Modernizing Maryland's HIV laws: A priority for Black Marylanders

Yahoo

21-02-2025

HIV self-test kits in a community center in the Philippines, which have been affected by the freeze on U.S. Agency for International Development funds. Advances in medication and testing im the past 20 years have made HIV a manageable condition, allowing those with the virus to live long, healthy lives. (Photo by)
As Black gay men living and aging with HIV, we have borne witness to profound loss and remarkable progress in the fight against HIV and AIDS. Together, we have dedicated our lives to service and advocacy through our work at AIDS United and our leadership of the Presidential Advisory Council on HIV/AIDS and the U.S. People Living with HIV Caucus.
Yet even as we lead national efforts to advocate for people living with HIV, the state laws that govern our lives and our hometowns lag far behind. We both live in Maryland, and we know it is past time for this state to align its HIV laws with modern science and justice.
In our work, we often find that people are unaware of the stunning progress in HIV treatment and prevention. Let us share the good news: Thanks to scientific breakthroughs over the past 20 years, HIV is now a manageable chronic condition allowing us to live long and healthy lives without fear of dying of AIDS (one of us is over 60 and the other over 70!).
People living with HIV who maintain treatment can achieve an undetectable viral load, meaning they cannot transmit HIV to sexual partners. The significance of this development cannot be overstated. Because of effective treatment, more than half of people living with HIV are now over 50 years old.
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Not only do we have effective treatment, we also have highly effective prevention medications: PrEP (pre-exposure prophylaxis) is essentially 100% effective in preventing HIV transmissions and PEP (post-exposure prophylaxis) has been available for decades to address an HIV exposure within hours of occurring.
Centers for Disease Control and Prevention data reflect this progress and show declining rates of HIV transmission. Yet outdated laws continue to hold back progress. That is true for Maryland.
Despite everything that has changed in science, medicine and social justice, Maryland's HIV laws remain stuck in the past. When Maryland passed its criminal penalties for HIV in 1989, there was no widely available test for HIV. Rapid testing would not be available until 1992.
In the decades since then, Black Marylanders have faced unequal access to health care, as well as harmful state penalties targeting people living with HIV. The consequences have been devastating. In 2023, nearly 75% of Marylanders living with diagnosed HIV were Black.
This stark disparity is amplified by the criminal justice system: In Maryland, the law that punishes people living with HIV is used against Black men 82% of the time. We can repeal this law and immediately reduce the stigma that holds people back from HIV testing to know their status and getting into life-saving treatment.
Furthermore, the groundbreaking prevention medications are not widely available: Less than one in five of Marylanders who could benefit from PrEP and PEP can access them. Nationwide, only 9% of Black people who could benefit from PrEP received a prescription. Black and Latinx communities face particular challenges from uninsurance rates, medical mistrust rooted in historical discrimination and ongoing health care inequities.
We know how to address these disparities. Maryland can make sure the Medical Assistance Program covers HIV treatment and prevention as prescribed by a doctor without any prior authorizations by patients' insurance plan. Black and Latino Marylanders face the greatest barriers to accessing these life-saving medications, and many are insured by the Medical Assistance Program. Increasing access will help us reach the more than 27,000 Marylanders who could benefit from PrEP, reduce new diagnoses and better serve the one in six who rely on the program for health care.
The Maryland legislature is poised to pass overdue HIV reforms this year, joining 13 states with modernized HIV laws, including New Jersey, Iowa, North Carolina and Virginia. We can lead the way in ending the HIV epidemic by passing a comprehensive package of bills to reduce stigma and expand access, including one named in memory of our Maryland brother in HIV advocacy, Carlton R. Smith, whose work in Baltimore helped save lives. These commonsense reforms have bipartisan support and will immediately reduce stigma and increase access to care.
For years, we have lobbied for federal action to end the HIV epidemic, and we helped craft the current national plan to do so. We cannot achieve this goal unless states like Maryland step up. With a new federal administration that does not share our values around civil rights and health care access, it is more important than ever that Maryland acts to protect our own.
Together, we envision a Maryland where all people have access to life-saving HIV prevention and treatment, and HIV stigma and criminalization are relics of the past.