Support for HIV Testing and HIV Criminalization Among Offenders Under Community Supervision, Brad Barber and Bronwen Lichtenstein, Research in the Sociology of Health Care, Volume 33, 253-273 (2015)

In a survey of 197 Alabama probationers and parolees to determine offenders' knowledge of HIV and Alabama’s HIV-specific criminal law, and their level of support for HIV testing and mandatory disclosure, the vast majority supported both testing and criminalization of non-disclosure as key elements of HIV prevention. Many of those surveyed view HIV as a “killer disease” and people living with HIV as potential murderers. General knowledge about how HIV is transmitted was reasonably good, although 38% incorrectly believe that mosquitos transmit HIV. Inaccurate perceptions about the ease of transmission and the efficacy of current treatment options, however, might explain the significant support for the belief that non-disclosure is "an act of murder or death sentence."

Noting the extent to which "participants supported punitive sanctions for HIV non-disclosure and distanced themselves from PLWHA in them-and-us polarities," the authors posit that these responses “reflect the power of HIV stigma to create social distance from the ‘other,’ even among convicted offenders who have a discredited identity of their own." The authors posit that the implications of their findings are that stigma may be particularly harsh in HIV-affected communities.

The authors offer important context on health disparities and social justice. “HIV disparities are the product of social difference according to intersections of gender, race/ethnicity, poverty, sexual identity, and other markers of social status. In sociological terms, HIV disparities exemplify the social constructivist paradigm in which patterns of disease and death are shaped by history, social structure, and the lived environment…power and domination are at the crux of the matter, with stigma being the means by which social inequality is strengthened and reinforced through moral judgments about who becomes infected or ill.”

In closing, the authors observe, "If HIV laws serve to legitimize prejudice and discrimination against PLWHA, then efforts should be made to synchronize HIV codes or policies with statutes for notifiable sexually transmitted infections such as syphilis or gonorrhea, and to review health care practices that appear too legalistic or alienating for people with a history of involvement with coercive authority.”