Missouri backs off use of HIV client acknowledgment form

KANSAS CITY, MO. — After a Michigan Messenger investigation, Missouri is no longer requiring HIV-positive individuals to sign a document acknowledging the state’s reckless exposure law in order for those persons to qualify for federally funded medical programs.

“That particular form that’s used in case management will be eliminated,” said Michael Herbert, HIV program director for the Missouri Department of Human and Senior Services. “When [Michigan Messenger] called us it gave us an opportunity to re-evaluate policies and procedures and yeah that is something that is not necessarily required.”

Herbert made the comments following an appearance at a Campaign to End AIDS conference in Kansas City, MO in April.

Michigan Messenger reported in March that advocates were troubled by a spike in prosecutions of HIV-positive persons under the state’s HIV specific criminal law. That law requires disclosure of one’s HIV-positive status prior to sexual contact, needle sharing or other behaviors shown to spread the virus. The law also criminalizes biting and was amended in 1997 to make it easier for state officials to criminally charge HIV positive persons for violating the law if they test positive for another sexually transmitted disease. That amendment allowed the state to become the victim in the prosecution, and the mere positive test result was enough to prove the HIV-positive person had engaged in behavior that “recklessly exposed” another to the virus.

During Messenger’s investigation, it became known that HIV-positive people were required to sign a document acknowledging the state’s law and agreeing to abide by it. The document signature was tied to accessing federally funded Ryan White Medical Case Management programs as well as the AIDS Drug Assistance Program which helps pay for the the expensive anti-retroviral medications that control the virus.

Similar documents came under fire in Michigan after Messenger reported that some of the documents did not correctly explain Michigan’s law. As a result, advocates called on state officials to call for the elimination of the documents, and civil rights advocates called for an investigation. The Michigan Department of Community Health sent a letter to local health departments telling them the documents were neither “endorsed or encouraged” by MDCH policies and procedures. The letter from MDCH noted that the documents could lead to stigmatization and undermine attempts to prevent new infections.

Trish Steen, who serves on several planning councils dealing with HIV in Missouri, said the revocations of the documents was an important step in Missouri’s battle against the virus, as well as stigma and discrimination against those infected.

“It’s really just a wasted piece of paper considering the fact the law binds us regardless,” Steen said. “It really is irrelevant. Why does anyone need to sign a piece of paper acknowledging the disclose laws? We are told about the law from the get go (upon diagnosis). The paper only serves to criminalize us as HIV-positive people and adds to stigma after 30 years of epidemic.”