Pennsylvania State Senator Vince Hughes and Representatives Ben Waxman and Malcolm Kenyatta recently introduced legislation (HB 2171) to repeal a felony sentencing enhancement for people living with HIV.
In Pennsylvania, sex work related charges — referred to as prostitution in the penal code — are typically misdemeanors, but people living with HIV can be charged with felonies. This is due to one of two remaining laws in Pennsylvania that include increased penalties for people living with HIV. The other targets people who are incarcerated.
“There’s essentially discrimination against people with HIV and AIDS written into our criminal code,” Waxman said.
In Tennessee, sentence enhancements are being challenged in court for violating the rights of disabled people under the Americans with Disabilities Act. Activists in Pennsylvania said sentence enhancements do more than violate rights. They also contribute to misinformation.
Pennsylvania laws
“In the late ’80s and early ’90s, we saw many states passing HIV criminalization laws, and they really stemmed from a misguided effort to stop the spread of HIV,” said Ronda Goldfein, executive director of the AIDS Law Project of Pennsylvania. “The idea that if we punish people — criminally punish people — then they will somehow change their behavior and that would lower risk.”
A recent poll of 700 Pennsylvania voters found that over 70% of respondents believe HIV-specific laws are meant to improve public health and safety, but Goldfein underlined that this isn’t their effect. Instead, laws like these further stigmatize people who pose very little risk to others.
The Pennsylvania law that enhances sex work charges for people living with HIV was enacted in 1995 — but Goldfein said it’s only been used 43 times. This shows that the law isn’t doing much to curb any imminent threats related to HIV, she underlined.
Charges can be filed on the “possibility” of harm even when people have taken proper precautions to ensure that the likelihood of harm has not occurred. For instance, Goldfein noted that people living with HIV can face increased penalties for sex work charges even if physical contact has not occurred.
If this bill passes, people living with HIV will still face legal risks. People with the condition have been charged with various types of misconduct even when no other crimes have occurred based solely on their HIV status — including assault, reckless endangerment, murder and attempted murder. They could still be charged this way under broad interpretations of applicable laws if prosecutors exploit a defendant’s HIV status.
Goldfein successfully fought the inclusion of HIV in the “no spitting” law — which was enacted during the height of the pandemic to protect police officers from COVID and other communicable diseases. The language of that bill, HB 103 which became Act 99, originally promoted the idea that HIV could potentially be transmitted through saliva — which is impossible. (The only fluids through which HIV can be transmitted is by blood, semen and pre-seminal fluid, vaginal and rectal fluids, or breast milk.) Misinformation further stigmatizes people living with HIV.
Research published in 2023 by GLAAD noted that less than 50% of people feel knowledgeable about HIV, but that growing numbers of people are uncomfortable interacting with those living with the condition.
“There are still people that really believe that it’s a death sentence and aren’t caught up with how much treatment is available,” said Waxman, who believes intentionally educating others will help the proposed bill become a success. “Someone who has this illness is not necessarily someone who is a danger to other people. This seems to be where we need to start the conversation.”
The GLAAD study highlighted that 81% of people believe it should be a crime for someone living with HIV to have sex without disclosing their HIV status. However, shifting laws to focus on disclosure would further stigmatize people living with HIV as “the bad guys,” Goldfein emphasized, displacing individual responsibility onto others.
“Instead, the message we should be giving people is we should all protect ourselves,” she said, noting the importance of taking personal accountability for personal health.
The impacts of criminalization
“In 2024, the stigma still exists. In some ways, it’s actually worse than before — because when people thought that we were going to die, there was a lot of compassion for people with HIV,” said Michelle Troxell, who has been living with HIV for 35 years.
“If you’re so worried about contracting HIV, go on PrEP,” she said. In 2022, only 36% of the HIV-negative people who would benefit from PrEP were actually taking it.
“Today, we know that if people can get on to treatment and stay on treatment, they don’t transmit the virus,” Troxell underlined, noting that this is the most effective way to prevent transmission. “But how can we get people to get tested and to stay in treatment if we’re criminalizing them? We can’t.”
Sex workers do what they can to ensure their own workplace practices are healthy and safe — but because that industry is still criminalized, they have to advocate for themselves without many systems that will protect them.
“I don’t always feel like I have full control over a date,” said a 22-year-old trans woman living with HIV who preferred to remain anonymous. As a sex worker, she uses condoms and gets frequent testing to ensure her viral load is undetectable — but she doesn’t always disclose her status to clients.
“That’s a way I protect myself from violence,” she said. “But I’d be viewed as the criminal if he takes off the condom without my consent?”
She has been assaulted in the past and hasn’t felt comfortable contacting police because of fear that non-disclosure would be used against her in court. Troxell, who leads the Pennsylvania HIV Justice Alliance, saw a colleague encounter a similar problem. When she reported a rape, “the person who raped her pressed charges because she had HIV,” she explained. Another colleague attempted to break up with a partner who used her HIV status as revenge.
“They hit her with two felonies and two misdemeanors,” she said. “If you have a felony, you can’t get public housing. You can’t get a student loan. It’s extremely difficult to access health care with a criminal record.”
Troxell explained that even when these cases aren’t prosecuted, people’s lives are still negatively impacted. Their reputations are tarnished, they may lose access to work, custody or schooling issues may arise for their children, and more.
“Many people who are involved in sex work don’t report assaults because they worry no one will believe them. The same thing happens with people living with HIV. They don’t report being abused or being assaulted, being in a domestic violence situation,” explained Troxell, a mother and nurse who is a former sex worker.
Hopes for decriminalization
“How else do we get the help we need?” asked Miss K, who has been living with HIV since 2014 and noted that she has exchanged sex for resources during “survival mode.”
She emphasized that many people living with HIV already deal with significant challenges — such as housing and food insecurity, fewer opportunities for work and education, and other disparities. Some have experienced discrimination in healthcare settings or from law enforcement. She noted that it’s difficult to know how or where to get support — especially when both sex work and aspects of living with HIV are criminalized.
She works with Positive Women’s Network of Pennsylvania and various other statewide organizations — including a coalition that combats the criminalization of HIV from a BIPOC lens. But without full decriminalization — and unionization, she argued, people will continue to live with fear and along the margins.
In 2019, sex workers accounted for just 8% of new HIV cases globally — and decriminalizing sex work could avert new cases by up to 46%.
“The fact that decriminalizing HIV and decriminalizing sex work together would prevent the actual spread of HIV tells me all I need to know about the intentional discrimination occurring in the current laws,” noted another activist, who preferred to remain anonymous.
“I don’t think we should be criminalizing sex work. We should not be arresting sex workers,” said Waxman. “I know that we’re maybe a little bit far from that legislatively or politically — but that’s where I’m at, and I feel that way very strongly.”
“On the local level, a lot of it is at the discretion of the district attorney’s office as well as the local police department,” he noted — which means it might be possible for activists to pass local ordinances before a state law is ever proposed.
HB 2171 does not address sex work decriminalization. Although many HIV activists spoke to PGN about their own hopes that sex work would eventually be decriminalized, advocates are being realistic about what feels possible in the current legislature. For now, they’ve chosen to prioritize actions that will reduce stigma and increase quality of life for people living with HIV.
Advocates want laws to follow the science
“HIV is a manageable, chronic illness — like diabetes,” explained Shekinah Rose, a trans woman and elder who received an HIV diagnosis in 1985 when testing first became available in her city.
“How can I — as an undetectable, untransmittable person — be charged for something that I can’t transmit?” she asked. “That’s just outdated science.”
She noted that any laws related to HIV status can scare people away from getting tested. This negatively impacts their own health — and for those who are positive, without medication, they can also transmit HIV.
“Living this long with HIV, I’m horrified that I’ve been wearing several balls and chains around my leg — and they’re not coming off until we get this bill — HB 2171 — passed,” Rose noted.
“This is just one step in ongoing work to normalize the experience of living with HIV,” she added. Another important aspect of improving people’s lives is empowering them to advocate on behalf of themselves and their communities.
People living with HIV in Pennsylvania are invited to participate in a six-week advocacy training program hosted by Pennsylvania HIV Justice Alliance. The organization has developed a report outlining the effects and harm of HIV criminalization, highlighting the science of transmission to underline the excess nature of HIV laws.
Rose explained that there’s a strong need to improve sex education, address otherizing language in care and research settings, correct misconceptions perpetuated by the media, and improve cultural competencies in order to address health care disparities. Much of this work already lands on the plates of people living with HIV — who teach medical providers, researchers, and other experts in the field how to be better allies. Rose, who is a leader in numerous activism efforts at the state and local level and has been recognized for her global efforts, noted that this dedication to the community makes people living with HIV poised to lead initiatives that will truly make an impact on both transmission rates and on quality of life.
“Let us take responsibility for our communities,” she underlined.
The Pennsylvania HIV Justice Alliance is pursuing ongoing community-building and advocacy work across the state. To participate or collaborate, please contact [email protected]