HIV criminalization laws

There is strong evidence that HIV criminalization laws do not prevent HIV transmission or reduce risky sexual behaviors (Keralis 2024, Lee 2014, Burris 2007). Laws that criminalize HIV pose a barrier to HIV prevention and treatment by discouraging people living with HIV (PLWH) and individuals at high risk from getting tested and seeking treatment (Bonett 2020, Dibble 2022).

HIV criminalization laws are linked to a reduced likelihood of seeking treatment among PLWH (Bonett 2020) and HIV testing among men having sex with men (MSM) (Dibble 2022). In states with HIV criminalization laws, frequent media reporting on criminalization of HIV exposure is associated with decreases in the number of people getting tested (Lee 2014). Public health experts argue that the fear created by HIV criminalization leads to delayed testing, increasing the number of individuals who are HIV positive but unaware of their health status and missing timely treatment (Lee 2014). In California, reform of HIV criminalization laws (i.e., criminal charges only for actual transmission or specific intent to transmit the disease) increased HIV testing among individuals who engage in behaviors with high risk of getting or transmitting HIV (Keralis 2024).

HIV criminalization laws do not appear to affect beliefs about risky sexual behaviors (e.g., unprotected sex or not disclosing HIV status to a partner) among PLWH and individuals at high risk of HIV (Burris 2007), and awareness of the laws is not associated with a reduction in risky sexual behavior (Galletly 2012). PLWH are less likely to disclose HIV status to partners in states with strict HIV criminalization laws and more aggressive prosecutions than in states with less strict HIV criminalization laws (NBER-Delavande 2007).

HIV criminalization laws increase stigma (e.g., being treated as a sex offender) and discrimination toward PLWH (Sykes 2016, Fulham 2025, Ferguson 2023, NACCHO 2020, Sero Project-Survey 2021) and undermine their health and safety (Breslow 2020, Cross 2020, NACCHO 2020); such harm caused by the laws often outweighs intended public health benefits for PLWH (Csete 2011). A national survey of PLWH suggests HIV criminalization laws decrease trust in public health officials (Sero Project-Survey 2021). Black MSM living in states with HIV criminalization laws report higher levels of stigma and discrimination from communities compared to Black MSM in states without the laws (Baugher 2021). HIV criminalization laws may increase stigma toward PLWH involved in the justice system (Sykes 2016) and endanger the health and safety of survivors of intimate partner violence who live with HIV (Cross 2020). Experience of HIV stigma can lead to poorer health outcomes and reduced engagement in medical treatment (Williams Institute-Sears 2020a).

In the U.S., state HIV criminalization laws were enacted mostly during 1980s and 1990s, and they do not reflect current biomedical advancements that enable treatment and prevention of transmission of HIV (CDC-HIV Criminalization 2023, CHLP-Transmission). For example, sexual HIV transmission risk is very low for PLWH who are treated with antiretroviral therapy (Gram 2025, Lehman 2014). Experts and researchers indicate that many behaviors HIV laws charge criminal offenses for (e.g., being exposed to spitting) have zero risk of HIV transmission (Williams Institute-Cisneros 2024a, Mayer 2018, CHLP-Transmission, NACCHO 2020, ANAC 2015).

Experts and researchers recommend repealing or modernizing HIV criminalization laws to reflect current science and medical advancements, substantially limiting HIV-related prosecution, and enacting laws that protect the human rights of PLWH (Foote 2018). Other recommendations include implementing programs that help PLWH share their status with their partners and families and provide counseling (Chenneville 2015); training and education of judges, prosecutors, and law enforcement on HIV transmission risk and negative impact on PLWH (Foote 2018); engaging nurse practitioners for HIV-related policy change and advocacy (Herndon 2025); and campaigns for HIV law reform (Hoppe 2025). Researchers also recommend a multicomponent approach of education, community engagement, counseling, supportive groups, and HIV specialists to effectively reduce internalized HIV-related stigma and discrimination in healthcare settings (Ferguson 2023).

States with HIV criminalization laws tend to have higher HIV incidence rates (Keralis 2023), larger Black populations (Kay 2017), and greater structural stigma related to sexual orientation (Tran 2019).

There is strong evidence that HIV criminalization laws increase disparities in arrest and prosecution for people living with HIV (PLWH), particularly for individuals from racially minoritized backgrounds, women, and LGBTQ+ communities (Csete 2023, Bernard 2022a, Lennon-Dearing 2024, NACCHO 2020). Other groups disproportionally charged and convicted under HIV criminalization laws include sex workers, immigrants, and Indigenous populations (Csete 2023, Bernard 2022a, Lennon-Dearing 2024).

In the U.S., HIV criminalization laws disproportionately affect sexual and gender minorities and individuals from racially minoritized backgrounds (Williams Institute-Cisneros 2022, Williams Institute-Cisneros 2024b, Williams Institute-Cisneros 2024c, Cann 2019), including women (Burris 2008) and queer and transgender individuals who are Black (Listerud 2025). For example, women and individuals who are Black are over-represented in HIV-related arrests in Ohio (Williams Institute-Cisneros 2024c). In California, individuals living with HIV who are Black, Hispanic, or female are over-represented in those who had contact with the criminal justice system; they are also less likely to be released without charges compared to men living with HIV who are white (Williams Institute-Hasenbush 2015). A Michigan-based study of HIV-specific criminal convictions indicates that women who are white and men who are Black with female partners are at the greatest risk of conviction (Hoppe 2015).

HIV criminalization laws increase the risk of deportation for immigrants (Williams Institute-Hasenbush 2016). Additionally, men who have sex with men (MSM) who are Black and live in states with HIV criminalization laws are more likely to experience discrimination and stigma from their communities compared to those who are white, and compared to MSM who are Black and live in states without HIV laws (Baugher 2021).

When the AIDS epidemic began in the U.S., federal response was slow to acknowledge and respond, in part because AIDS primarily affected gay men in a time when many states still criminalized homosexuality. While the first case of HIV/AIDS in the U.S. was reported in 1981 (HIV.gov, Bennington-Castro 2020), major federal funding wasn’t allocated until 1985 (Bennington-Castro 2020).

Starting with New Jersey, public fear of HIV led many states to establish HIV criminalization laws in the 1980s and 1990s, long before pharmaceuticals were available to treat or prevent transmission (AAHIVM, CDC HIV-Criminalization, Harsono 2017). The Ryan White CARE Act in 1990 forced all U.S. states to prove they had a legal proceeding to prosecute people living with HIV (PLWH) who may expose others to HIV, in order to qualify for federal funding (Harsono 2017). Supporters of HIV criminalization have claimed that such criminalization laws can deliver a clear message to PLWH about what is right and wrong and can make them change their risky behaviors (Burris 2007). Opponents of HIV criminalization have made efforts to educate lawmakers and advocates about how HIV is transmitted and how the laws do not reflect current science (e.g., low transmission risk of behaviors and the development of effective treatment), along with stigma and discrimination for PLWH (Sero Project-HINAC, CHLP-Toolkit).

Experts and researchers emphasize the importance of social and structural interventions for HIV prevention, such as increasing access to HIV testing, removal of legal barriers to safer injection practices, health care coverage, stable housing, and education to better train individuals like police officers (Kapadia 2022, Adimora 2010). In 2018, $19 billion in federal funds allocated to U.S. cities for local public health efforts prevented 57,000 deaths from HIV/AIDS (Dillender 2023).

• Does your state have HIV criminalization laws? If yes, how many people living with HIV have been prosecuted so far? Which groups are disproportionately affected?
• What training and public education are available for law enforcement, judges, and the public to address stigma and biases toward people living with HIV in your state? Are there resources and/or funding to protect the rights of PLWH, support treatment, and ensure they live full lives?
• Who are your key partners for repealing or modernizing HIV criminalization laws in your state? How can public health departments, community organizations, legislators, and people living with HIV work together to drive these reforms?

As of November 2025, 32 states have laws that impose criminal penalties on people living with HIV (PLWH) for actual or perceived HIV exposure and/or transmission. Fourteen states criminalize blood or organ donation by PLWH. Ten states impose heightened criminal penalties on PLWH who engage in sex work, and 11 states impose longer sentences for PLWH who are accused of violating a general criminal law (CHLP-Map 2025).

More than ten states have repealed or modified their HIV criminalization laws. Texas (in 1994), Illinois (2021), New Jersey (2022), North Dakota (2025), and Maryland (2025) repealed laws that exclusively and solely criminalized HIV. Five states (Iowa, California, Washington, Nevada, and Georgia) have modified their laws to focus exclusively on intentional transmission for HIV transmission offenses (CHLP-HIV Law timeline).

‡ Resources with a focus on equity.

CHLP-PJP^‡ - Positive Justice Project (PJP) Steering Committee. (2015). Guiding principles for eliminating disease-specific criminal laws. The Center for HIV Law and Policy (CHLP).

CHLP-Toolkit^‡ - The Center for HIV Law and Policy (CHLP). (2013). A toolkit for community advocates, volume 3.

HIV Justice Academy-Resource^‡ - HIV Justice Academy. (2026). Resource library. Retrieved March 21, 2026.

* Journal subscription may be required for access.

AAHIVM - American Academy of HIV Medicine (AAHIVM). (n.d.). HIV criminalization. Accessed April 7, 2026.

Adimora 2010 - Adimora, A. A., & Auerbach, J. D. (2010). Structural interventions for HIV prevention in the United States. Journal of Acquired Immune Deficiency Syndromes, 55 Suppl 2(0 2), S132–S135.

ANAC 2015 - Association of Nurses in AIDS Care (ANAC). (2015). Position statement: HIV criminalization laws and policies promote discrimination and must be reformed. Journal of the Association of Nurses in AIDS Care, 26(2), 215-217.

Baugher 2021 - Baugher, A. R., Whiteman, A., Jeffries, W. L. IV, Finlayson, T., Lewis, R., Wejnert, C., & NHBS Study Group. (2021). Black men who have sex with men living in states with HIV criminalization laws report high stigma, 23 U.S. cities, 2017. AIDS, 35(10), 1637-1645.

Bennington-Castro 2020 - Bennington-Castro J. How AIDS remained an unspoken—but deadly—epidemic for years. History. 2020.

Bernard 2022a - Bernard, E. J., Symington, A., & Beaumont, S. (2022). Punishing vulnerability through HIV criminalization. American Journal of Public Health, 112(S4), S395–S397.

Bonett 2020* - Bonett, S., Meanley, S., Elsesser, S., & Bauermeister, J. (2020). State-level discrimination policies and HIV pre-exposure prophylaxis adoption efforts in the U.S. Health Affairs, 39(9), 1575-1582.

Breslow 2020* - Breslow, A. S., & Brewster, M. E. (2020). HIV is not a crime: Exploring dual roles of criminalization and discrimination in HIV/AIDS minority stress. Stigma and Health, 5(1), 83–93.

Burris 2007* - Burris, S., Beletsky, L., Burleson, J. A., Case, P., & Lazzarini, Z. (2007). Do criminal laws influence HIV risk behavior? An empirical trial. Arizona State Law Journal, Temple University Legal Studies Research Paper No. 2007-03.

Burris 2008* - Burris, S., & Cameron, E. (2008). The case against criminalization of HIV transmission. JAMA, 300(5), 578–581.

Cann 2019* - Cann, D., Harrison, S.E., & Qiao, S. (2019). Historical and current trends in HIV criminalization in South Carolina: Implications for the southern HIV epidemic. AIDS and Behavior, 23(Suppl 3), 233–241.

CDC HIV-Criminalization - Centers for Disease Control and Prevention (CDC). (2023). HIV criminalization and ending the HIV epidemic in the U.S. Retrieved April 7, 2026.

CDC HIV-Exposure - Centers for Disease Control and Prevention (CDC). (2023, March 3). HIV and STD criminalization laws. Retrieved April 7, 2026.

CDC-HIV Criminalization 2023 - Centers for Disease Control and Prevention (CDC). (2023, January). HIV criminalization and ending the HIV epidemic in the U.S. Retrieved March 21, 2026.

Chenneville 2015* - Chenneville, T., Lynn, V., Peacock, B., Turner, D., & Marhefka, S. L. (2015). Disclosure of HIV status among female youth with HIV. Ethics & Behavior, 25(4), 314-331.

CHLP-HIV Law timeline - The Center for HIV Law and Policy (CHLP). (2025). Timeline of state reforms and repeals of HIV criminalization laws. Accessed April 7, 2026.

CHLP-Map 2025 - The Center for HIV Law and Policy (CHLP). (2025, November). Mapping HIV criminalization laws in the U.S.

CHLP-Sourcebook 2024 - The Center for HIV Law and Policy (CHLP). (2024, January). HIV criminalization in the United States: A sourcebook on state and federal HIV criminal law and practice.

CHLP-Toolkit - The Center for HIV Law and Policy (CHLP). (2013). A toolkit for community advocates, volume 3.

CHLP-Transmission - The Center for HIV Law and Policy. (2017). Routes, risks and realities of HIV transmission and care: Current scientific knowledge and medical treatment.

Cross 2020 - Cross, C. K. (2020). The dangers of disclosure: How HIV laws harm domestic violence survivors. Washington Law Review, 95(1), 83.

Csete 2011* - Csete, J., & Elliott, R. (2011). Criminalization of HIV transmission and exposure: In search of rights-based public health alternatives to criminal law. Future Virology, 6(8), 941-950.

Csete 2023* - Csete, J., Elliott, R., & Bernard, E. J. (2023). So many harms, so little benefit: A global review of the history and harms of HIV criminalisation. The Lancet HIV, 10(1), e52–e61.

Dibble 2022 - Dibble, K. E., Murray, S. M., Wiginton, J. M., Maksut, J. L., Lyons, C. E., Aggarwal, R., Augustinavicius, J. L., Al-Tayyib, A., Sey, E. K., Ma, Y., Flynn, C., German, D., Higgins, E., Anderson, B. J., Menza, T. W., Orellana, E. R., Flynn, A. B., Wermuth, P. P., Kienzle, J., … Baral, S. D. (2022). Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States. BMC Health Services Research, 22, 1179.

Dillender 2023 - Dillender, M. (2023). Evidence and lessons on the health impacts of public health funding from the fight against HIV/AIDS. American Economic Review, 113(7), 1825-87.

Ferguson 2023 - Ferguson, L., Gruskin, S., Bolshakova, M., Rozelle, M., Yagyu, S., Kasoka, K., Oraro-Lawrence, T., Motala, A., Stackpool-Moore, L., & Hempel, S. (2023). Systematic review and quantitative and qualitative comparative analysis of interventions to address HIV-related stigma and discrimination. AIDS, 37(13), 1919-1939.

Foote 2018 - Foote, C., Bernard, E., & Mykhalovskiy, E. (2018). Solutions to ending the global social problem of HIV criminalization. In G. W. Muschert, K. M. Budd, M. Christian, B. V. Klocke, J. Shefner, & R. Perrucci (Eds.), Global Agenda for Social Justice (pp. 31-40). Bristol University Press.

Fulham 2025 - Fulham, K. (2025, October). Punishment without principle: HIV criminalization and the sex offender registry. Brooklyn Law School, Research paper, no. 803.

Galletly 2012* - Galletly, C. L., Pinkerton, S. D., & DiFranceisco, W. (2012). A quantitative study of Michigan's criminal HIV exposure law. AIDS Care, 24(2), 174-179.

Gram 2025* - Gram, E. G., Biering, I. E., Olsen, O., & Gram, G. J. (2025). Evidence of zero-risk transmission of HIV in the era of antiretroviral therapy: A systematic review and meta-analyses. Public Health, 239, 149-155.

Harsono 2017 - Harsono, D., Galletly, C. L., O'Keefe, E., & Lazzarini, Z. (2017). Criminalization of HIV exposure: A review of empirical studies in the United States. AIDS and Behavior, 21(1), 27–50.

Herndon 2025* - Herndon, V., McGee, K., Waldrop, J., & Walton, A. M. (2025). Decriminalizing HIV in Indiana: A policy analysis. The Journal for Nurse Practitioners, 21(6), 105396.

HIV.gov - HIV.gov. HIV and AIDS timeline.

Hoppe 2015* - Hoppe, T. A. (2015). Disparate risks of conviction under Michigan’s felony HIV disclosure law: An observational analysis of convictions and HIV diagnoses, 1992–2010. Punishment & Society, 17(1), 73-93.

Hoppe 2025 - Hoppe, T., & Hall, E. (2025). How did they do it? Analyzing the landscape of HIV criminalization reform in the USA. Sexuality Research and Social Policy. Advance online publication.

Kapadia 2022 - Kapadia, F. (2022). Structural interventions that reduce HIV vulnerability: A public health of consequence. American Journal of Public Health, 112, 826-827.

Kay 2017* - Kay, E. S., & Smith, B. D. (2017). State-level HIV criminalization laws: Social construction of target populations? Journal of Policy Practice, 16(2), 133-146.

Keralis 2023* - Keralis J. M. (2023). HIV criminalization laws and enforcement: Assessing the relationship between HIV criminalization at the state level, policing at the county level, and county-level HIV incidence rates. AIDS and Behavior, 27(11), 3713-3724.

Keralis 2024 - Keralis, J. M., Bourbeau, A., Delaney, K. P., Odunsi, S., & Valentine, S. S. (2024). HIV: California's 2018 criminalization reform and testing among those reporting risk behavior. Journal of Public Health Policy, 45(4), 673-686.

Lee 2014* - Lee, S. G. (2014). Criminal law and HIV testing: Empirical analysis of how at-risk individuals respond to the law. Yale Journal of Health Policy, Law, and Ethics, 14(1), 194-238.

Lehman 2014 - Lehman, J. S., Carr, M. H., Nichol, A. J., Ruisanchez, A., Knight, D. W., Langfrd, A. E., Gray, S. C., & Mermin, J. H. (2014). Prevalence and public health implications of state laws that criminalize potential HIV exposure in the United States. AIDS and Behavior, 18, 997-1006.

Lennon-Dearing 2024* - Lennon-Dearing, R. (2024). Criminalization of human immunodeficiency virus in the United States. Nursing Clinics, 59(2), 201-217.

Listerud 2025* - Listerud, L., Meanley, S., Richards, A., Kosciow, B., & Bonett, S. (2025). A decarceral response to HIV criminalization in the Black LGBTQIA+ community. American Journal of Public Health, 115(7), 1157-1165.

Mayer 2018 - Mayer, K. H., Sohn, A., Kippax, S., & Bras, M. (2018). Addressing HIV criminalization: Science confronts ignorance and bias. Journal of the International AIDS Society, 21(7), e25163.

NACCHO 2020 - National Association of County and City Health Officials (NACCHO). (2020, April). Statement of policy: Stigma, discrimination, and criminalization against persons with infectious diseases.

NBER-Delavande 2007 - Delavande, A., Goldman, D., & Sood, N. (2007). Criminal prosecution and HIV-related risky behavior. NBER Working Paper 12903.

Sero Project-HINAC - Sero Project. (n.d.). HIV is Not a Crime National Training Academy (HINAC). Retrieved March 21, 2026.

Sero Project-Survey 2021 - Sero Project. (2023). The National HIV Criminalization Survey 2021. Accessed April 7, 2026.

Sykes 2016 - Sykes, B. L., Hoppe, T. A., & Maziarka, K. D. (2016). Cruel intentions? HIV prevalence and criminalization during an age of mass incarceration, U.S. 1999 to 2012. Medicine, 95(16), e3352.

Tran 2019* - Tran, N. K., Hatzenbuehler, M. L., & Goldstein, N. D. (2019). Potential relationship between HIV criminalization and structural stigma related to sexual orientation in the United States. Journal of Acquired Immune Deficiency Syndromes, 80(5), e106-e108.

Williams Institute-Cisneros 2022 - Cisneros, N., Sears, B., & Lennon-Dearing, R. (2022, June). Enforcement of HIV criminalization in Tennessee. UCLA School of Law, The Williams Institute.

Williams Institute-Cisneros 2024a - Cisneros, N., Foote, C., Schlebecker, P., & Sears, B. (2024, November). HIV criminalization in Indiana: Evaluation of transmission risk. UCLA School of Law, The Williams Institute.

Williams Institute-Cisneros 2024b - Cisneros, N., Tentindo, W., Sears, B., Macklin, M. L, & Bendana, D. (2024, January). Enforcement of HIV criminalization in Maryland. UCLA School of Law, The Williams Institute.

Williams Institute-Cisneros 2024c - Cisneros, N., Sears, B., & Tentindo, W. (2024, February). Enforcement of HIV criminalization in Ohio. UCLA School of Law, The Williams Institute.

Williams Institute-Hasenbush 2015 - Hasenbush, A., Miyashita, A., & Wilson, B. D. M. (2015, December). HIV criminalization in California: Penal implications for people living with HIV/AIDS. UCLA School of Law, The Williams Institute.

Williams Institute-Hasenbush 2016 - Hasenbush, A., & Wilson, B. D. (2016, September). HIV criminalization against immigrants in California. UCLA School of Law, The Williams Institute.

Williams Institute-Sears 2020a - Sears, B., & Goldberg, S. K. (2020). HIV criminalization in Florida: Evaluation of transmission risk. UCLA School of Law, The Williams Institute.