Using a human rights framework to identify the opportunities and shortcomings of the affordable care act to ameliorate health disparities among persons with HIV/AIDS

A key theme of the Patient Protection and Affordable Care Act (ACA) was the reduction of health disparities. For persons with HIV/AIDS, however, the threat of discrimination and even imprisonment have become tools to combat its transmission. The enactment of legislation worldwide criminalizing non-disclosure of HIV status, alongside a spate of judicial rulings at the state and federal levels, present a formidable challenge to alleviate the disease burden among affected populations, deter screening among at-risk individuals. My objective was to utilize a rights-based approach, drawing from international instruments and comments, to identify the features of the ACA that promote health among persons with HIV/AIDS, and identify the gaps against a backdrop of legislative developments and judicial rulings in the U.S. and abroad. This research conducted a comprehensive review of recent court rulings, laws, and epidemiological studies to address the legal, ethical, and epidemiological issues that are implicated by federal, state, and international efforts to reduce health disparities among persons affected with HIV/AIDS in the U.S. and abroad. Finding that existing laws do not adequately address the practical challenges of litigating cases of HIV disclosure, reinforce unethical treatment of persons afflicted with HIV/AIDS, and impede contemporary and innovative interventions (based on epidemiological evidence) to contain and control the spread of disease, this presentation recommends repealing existing HIV criminalization laws, conducting surveillance of HIV as it is embedded within the broader context of STIs, and targeting the couple (rather than the individual) as part of a broader public health campaign.