As the tide turns: The changing HIV/AIDS epidemic and the criminalization of HIV exposure

Cornell Law Review

Volumn 94, Issue 3, 2009, Pages 707-741

  McArthur, James B ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIRETROVIRUS AGENT;

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ANTIVIRAL RESISTANCE; ARTICLE; CRIME; CRIMINAL LAW; DISEASE TRANSMISSION; DRUG EFFECT; ETHICS; GOVERNMENT; HIGH RISK BEHAVIOR; HIGHLY ACTIVE ANTIRETROVIRAL THERAPY; HISTORY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFORMED CONSENT; LEGAL ASPECT; MULTIDRUG RESISTANCE; MUTATION; PATHOGENICITY; SEXUAL BEHAVIOR; SEXUALITY; UNITED STATES; VIOLENCE; VIROLOGY;

ACQUIRED IMMUNODEFICIENCY SYNDROME; ANTI-RETROVIRAL AGENTS; ANTIRETROVIRAL THERAPY, HIGHLY ACTIVE; CRIME; CRIMINAL LAW; DISEASE TRANSMISSION, INFECTIOUS; DRUG RESISTANCE, MULTIPLE; DRUG RESISTANCE, VIRAL; DUTY TO WARN; HISTORY, 20TH CENTURY; HISTORY, 21ST CENTURY; HIV; HIV INFECTIONS; HUMANS; MUTATION; RISK-TAKING; SEXUAL BEHAVIOR; SEXUAL PARTNERS; STATE GOVERNMENT; UNITED STATES; VIOLENCE;

EID: 65349168480     PISSN: 00108847     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (362)

1. HIV, the Human Immunodeficiency Virus, is the virus that causes AIDS, the Acquired Immune Deficiency Syndrome. Hiroaki Mitsuya & Samuel Broder, Strategies for Antiviral Therapy in AIDS, 325 NATURE 773, 773 (1987). Together, they are known as "HIV/ AIDS."
2. See, e.g., William Jefferson Clinton, Op-Ed., AIDS Is Not a Death Sentence, N.Y. TIMES, Dec. 1, 2002, § 4, at 9 ("[M]edicine can turn AIDS from a death sentence into a chronic illness ....").
3. For the story of Larry Kramer's battle to get the medical profession to recognize that HIV/AIDS is a chronic illness, and that he should receive a liver transplant, see Jeff Stryker, H.I.V. Patients Get Fresh Hopes for Donor Organs, N.Y. TIMES, Dec. 11, 2001, at F6.
4. Jack Begg, Word for Word/Nameless Dread: 20 Years Ago, the First Clues to the Birth of a Plague, N.Y. TIMES, June 3, 2001, § 4, at 7.
5. See Sheryl Gay Stolberg, In AIDS War, New Weapons and New Victims, N.Y. TIMES, Jun. 3, 2001, § 1, at 1 (explaining that though HIV/AIDS was previously found most frequently among gay white men, today the disease is also found among heterosexual men, women, intravenous drug users, blacks, whites, and Hispanics).
6. Lawrence K. Altaian, Promise and Peril of New Drugs for AIDS, N.Y. TIMES, Feb. 8, 2000, at Fl;
7. accord People v. Russell, 630 N.E.2d 794, 795 (Ill. 1994) (taking judicial notice "that the HIV virus is a precursor to AIDS, a progressive and inevitably fatal disease syndrome").
8. Stolberg, supra note 4.
9. Id.
10. Lawrence K. Airman & Andrew Pollack, 2 New Drugs Offer Options to Fight H.I.V. in Novel Ways, N.Y. TIMES, Feb. 28, 2007, at Al;
11. see also Abigail Zuger, AIDS Doctor Looks Back on a Long Slow Climb, N.Y. TIMES, June 5, 2001, at Fl ("The year is 1997. A wonderful, disorienting new era has dawned; drugs called protease inhibitors literally lift people with AIDS out of the grave, depositing them back into their lives with a thump. Everything reels backward. Cheekbones vanish back into cheeks, lost pounds redeposit themselves, lost immune cells return, life plans rewind back to the beginning.").
12. Altaian & Pollack, supra note 8;
13. see also Kate Stone Lombardi, AIDS Continues Move Among Heterosexuals, N.Y. Times, Oct. 4, 1998, § 14 (Westchester), at 8 ("The advent of powerful AIDS drug cocktails can mean that an H.I.V. diagnosis is no longer a death sentence ....").
14. See Stolberg, supra note 4 (listing other side effects, including "diarrhea, kidney stones, high blood sugar, and high cholesterol as well as disturbed dreams").
15. See Altaian & Pollack, supra note 8;
16. Kate Traynor, Integrase Inhibitor Gains FDA Approval, 64 AM. J. HEALTH-SYS. PHARMACY 2310, 2310 (2007).
17. See Altaian & Pollack, supra note 8.
18. Id..
19. See Zuger, supra note 8 ("The year is 2000. Some patients have been through every drug in the book. Some get sick. Some stay well.... The year is 2001-last week, actually. One of my patients, bones thinned to britde shells by his medications, has broken both hips, one after another. He is learning how to walk now for the third time over. Another is on the ward upstairs trying to remember his name - none of the drugs have worked for him.").
20. Donald G. McNeil Jr. & Lawrence K. Altman, Scientists Urge More Study on a Rare Strain of H.I.V., N.Y. TIMES, Feb. 13, 2005, § 1, at 39.
21. ARK. CODE ANN. § 5-14-123 (2006);
22. CAL. HEALTH & SAFETY CODE §§ 1621.5 (West 2007), 120291 (West 2006);
23. FLA. STAT. ANN. §§ 381.0041 (11)(b), 384.24(2) (West 2007);
24. GA. CODE ANN. § 16-5-60(c), (d) (2007);
25. IDAHO CODE ANN. § 39-608 (2002);
26. 720 ILL. COMP. STAT. ANN. 5/12-16.2 (West 2002);
27. IOWA CODE ANN. § 709C.1 (West 2003);
28. KAN. STAT. ANN. § 21-3435 (2007);
29. LA. REV. STAT. ANN. § 14:43.5 (2007);
30. MD. Code ANN., HEALTH-GEN. § 18-601.1 (LexisNexis 2005);
31. MICH. COMP. LAWS ANN. § 333.5210 (West 2001);
32. MO. ANN. STAT. § 191.677 (West 2004);
33. NEV. REV. STAT. ANN. § 201.205 (LexisNexis 2006);
34. N.J. STAT. ANN. § 2C:34-5 (West 2005);
35. N.D. CENT. CODE § 12.1-20-17 (1997);
36. OHIO REV. CODE ANN. §§ 2903.11, 2921.38, 2927.13 (LexisNexis 2006);
37. OKLA. STAT. ANN. tit. 21, § 1192.1 (West 2002), tit 63, § 1-519 (West 2004);
38. S.C CODE ANN. § 44-29-145 (2002);
39. TENN. CODE ANN. §§ 39-13-109, 68-32-104 (2006);
40. VA. CODE ANN. §§ 18.2-67.4:1, 32.1-289.2 (2004);
41. WASH. REV. CODE ANN. §§9A.36.011 (West 2000), 9A.36.021 (West 2000 & Supp. 2008). Although many states treat the HIV status of the perpetrator as an aggravating condition in cases of rape or prostitution, this Note does not consider those statutes.
42. Altaian, supra note 5.
43. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
44. See Zuger, supra note 8.
45. See, e.g., Altaian & Pollock, supra note 8.
46. State v. Musser, 721 N.W.2d 734 (Iowa 2006).
47. Id. at 741. Section 709C.1 of the Iowa Code reads, in part: 1. A person commits criminal transmission of the human immunodeficiency virus if the person, knowing that the person's human immunodeficiency virus status is positive, does any of the following: a. Engages in intimate contact with another person.... 2. For the purposes of this section:... b. "Intimate contact" means the intentional exposure of the body of one person to a bodily fluid of another person in a manner that could result in the transmission of the human immunodeficiency virus.... 4. This section shall not be construed to require that an infection with the human immunodeficiency virus has occurred for a person to have committed criminal transmission of the human immunodeficiency virus.
48. Musser, 721 N.W.2d at 741.
49. Id. at 749-50.
50. The court found that Mr. Musser possessed intent to harm merely because he engaged in sex, regardless of his belief that he would or would not cause harm. Id.
51. IOWA CODE ANN. § 709C. 1(1) (West 2003).
52. Musser, 721 N.W.2d at 749.
53. Id. at 741.
54. Julio S.G. Montaner et al., The Case for Expanding Access to Highly Active Antiretroviral Therapy to Curb the Growth of the HIV Epidemic, 368 LANCET 531, 531 (2006).
55. Musser, 721 N.W.2d at 740.
56. Id. at 749.
57. See, e.g., Michael J. Selgelid, Ethics and Drug Resistance, 21 BIOETHICS 218, 218 (2007) ("Though not a new phenomenon, the problem of drug resistance is increasingly being recognized as a serious, growing threat to global public health.");
58. Elizabeth Olson, Antibiotic Misuse Turns Treatable to Incurable, N.Y. TIMES, June 13, 2000, at F2 (discussing a report issued by the World Health Organization that "describes how the major infectious diseases are gradually becoming impervious to existing drugs, reducing the curative power of 'once life-saving medicines to that of a sugar pill"').
59. See, e.g., Selgelid, supra note 31, at 218;
60. Olson, supra note 31;
61. Kevin Sack, Lethal Bacterial Infections Are Found More Common, N.Y. TIMES, Oct. 17, 2007, at A14.
62. In the spring of 2007, Andrew Speaker, a lawyer from Boulder, Colorado, provided a vivid example of the risks of drug-resistant diseases. Mr. Speaker flew to Europe even though he believed he was infected with drug-resistant tuberculosis. Dan Frosch, Traveler with TB Is Released After Treatment in Denver, N.Y. Times, July 27, 2007, at A14.
63. The strain of tuberculosis that infected Mr. Speaker turned out not to be "extensively drug-resistant," and responded well to antibiotics. Id.
64. Mitsuya & Broder, supra note 1, at 773.
65. Id.
66. RANDY SHILTS, AND THE BAND PLAYED ON: POLITICS, PEOPLE, AND THE AIDS EPIDEMIC 73-74 (1987).
67. Id. at 301.
68. Id. at 87 (recounting researchers' initial deduction that HIV is sexually transmitted in 1981).
69. Id. at 206-07 (recounting a 1982 press conference in which researchers suggested that intravenous drug use spreads the disease).
70. Id. at 547 (describing the frequency of "transfusion AIDS cases" at a San Francisco blood blank, and nationally, in 1985).
71. Id. at 546-47 ("'They knew you could get AIDS from blood in 1982!' she said to anyone who would listen. 'Why didn't they do anything?'").
72. Id. at 500-01 (describing the growth of AIDS hysteria in European countries in 1984).
73. Id. at 11, 21-24.
74. The story of "Patient Zero" was the narrative heart of Shilts's book. See Susan Bolotin, Slash, Bum and Poison, N.Y. TIMES, Apr. 13, 1997, § 7, at 8 (book review) ("Because of Patient Zero, the AIDS story had a beginning, a locus for our curiosity, even our animus.");
75. see also Christopher Lehmann-Haupt, Book Review, N.Y. TIMES, Oct. 26, 1987, at C20 (reviewing SHILTS, supra note 35).
76. SHILTS, supra note 35, at 23 (describing how researches referred to Dugas as "Patient Zero" as they tried to retrace his travels to better understand his role in the "coming [AIDS] epidemic").
77. See id. at 147 ("40 of the first 248 gay men to get [HIV/AIDS] might ... all have had sex either with [Dugas] or with men sexually linked to him.").
78. See id. at 136, 165. ("'You may be passing it around or you might have gotten it from someone else.' The last part of Darrow's comment, it turned out, would probably have been best left unsaid given Gaetan's subsequent activities.").
79. See id. at 84.
80. Id. at 165.
81. Id. at 262 ("Legally, they decided there was nothing they could do about Gaetan Dugas.").
82. Exec. Order No. 12,061, 52 Fed. Reg. 24,129 (June 24, 1987).
83. For trenchant criticism of the composition of the Commission, see Bad Advice on AIDS, 328 NATURE 366, 366 (1987) ("His advisory panel consists of people whose ideological qualifications are clear, but whose expertise on AIDS is not just suspect but non-existent-").
84. PRESIDENTIAL COMM'N ON THE HUMAN IMMUNODEFICIENCY VIRUS EPIDEMIC, REPORT OF THE PRESIDENTIAL COMMISSION ON THE HUMAN IMMUNODEFICIENCY VIRUS EPIDEMIC 130 (1988) [hereinafter PRESIDENTIAL COMMISSION REPORT].
85. Id.
86. Michael L. Closen et al., Discussion, Criminalization of an Epidemic: HIV-AIDS and Criminal Exposure Laws, 46 ARK. L. REV. 921, 928 (1994).
87. See id.
88. Id. at 929-30.
89. See PRESIDENTIAL COMMISSION REPORT, supra note 50, at 130.
90. But commentators also praised the intent requirement of traditional criminal law. See Closen et al., supra note 52, at 933.
91. See PRESIDENTIAL COMMISSION REPORT, supra note 50, at 130.
92. See Larry Gostin, The Politics of AIDS: Compulsory State Powers, Public Health, and Civil Liberties, 49 OHIO ST. L.J. 1017, 1038 (1989) ("It is not unreasonable for society to establish clear parameters as to the behaviors it will not tolerate. By drawing a bright line around the behaviors that pose serious public health risks, the law gives clear notice of the conduct which will be subject to criminal penalty.").
93. A further argument is that previous prosecutions for attempted murder had cast too wide a net, and caught HIV-infected individuals (usually prisoners) who had engaged in behavior that had little chance of spreading the disease, such as biting. See Closen et al., supra note 52, at 936-37.
94. See Donald H.J. Hermann, Criminalizing Conduct Related to HIV Transmission, 9 ST. LOUIS U. PUB. L. REV. 351, 352-53 (1990).
95. Some commentators who supported the notice requirement believed that public health law, rather than criminal law, was the proper tool for preventing HIV transmission. See Closen et al., supra note 52, at 935.
96. See PRESIDENTIAL COMMISSION REPORT, supra note 50, at 131.
97. See id.
98. Id.
99. See id. (setting forth specific behaviors subject to criminal sanctions.).
100. Id.
101. See id.
102. Id.
103. Id. at 130.
104. Ryan White Comprehensive AIDS Resources Emergency Act of 1990, Pub. L. No. 101-381 § 2647, 104 Stat. 576, 603 (codified at 42 U.S.C. § 300ff-47) (repealed 2000).
105. Closen et al., supra note 52, at 940.
106. This Note addresses the following statutes: ARK. CODE. ANN. § 5-14-123 (West 2005) (criminalizing "the offense of exposing another person to [HIV] if the person knows he or she has tested positive for [HIV] and exposes another person to [HIV] infection through the parenteral transfer of blood or a blood product or engages in sexual penetration with another person without first having informed the other person of the presence of [HIV]");
107. CAL. HEALTH & SAFETY CODE §§ 1621.5 (West 2007), 120291 (West 2006) (criminalizing both the donation of blood or other tissue "by [any] person knowing he or she has AIDS" and any "unprotected sexual activity when the [HIV] infected person ... acts with the specific intent to infect the other person with HIV");
108. FLA. STAT. ANN. §§ 381.0041(ll)(b), 384.24(2) (West 2007) (criminalizing the donation of blood or other tissue by anyone who knows he or she is infected with HIV and "has been informed that he or she may communicate this disease by donating blood" and criminalizing sexual intercourse by anyone who knows he or she is infected with HIV and who knows "that he or she may communicate this disease through sexual intercourse ... unless such other person has been informed");
109. Ga. CODE ANN. §§ 16-5-60(c), (d) (2007) (criminalizing, for any person who knows he or she is infected with HIV, any sexual act when the other person is not informed, sharing used hypodermic needles, donating blood or other bodily fluids when infection is not disclosed, and use of bodily fluids against a peace or correctional officer);
110. IDAHO CODE ANN. § 39-608 (2002) (criminalizing any action by a person who knows he or she is infected with HIV or AIDS that exposes another to their bodily fluids);
111. 720 ILL. COMP. STAT. ANN. 5/12-16.2 (West 2007) (criminalizing engaging in intimate contact with another, transferring or donating of blood or other tissue, and dispensing non-sterile drug paraphernalia by a person who knows he or she is infected with HIV);
112. IOWA CODE ANN. § 709C.1 (West 2003) (criminalizing engaging in intimate contact with another, transferring or donating blood or other tissue, and dispensing non-sterile drug paraphernalia by a person who knows he or she is infected with HIV);
113. KAN. STAT. ANN. § 21-3435 (2007) (criminalizing engaging in sexual intercourse with another, transferring or donating blood or other tissue, and sharing non-sterile syringes by a person who knows he or she is infected with a "life threatening communicable disease" with the intent to expose another to the disease);
114. LA. REV. STAT. ANN. § 14:43.5 (2007) (criminalizing the intentional exposure of another "to any AIDS virus through any means or contact without the knowing and lawful consent of the victim");
115. MD. CODE ANN., HEALTH-GEN. § 18-601.1 (LexisNexis 2005) ("Any individual who has the [HIV] virus may not knowingly transfer or attempt to transfer the [HIV] virus to another individual."); MICH. COMP. LAWS ANN. § 333.5210 (West 2001) (criminalizing "sexual penetration with another person" by a person who knows he or she is are infected with AIDS or HIV without informing the other person of the condition);
116. Mo. ANN. STAT. § 191.677 (West 2004) (criminalizing engaging in sexual intercourse with another, donating blood or other tissue, sharing needles, and biting another by a person who knows he or she is infected with HIV);
117. NEV. REV. STAT. ANN. § 201.205 (LexisNexis 2006) (stating that a person who has "actual notice" of HIV infection and "intentionally, knowingly or willfully engages in conduct in a manner that is intended or likely to transmit the disease to another person is guilty of a category B felony");
118. N.J. STAT. ANN. § 2C:34-5 (West 2005) (criminalizing "sexual penetration without the informed consent of the other person" by a person infected with HIV or AIDS);
119. N.D. CENT. CODE § 12.1-20-17 (1997) (criminalizing the willful "transfer of bodily fluid that may contain the human immunodeficiency virus");
120. OHIO REV. CODE ANN. §§ 2903.11, 2921.38, 2927.13 (LexisNexis 2006) (criminalizing donating blood or tissue and engaging in sexual activity by a person who knows he or she is infected with HIV and any attempt to cause other to come into contact with bodily fluids by infected inmates);
121. OKLA. STAT. ANN. tit. 21, § 1192.1 (West 2002), tit. 63, § 1-519 (West 2004) (criminalizing any intentional "conduct reasonably likely to result in the transfer of [bodily fluids] into the bloodstream of another" by a person who knows he or she is infected with HIV);
122. S.C. CODE ANN. § 44-29-145 (2002) (criminalizing donating blood or tissue, engaging in sexual activity, and sharing needles by a person who knows he or she is infected with HIV);
123. TENN. CODE ANN. §§ 39-13-109, 68-32-104 (2006) (criminalizing donating blood or tissue, engaging in intimate contact, and sharing needles by a person who knows he or she is infected with HIV);
124. VA. CODE ANN. §§ 18.2-67.4:1, 32.1-289.2 (2004) (criminalizing donating blood or tissue and engaging in sexual acts by a person who knows he or she is infected with HIV);
125. WASH. REV. CODE §§ 9A.36.011, 9A.36.021 (West 2000) (criminalizing exposing another person to HIV by a person who knows he or she is infected with HIV).
126. See Closen et al., supra note 52, at 930-35 (noting that such statutes were intended to reduce transmission, address moral culpability, and encourage testing);
127. Gostin, supra note 57, at 1017 ("Some politicians have demanded isolation and criminal confinement of 'recalcitrant' AIDS carriers.").
128. See, e.g., 720 ILL. COMP. STAT. ANN. 5/12-16.2 (West 2002). ("A person commits criminal transmission of HIV when he or she, knowing that he or she is infected with HIV ...."). Some states, by requiring intentional transmission, implicitly require such knowledge. See, e.g., LA. REV. STAT. ANN. § 14:43.5 (2007) ("No person shall intentionally expose another to any acquired immunodeficiency syndrome ....").
129. The possibility that "knowledge" of infection may extend to those who have not received a positive HIV test but should have known they were infected troubles some commentators. See, e.g., Amy L. Mc-Guire, Comment, AIDS as a Weapon: Criminal Prosecution of HIV Exposure, 36 HOUS. L. REV. 1787, 1807-08 (1999).
130. References to causative agents, e.g., TENN. CODE ANN. §39-13-109(b) (1) (2006) ("'HIV' means the human immunodeficiency virus or any other identified causative agent of acquired immunodeficiency syndrome."), reflect arguments made at the time of their passage that HIV was not the cause of AIDS.
131. See New-Style Abuse of Press Freedom, 366 NATURE 493, 493 (1993).
132. PRESIDENTIAL COMMISSION REPORT, supra note 50, at 131. 73 CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006). 74 IDAHO CODE ANN. § 39-608(1) (2002).
133. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
134. PRESIDENTIAL COMMISSION REPORT, supra note 50, at 131.
135. FLA. STAT. ANN. § 384.24(2) (West 2007).
136. IOWA CODE ANN. § 709C.1 (West 2003) (requiring only an act and knowledge "that the person's [HIV] status is positive").
137. The Model Penal Code defines recklessness as follows: A person acts recklessly with respect to a material element of an offense when he consciously disregards a substantial and unjustifiable risk that the material element exists or will result from his conduct. The risk must be of such a nature and degree that, considering the nature and purpose of the actor's conduct and the circumstances known to him, its disregard involves a gross deviation from the standard of conduct that a law-abiding person would observe in the actor's situation. MODEL PENAL CODE § 2.02(2)(c) (1985).
138. The focus on risky behavior is reflected in judicial justifications of these statutes. See, e.g., People v. Jensen, 586 N.W.2d 748, 755 (Mich. App. 1998) ("Knowingly engaging in sexual conduct capable of transmitting HIV without informing a partner of being HIV infected is the culpable state of mind that can cause the partner's resulting infection and eventual death.");
139. see also State v. Musser, 721 N.W.2d 734, 749 (Iowa 2006).
140. IOWA CODE ANN. § 709C.1 (a) (West 2003).
141. "Exposure" does not require actual infection with HIV; instead, it occurs when the HIV-infected individual provides the disease with an opportunity to spread between individuals. See State v. Roberts, 844 So. 2d 263, 272 (La. App. 2003).
142. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006);
143. IOWA CODE ANN. § 709C.1 (West 2003).
144. Although Iowa's statute defines its offense as "criminal transmission of the human immunodeficiency virus," transmission is not required to commit the crime. See Musser, 721 N.W.2d at 749 (comparing criminal transmission of HIV to first-degree robbery, which "does not require that any actual injury result from the defendant's action").
145. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
146. Id. § 120291 (b) (2) (" 'Unprotected sexual activity' means sexual activity without the use of a condom.").
147. Id. § 120291(b)(1) ("'Sexual activity' means insertive vaginal or anal intercourse on the part of an infected male, receptive consensual vaginal intercourse on the part of an infected woman with a male partner, or receptive consensual anal intercourse on the part of an infected man or woman with a male partner.").
148. IOWA CODE ANN. § 709C.1 (1) (a) (West 2003). The definition of "intimate contact" is almost as vague: " 'Intimate contact' means the intentional exposure of the body of one person to a bodily fluid of another person in a manner that could result in the transmission of the human immunodeficiency virus." Id. § 709C.l(2)(b).
149. Id. §709C.l(l)(b).
150. Id. §709C.l(l)(c).
151. MICH. COMP. LAWS ANN. § 333.5210(2) (West 2001).
152. MO. ANN. STAT. § 191.677(2)(c) (West 2004).
153. Id. § 191.677(4).
154. WASH. REV. CODE ANN. § 9A.36.011(l)(b) (West 2000) ("A person is guilty of assault ... if he or she, with intent to inflict great bodily harm ... [a]dministers, exposes, or transmits to ... another ... [HIV]....").
155. See, e.g., IDAHO CODE ANN. § 39-608(3) (a) (2002).
156. California actually places the burden on the prosecution, who must prove the defendant "has not disclosed his or her HIV status." See CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
157. KAN. STAT. ANN. § 21-3435 (2007);
158. WASH. REV. CODE ANN. § 9A.36.011(b) (West 2000).
159. KAN. STAT. ANN. § 21-3435 (2007);
160. WASH. REV. CODE ANN. § 9A.36.011(b) (West 2000).
161. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
162. TENN. CODE ANN. § 39-13-109(c) (2006).
163. OHIO REV. CODE ANN. § 2903.11(B)(1) (LexisNexis 2006) (making nondisclosure an element of the crime when the victim is an adult).
164. Id. §2903.11 (B)(3).
165. Id. §2903.11 (B)(2).
166. IDAHO CODE ANN. § 39-608(3)(b) (2002).
167. CAL. HEALTH & SAFETY CODE § 120291 (a) (West 2006);
168. see supra text accompanying notes 17-20.
169. State v. Musser, 721 N.W.2d 734, 741 (Iowa 2006);
170. see supra text accompanying notes 21-30.
171. MD. CODE ANN., HEALTH-GEN. § 18-601.1(b) (LexisNexis 2005).
172. This is a surprisingly small punishment relative to other statutes, especially considering the prosecution must prove knowing transmission of the disease before it can even obtain a conviction. Id. §18-601.1(a).
173. MO. ANN. STAT. § 191.677(2) (West 2004).
174. Id. §558.011(1).
175. See, e.g., State v. Gonzalez, 796 N.E.2d 12, 36 (Ohio Ct. App. 2003) ("On the court's worksheet, the court noted that Gonzalez 'sentenced victim to death.' The court stated at the hearing that Gonzalez had committed one of the worst forms of felonious assault Based on this finding, the trial court gave Gonzalez the maximum eight-year term for each count.").
176. Id.
177. Id. at 36-37.
178. The Ohio Court of Appeals' affirmation of the sentencing on the grounds of infection, see id. at 37 ("We hold mat the court's reasons supporting its finding that Gonzalez committed the worst form of the offense were quite clearly stated in the record."), is dubious in light of the court's holding in the same case that the trial court should not have admitted evidence of the infection because the crime was exposure not transmittal of the virus, id. at 35, but that the error was harmless, id. at 35.
179. E.g., GA. CODE ANN. § 16-5-60(c)(5) (2007).
180. Some states place these provisions in other sections of their code. E.g., CAL. HEALTH & SAFETY CODE § 1621.5 (West 2007).
181. GA. CODE ANN. § 16-5-60(d) (2007) (making it a felony punishable by between five and twenty years incarceration for an HIV-infected person to use his or her "bodily fluids, ... saliva, urine, or feces" to transmit HIV to an officer).
182. WASH. REV. CODE ANN. §§ 9A.36.011 (West 2000), 9A.36.021 (West 2000 & Supp. 2008) (forbidding the administration, transmission, or exposure to another of "poison, the human immunodeficiency virus ... or any odier destructive or noxious substance").
183. See, e.g., Zita Lazzarini et al., Evaluating the Impact of Criminal Laws on HIV Risk Behavior, 30 J.L. MED. & ETHICS 239, 252 (2002) ("Most likely, these statutes were passed for symbolic rather than HIV-prevention reasons.").
184. Closen et al., supra note 52, at 932.
185. Id. at 946.
186. Joint U.N. Programme on HIV/AIDS [UNAIDS], Criminal Law, Public Health and HIV Transmission: A Policy Options Paper, at 23, UNAIDS Doc. UNAIDS/02.12.E (June 2002) (prepared by Richard Elliott), available at http://data.unaids.org/Publications/IRC-pub 02/JC733-CriminalLaw-en.pdf [hereinafter UNAIDS Paper] ("If... criminalization serves to undermine our overall public health response to the HIV epidemic, then we must seriously question whether the gains from criminalization are worth it." (internal quotation omitted)).
187. Id. at 24-25.
188. Id. at 23-24.
189. Id. at 25.
190. Scott Burris et al., Do Criminal Laws Influence HIV Risk Behavior? An Empirical Trial, 39 ARIZ. ST. L.J. 467, 511-12 (2007) ("[N]othing in our findings suggest that the uninfected in our sample were relying on the belief that infected people would be disclosing or using condoms in obedience to statute.").
191. Id. at 512.
192. See Closen et al., supra note 52, at 934.
193. MO. ANN. STAT. § 191.677(2)(c) (West 2004).
194. See Closen et al., supra note 52, at 933-34 (noting that criminalizing a particular behavior "may create an impression that the ... behavior actually poses some risk of HIV transmission").
195. Burris et al., supra note 122, at 476.
196. E.g., MO. ANN. STAT. § 191.677(4) (West 2004) ("The use of condoms is not a defense to a violation of ... this section.").
197. See Burris et al., supra note 122, at 476 (noting that condom use decreases the risk of infection from vaginal intercourse from 1 in 1000 or 1 in 2000 to 1 in 10000 or 1 in 20000 respectively).
198. ARK. CODE. ANN. § 5-14-123(c)(l) (2006).
199. Carol L. Galledy & Steven D. Pinkerton, Toward Rational Criminal HIV Exposure Laws, 32 J.L. MED. & ETHICS 327, 335 (2004).
200. UNAIDS Paper, supra note 118, at 20-21.
201. Galletly & Pinkerton, supra note 131, at 328.
202. Burris et al., supra note 122, at 486.
203. See Galletly & Pinkerton, supra note 131, at 329-30.
204. Id. at 331.
205. Gostin, supra note 57, at 1056.
206. Closen et al., supra note 52, at 947-48.
207. WASH. REV. CODE ANN. § 9A.36.011(b) (West 2000).
208. Galletly & Pinkerton, supra note 131, at 330 ("The end result [of the more general approach] is that there is little advance notice as to what constitutes proscribed behavior.").
209. UNAIDS Paper, supra note 118, at 21.
210. Burns et al., supra note 122, at 507-08.
211. Lazzarini et al., supra note 115, at 247.
212. Burris et al., supra note 122, at 488 (quoting Lazzarini et al., supra note 115, at 247).
213. Id. at 489.
214. Id.
215. Altman, supra note 5.
216. See Sebastian Bonhoeffer et al., Letter to the Editor, Causes of HIV Diversity, 376 NATURE 125, 125 (1995) ("The human immunodeficiency virus (HIV) is characterized by enormous genetic flexibility, which gives rise to drug resistance, escape from immune responses and failure of vaccination attempts.").
217. Vladimir V. Lukashov & Jaap Goudsmit, The Pros and Cons of Studying HIV Evolution in Real Time, 101 CELL 129, 129 (2000) (book review).
218. See Franziska Michor & Martin A. Nowak, Immunology Tomorrow, 420 NATURE 741, 742 (2002) (book review) ("There is a highly dynamic balance of power between HIV and the immune system, which is slowly shifted as a consequence of virus evolution to allow the virus to escape from immune recognition and to reproduce more efficiendy in a broader range of different cells."); see also Sebastian Bonhoeffer & Paul Sniegowski, The Importance of Being Erroneous, 420 NATURE 367, 367 (2002).
219. See Hannah Hoag, Testing New Ground, 429 NATURE 682, 682 (2004) ("The programmers [of] ... HIV-1-resistance software must update their algorithms regularly because the virus mutates - and acquires drug resistance - so quickly.").
220. Yung-Kang Chow et al., Use of Evolutionary Limitations of HIV-1 Multidrug Resistance to Optimize Therapy, 361 NATURE 650, 650 (1993).
221. Id.
222. Julio Montaner & John Mellors, Better Salvage Therapy for HIV-1 Infection Still Needed, 353 LANCET 1857, 1857 (1999).
223. Researchers defined success as "viral suppression to fewer than 400 HIV-1 RNA copies/mL plasma." Id.
224. Success rates were lower for those individuals who had already developed resistance to one of the classes of drugs. Id.
225. Brian Gazzard, Antiretroviral Therapy for HIV: Medical Miracles Do Happen, 366 LANCET 346, 346 (2005).
226. K. Porter et al., CASCADE Collaboration, Determinants of Survival Following HIV-1 Seroconversion After the Introduction of HAART, 362 LANCET 1267, 1267 (2003).
227. Jonathan A.C. Sterne et al., Long-Term Effectiveness of Potent Antiretroviral Therapy in Preventing AIDS and Death: A Prospective Cohort Study, 366 LANCET 378, 381 (2005).
228. Paul Smaglik, Reservoirs Dog AIDS Therapy, 405 NATURE 270, 270 (2000).
229. Id.
230. Id.
231. For an explanation of the virus's mechanism for doing so, see Roger J. Pomerantz, Cross-Talk and Viral Reservoirs, 424 NATURE 136, 136-37 (2003).
232. Pietro L. Vernazza, Genital Shedding of HIV-1 Despite Successful Antiretroviral Therapy, 358 LANCET 1564, 1564 (2001).
233. Marcus Kaul et al., Pathways to Neuronal Injury and Apoptosis in HIV-Associated Dementia, 410 NATURE 988, 988 (2001).
234. Smaglik, supra note 158, at 270.
235. Id. at 272;
236. see also Steven G. Deeks, Treatment of Antiretroviral-Drug- Resistant HIV-1 Infection, 362 LANCET 2002, 2003 (2003) ("These cells harbour infectious HIV-1 for decades, so eradication is unlikely.").
237. Sterne et al., supra note 157, at 378.
238. Altman & Pollack, supra note 8.
239. Id.
240. See id. (discussing possible approval of the two classes). The FDA approved the drugs later in 2007.
241. New AIDS Drug Approved, N.Y. TIMES, Aug. 7, 2007, at A11 (announcing approval of maraviroc, the portal inhibitor);
242. Press Release, Merck, FDA Approves ISEN-TRESS (raltegravir) Tablets, First-in-Class Oral HIV-1 Integrase Inhibitor (Oct. 12, 2007), available at http://www.natap.org/2007/HIV/101507-05.htm (announcing approval of raltegravir, an integrase inhibitor).
243. See Deeks, supra note 164, at 2002 ("Continuing viral replication during therapy leads to the accumulation of drug-resistance mutations, resulting in increased viral load and a greater risk of disease progression.").
244. Montaner & Mellors, supra note 154, at 1857.
245. See Deeks, supra note 164, at 2003.
246. Salvage therapy is a general term for therapies used to treat individuals for whom antiretroviral therapy is not working. See id. at 2002.
247. Id. at 2003, 2007.
248. These regimens become more effective as the number of antiretroviral drugs used is increased or when a drug from a class to which the patient's HIV has not been exposed before is used. Id. at 2005.
249. Id. at 2007 ("Each additional drug is associated with ... a higher risk of treatment-related adverse events (eg, drug-associated toxicity, drug interactions, and inconvenience for the patient).").
250. Cost is unfortunately also an issue. Id.
251. See Michael M. Lederman et al., A New Approach for "Deep Salvage" Trials in Advanced HIV Infection, 21 AIDS 1503 (2007).
252. Edward Susman, Many HIV Patients Carry Mutated Drug-Resistant Strains, 359 LANCET 49, 49 (2002);
253. see also, Natasha Loder, Drug-Resistant HIV Shows a Worrying Increase in the UK, 407 NATURE 120, 120 (2000);
254. Justin McCurry, Drug-Resistant Strains of HIV Increase Sharply in Japan, 362 LANCET 1052, 1052 (2003).
255. Lederman et al., supra note 174, at 1503.
256. See Deeks, supra note 164, at 2004 ("Most drug resistance is due to incomplete suppression with HAART ....").
257. Many commentators believe that those who have failed drug therapy have done so because they have failed to adhere properly to their regimen. See id. at 2003 ("Patients who could not adhere to a simple initial regimen are unlikely to manage more complicated salvage regimens.");
258. see also Colin Macilwain, "Better Adherence Vital in AIDS Therapies", 390 NATURE 326, 326 (1997).
259. See Oren J. Cohen & Anthony S. Fauci, Transmission of Drug-Resistant Strains of HIV-1: Unfortunate, but Inevitable, 354 LANCET 697, 697 (1999);
260. see also Deeks, supra note 164, at 2003 ("The proportion of patients newly infected with drug-resistant HIV-1 has increased significantly over the past few years.").
261. See Lawrence K. Altman, Bright Spots, Lost Chances on AIDS, N.Y. TIMES, Sept. 12, 2006, at F5;
262. see also N. Kumarasamy, Generic Antiretroviral Drugs - Will They Be the Answer to HIV in the Developing World?, 364 LANCET 3, 3 (2004) ("The cost of combination HIV-antire-troviral treatment has plummeted in the past 12 months ....").
263. See AIDS Myths That Need Eradicating, 382 NATURE 283, 283 (1996).
264. See Lawrence K. Altman, AIDS Drugs Reach More People, U.N. Report Says, but Not Enough, N.Y. TIMES, Apr. 18, 2007, at A7 ("Although prices for the standard antiretroviral drugs have fallen, health officials are concerned about the high costs of second-line, or backup, drugs that are needed when the first-line drugs fail.");
265. see also Celia W. Dugger, Clinton Foundation Announces a Bargain on Generic AIDS Drugs, N.Y. TIMES, May 9, 2007, at A9 ("Second-line drugs have typically cost about 10 times as much as first-line therapies.").
266. See Kelly Morris, Treating HIV/AIDS Information Overload, 352 LANCET 1866 (1998) (discussing the plethora of online resources available concerning HIV and AIDS such as wire services, information databases, and publications that can be ordered over the internet).
267. Douglas D. Richman, HIV Chemotherapy, 410 NATURE 995, 997 (2001) ("No drug is without toxicity. When antiretroviral drugs were first introduced, risks and toxicities were tolerated in the face of imminently life-threatening disease. With prolonged chronic therapy and the disappearance of the common symptoms of underlying HIV disease, adverse complications of antiretroviral drugs are being identified and characterized. As patients assume asymptomatic lives with hopes of prolonged survival, several toxicities represent increasing concerns regarding antiretroviral drug use.").
268. At least one study has suggested a link between antiretrovirals and leprosy. Donald G. McNeil Jr., Worrisome New Link: AIDS Drugs and Leprosy, N.Y. TIMES, Oct. 24, 2006, at F1.
269. Andrew Carr & David A. Cooper, Adverse Effects of Antiretroviral Therapy, 356 LANCET 1423, 1428 (2000).
270. See A. Carr et al., An Objective Case Definition of Lipodystrophy in HIV-infected Adults: A Case-Control Study, 361 LANCET 726, 726 (2003) ("Lipodystrophy is disfiguring and potentially stigmatising, and thus can hinder adherence to, and reduce effectiveness of, antiretroviral treatment.").
271. Andrew Carr et al., Diagnosis, Prediction, and Natural Course of HIV-1 Protease-Inhibitor-Associated Lipodystrophy, Hyperlipidaemia, and Diabetes Mellitus: A Cohort Study, 353 LANCET 2093, 2093 (1999).
272. Courtney V. Fletcher, Enfuvirtide, a New Drug for HIV Infection, 361 LANCET 1577, 1577 (2003).
273. This problem may be improving; HAART may reduce the incidence of problems like HIV-associated dementia. See Kaul et al., supra note 162, at 988.
274. Id.
275. Shaila Dewan, Waiting List for AIDS Drugs Causes Dismay in South Carolina, N.Y. TIMES, Dec. 29, 2006, at A16 (noting that, in some places, HIV/AIDS "still carries a stigma so heavy that patients often do not tell their own family that they are infected").
276. See, e.g., Catherine M. Wilfert et al., Science, Ethics, and the Future of Research into Maternal Infant Transmission of HIV-1, 353 LANCET 832, 832 (1999)
277. (citing rates of mother-infant transmission of 5-8 percent); Augusto E. Semprini et al., Letter to the Editor, Reproductive Counselling for HIV-Discordant Couples, 349 LANCET 1401, 1402 (1997) ("[A]fter more than 1000 insemination attempts in 350 couples and nearly 200 pregnancies there was not a single case of female seroconversion or paediatric infection.").
278. See Landon Myer et al., Reproductive Decisions in HIV-infected Individuals, 366 LANCET 698, 699 (2005).
279. See Montaner et al., supra note 28, at 531.
280. Id.
281. Id. at 531-32;
282. Travis C. Porco et al., Decline in HIV Infectivity Following the Introduction of Highly Active Antiretroviral Therapy, 18 AIDS 81, 85 (2004).
283. Montaner et al., supra note 28, at 531.
284. Id. (acknowledging that "current treatment strategies cannot eradicate HIV infection" but arguing that HAART is an effective means to limit transmission).
285. See Clinton, supra note 2.
286. Predicting these patients' "long-term prognosis," however, is still difficult. See Gazzard, supra note 155, at 347.
287. See Robert Blumenthal & Dimiter S. Dimitrov, Targeting the Sticky Fingers of HIV-1, 129 CELL 243, 243-44 (2007).
288. Jon Cohen, Report of Novel Treatment Aimed at Latent HIV Raises the "C Word", 309 SCIENCE 999, 999 (2005) (evaluating discussions resulting from a report of "an unusual treatment of four HIV-infected people, [which] the authors suggest ... may point the way to a 'cure of HIV in the future'").
289. See id. ("'It's an alternative approach that's worth pursuing,' says Anthony Fauci .... 'But you have to be very careful about the hope you have for eradication with this. We went through the same thing a few years ago.'").
290. See Loder, supra note 175, at 120.
291. Deeks, supra note 164, at 2002 ("Mutations conferring resistance to antiretroviral drugs commonly lower the enzymatic efficiency of the target enzyme, resulting in a virus that replicates inefficiently ....").
292. Martin Markowitz et al., Infection With Multidrug Resistant, Dual-Tropic HIV-1 and Rapid Progression to AIDS: A Case Report, 365 LANCET 1031 (2005).
293. See Richard Jefferys, Letter to the Editor, Multidrug- Resistant, Dual-Tropic HIV-1 and Rapid Progression, 365 LANCET 1923, 1923 (2005) (describing the discovery of such a case as statistically inevitable).
294. At least a few critics suggested an alternative explanation as troubling as that contained in the report: the patient suffered from co-infection with two drug-resistant strains of HIV. Geoffrey S. Gottlieb & David C. Nickle, Letter to the Editor, 365 LANCET 1923, 1923-24 (2005).
295. By 1988, Florida, Idaho, Louisiana, and Nevada already had HIV-specific criminal legislation. See PRESIDENTIAL COMMISSION REPORT, supra note 50, at 130.
296. See Closen et al., supra note 52, at 928 ("A practical problem in homicide prosecution based on HIV transmission exists in that the person prosecuted for transmitting HIV to another person is likely to the before the victim. A homicide prosecution is not possible because the victim will not have died.").
297. See Clinton, supra note 2.
298. See supra text accompanying notes 183-92.
299. See supra text accompanying notes 169-74.
300. See supra note 168.
301. See supra notes 202-05 and accompanying text.
302. Reports of the New York case made the front page of the New York Times. Marc Santora & Lawrence K. Altman, Rare and Aggressive H.I.V. Reported in New York, N.Y. TIMES, Feb. 12, 2005, at Al.
303. But see Marc Lacy & Lawrence K. Altman, Advocates Share Ideas in Teaching About AIDS, N.Y. TIMES, Aug. 10, 2008, § 1, at 16 (discussing attempts to educate an unreceptive public about the risks of HIV infection).
304. PRESIDENTIAL COMMISSION REPORT, supra note 50, at 130.
305. Id.
306. See supra notes 183-92 and accompanying text
307. Hermann, supra note 58, at 352-53.
308. See supra notes 124-43 and accompanying text.
309. See Burris et al., supra note 122, at 481-82.
310. See State v. Musser, 721 N.W.2d 734 (Iowa 2006).
311. See supra notes 71-72 and accompanying text.
312. See, e.g., JEREMY BENTHAM, AN INTRODUCTION TO THE PRINCIPLES OF MORALS AND LEGISLATION 165-74 (J.H. Burns & H.L.A. Hart eds., Athlone Press1970) (1789).
313. Burris et al., supra note 122, at 486.
314. See supra notes 75-81 and accompanying text.
315. CAL. HEALTH & SAFETY CODE § 120291(a) (West 2006).
316. See FLA. STAT. ANN. § 384.24(2) (West 2007) (criminalizing sexual intercourse "when such person knows he or she is infected with [HIV] and when such person has been informed that he or she may communicate this disease to another person through sexual intercourse").
317. See supra notes 193-97 and accompanying text.
318. See supra notes 78-81 and accompanying text
319. See supra notes 78-81 and accompanying text
320. See, e.g., BENTHAM, supra note 222, at 165-74.
321. IOWA CODE ANN. § 709C.1 (1) (a) (West 2003).
322. Id. §709C.l(2)(b).
323. See supra notes 94-102 and accompanying text. Clearly, where the burden lies in proving disclosure will make a great difference in how effective disclosure is in protecting the HIV-positive individual from conviction.
324. See supra notes 94-102 and accompanying text.
325. See Lazzarini et al., supra note 115, at 246-49.
326. See Closen et al., supra note 52, at 939 n.69.
327. See Burns et al., supra note 122, at 510.
328. The individual known as Patient Zero. See supra notes 42-48 and accompanying text.
329. See Burns et al., supra note 122, at 480.
330. See id. at 507-08.
331. Gostin, supra note 57, at 1023-25.
332. MO. ANN. STAT. § 191.677(1) (2) (c) (West 2004)
333. NEV. REV. STAT. ANN. § 201.205(1) (LexisNexis 2006).
334. See Bums et al., supra note 122, at 486 (noting that existing statutes use "wildly overbroad and risk-insensitive definitions of culpable behavior" and fail to link culpability and punishment to risk).
335. See supra notes 219-20 and accompanying text.
336. See Galletly & Pinkerton, supra note 131, at 330 (noting that general terms such as "likely to transmit" in Nevada statute or "could" in Illinois and Iowa statutes are susceptible to multiple interpretations, providing little advance notice on proscribed behaviors).
337. See Susan B. Gellman & Frederick M. Lawrence, Agreeing to Agree: A Proponent and Opponent of Hate Crime Laws Reach For Common Ground, 41 HARV. J. ON LEGIS. 421, 444-48 (2004).
338. The Model Penal Code defines "recklessly endangering another person" as: A person commits a misdemeanor if he recklessly engages in conduct which places or may place another person in danger of death or serious bodily injury. Recklessness and danger shall be presumed where a person knowingly points a firearm at or in the direction of another, whether or not the actor believed the firearm to be loaded. MODEL PENAL CODE § 211.2 (1985).
339. See supra notes 76-81 and accompanying text.
340. Burris et al., supra note 122, at 479-81 ("Is suggesting condom use an admission of infection or a question about the partner's status? Does seeking sex in a bath house equal consent to HIV exposure? If one's HIV medications are in plain sight in the bedroom, is verbal disclosure required? If you don't ask, does that mean I don't have to tell?").
341. Gostin, supra note 57, at 1052.
342. Galletly & Pinkerton, supra note 131, at 328.
343. Id.
344. See supra notes 193-97 and accompanying text.
345. See Gazzard, supra note 155, at 347.
346. Burris et al., supra note 122, at 496, 517.
347. See id. at 477.
348. See PRESIDENTIAL COMMISSION REPORT, supra note 50, at 130.
349. Man Pleads Guilty in Rape Cases and Exposing Woman to H.I.V., N.Y. TIMES, Feb. 27, 1999, at B6.
350. John W. Fountain, After Arrest, Campus Queues for H.I.V. Tests, N.Y. TIMES, May 1, 2002, at A16.
351. See Galletly & Pinkerton, supra note 131, at 335.
352. See supra notes 179-92 and accompanying text.
353. The Model Penal Code divides assault into "simple assault," which includes "at-tempt[ing] to cause or purposely, knowingly or recklessly caus[ing] bodily injury to another," and "aggravated assault," defined as "attempt[ing] to cause serious bodily injury to another, or caus[ing] such injury purposely, knowingly or recklessly under circumstances manifesting extreme indifference to the value of human life." MODEL PENAL CODE § 211.1 (1985). California employs three categories to reach a similar result. "An assault is an unlawful attempt, coupled with a present ability, to commit a violent injury on the person of another." CAL. PENAL CODE § 240 (West 2008). "A battery is any willful and unlawful use of force or violence upon the person of another." Id. § 242.
354. Prosecutors need not prove intent to prove that behavior is willful, although recklessness and negligence alone should not result in a conviction. See People v. Colantuono, 865 P.2d 704, 713-14 (Cal. 1994).
355. "Assault with deadly weapon or force likely to produce great bodily injury" is "an assault upon the person of another with a deadly weapon or instrument other than a firearm or by any means of force likely to produce great bodily injury." PENAL CODE § 245.
356. See MODEL PENAL CODE § 211.1 (1985) (assault).
357. Id.
358. See generally Peter Piot et al., The Global Impact of HIV/AIDS, 410 NATURE 968 (2001) (calling for responses to HIV/AIDS on a scale commensurate with the epidemic).
359. See John Maddox, A Disappointing Decade of AIDS, 362 NATURE, 13, 13 (1993).
360. See supra Part II.
361. See supra notes 148-51 and accompanying text.
362. See supra notes 31-32 and accompanying text.