SB 17 - CRIMINAL TRANSMISSION OF HIV Number 0056 CHAIRMAN BUNDE announced the first item on the agenda was SB 17, "An Act creating the crime of criminal transmission of human immunodeficiency virus (HIV)." He asked the sponsor, Senator Robin Taylor to present his bill. Number 0064 SENATOR ROBIN TAYLOR, Sponsor of Senate Bill 17, directed committee members' attention to the packet of media reports, specifically the Associated Daily Press article from the Anchorage Daily News dated February 9, 1998, about the transmission of HIV and why many individuals believe it's important to have protections for the citizens of Alaska against this type of reckless and endangering criminal activity. SENATOR TAYLOR stated there are 27 other states that have similar laws. Senate Bill 17 does not criminalize the disease; it criminalizes irresponsible conduct that puts others at risk. The Department of Health & Social Services reports the majority of HIV cases in Alaska resulted from consensual sex. The question is, "Would consent have been given if the risks were known?" This legislation does not shift the burden of proof to the defendant; the state would still have to prove that the defendant knew he/she was infected and did not warn the person being exposed. The provision of an affirmative defense protects the defendant; it does not shift the burden of proof. SENATOR TAYLOR said the Department of Health & Social Services, when asked in the Senate Finance Committee, could not provide any substantiation to the claim that SB 17 would have a "chilling effect" on testing programs. In fact, the Illinois Department of Health advised the Alaska Legislative Research Section there was no decrease in testing as a result of their law. This statement came in March 1995, six years after the Illinois law had passed. Senate Bill 17 is modeled on the Illinois statute which has been upheld in both the state appellate and supreme courts. Senator Taylor stated that SB 17 will not affect any needle exchange programs. Number 0249 CHAIRMAN BUNDE pointed out the University of Alaska Anchorage had started a needle exchange program. SENATOR TAYLOR concluded that Congressman Tom Coburn of Oklahoma, a medical doctor, introduced House Resolution 1062, the HIV Prevention Act, which has 90 co-sponsors in the U.S. House of Representatives, and included in its provisions is sense of the Congress language that the states should criminalize the intentional transmission of HIV. The sponsor statement for HR 1062 states that 79 percent of Americans believe that those who knowingly infect another person should face criminal charges. House Resolution 1062 has also been endorsed by the American Medical Association (AMA). Number 0328 REPRESENTATIVE J. ALLEN KEMPLEN inquired if society had ever made a policy statement before about the criminal transmission of a virus. He was thinking in particular about the outbreak of syphilis some years ago and syphilis if it goes untreated will kill. He wondered if during the time that syphilis was a social concern and before public policies were put in place helping to mitigate that concern, were there instances of communities criminalizing the transmission of syphilis. SENATOR TAYLOR wasn't aware of a criminal penalty for the transmission of syphilis. He added that syphilis is treatable and the advancement in medicine has reduced some of the threat; however, he did not want to give anyone the impression that syphilis, gonorrhea and other diseases transmitted in that fashion are not still a very serious problem in the United States; they are. With reference to Representative Kemplen's question, he thought it could best be explained through the laws passed by the U.S. Government involving the transmission of typhus, which can be treated, but it's quite deadly. The "Typhoid Mary" statutes prevent a person with this illness from working in certain establishments because it could be transmitted to other people. In fact, those people who have failed to be properly certified and are found in those establishments, are violating the law. He said in each of the instances, a person had a chance of survival; whereas, to his knowledge, no one has survived this infection. Number 0515 REPRESENTATIVE KEMPLEN remarked the literature he's seen on HIV, just as with syphilis, medical research and technology is moving forward very quickly to produce a medical response to that virus and treating it as a public health issue seemed to be producing results. He questioned the wisdom of treating the HIV virus in the criminal arena. Number 0620 SENATOR TAYLOR advised that as of December 31, 1997, 412 Alaskans had been confirmed to have AIDS, the result of HIV infection. Since tracking began in 1982, 202 of these cases have known to have died. He couldn't imagine that anyone thinking it was anything other than a criminal act if their daughter had been infected, as the 13 young women were infected by one man on the East Coast this last year. As a consequence, that state believes it's a criminal activity. Twenty-seven other states have criminalized it because they have encountered that type of predatory person, who knows full well they run a serious health risk to others by their activities, recklessly go forward, participate in these activities, and don't even have the decency to notify their sexual partner of the risk that partner may be encountering. Number 0701 REPRESENTATIVE FRED DYSON asked if Senator Taylor had said or inferred the AMA has endorsed exactly this kind of legislation. SENATOR TAYLOR responded, not exactly. The AMA has endorsed a House Resolution that speaks to the same thing; that resolution says as part of its language, "Sense of the Congress statement," that indicates that states should criminalize the intentional transmission of HIV. REPRESENTATIVE DYSON asked, "And were they speaking just generally - the knowing transmission; in other words...." SENATOR TAYLOR responded affirmatively. CHAIRMAN BUNDE asked if there were other questions for the sponsor. Hearing none, he asked Dr. Middaugh to present his comments. Number 0765 JOHN MIDDAUGH, M.D., Chief, Epidemiology Section, Division of Public Health, Department of Health & Social Services, testified he is a physician, board certified in internal medicine, also in public health and preventive medicine, and has been in a position with the Section of Epidemiology, Division of Public Health, since 1980. He stated the first individual in Alaska with the diagnosis of AIDS was found in 1982 and one of his responsibilities and duties has been to try to work to prevent individuals being infected with the HIV virus. Number 0860 DR. MIDDAUGH requested the committee to oppose SB 17 because there is testimony from the Department of Law stating Alaska has adequate statutes that can take care of an individual who attempted knowingly to cause harm by transmitting this virus but most importantly, because criminalizing an infection is diametrically opposed to effective action to prevent disease transmission. The major priority to try to prevent individuals from becoming infected with this virus involves getting individuals to volunteer themselves to be tested; and when an individual is found who is infected with this virus, to work with that individual to name their contacts and other individuals who may also be at risk of being infected; to test those individuals and to work with those who are positive. He said the virus is fragile and hard to acquire and partner notification activities are targeted and focused to try to interrupt the chain of transmission. DR. MIDDAUGH said the division would generically oppose criminalizing any infection. There are many infectious diseases that can in fact be transmitted by similar types of behaviors and activities; hepatitis B, hepatitis C, herpes virus. In fact, the road of criminalization provides disincentives for people to come to public health and medical professionals to seek care and to put themselves at a place of identifying their activities and those others who may be at risk and that offers an opportunity, as well, to put individuals and offer them access to treatment. Number 0910 DR. MIDDAUGH stated the tremendous breakthrough that's occurred in the last couple years have been the development, for the first time, of drugs that are effective in preventing replication of the HIV virus in individuals. Unfortunately, these drugs are not yet effective in curing an individual from the infection; the drugs are extremely costly, have numerous side effects, and unfortunately, the virus can mutate and become resistant. Nevertheless, among individuals who are taking the drugs effectively, the virus load of a person can drop down to zero or near zero, which means the person would be far less able to transmit the virus to another individual. In addition, once an individual is infected with the virus, it takes an average of six to ten years in an untreated person, before illness occurs resulting in symptoms that result in a diagnosis of AIDS. He said with the advent of these new drugs, it's conceivable that individuals who are infected and are taking these medications, may go many decades without any illness and without an ability to transmit the virus to another person. Because of these advances, the Division of Public Health and the medical community have proposed making HIV a reportable condition that is required to be reported to the Division of Public Health and the division's goal is that every individual infected becomes identified and offered these voluntary services of partner notification, case management and access to the medications. Number 1007 DR. MIDDAUGH said SB 17, as written, does not criminalize transmission of the virus, but merely exposure to it. And in fact, the definition of exposure is so broad that it can encompass almost any potential exposure to bodily fluid. The Alaska State Medical Association opposes this legislation; the Public Health Association opposes this legislation; and most of the individuals involved on the front-line with public health and medical training and background are in opposition to the legislation. In anticipation of the interest in and concerns over the egregious incident in New York led him to call the Commissioner of Health at Chautauqua County to ask him what occurred there and what his opinion was about the need to criminalize HIV transmission. He recounted that an individual who was infected and had been counseled, so he knew of his infection and the risks, nevertheless sold drugs, engaged in unprotected sex and shared intravenous drug equipment with numerous women of whom many became infected. The public health response, as soon as that incident was known, was to do the partner notification, support the families and those infected, and to remove this individual from the ability to continue this behavior. In fact, that individual has been in jail in New York City since September on charges of drug abuse and burglary, awaiting sentencing, after which he will be arraigned and indicted in Chautauqua County. The Commissioner of Health, having gone through the trauma of those events in his community and the media inspection and scrutiny, opposes criminalization of HIV. He offered to answer questions for the committee and reiterated his opposition to SB 17. Number 1114 CHAIRMAN BUNDE asked if HIV was a reportable disease at this time. DR. MIDDAUGH responded that AIDS has been required to be reported since 1985, and the division is in the midst of the process with public hearings to take place on March 25 and March 26, to make HIV a (indisc.) reporting a requirement by all health care providers and laboratories in the state of Alaska to the Division of Public Health. CHAIRMAN BUNDE asked if an HIV positive person is capable of transmitting the virus or is it the person with full blown AIDS that transmits it? DR. MIDDAUGH replied the scientific ability to transmit would be dependent upon the presence of the virus and the virus is not equally present at all times during a person's lifetime. If a person were taking the medications, then the virus may drop to such a low level that a person could not infect another individual. CHAIRMAN BUNDE inquired if an untreated HIV person is capable of infecting another individual. DR. MIDDAUGH said at different times in the course of the illness. Shortly after an initial infection, the virus replicates and it is in higher presence in bodily fluids. Then it drops to a level that may or may not be very low, where there may or may not be a risk of transmission, and then late in the course of illness when the virus destroys the immune system, the virus tends to be in much higher quantities in a person, where transmission would be potentially more likely. Number 1217 REPRESENTATIVE DYSON asked Dr. Middaugh to respond to Senator Taylor's statement that this concept has been endorsed by the AMA. DR. MIDDAUGH said he had no knowledge that the AMA has endorsed criminalization of HIV. The Coburn legislation has many components to it, but one of the congressman's primary goals has been to establish reporting of HIV infection by name in the United States. Dr. Coburn has also proposed numerous other interventions related to HIV and AIDS over the last few years, but the Alaska State Medical Association opposes criminalization of HIV. He offered to provide specific information to the committee on the AMA's position on criminalizing HIV. Number 1265 REPRESENTATIVE JOE GREEN asked, "Would there be any advantage to an individual who might have lived a lifestyle such that he could suspect that he might have HIV, that with or without this bill would alter his wanting to check. For example, you have a certain lifestyle and you think you might - without it becoming a felony, I might go get checked and I may or may not have it. But with this as a felony, if I find that I have it and then do some activity that could pass that on, could that in your experience, be a deterrent for checking?" DR. MIDDAUGH said his interpretation of the legislation is that if an individual was never to be tested, that would be a form of defense that he did not know he was infected, so therefore, how could he be expected to ever be prosecuted for any behavior he undertook. He said, "Part of the concern we have is that our entire goal at the moment is get individuals who may be at risk or are at risk through their behaviors to be tested. In order to be effective in preventing infection, we have to have at risk behaviors plus infection with the virus. If individuals choose to engage in high risk behaviors and none of them are infected, the virus will not be passed on and if the individuals are infected and do not engage in high risk behaviors, the infection will not be passed on." He noted that one of the shocking things to the commissioner in Chautauqua County, was the fact that so many young women voluntarily chose to engage in high risk behaviors with this predatory individual in spite of widespread knowledge of HIV among them through extensive efforts between the health department and the education department that provided a high level of knowledge to those young women. There was a clear expectation of the need of constant affirmation of responsible behavior among all persons. Number 1369 REPRESENTATIVE GREEN recalled that Dr. Middaugh had indicated the level of infection drops and then rises within an infected person and he inquired if testing provides any benefit for a person who suspects they are infected. DR. MIDDAUGH responded during the last few years groups of anti- retro viral medications have been developed, which for the first time have been proven to be a benefit and intervening to prevent the virus from being able to continue to multiply and to attack the immune system. The drugs are expensive, have numerous side effects and involve taking a large number of pills on a very rigid schedule. Great efforts are underway to develop better drugs and, in fact, vaccines that might also instead of preventing infection where it appears technology will not be able to that, will be able to attack the virus through vaccination to neutralize the ability of the virus to cause damage to the immune system. The goal has shifted from preventing or curing an individual from infection to being able to basically, neutralize the virus in a person so that it doesn't harm the individual - the host - and also cannot be transmitted to others. He said there are great benefits to individuals today from knowing their HIV status and be appropriately put on medications, depending on the individual's status. REPRESENTATIVE GREEN asked Dr. Middaugh if a public right to know would prevent individuals from being tested? DR. MIDDAUGH said the diseases that are required to be reportable go with a very strong confidentiality provision. One of the great concerns in America and among individuals who are potentially at risk, is the balance of having anyone, other than themselves and perhaps their primary health care provider, know of this information. However, it's essential for public health agencies to be able to have this information in order to work with individuals who are infected and for primary health care providers in order to help interrupt these chains of infectious transmission and to assure access to care. The data that would be reportable would not be able to be made available to the public; it would be held completely confidential and used only with that individual and the primary health care provider to secure improved treatment and to work with individuals on a voluntary basis to identify others at risk who are engaging in similar high risk behavior. Number 1542 REPRESENTATIVE GREEN asked if SB 17 were adopted and a person finds they have HIV and infected another person, would it then become public knowledge. DR. MIDDAUGH commented that one of the reasons medical and public health people so oppose this kind of criminalization, is exactly that reason. The ability to hold in confidence, information that's used to interrupt diseases is essential. He gave the example of an outbreak of a disease such as hepatitis from a restaurant, and the public health community needed to go in and attempt to discern why the outbreak was occurring, what the agent was and how to intervene, and no one would talk to the health department because they would have to disclose potential behavior that might subject them to criminal penalties. That is a very important distinction between the role of public health and medical experts trying to prevent diseases and interrupt transmission versus the interface of individuals being asked to disclose activities that might subject them to legal penalties. Number 1606 REPRESENTATIVE AL VEZEY asked what prevents an individual who suspects they may have contracted a terminal disease from getting tested. DR. MIDDAUGH said there are many things that motivate people to conduct themselves in many different ways and that in the routine and normal state of affairs, most individuals behave responsibly, cooperate, are concerned about themselves and attempt to do reasonable, logical and rational things. There are other individuals, who in spite of education and laws, continue to behave in ways that are inexplicable. One of the reasons the person in Chautauqua County has not been sentenced is because he's undergoing evaluation for suspected mental illness. There are numerable reasons why individuals may or may not do what we wish them to do for their own good and one of the interfaces is the goal of dealing with most circumstances. The event in Chautauqua County, in the mind of the Commissioner of Health, is so extraordinary that it's understandable the abhorrence of what occurred, but that's not a reason to criminalize this disease. REPRESENTATIVE VEZEY understood that Dr. Middaugh had said that some people just behave irrationally and would not get tested. DR. MIDDAUGH said that was true. REPRESENTATIVE VEZEY commented that if a person can be prosecuted under existing law for deliberate or careless transmission of HIV, isn't that a deterrent to people getting tested. DR. MIDDAUGH replied given that the interface between law and medicine is somewhat contentious and that many people without knowledge are more than willing to give learned and unlearned opinions in areas they're not familiar with, he suggested that the representative of the Department of Law be given the opportunity to respond specifically to what laws are available related to an ability to intervene if an individual is knowingly attempting to harm someone through the transmission of any infection. He thought that part of the concern with this legislation is the potential broad sweep of its definitions and picking out one particular virus, and then trying to understand what the implications to that are for individuals both for a defense or under the circumstances by which people might argue what was said, what did they know, what did they agree to, all of which, are in a way, less of concern to intervening, to prevent the infection and to enlisting cooperation of individuals in that effort. Number 1768 REPRESENTATIVE VEZEY said suppose there's a law that allows the state to prosecute a person who is exposing others to the AIDS virus in a negligent manner. The person is locked up in jail where they have the opportunity to expose an entire new population and there are laws which prevent the individuals exposed from being notified. DR. MIDDAUGH said this is a virus that's not transmitted casually and individuals have responsibilities for the actions they assume and choose to engage in. That's one of the reasons why one of the major efforts in public health is to target individuals undergoing high risk behavior and who are getting infected, but there's also a tremendous challenge to constantly educate all individuals about the need to be responsible. He noted there's an entire group of kids growing up today who have no concept of what the older group has gone through in the last 15 years with this virus and these dangers. He thought the fundamental ability to identify and to apply appropriate treatment of individuals with the virus is one of the great efforts of public health. REPRESENTATIVE VEZEY asked will a person with the AIDS virus contract AIDS in six to ten years or die in six to ten years. DR. MIDDAUGH explained the virus enters the body and then within generally six to ten weeks, antibodies form and are then present throughout the rest of the individual's life. Today, there are tests to measure the virus, itself. Once the virus is in the body, there's what's called an incubation period and that's the period the virus resides in the body, but no symptoms or adverse measurable effects from the virus are present to make a person ill or to make anyone know the person is carrying it, except it can be detected with a blood test. Then, AIDS is a syndrome and what that means is it's a constellation of abnormalities related to illnesses, diseases, and effects on the immune system, that when they combine together meet what's a case definition of AIDS - Acquired Immune Deficiency Syndrome - and that's indicative of a certain level of impairment of the immune system and the subsequent diseases and illnesses that then attack and ravage the body. Once a person has AIDS, there's a period which is quite variable, until an individual dies from the cumulative impact of the continued virus attack on the immune system and the subsequent diseases and illnesses that affect a person. With the new medications, by placing a person on the medications earlier, then those illnesses are delayed or potentially, hopefully in the future, prevented and the impact of that virus will extend the time of AIDS. He directed the committee's attention to a handout which shows the number of deaths from AIDS has dropped dramatically in the United States and in Alaska in the last couple years, which is almost certainly due to being able to treat individuals with these anti-retro viral medications. Number 1976 REPRESENTATIVE BRIAN PORTER said he was somewhat confused on the requirement for confidentiality, but he thought some of the potential victims of the individual from New York had prior knowledge or had been informed, but still continued their relationship with him. DR. MIDDAUGH commented they knew the person was engaging in risky behaviors, but did not know the person was HIV positive. REPRESENTATIVE PORTER understood that current confidentiality requirements would not allow public health officials or anyone to communicate to a person that his/her spouse was HIV positive. DR. MIDDAUGH explained how partner notification activities work. Individuals are informed that they have been exposed or there's reason to believe they've been exposed to an infectious disease, but the identity of that person is not revealed so that, in fact, on a practical basis, it could be very obvious to an individual the source of that exposure. But the public health professional community does not breach that confidentiality by identifying specific sources of exposure, except in a rare instance which is what Chautauqua County faced of having to release this individual's name publicly and went through numerous ethics committees and looked at what their duties were to their community and what the implications were of protecting confidentiality of that reported information. Number 2071 REPRESENTATIVE GREEN said, "You indicated that this is not an easily transmitted virus. So that the public is not at risk if people are working in certain fields, is there anything in your knowledge that says that someone who tests positive would be restricted from activities - working in a hash house, working in a hospital or things like that?" DR. MIDDAUGH responded absolutely. Number 2096 SENATOR TAYLOR stressed the other criminal laws which a person could be prosecuted under require knowing and intentional conduct to actually try to kill someone; these individuals don't want to kill someone; they want to make love with them and will use every lie or every inducement to get them in bed and will never tell the partner they are HIV positive. If the drug dealer in New York had been required by law to inform the 13 young women that he was HIV positive, he would be prosecuted on that. Apparently there's a group of people who want to protect this activity and the excuse is that it may have a "chilling effect" on testing. Of the 27 states that have implemented this law, there's no citation which indicates that a decline in testing has occurred. He stressed that he wants it to have a chilling effect on the sexual activity of the people who are predatory towards Alaska's population. CHAIRMAN BUNDE announced the committee would now hear public testimony. He asked Scot McRoberts to testify from Anchorage. Number 2182 SCOT McROBERTS, Outreach Coordinator, testified via teleconference from Anchorage that he has had HIV for 14 years and is considered a long term survivor. He strongly opposed to SB 17 and urged the committee not to pass it. He said SB 17 strongly discourages individuals from seeking medical treatment. This legislation doesn't even require transmission for conviction, but just the mere cry from a person that they've been exposed. Number 2249 DEE JAY JOHANNESSEN, Executive Director, AIDS Care Network, testified via teleconference from Anchorage, in opposition to SB 17. He referred to the sponsor statement, "The sad fact is that the rate of infection in Alaska is increasing" and said that is not true. According to the State of Alaska Epidemiology Bulletin, the rate decreased every year since 1982; starting at 9.9 percent in 1982 and ending at .2 percent in 1997. Again, referring to page 4 of the sponsor statement regarding an increase in testing for HIV in Illinois since the passage of legislation, he said the reason for the increase in testing was the passage of the Ryan White Care Act of 1990, which for the first time in the United States provided funding for HIV testing and counseling. Alaska doesn't have the provision but HIV testing went up 250 percent from 1990 to 1997. He said this bill targets people living with AIDS. He referred to page 1, line 7, and said, "You have to be a person who is infected with HIV, so I, who am HIV negative, could pass off a tainted syringe and you could not prosecute me under this statute; you have to be HIV positive to be prosecuted." He said the biggest issue of the legislation is that it's not intended to punish those who have contracted HIV, it's intended to protect others who may be unknowingly exposed to the virus. An individual living in the United States in 1998, who knowingly engages in unprotected sex, is not unknowingly being exposed. We all have a responsibility to protect ourselves from HIV infection and we have the ability to do that. CHAIRMAN BUNDE thanked Mr. Johannessen for testifying and asked Julie Close to comment. Number 2333 JULIE CLOSE, Case Manager, Interior AIDS Association, testified via teleconference from Fairbanks that she currently case manages 20 individuals who are HIV positive. She said that many of these individuals are married or are in monogamous relationships ... TAPE 98-23, SIDE B Number 0001 MS. CLOSE ... and active lives. She believes this bill attempts to legislate morality, intimacy and personal choices and may encourage jilted partners to seek criminal and legal retribution once a relationship has ended. Her main concern is that this bill may discourage HIV positive individuals in her office from discussing prevention issues and obtaining safer sex materials for fear that confidentiality may be breached because of the potential of a future criminal case. Ultimately, SB 17 puts the focus of responsibility on no one, encouraging ignorance of a person's HIV status, and the belief that a law can guarantee a person's safety. The responsibility for avoiding transmission of this disease falls on everyone, HIV positive or not, aware or not, and cannot be legislated. Number 0050 CHAIRMAN BUNDE announced that HB 384 would be held over until Friday, March 20, and in all likelihood HB 340 would be held over also. He requested Pat Cahill to present his comments. Number 0056 PAT CAHILL, Outreach Worker, Interior AIDS Association, agreed with the remarks of the individuals previously testifying in opposition to SB 17. He finds this legislation upsetting because if he was HIV positive and married and he and his wife were having intimate relations, he would become a criminal. He questioned the right to legislate what he and his wife do in the privacy of their home. CHAIRMAN BUNDE thanked Mr. Cahill for his testimony and called on Michael Hughes to testify. Number 0085 MICHAEL HUGHES testified via teleconference from Anchorage, that he is distressed by the inflammatory nature of this legislation to attempt to single out a group of people based upon their sexuality; i.e., gay men. Number 0120 MARY LEE, HIV Counselor, Municipality of Anchorage, testified from Anchorage via teleconference that she's been in her current position since 1991 and an Alaskan resident for over 40 years. One of her jobs as an HIV counselor is to help a newly HIV positive person to not only deal with the (indisc.) fact that they are positive, but also to notify the partner as soon as possible. She has never had anyone refuse to tell the partner; the HIV positive individual goes to the extreme to locate a partner or partners and notify them of the HIV positive result. She stressed these people are not criminals; have never been criminals; and the people she counsels have no murderous intent. She strongly supported the comments of Dr. Middaugh, Dee Jay Johannessen and other HIV positive people. CHAIRMAN BUNDE thanked Ms. Lee for her comments and asked Chris Carpentino to present his remarks. Number 0192 CHRIS CARPENTINO testified via teleconference from Fairbanks and said he is an Alaskan resident living with HIV. While he heard many comments at the beginning of the hearing about intentional transmission of this disease, this bill doesn't say anything about intentional transmission; it just states that if he voluntarily engages and seeks contact with another person, he could be convicted of a felony. He believes that's wrong. The major things in his life, as well as anyone else's life, are food, shelter and human intimate contact. CHAIRMAN BUNDE thanked Mr. Carpentino for his testimony and asked Carey Cummings to present her testimony. Number 0218 CAREY CUMMINGS, Outreach Worker, Interior AIDS Association, testified via teleconference from Fairbanks and supported the comments of her colleagues who opposed SB 17. She said HIV is a public health issue; not a moral issue and certainly not a criminal one. Criminalizing intimate contact further stigmatizes an already highly discriminated group of people. Prevention of the spread of the virus will not be accomplished by punishing infected individuals for fulfilling the basic human need for intimacy. Furthermore, less people will be accessing HIV testing services because of fear of potential legal ramifications. Therefore, this legislation would undermine current prevention efforts for both HIV positive and HIV negative individuals and early treatment for infected individuals would be seriously compromised resulting in potential increases of AIDS related deaths at a time when treatments are improving. CHAIRMAN BUNDE thanked Ms. Cummings for her testimony and asked Marcus Ortelee to present his comments. Number 0258 MARCUS ORTELEE, Volunteer, Interior AIDS Association, testified via teleconference from Fairbanks. He has been a volunteer at the Interior AIDS Association for the last nine years. He agreed with the other witnesses that this bill should not be passed. He's known people and still knows people who have had AIDS for over 20 years and are living very healthy lives and are in monogamous relationships. He said SB 17 regulates private lives which should not be done by the state. He knows of HIV positive individuals who have HIV negative partners and engage in protected sex; it's an adult decision and should be left up to the individual. CHAIRMAN BUNDE thanked Mr. Ortelee for testifying and called on Ilena Cramer to present her remarks. Number 0298 ILENA CRAMER, Women's Outreach Worker, Interior AIDS Association, testified from Fairbanks via teleconference and said it is her job to help women ask themselves where does their personal responsibility begin. The government cannot fix all of society's woes and shouldn't even try. This bill makes intimacy illegal and more dangerous than it already is for women today. People must learn to protect themselves in this day and age. Some people would rather choose to close their eyes to their own dangerous behaviors and point fingers and find blame at other people. Having HIV is not a crime; it is a disease and a government cannot legislate a disease. She said this legislation would take all the responsibility out of the hands of people and place it in the hands of courts, clogging up the system with disgruntled ex-lovers. The only way to prevent HIV is through education, behavior change and responsible behavior. This legislation will not cut down on HIV transmission rate; it will increase ignorance, increase hatred and will punish HIV positive people who have already been punished enough. CHAIRMAN BUNDE asked Susan Carpentino to present her testimony. Number 0357 SUSAN CARPENTINO testified via teleconference from Fairbanks. She is the mother of an HIV positive young man. She strongly opposes this legislation. She suggested that if this sexually transmitted disease is going to be considered a criminal act, then all other venereal diseases should be included because if gone untreated, will cause someone to die. CHAIRMAN BUNDE thanked Ms. Carpentino for her testimony and asked Michael Coons to testify. Number 0389 MICHAEL COONS, Paramedic, testified via teleconference from the Mat-Su Legislative Information Office, in support of SB 17. He understands that Nevada has a similar law and according to television reports, is mainly targeting prostitutes and known drug users that are knowingly HIV positive and continue to engage in activities. As a health care provider, he does have concern with being infected with HIV. He related an incident whereby the family of an individual who knew he was hepatitis B terminal, refused to notify the ambulance crew who did mouth to mouth resuscitation and both ambulance crew members contracted hepatitis B. Number 0470 CHAIRMAN BUNDE thanked Mr. Coons for his comments and closed public testimony on SB 17. He announced that SB 17 would be held in committee and heard again at a later time.