison industrial complex, further enhance these charges. 

HIV grants are being cut and the research enterprise is under assault. What would you say to leaders to make them reconsider their positions on these laws?

Listerud: These laws are not only directly harmful to people living with HIV, but may be impeding broader efforts to end the HIV epidemic. Research has found that in places with widely publicized HIV criminalization laws, people are less likely to get tested for HIV and rates of HIV transmission are actually higher–so these laws, which were conceived as measures to stop the spread of HIV may actually be worsening the spread.

Bonett: Also, it is not discussed enough, but the cost to incarcerate an individual is incredibly high. Between 1997 and 2020, Florida spent $15.2 million in incarceration costs for HIV-related convictions. This funding could be much better spent on efforts that actually prevent and treat HIV, not criminalize it.  

You say these HIV laws cannot be reformed and should be abolished. Why is that necessary?

Bonett: We argue for an abolitionist approach over efforts to modernize statutes because we believe that modernization only further concretizes criminalization, making a statement that certain people still deserve to be incarcerated for a disease, even if that pool of people decreases.

Listerud: Some laws aimed at modernizing statutes that claim to catch up with the evidence on HIV transmission rates make a critical misstep. Not only will these laws continue to disproportionately target Black marginalized communities, who are disproportionately impacted by HIV, there is no evidence base that supports criminalization as a public health effort to prevent or treat HIV. Modernized statutes maintain the status quo while abolitionist approaches refuse to contribute to a system of exploitation. 

You say these HIV laws are part of a larger system of discrimination. How so?

Listerud: Evidence strongly points to how these laws disproportionately impact Black marginalized individuals living with HIV. Black and Brown communities proportionally have some of the highest rates of HIV and lowest access to prevention and treatment services due to a myriad of factors, many of which are rooted in racism. For example, while 12% of Missourians identify as Black, they account for 45% of people living with HIV and 61% of HIV-related convictions. This pattern of deep disparities for Black people is reflected in almost all aspects of our society from housing to health to mass incarceration to education, and HIV criminalization rates are only a part of this larger system that purposefully disadvantages and exploits Black people in this country with the ever-present looming legacy of slavery and segregation. 

What other recommendations do you have?

Listerud: While we’ve mentioned redistributing funds away from the prison industrial complex, we also recommend focusing on increasing access to preventative services and reducing HIV stigma. Prevention goes beyond access to condoms, PrEP, and testing, as alleviating poverty is an essential step in truly reducing not only HIV incidence and disparities but many other conditions rooted in social factors. Focusing on decreasing HIV stigma also means reducing stigma against the marginalized communities who are often associated with HIV and labeled as dangerous or deviant. This must involve a social movement to end the exploitation of these communities that relies on their constant dehumanization which requires us to instead campaign to value racially marginalized communities who deserve care, support, and freedom. 

Where would you like to go next in your research?

Listerud: Our next directions may center on exploring history for similar cases of criminalization and modeling our suggestions based on these previous efforts. This requires examining our past as a blueprint because struggles towards abolition have always been present. This country was founded during a time when not all ‘men’ were entitled to the same rights as cisgender heterosexual white men, an American tradition that persists to this day and permeates all facets of society including law and policy. Our ‘justice’ system is inherently built on injustice perpetrated against Black and other marginalized peoples, and decriminalizing HIV is just a small step towards true justice. Future research could not only bolster these efforts but serve as a rallying cry to encourage those uncertain about the abolitionist movement to see the vision for a future free from these oppressive structures and laws because oppression and racial injustice does not have to be inevitable.

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The study, “A Decarceral Response to HIV Criminalization in the Black LGBTQIA+ Community,” was published on June 1, 2025 in American Journal of Public Health. Authors include Louis Listerud, Steven Meanley, Alana Richards, Blake Kosciow, and Stephen Bonett.

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