Love (and Law) in the Time of HIV

JOHANNESBURG — A couple of years ago, courtesy of a joyous English summer, Cupid shot his arrow straight through my student heart. I fell in love with a charming American filmmaker. A blustery romance ensued. In the era of Skype, the ocean separating us had no chance of drowning our romantic spirits, and a few months later, I visited him in New York.

There was an ominous silence in the air that sunny late afternoon as we walked along the Hudson River. When we paused, he whispered, “I have been H.I.V. positive for several years.” We had had unprotected sex back in London.

That unforgettable confession, and the summer of English passion, revisited me recently as a public debate raged here about whether knowingly exposing someone to H.I.V. should be considered a criminal offense. Helen Zille, the leader of South Africa’s biggest opposition party (the Democratic Alliance), has been arguing yes. Drawing on the work of the H.I.V. and AIDS expert Helen Epstein, Zille contends that “the entrenched culture of multiple concurrent sexual partners” explains why South Africa faces a general epidemic. (Almost one in eight South Africans are infected with H.I.V.) And she argues that everyone should “accept responsibility for preventing risk to others.” If it were up to her, the American filmmaker would be declared a criminal and perhaps thrown in jail.

I felt instant shock and fear when he broke the news to me. But shock and fear are instinctual responses that have no regard for clinical truths. And criminalizing knowingly exposing someone to H.I.V. is a bad idea. For one thing, it would thwart important public health programs: it would undermine both the policies designed to eliminate the stigma associated with H.I.V. and AIDS and the efforts that encourage people to regularly get tested for the virus. (If you don’t test, and don’t know if you have H.I.V., no legal liability follows.) Having H.I.V. is no longer a death sentence; it has become a manageable chronic condition. Criminalization would only perpetuate that medical myth.

It would also discourage infected persons and the affected ones around them from living openly and without shame. In Grahamstown, the small town of the Eastern Cape where I was born and raised, AIDS is still a word that dare not be spoken; it’s called “the big flu.” Zille’s proposed policy would only perpetuate such prejudices and irrational views.

Maybe that’s the point. People like Zille are outraged, one might generously say, on behalf of one Eusebius McKaiser who was innocently exposed to possible H.I.V. infection by an irresponsible lover. Her proposal betrays a moral agenda: lurking beneath the condemnation of concurrent relationships is a disdain for the assumed sexual preferences of many African men.

The problem is that moralizing on the basis of hackneyed cultural positions gets in the way of evidence-based public-health policies. In North America and Europe, where there is no AIDS epidemic, stigmatization is less of a concern: Perhaps the American filmmaker should be prosecuted in the United States because criminalizing knowing exposure to H.I.V. is unlikely to set back the fight against the virus’s reach among, say, gay men in New York. But in South Africa, the sheer scale of the epidemic, and entrenched myths and stigmas, call for a different policy. Criminalization would have disastrous effects on public health in the region, the world’s most affected by the virus.

And it would reinforce the dubious notion that we are all hapless sexual victims. Why should the American filmmaker be responsible for my decision to have unprotected sex? He probably had an ethical obligation to not place me at risk by insisting that we use condoms. But it’s less clear that he had a duty to disclose his status to me.

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Eusebius McKaiser is a political analyst at Wits University in Johannesburg, South Africa. 

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Ten Secrets to Making Love Last By: Edwin Locke, PhD and Ellen Kenner, PhD

Do you
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It
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If
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Or
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Your
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You’re
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Its
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Here’s
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