Words Matter: Quarantine People Living With HIV?

Words matter, especially in the world of public health. In a recent meeting, State Rep. Betty Price, wife of former U.S. Secretary of Health and Human Services Dr. Tom Price, evoked a harmful and ignorant 1980s-era fear around HIV. A fear those of us in public health have long-worked to leave behind us. Mrs. Price inquired about the ability of the state of Georgia to quarantine people living with HIV in order to stop the spread of the virus, asking, “What are we legally able to do?”

Mrs. Price added more problematic language, “It seems to me it’s almost frightening, the number of people who are living that are potentially carriers. Well they are carriers, with the potential to spread, whereas in the past they died more readily and then at that point they are not posing a risk. So we’ve got a huge population posing a risk if they are not in treatment... too many of our fellow citizens who have HIV are not compliant with the effective treatment of this now chronic disease. This is sad and troubling because we have come so far in HIV treatment, to the point where an HIV patient receiving recommended treatment is no longer able to transmit the disease to another person. This is something to celebrate, especially in stemming the transmission from a mother to her newborn baby.”

I watched this meeting in horror. Words matter, and in this case, the words Mrs. Price used were abhorrent and stigmatizing. To refer to people living with HIV as “carriers” dehumanizes people and evokes stigma, shame, and guilt. To even ask whether a quarantine could be put in place and suggest that it was not put in place previously because people were dying “readily” are painful words. This is what harkens back to the 1980s when fear and ignorance about HIV were rampant and our only response was to care for people as they died.

We have made so much progress since those dark times. People living with HIV who are on effective treatment and who achieve a sustained, undetectable viral load do not sexually transmit the virus to their HIV-negative partners. Mrs. Price, however, relegates the celebration to mothers and their newborns. To be clear, our ability to ensure HIV-positive mothers do not transmit the virus to their babies is reason to celebrate. But this suggests that other people living with HIV, many of whom are people of color, young, and gay, do not have the same reason to celebrate. Everyone living with HIV deserves this celebration.

We face many challenges in the fight against HIV, including ensuring that people living with HIV receive treatment. But with new tools to fight the epidemic, we are making remarkable progress. New infections in the U.S. dropped 18% from 2008-2014. Having an undetectable viral load and being unable to sexually transmit the virus has the potential to remove the stigma of living with HIV. It is also strong motivation to adhere to a prescribed treatment regimen, regularly monitor one’s viral load, and ensure that it remains undetectable. Effective treatment benefits not only the individual, but also prevents new transmissions.

Mrs. Price attempted to walk back her many harmful statements, but words still matter. Stigmatizing people living with HIV only continues to perpetuate their reluctance to learn their status, seek and remain in medical care, and achieve an undetectable viral load. I implore our elected officials to focus on the opportunities that are in front of us to end new HIV infections. Using dehumanizing, fear-inducing rhetoric will only contribute to the problem – and that drains the energy this movement needs as we work to end the HIV epidemic.