Iowa

Iowa criminalises HIV ‘exposure’ through a general infectious disease law. Previously, the law was HIV-specific, but in 2014 Iowa ‘modernised’ the law to significantly reduce its scope. However, people living with HIV have been prosecuted both before and after the 2014 reform.

Prior to reform, the offence of ‘criminal transmission of HIV’ made it a crime for people living with HIV to engage in ‘intimate contact’, transfer or donate blood, organs, or fluids, or share used drug paraphernalia. ‘Intimate contact’ was defined broadly to include the intentional exposure of the body to the fluids of another in a manner that could result in transmission. Despite its name the law explicitly did not require transmission. It was an affirmative defence to disclose HIV-positive status prior to contact. The offence was a class B felony carrying a penalty of up to 25 years’ imprisonment, and those convicted were also required to register as sex offenders.

We are aware of at least four cases under the pre-reform law, including landmark legal proceedings in the case of Nick Rhoades, who was arrested in 2008 for having consensual protected sex without disclosing his status. Despite the facts that there was only one incident and a condom was used, he was given the maximum sentence of 25 years’ imprisonment and forced to register as a sex offender. Protracted criminal proceedings over the following six years resulted in his conviction being overturned by the Iowa Supreme Court on the basis that there was no prospect of transmission in the case, which was required under the law.

Around the same time, Iowan organisations began to organise to modernise the law in the state. These reform efforts were led by local HIV organisation, CHAIN, for more than five years with support from other organisations such as local LGBTQ organisation, One Iowa. In 2014 these efforts were successful in pushing the legislature to amend the law, when an amending bill was passed by both the Senate and House in Iowa, before being signed into law by the Governor in May 2014.

This bill made significant changes to the ‘exposure’ law. Firstly, the provision was broadened out to other infectious diseases, no longer limiting it purely to HIV. Categories of culpability were created based on intent and transmission; intentional transmission remains a class B felony, while intentional exposure without transmission and reckless exposure with transmission are both class D felonies, punishable with up to five years’ imprisonment and a fine, while reckless exposure without transmission is a serious misdemeanour with a penalty of up to one year imprisonment and a fine. Importantly, ‘exposure’ is defined as requiring conduct which poses a ‘substantial risk’ of transmission.

A number of safeguards and defences were built into the new law. Taking practical measures to prevent transmission, such as compliance with treatment regimens, is a defence to prosecution, as is disclosing status and offering to take such measures which the other party rejects, while disclosure of status in itself continues to be a defence. The law explicitly excludes vertical transmission through pregnancy from its scope, and also states that ‘exposure’ alone is insufficient to prove intent to transmit. The reform also removed the requirement to register as a sex offender for this provision, and retroactively applied this to remove those already on the register.

Despite the scope of the law being narrowed, a number of prosecutions of people living with HIV have been seen since the 2014 reform. The majority of these relate to incidents of sexual ‘exposure’, however a 2017 case saw a woman charged under the law after allegedly biting a person and drawing blood during a fight. The outcome of the case is not known.

Laws under the Public Health Title also regulate those living with HIV. There are misdemeanour offences of knowing ‘exposure’ to communicable diseases and supplying false information in relation to a blood donation (see our report, Bad Blood, for a global analysis of the criminalisation of blood donations). Health officials also have the power to enforce treatment, quarantine, and isolation on people living with diseases.

For a detailed analysis of HIV criminalisation in Iowa, as well as all other US states, see the Center for HIV Law and Policy report, HIV Criminalisation in the United States: a Sourcebook on State and Federal HIV Criminal Law and Practice.