Dissertation
My dissertation research examines the application of HIV law in Michigan, particulary the felony disclosure statute that makes it illegal for HIV-positive people to have sex without first disclosing their HIV-positive status.
Below, you can find both short (150-word) and more substantial (1500-word) abstracts detailing my research questions, methods, and preliminary findings. Please don't hesitate to contact me directly to request additional information about my research.
From Sickness to Badness: Enforcing Michigan HIV Law as a Site of Social Control
150-Word Abstract:
People infected with HIV in Michigan are required by law to disclose their HIV-positive status to their sexual partners. Failure to do so is a felony, sentencing for which varies widely but has included jail time. To analyze how this law is enforced, I will conduct qualitative interviews and surveys with health officials and prosecuting attorneys throughout the state and analyz trial transcripts. Building on the sociological insights of theorists such as Foucault and Conrad, I argue that the application of Michigan HIV law operates as a form of social control in that it renders practices conventionally understood in terms of medicine into crime. With recent attempts in African countries to make HIV infection punishable by death, this dissertation responds to the urgent need to understand not only how justice has been medicalized but also how particular health issues come to lend themselves to interdiction and punishment.
1500-Word Overview:
My dissertation, From Sickness to Badness: Enforcing Michigan HIV Law as a Site of Social Control, examines the application of Michigan public health and criminal laws that regulate the sexual practices of HIV-positive individuals. Under Michigan law, it is a felony for people infected with HIV (the virus that causes AIDS) to have sex without first disclosing their HIV-positive status to their sexual partners. Drawing on the theoretical insights of scholars such as Michel Foucault, Peter Conrad, and Irving Zola, I argue that these statutes operate as an important site of social control by transforming practices conventionally understood as a medical problem (the risk of transmitting a disease) into a criminal problem. This transformation of sickness into badness has important implications for our understanding of justice, health, and sexuality.
Over thirty US states currently have some form of HIV disclosure law, although Michigan’s is particularly broad in that it criminalizes any form of sexual behavior – regardless of actual risk of transmission or intent to harm. Indeed, most defendants are never accused of transmitting the virus to their partners or even intending to do so. Sexual contact is sufficient for prosecution. Like the majority of such laws, Michigan’s statute was enacted before powerful antiretroviral medications were introduced in 1995, effectively transforming HIV from a terminal illness into a chronic disease. That was a time in which ignorance and fear about the virus were widespread.
Despite the growing number of such criminal statutes both within the United States and internationally, little is known about how these laws are actually enforced. Local reports suggest that only a small minority of such cases are pursued legally. Those cases that are prosecuted often involve members of communities whose sexualities are highly stigmatized – particularly African-American men, gay men, and female sex workers. As such, critics have questioned whether the enforcement of HIV disclosure laws may be compounding inequalities of race, gender, sexuality, and class. By discovering how cases of non-disclosure come to be identified by institutions of public health as constituting a “health threat to others” and by indicating how some of those cases end up before the courts, this project will break new ground: it will be the first systematic research into how HIV disclosure laws are actually enforced.
My project is divided into three phases, each of which corresponds to a different enforcement context: first I study public health departments, then prosecuting attorney offices, and finally the courtroom. The first phase examines the surveillance techniques that local health officials employ to identify individuals who they suspect are not disclosing their HIV-status. In coordination with Michigan Department of Community Health staff, I conducted qualitative, in-depth interviews with local health officials responsible for managing these cases in fourteen of the seventeen health jurisdictions for HIV/AIDS across Michigan. Each interview lasted about an hour. Participants also completed a survey that assesses their attitudes towards hypothetical “health threat” cases, HIV disclosure, and HIV positive people, as well as their knowledge of HIV risk.
An analysis of these data is currently under review at a major journal. In particular, my research reveals that officials in a small number of health jurisdictions are employing epidemiological surveillance technologies to assist in identifying “health threat” cases. For example, officials reported using Partner Services (in which newly diagnosed individuals are asked to report their previous sexual partners, so that those individuals can be contacted for testing and, if necessary, treatment) as a means of identifying HIV-positive individuals who may not be disclosing their status. In these jurisdictions, health officials would ask newly diagnosed individuals if anyone they reported as a partner had mentioned being HIV-positive. If they replied that no one had said anything, then the official would run the list of partner names against the state’s Mandatory Names Reporting database that includes the names of everyone in the state who has ever been diagnosed as HIV-positive. Anyone on the list of partners who was known to be HIV-positive would then be investigated as a “health threat,” an investigation that could have legal repercussions.
These findings have opened up new questions for the next two phases of this project. Now that the techniques employed by health officials to assist in identifying “health threat” cases have been identified, additional research is needed to examine what happens to these cases if and when they enter the criminal justice system. There are several sources of data that will help tell this side of the story. The second, ongoing phase of this project involves qualitative, in-depth interviews with prosecuting attorneys in Michigan. I have begun data collection for this phase by contacting prosecuting attorneys in jurisdictions with high HIV prevalence rates and asking them to refer me to other prosecuting attorneys in the state whom they think I should contact. In doing so, I hope to gain insight into why some cases are selected for prosecution, while others are not. What kinds of evidence do these officials require in order to prosecute? How do they interpret the law’s particularities? Examining these kinds of questions will reveal the gatekeeping nature of prosecuting attorneys, while showing if and how social factors such as race, sexuality, and class come to inform their decision-making about which cases to pursue.
Finally, using conviction records obtained from the Michigan Police Historical Archive, I will analyze a sample of court transcripts in order to understand how the individuals who are targeted for prosecution are legally treated, how the cases are argued, and which social factors (if any) influence court proceedings. How exactly do attorneys establish that the sexual practices of HIV-positive persons constitute a crime worthy of punishment? Sociologists of law have long demonstrated how the particular “facts” of a case become transformed in the courtroom into narratives of villainous, malicious, and/or reckless offenders and helpless, undeserving, and/or damaged victims – but little is known about how medical problems are reshaped in the courtroom into problems deserving of legal intervention. Through close readings of these cases, this third phase of the project will describe how HIV risk is turned into narrative, how it is made into a story for the purposes of the legal drama played out in the courtroom. This phase of the project will most clearly help to explain how sickness comes to be framed as badness in a court of law.
This research is important and timely in terms of its scholarly impact as well as its potential implications for legal and political practice. I intend for this project to contribute to theory and practice in at least three ways. First, this project illuminates how Michigan’s disclosure laws are actually applied, and how social factors (such as race, class, sexuality, and gender) shape their application. Evidence that these laws’ application disproportionately impacts stigmatized minorities would have important implications for justice, just as evidence that health officials employ epidemiological surveillance technologies for legal enforcement would have important implications for health policy.
Theoretically, this project contributes to our understanding of medical social control, a concept pioneered by sociologists such as Irving Zola and Peter Conrad. These scholars helped to formulate the now widely used concept, medicalization – or, the transformation of deviant behaviors into medical problems (for instance, attention deficit disorder or female sexual dysfunction). But the actual transformation of sickness into badness has not yet been well described. Thus, my study will provide an empirical foundation for new theoretical insights into medical social control.
Finally, with recent moves in several African countries to make HIV infection a crime punishable by death, it is clearly urgent to understand not only how justice has been medicalized but also how particular health issues come to lend themselves to interdiction and punishment. By showing how HIV comes to be framed as a legal problem in Michigan, this project raises larger questions about justice and medicine that have implications beyond Michigan and beyond HIV.