 | This article possibly contains original research .(December 2021) |
During the US HIV/AIDS Crisis, female prostitutes were seen as vectors of the disease. While there is little reliable data to back up that perception, it can be directly linked to the criminalization of HIV and medical discrimination against prostitutes during the crisis. [lower-alpha 1] [lower-alpha 2]
Laws criminalizing prostitution and societal stigmas against the sex trade made it difficult to collect accurate data about the rates of HIV among women exchanging sex during the HIV/AIDs health crisis. The numbers also likely vary heavily by state due to differences in population density, poverty rates, cultural values, education quality, and other factors. [1] In 1987, the CDC published the results of a study of 2159 women engaged in the sex trade referred to them by law enforcement or medical clinics in coastal states (although only a portion of the data was used). Less than 12% tested positive for HIV, with the results varying from 0% to 57% by state. 76% of those who tested positive were also users of intravenous drugs. This suggests that unsterile needles may have been a greater risk factor than frequent sexual contact for those engaged in sexual labor, but with a lack of reliable data it is impossible to draw any firm conclusions. [2] First hand accounts from those in the sex trade during the crisis are also largely absent. Most of the information about these women comes from court records and news reports from the time. [3]
During the HIV crisis, most media coverage of those in the sex trade was highly sensationalized, which exacerbated the negative public perception of the sex industry. [4] News reports portrayed those arrested for selling sex as what lawyer and author Stephanie Kane called “the mythic prostitute:” they exist only for the purpose of having sex, without any non-sexual emotions or ambitions. When an HIV positive individual was arrested for the exchange of sex, it was vigorously reported, frequently villainizing the individual, and by association all prostitutes, as an active threat to public safety. [4] Racial biases heavily influenced the extent and type of coverage those trading sex would receive from the media. White individuals in the sex trade were more likely to be painted in a semi-sympathetic light and described as mentally ill drug addicts, while those who were black and in the sex trade (and other people of color) were nearly always seen as malicious seducers actively seeking to spread HIV to innocent white women. [4] While black media did not employ the same Jezebel stereotype as mainstream media, it did perpetuate the false dichotomy of ‘evil’ sex workers versus ‘innocent’ clients, as well as place an emphasis on protecting married women even though they were a relatively low-risk group. [4]
According to Kane's theory, “the mythic prostitute” [3] exists only to spread disease. Since HIV was almost always fatal, the exchange of sex was seen as equivalent to murder. [4]
Multiple politically influential figures and journalists described having sex while HIV positive as equivalent to fatally shooting someone. [3] [4] By 1988, 13 states had passed laws codifying having sex with HIV as a felony, where selling sex was usually only a misdemeanor; those exchanging sex while positive for HIV were frequently charged with attempted murder. [4] This approach was explicitly recommended by the Presidential Commission on the Human Immunodeficiency Virus Epidemic Report published in 1988. The commission wrote that “Penalties for prostitution are too lenient, and enforcement of prostitution laws are erratic.” These recommendations became mandates two years later when the Ryan White CARE Act was passed, requiring states to demonstrate their capability to prosecute individuals who had sex while HIV positive in order to qualify for federal funding. [4]
HIV criminalization laws frequently reproduced already-existing statistical biases of the justice system. Women who exchanged sex in public areas were disproportionately likely to be arrested compared to those who were not working outdoors. [3] The enforcement of the laws also disproportionately targeted everyone working in the sex trade: despite the fact that those exchanging sex were far more likely to catch HIV from her client than the other way around, [4] clients were almost never charged. [3] Sentencing disparities between racial groups were glaring. Convicted white women were significantly more likely to be sent to a mental institution and receive HIV treatment, while black prostitutes were almost always jailed. [4]
Critics have questioned the Constitutionality of many HIV criminalization laws. The Presidential Commission clarified that while having sex while HIV positive should be a felony, arrestee confidentiality should be respected, healthcare professionals should be consulted in sentencing, and only sex acts scientifically proven to spread HIV should be prosecuted. These recommendations were not taken into consideration by many states. The confidentiality of arrestees was not protected by the courts. Prostitutes often had incredibly personal information published in the press, including addresses and medical records. [3] Courts also frequently ignored scientific evidence as to which acts could facilitate the transmission of HIV: in multiple cases, these women were charged for giving oral sex despite the fact that transmission from prostitute to client would be nearly impossible. [3] HIV laws also set forward extremely low requirements for conviction. The prosecution did not have to prove that there was malicious intent, nor that the defendant had actually given anyone HIV, nor that the sex act in question could spread HIV. [3] In most cases, being in the sex trade and having HIV was enough to receive a conviction.
Sex education during the 1980s tended to be abstinence-only. Conservative Christian values held by parents, teachers, state legislatures, and the presidential administration made it taboo to talk about sex at all, especially around children. This not only prevented teaching about safe sex in the classroom, but also in anything else that a child might see, including news broadcasts and CDC press releases. [5] Dr. James Manson, head of the CDC under President Reagan, stated after the crisis that political pressure from the presidential administration heavily discouraged him from releasing specific information about how the virus was spread. While the CDC did recommend condom use, explicit information about how HIV spread never reached many US citizens. [5] Proper sex education was heavily correlated with reduced occurrence of STIs for individuals exchanging sex. [1] The perceived threat of the sex trade spreading HIV assumed that those trading sex understood how HIV spread, and were thus acting out of deliberate malice. However, due to poverty and lack of access to sex education, it is likely that many did not understand methods of safe sex. [3] Accurate statistics on condom usage at the time were not gathered, but there were several legal cases against individuals who were HIV positive where they claimed their client refused to use a condom, despite their insistence, [3] showing some understood the importance of condom usage.
During the early years of the US AIDS epidemic, there were a minority of doctors who refused to see any patient who had HIV, expressing a fear that they could catch HIV from their patient. [6] In 1987, the American Medical Association publicly stated that “A physician may not ethically refuse to treat a patient whose condition is within the physician’s current realm of competence solely because the patient is infected with HIV.” [6] However, doctors would also refuse to treat HIV positive patients on moral grounds. Patients who were in the sex trade, drug users, and/or part of the LGBTQIA+ were in some cases turned away or given inadequate medical treatment because healthcare professionals had moral objections to their behavior. [6] The Presidential Commission's report explicitly condemned this practice. While only a minority of doctors would turn patients away, the frequency of more subtle medical discrimination during this time has gone largely uninvestigated. It is unknown whether or not perceived ‘immoral’ people were treated respectfully by doctors, and to what extent medical discrimination discouraged them from seeking treatment in the first place.
Medical research into human immunodeficiency virus was heavily stunted by the state of the publishing industry during the 1980s. Most respected medical journals had publication restrictions requiring that articles be peer reviewed and published by that journal before the researcher announced their results publicly (Ingelfinger Rule). Researchers who violated this rule would be blacklisted, which could spell the end of their career. [5] This system existed, in part, to verify scientific claims before they were released to the general public, but it has been criticized for allowing journals exclusive coverage of the ‘freshest’ content as a means of boosting the journal's revenue. [5] That sensationalism combined with the limited spaces for publication stunted critical research into HIV. Not only not released to the press, they were also kept secret from other researchers. A competitive publishing industry and the threat of blacklisting prevented scientists from sharing their unpublished research with colleagues even at medical conferences, hindering collaboration. [5]
Safe sex is sexual activity using methods or contraceptive devices to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks. It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks.
The AIDS epidemic, caused by HIV, found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.
HIV/AIDS originated in the early 20th century and has become a major public health concern and cause of death in many countries. AIDS rates vary significantly between countries, with the majority of cases concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total population infected worldwide – approximately 35 million people – were Africans, of whom around 1 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 100 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, leading to raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic, with life-expectancy in some countries reaching as low as thirty-nine years.
The spread of HIV/AIDS has affected millions of people worldwide; AIDS is considered a pandemic. The World Health Organization (WHO) estimated that in 2016 there were 36.7 million people worldwide living with HIV/AIDS, with 1.8 million new HIV infections per year and 1 million deaths due to AIDS. Misconceptions about HIV and AIDS arise from several different sources, from simple ignorance and misunderstandings about scientific knowledge regarding HIV infections and the cause of AIDS to misinformation propagated by individuals and groups with ideological stances that deny a causative relationship between HIV infection and the development of AIDS. Below is a list and explanations of some common misconceptions and their rebuttals.
HIV-positive people, seropositive people or people who live with HIV are people infected with the human immunodeficiency virus (HIV), a retrovirus which if untreated may progress to acquired immunodeficiency syndrome (AIDS).
Men who have sex with men (MSM) refers to all men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay, bisexual, pansexual or various other sexualities, but also for example male prostitutes. The term is often used in medical literature and social research to describe such men as a group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. An alternative term, males who have sex with males is sometimes considered more accurate in cases where those described may not be legal adults.
Criminal transmission of HIV is the intentional or reckless infection of a person with the human immunodeficiency virus (HIV). This is often conflated, in laws and in discussion, with criminal exposure to HIV, which does not require the transmission of the virus and often, as in the cases of spitting and biting, does not include a realistic means of transmission. Some countries or jurisdictions, including some areas of the U.S., have enacted laws expressly to criminalize HIV transmission or exposure, charging those accused with criminal transmission of HIV. Other countries charge the accused under existing laws with such crimes as murder, manslaughter, attempted murder, assault or fraud.
AIDS is caused by a human immunodeficiency virus (HIV), which originated in non-human primates in Central and West Africa. While various sub-groups of the virus acquired human infectivity at different times, the present pandemic had its origins in the emergence of one specific strain – HIV-1 subgroup M – in Léopoldville in the Belgian Congo in the 1920s.
The global pandemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally. Of these, 29.8 million people (75%) are receiving antiretroviral treatment. There were about 630,000 deaths from HIV/AIDS in 2022. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.
The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. It can be managed with treatment. Without treatment it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS).
Prostitution in Turkey is legal and regulated. The secularization of Turkish society allowed prostitution to achieve legal status during the early 20th century. Known as "general houses" (genelevler) in the country, these are state run brothels which must receive permits from the government to operate. In turn, the regulatory agencies issue identity cards to sex workers that give them rights to some free medical care and other social services. However, many local governments now have a policy of not issuing new registrations, and in some cities, such as Ankara and Bursa, brothels have been demolished by court order. In 2012, it was estimated there are 100,000 unliscenced prostitutes in Turkey, half of whom are foreign born.
A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of transmitting them on to others. The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes cases with no symptomatic disease. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.
The Democratic Republic of the Congo was one of the first African countries to recognize HIV, registering cases of HIV among hospital patients as early as 1983.
The Dominican Republic has a 0.7 percent prevalence rate of HIV/AIDS, among the lowest percentage-wise in the Caribbean region. However, it has the second most cases in the Caribbean region in total web|url=http://www.avert.org/caribbean-hiv-aids-statistics.htm |title=Caribbean HIV & AIDS Statistics|date=21 July 2015}}</ref> with an estimated 46,000 HIV/AIDS-positive Dominicans as of 2013.
The relationship between religion and HIV/AIDS has been an ongoing one, since the advent of the pandemic. Many faith communities have participated in raising awareness about HIV/AIDS, offering free treatment, as well as promoting HIV/AIDS testing and preventative measures. Christian denominations, such as Lutheranism and Methodism, have advocated for the observance of World AIDS Day to educate their congregations about the disease. Some Churches run voluntary blood testing camps and counselling centers to diagnose and help those affected by HIV/AIDS.
Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.
HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.
Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.
Infectious diseases within American correctional settings are a concern within the public health sector. The corrections population is susceptible to infectious diseases through exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors. The spread of infectious diseases, such as HIV and other sexually transmitted infections, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis, result largely from needle-sharing, drug use, and consensual and non-consensual sex among prisoners. HIV and hepatitis C need specific attention because of the specific public health concerns and issues they raise.
Many women have been infected with the HIV/AIDS virus. The majority of HIV/AIDS cases in women are directly influenced by high-risk sexual activities, injectional drug use, the spread of medical misinformation, and the lack of adequate reproductive health resources in the United States. Women of color, LGBT women, homeless women, women in the sex trade, and women intravenous drug users are at a high-risk for contracting the HIV/AIDS virus. In an article published by the Annual Review of Sociology, Celeste Watkins Hayes, an American sociologist, scholar, and professor wrote, "Women are more likely to be forced into survival-focused behaviors such as transactional sex for money, housing, protection, employment, and other basic needs; power-imbalanced relationships with older men; and other partnerings in which they cannot dictate the terms of condom use, monogamy, or HIV." The largest motivator to become part of the sex trade was addiction, the second largest being basic needs, and the third was to support their children/family.