State Representative Juandalynn Givan (D-Birmingham) after hearing about a minister in Montgomery who engaged in ministerial misconduct with multiple women from his congregation and had infected several with HIV/AIDS presented a bill in the state house, HB 50, that would increase the penalty for knowingly transmitting a sexually transmitted disease (STD*) from a Class C Misdemeanor to a Class C Felony. This was a horrible event. Ministerial misconduct even without the transmission of disease is an act of betrayal of calling and trust from the congregation that alters the member’s lives of that congregation for generations to come. Few denominations have been willing or able to train their leadership in developing healthy boundary skills and effectively deal with the aftermath when those boundaries are broken. That said, criminalizing transmission is not an effective disease prevention strategy.
The result of criminalizing transmission of STDs only increases the stigma and shame that already surrounds STDs and the behaviors that transmitted them. It makes it harder for people to come forward to seek testing and treatment because they, themselves, do not want to know and risk the penalty of this law. This is on the front end of the law. Once convicted of a felony in this state the person is disenfranchised of their voting rights. More on this later.
For complete disclosure before becoming an ordained minister in the Unitarian Universalist faith, I was the co-founder of the Interfaith AIDS Ministry of Greater Danbury in Connecticut where I served as executive director for eleven years. I was also a certified HIV/AIDS prevention educator through the American Red Cross for 15 years. I am also a gay man. So I believe I come to this topic with some expertise and years of experience in preventing the spread of HIV as well as other sexually transmitted diseases.
What exactly is happening in the state of Alabama regarding STDs? It is no secret that Alabama has some of the highest rates of STDs in the country. Chlamydia, gonorrhea, and syphilis cases are statewide double the national average and in some counties like Montgomery and Dallas, 4x the national average. It is also no secret that Alabama, like the rest of the south, has among the highest rates of transmission of HIV in the country.
This is certainly an issue that needs to be addressed by our state legislature. The question is how to address the epidemic of sexually transmitted diseases in the state to prevent its spread.
Public Health protocol in stopping the spread of any disease is to find out the population that is most affected by a disease outbreak and to then target that community with prevention efforts that includes broad based education of the entire population about the disease and how it is and is not transmitted. In Alabama the transmission of HIV/AIDS, already high, has been increasing every year since 2005 in young adults ages 15-29. This group is twice as likely to become infected with HIV than other age groups. Young African American males of this cohort is 10 times more likely to become infected with HIV than “the average Alabama resident” (read White). In Alabama, African Americans are 7 times more likely to become infected with HIV than non-African Americans. African American females in Alabama are 8 times more likely to become infected with HIV than non-African American females. I’m curious as to what happened circa 2005 that would be a factor in the upswing of infections.
In December 2011, Governor Bentley wrote executive order number 26 forming a task force to address HIV/AIDS in the state. No where in this executive order is the word education mentioned as a priority prevention strategy. And within the state plan that was developed, outside of mentioning the various good work done by AIDS organizations, only one line mentions the need for education services but it does not indicate how these will services will be developed or what authority this plan has in the development of state budgets. This is problematic. It reveals a lack of serious commitment by Governor Bentley to reduce the spread of HIV/AIDS and other STDs. His refusal to expand medicaid and to find ways to increase access to medical care in rural areas of the state is troubling to say the least in light of this STD health crisis that affects over hundreds of thousands people in Alabama.
In those states where there is comprehensive sexuality education mandated to be taught in schools there is a significant drop in STDs and HIV/AIDS transmission. In Alabama it is not mandated and if sex education is taught it is abstinent based only. Further the sexual behaviors of gays, lesbians and transgender must by law be taught as unacceptable behavior and illegal in the state of Alabama. Rep. Todd has prefiled a bill HB 252 to remove this from the abstinent based curriculum.
According to the Guttmacher Institute review of State Policies on Sex and HIV Education, Alabama is not mandated to offer sex education, it is mandated to offer HIV education. But here is the caveat, it is only mandated to be age appropriate not medically accurate, not culturally appropriate and unbiased, nor is it mandated to not promote religion. Parents can opt-out their children from this education. When abstinence is the only approved method being taught STDs will soar. This is not opinion. This is a fact proven over and over again in the raw data.
Add to this the factors of poverty in the state. Lawrence Robey, Madison County’s health officer focused on this factor regarding the high rates of infection of chlamydia, gonorrhea, and syphilis. “On average, residents in poorer communities are at greater risk to contract and transmit STDs because of substandard public education and transportation as well as smaller tax bases to pay for medical centers and physicians, Robey said. Likewise, wealthier counties in northern Alabama often have average or below average STD incidence.” All of these diseases and HIV/AIDS are transmitted in exactly the same manner through unsafe sexual practices.
So any effective prevention strategy cannot simply be the tracking, monitoring and treating those infected, which is the primary focus of Bentley’s task force. It must include comprehensive sexual education that teaches not only how to use safer sexual behaviors such as properly and correctly using latex condoms and dental dams but also relationship building skills including respecting the word NO from potential partners, how to talk about sexual history with a potential partner, and negotiating the limits and boundaries of the relationship. Without an all out concerted effort in talking honestly about healthy sexuality and how to develop positive sexual behaviors that promote health, this plan will and is failing.
Sexually transmitted diseases are on the increase in Alabama. In 2012, the last year the Alabama Department of Public Health posted a full year of numbers of chlamydia, gonorrhea and syphilis infections, 41,042 cases were reported nearly double the number of cases reported in 2004. As in HIV rates, there is a sudden and sustained upswing in infections beginning in 2005. What policy changes happened in 2004/2005 that placed thousands of people at risk of STDs?
The four sexual transmitted diseases I have mentioned are not the only ones in Alabama. HPV is also high in Alabama. There is about a 25% prevalence rate in young females age 15-19 and 45% prevalence rate of HPV in females aged 20-24 in the United States! The numbers that may already be infected in the state is outlandishly high. This STD is a cause cervical cancer that can be prevented through a vaccine. This fact alone should result in a public health policy that mandates all adolescents before they begin sexual behaviors are vaccinated. The rates of death from cervical cancer in Alabama is among the highest in the country. Two issues here. The first is this is a disease that is now preventable with vaccinations but because of our stigma regarding sexual behavior we are not protecting our children. The second issue is the access to timely medical care to treat the cancer once it develops.
There are other viruses such as herpes simplex (HSV) that while not a notifiable disease is sexually transmitted. There are estimates that upwards of 76% of the American population have this virus. This infection can cause severe medical complications in a person whose immune system is compromised. Should 76% of Alabamians be convicted of a Class C Felony for transmitting HSV? They know they have it, it is those lip cold sores and genital sores that develop on the body from time to time. Have they disclosed their HSV status to their sexual partners before engaging in intimacy (kissing)?
Rep. Givan’s HB 50 targets those who knowingly transmit a sexually transmitted disease to an unknowing partner with a class C felony. Given the fact that in this state the disproportionate numbers of African Americans who are living with sexually transmitted diseases but are perhaps too ashamed because of Alabama’s cultural mores surrounding shame and sexual behavior to discuss their illness with potential partners before engaging in sexual behavior makes this bill a disenfranchising law that will potentially remove thousands of African Americans disproportionately from the voting rolls. This felony could be considered to be under the sexual abuse category of those felonies that cannot have voting rights restored after serving the sentence. I realize disenfranchising voters is not her intent. As an African American woman, she is painfully aware of the history of voting rights in this state against African Americans. Her bill is one of enabling others to take revenge on their sexual partners failure to disclose with the unintended consequence of mass disenfranchisement.
The responsibility for safer sexual relationships is on both partners. I recognize the power dynamics of this particular case and unfortunately it is a power dynamic that is prevalent in many relationships regardless of sexual orientation or gender identity. But if we are serious in reducing the spread of sexual transmitted diseases including HIV/AIDS then we must, absolutely must, teach and empower women to stand up for their sexual health in relationships. But to do this we must create a culture that is open in discussing sexuality.
Our schools must teach comprehensive, medically accurate, culturally unbiased, and free from religious proselytizing. Our schools must teach safer sexual relationship in a manner that does not stigmatize or marginalize the LGBTIQ persons in their classes. Rep. Todd’s bill HB 252 must be passed to remove the mandate to send a negative message regarding a minority of our students. We must de-stigmatize sexual behaviors so we can talk about sex in an open and healthy way with our young people.
My denomination, The Unitarian Universalist Association in partnership with the United Church of Christ developed a comprehensive sexual education curriculum called Our Whole Lives. It is curricula that is developed around the core values of self worth, sexual health, responsibility, and justice and inclusivity. It is an excellent program in teaching healthy sexuality and reducing the spread of STDs and HIV/AIDS. It is just one model of many that provides the resources our young people need in making healthy decisions about their most intimate relationships.
HB 50 is not the solution. It merely slams the jail house door on the person, nothing more. It does not curb the spread of STDs. There is no empowerment of the partner to take control of their sexual health only the taste of revenge which does not soothe the heart; only forgiveness can offer lasting resolution of this pain. Plus this will disenfranchise potentially thousands of African Americans and others from being able to vote in our state. HB 50 must be defeated as it serves no healthy purpose. Todd’s HB 252 must be passed as it will save lives.
*the more current medical term is Sexually Transmitted Infections (STIs) since not all result in disease but because this bill uses the older nomenclature of Sexually Transmitted Diseases (STDs) I am also using this term.