The criminal transmission of HIV in the United States varies among jurisdictions. More than thirty of the fifty U.S. states have prosecuted HIV-positive individuals for exposing another person to HIV. State laws criminalize different behaviors and assign different penalties. While pinpointing who infected whom is scientifically impossible, a person diagnosed with HIV who is accused of infecting another while engaging in sexual intercourse is, in many jurisdictions, automatically committing a crime. A person donating HIV-infected organs, tissues, and blood can be prosecuted for transmitting the virus. Spitting or transmitting HIV-infected bodily fluids is a criminal offense in some states, particularly if the target is a prison guard. Some states treat the transmission of HIV, depending upon a variety of factors, as a felony and others as a misdemeanor.
Criminal statutes were intended to reduce HIV transmission by encouraging safe sex practices, increased HIV testing, and disclosure of HIV status. The Ryan White CARE Act passed in 1990 had a significant influence on these laws, as states were required to have criminal regulations on HIV transmission to be eligible to receive federal funds for HIV-related health programs. Unfortunately, these laws did not appear to have the intended effect. In October 2012, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) called for the repeal of statutes that criminalize HIV-related behavior, writing: "Policies and laws that create HIV-specific crimes or that impose penalties for persons who are HIV-infected are unjust and harmful to public health around the world." It argued that such laws contribute to stigmatization and discrimination that inhibit diagnosis and result in "harsh sentencing for behaviors that pose little to no risk of HIV transmission." It advised that "All state and federal policies, laws and regulations ... be based on scientifically accurate information regarding HIV transmission routes and risk."[1]
In 2017 the Centers for Disease Control and Prevention (CDC) stated that those who are on HIV medication and have undetectable viral loads can no longer transmit the virus while their viral load is undetectable, but the possibility for a person to not use a prescription and continue to infect others remains.[2][3][4] They did not specify how long after an undetectable viral load test a person can guarantee that they are still undetectable, as viral loads can rise very quickly.