3-D rendering of an HIV virus

Not Another Scott County?

By Emily Beukema, Aila Hoss, and Nicolas Terry

In November 2014, Scott County, Indiana was the site of a now infamous HIV outbreak linked to intravenous drug use. Syringe service programs (SSP) would not only have curbed that outbreak but also could have prevented it from occurring in the first place. Later analysis found that then Governor Pence of Indiana failed to declare a state of emergency until two months after the peak infection rate and that, even after that declaration, disagreements among stakeholders later delayed the implementation of a temporary SSP. Absent those delays the number of infections could have been dramatically decreased.

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Photograph of memorial to victims of the El Paso, TX mass shooting

Pervasive Health Effects of Anti-Immigrant Rhetoric at the U.S.-Mexican Border

By Lilo Blank

The current xenophobic, racist, and anti-immigrant climate in the United States and its detrimental impact on immigrant communities and their health cannot be ignored. This month, gunmen have executed a series of mass shootings, including one specifically in El Paso, Texas, in which the gunman killed 22 people. The FBI is currently investigating the shooting as a suspected hate crime against immigrants. Terroristic acts of violence such as this are enough to incite fear in anyone, but especially in Hispanic communities on the border, who are facing additional forms of structural violence.

“Stigma is fundamentally about alienation and exclusion,” said stigma expert Dr. Daniel Goldberg, Associate Professor at the University of Colorado Anschutz Medical Campus’s Center for Bioethics and Humanities, in a recent interview. “Even when you control for access, people who are stigmatized get sicker and die quicker. And of course, we are social creatures. If stigma exists persistently and longitudinally, the more likely you are to be socially isolated, and social isolation is one of the most powerful predictors of mortality.”

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3D illustration of anatomically correct HIV Virus floating in the bloodstream

HIV Treatment: Functional Cures are Just One Aspect of Newsworthy Progress

Major news networks around the globe this week broke the story that a second HIV-positive patient appears to have been “functionally cured” of HIV.

In a welcome piece of good news, the world learned that an anonymous individual, known simply as “the London patient” has experienced a year and a half of sustained remission of the HIV virus without medication. The patient entered into remission after receiving a bone marrow transplant from someone naturally resistant to HIV infection. This is the second functional cure of HIV of its kind. The first such case occurred in 2007.

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Image of a man spurting out water from his mouth

Spitting at Science: The Unjustified Criminalization of Spitting While HIV-Positive

Saliva doesn’t transmit HIV. And no one has ever become HIV-positive because an HIV-positive person spit on them.

Yet a number of states, including Louisiana, Mississippi, Missouri, Nebraska, Ohio, Oklahoma, Pennsylvania, and Texas, either have laws that explicitly criminalize the act of spitting specifically if one is HIV-positive or in recent years have used the criminal law to prosecute and convict the act of spitting by an HIV-positive person. Read More

Senator Scott Wiener talking into a mic

Successful HIV Criminalization Reform in California: Q and A with Sen. Scott Wiener

The majority of states have laws that criminalize activities by HIV-positive people that are not criminalized when the rest of the population engages in them.

Many of these laws improperly single out HIV over other infectious diseases and reflect a lack of understanding of both how HIV spreads and how it can be treated.

In 2017, California passed legislation which modernized and improved California’s HIV criminalization law. One of the authors of the law was State Senator Scott Wiener. I recently had a chance to ask Sen. Wiener some questions about that process.

His responses are given here in hopes of supplying useful information for legislators, lobbyists, and activists in other states who are interested in starting the reform process in their own states or other jurisdictions around the world. This interview has been edited for clarity.

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EVENT: Punishing Disease: HIV and the Criminalization of Sickness

Punishing Disease: HIV and the Criminalization of Sickness
January 29, 2018, 12:00 PM
Wasserstein Hall, Room 3007
1585 Massachusetts Ave., Cambridge, MA

Please join us for a talk with Trevor Hoppe on his book, Punishing Disease: HIV and the Criminalization of Sickness. The book examines how and why US policymakers and public health systems have adopted coercive and punitive responses to stop the spread of HIV/AIDS. It also looks at how others diseases have been punished throughout history, and cautions against the extension of criminalization to diseases such as hepatitis and meningitis.

Trevor Hoppe is Assistant Professor of Sociology at the University at Albany, SUNY. He was previously a postdoctoral fellow in the Criminology, Law andSocietyDepartment at the University of California at Irvine. Hoppe’s research examines how punishment came to be a legitimate response to controlling HIV and disease more generally. In 2017, Hoppe published The War on Sex, a collection of essays co-edited with David Halperin analyzing the criminalization of sex, and Punishing Disease a monograph explaining the rise of punitive responses to HIV and other infectious diseases.

This talk is part of the Human Rights Program’s year-long speaker series examining the criminalization of human rights concerning gender, sexuality, and reproduction. It is co-sponsored by the Petrie-Flom Center for Health Law, Policy, Biotechnology and Bioethics, the Criminal Justice Policy Program, and the Center for Health Law Policy Innovation at Harvard Law School. 

 

NEW EVENT (1/29)! Punishing Disease: HIV and the Criminalization of Sickness

Punishing Disease: HIV and the Criminalization of Sickness
January 29, 2018, 12:00 PM
Wasserstein Hall, Room 3007
1585 Massachusetts Ave., Cambridge, MA

Please join us for a talk with Trevor Hoppe on his book, Punishing Disease: HIV and the Criminalization of Sickness. The book examines how and why US policymakers and public health systems have adopted coercive and punitive responses to stop the spread of HIV/AIDS. It also looks at how others diseases have been punished throughout history, and cautions against the extension of criminalization to diseases such as hepatitis and meningitis.

Trevor Hoppe is Assistant Professor of Sociology at the University at Albany, SUNY. He was previously a postdoctoral fellow in the Criminology, Law andSocietyDepartment at the University of California at Irvine. Hoppe’s research examines how punishment came to be a legitimate response to controlling HIV and disease more generally. In 2017, Hoppe published The War on Sex, a collection of essays co-edited with David Halperin analyzing the criminalization of sex, and Punishing Disease a monograph explaining the rise of punitive responses to HIV and other infectious diseases.

This talk is part of the Human Rights Program’s year-long speaker series examining the criminalization of human rights concerning gender, sexuality, and reproduction. It is co-sponsored by the Petrie-Flom Center for Health Law, Policy, Biotechnology and Bioethics, the Criminal Justice Policy Program, and the Center for Health Law Policy Innovation at Harvard Law School. 

Sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School with support from the Oswald DeN. Cammann Fund and Ropes & Gray LLP.

TODAY, 10/30 at 5 PM: Health Law Workshop with Aziza Ahmed

October 30, 2017 5-7 PM
Hauser Hall, Room 104
Harvard Law School, 1575 Massachusetts Ave., Cambridge, MA

Presentation: “‘Dead But Not Disabled’: A Feminist Legal Struggle for Recognition”

This paper is not available for download. To request a copy in preparation for the workshop, please contact Jennifer Minnich at jminnich@law.harvard.edu.

Aziza Ahmed is Professor of Law at the Northeastern University School of Law. She is an internationally renowned expert in health law, criminal law and human rights. Her scholarship examines the role of science and activism in shaping global and national law and policy with a focus on criminal laws that impact health. She teaches Property Law, Reproductive and Sexual Health and Rights, and International Health Law: Governance, Development and Rights. Professor Ahmed has been selected as a fellow with the Program in Law and Public Affairs (LAPA) at Princeton University. She will be combining her sabbatical and her fellowship to spend the 2017-2018 academic year developing her work on law, feminism and science into a book with particular emphasis on legal and policy responses to HIV.

Ahmed’s scholarship has appeared in the University of Miami Law ReviewAmerican Journal of Law and MedicineUniversity of Denver Law ReviewHarvard Journal of Law and GenderBoston University Law Review (online), and the American Journal of International Law (online), among other journals.

Prior to joining the School of Law, Ahmed was a research associate at the Harvard School of Public Health Program on International Health and Human Rights. She came to that position after a Women’s Law and Public Policy Fellowship with the International Community of Women Living with HIV/AIDS (ICW). Ahmed has also consulted with various United Nations agencies and international and domestic non-governmental organizations.

Ahmed was a member of the Technical Advisory Group on HIV and the Law convened by the United Nations Development Programme (UNDP) and has been an expert for many institutions, including the American Bar Association and UNDP. In 2016, she was appointed to serve a three-year term on the advisory board of the Northeastern University Humanities Center.

In addition to her BA and JD, Ahmed holds an MS in population and international health from the Harvard School of Public Health.

“The real possibility of an AIDS-free generation:” HIV Prevention and the Internet

By Clíodhna Ní Chéileachair

Last November, the National Health Executive (NHS) in the UK lost an appeal in the UK Court of Appeal regarding their failure to fund PrEP for individuals at risk of contracting HIV. PrEP, or Pre-Exposure Prophylaxis is a common term for regimes of anti-viral medication taken by individuals to lower their risk of being infected with HIV. Marketed as Truvada, clinical test results published by the National institute of Health in 2010 declared that the treatment could reduce the risk of contracting HIV by up to 90%, a rate that seemed farcical even in a world where information about HIV is more accessible than ever, and medical experimentation with cures has been steadily gaining steam. Based on those results, the U.S. Center for Disease Control issued interim guidelines for using the drug, despite the fact that it was over a year away from FDA approval, aware that doctors had been prescribing it off-label for HIV treatment. The titular quote is from former President Obama, speaking on World AIDS Day in 2011 about the breakthrough that PrEP represented. The story raises some fascinating questions about how doctors interact with experimental medicines when facing down diseases that will otherwise seriously compromise quality of life for patients, and even kill, but nonetheless remain unsanctioned by national healthcare providers and largely available through backchannels.

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FDA v. Opana ER: Opioids, Public Health, and the Regulation of Second-Order Effects

Earlier this month, the FDA announced that it is asking Endo Pharmaceuticals to remove the opioid Opana ER from the market.  Opana ER is an extended-release pain reliever often abused by those who take it.  While opioid abuse is nothing new, and many opioids leave those who take them addicted to narcotics or heroin, Opana ER is particularly dangerous because of how people misuse it.  The pill was designed to prevent would-be abusers from crushing and snorting it —  a popular means of ingesting prescription opioids.  Without the ability to crush and snort the drug, however, abusers turned to dissolving the pills and injecting them intravenously, leading to outbreaks of Hepatitis C, HIV, and other blood-borne diseases.  In Indiana’s Scott County, for instance, the prevalence of HIV has skyrocketed since the introduction of Opana ER to the local population, with 190 new cases since 2015.

While this foray into public health is somewhat surprising — given the anti-regulatory stance of the current administration and its billionaire backers — it is precisely the type of initiative the FDA should be taking.  Public health is a central part of the FDA’s mission statement, which notes that the agency “is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices.”  Traditionally, though, the FDA’s efforts to ensure safety and efficacy have been limited to the narrow context of individual patients taking medications as directed under physician supervision.  As the FDA noted in its Opana ER press release, this is the first time it has requested that an opioid be taken off the market as a result of its susceptibility to abuse and the associated public health consequences.

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