Closing the Book on Maryland's HIV Criminalization Law

By: Ranier Simons, ADAP Blog Guest Contributor

Science and equity slowly continue to push policy forward. On May 21, 2025, Maryland became the fifth state to decriminalize HIV. In February 2025, Maryland Senate Bill 356 and House Bill 39 passed in their respective chambers. On May 21, Governor Wes Moore signed the legislation into law with the official name, ‘The Carlton R. Smith Act’. Carlton R. Smith was an activist, long-term HIV survivor, and advocate championing Baltimore LGBTA and HIV services (Bishop, 2024; Medina, 2024). He passed away in May 2024, and as an active proponent of this legislation, it was fitting to name it after him. The effective date of the legislation is October 1, 2025. 

Photo Source: CHLP

The act repeals the previous law, which consisted of two concise sections: 

• (a) An individual who has the human immunodeficiency virus may not knowingly transfer or attempt to transfer the human immunodeficiency virus to another individual. 
• (b) A person who violates the provisions of this section is guilty of a misdemeanor and, on conviction, is subject to a fine not exceeding $2,500 or imprisonment not exceeding 3 years or both.

HIV criminalization means criminalizing living with HIV by criminalizing behavior that is not commonly criminalized when a person is HIV-negative. It also means adding enhanced punitive actions for a crime to those living with HIV convicted of a crime, more than the punishment if HIV was not involved (CHLP, 2025 May). The Maryland legislation was inherently problematic because it did not specify the means of transmission, did not require actual, verified transmission of the virus, and did not require any proof of intent. It merely needed someone to ‘knowingly’ expose another person to HIV (Cisneros et al., 2024). Additionally, it carved out HIV from general health statutes surrounding the spreading of other communicable diseases, adding a misdemeanor, monetary fine, and a maximum three-year imprisonment term (Cisneros et al., 2024).

The repealed Maryland statute was discriminatory regarding HIV status and race. From 2020-2022, enforcement of HIV criminalization laws was heavily concentrated in predominantly Black counties: 32% of the state's cases were in Baltimore City, 19% in Montgomery County, and 18% in Prince George’s County (Cisneros et al., 2024). Additionally, Black Marylanders were only 30% of the state's population and 71% of PLWHA, but they accounted for 82% of all HIV-related cases (Cisneros et al., 2024).

The Maryland statute ignored scientific evidence, which shows that a person with an undetectable viral load cannot transmit the virus. It also did not give any weight to a person living with HIV who disclosed their status or received consent from the other party (Cisneros et al., 2024). Thus, the latitude of defining actions as ‘knowledgeable exposure’ was predatorily wide.

Photo Source: The 19th

According to the Center for HIV Law and Policy (CHLP), in the United States, 32 states currently have HIV-specific criminalization laws, and 28 have HIV-related criminal penalty enhancements (CHLP, 2025 February). Additionally, some states have general statute criminal laws that allow HIV to be prosecuted in terms of assault with a deadly weapon or reckless endangerment. These laws are fundamentally not evidence-based because HIV cannot be transmitted through spitting, biting, fighting, or throwing bodily fluids. Outdated laws contribute to the stigma and reinforce opinions that contradict current medical science. 

In March of this year, North Dakota also got rid of its HIV criminalization laws. Before repeal, N.D. Cent. Code § 12.1-20-17 stated that PLWHA could be prosecuted for having sex if they did not disclose their status, even if the activity was low risk or posed no risk at all, such as with oral sex. The penalties for conviction were up to 20 years in prison and a Class A felony conviction. Additionally, people who shared syringes or needles without proper sterilization could have been prosecuted even without intent to transmit or any verified actual infection, as well as qualify for the same maximum 20-year imprisonment penalty and felony classification.

HIV criminalization laws do not benefit or improve public health or safety. In fact, HIV criminalization laws make people fearful of getting tested, seeking care, or even disclosing when undetectable and in treatment. It is imperative to continue to educate legislators as well as the public. It is unacceptable to allow these laws to keep PLWHA tangled in the justice system unduly, demoralize their existence, and continue to marginalize and disenfranchise racial and sexual minoritized groups.

[1] Bishop, K. (2024, June 6). Remembering Carlton Smith. Retrieved from https://chasebrexton.org/blog/remembering-carlton-smith

[2] Center For HIV Law and Policy (CHLP). (2025, February). Mapping HIV Criminalization Laws in the U.S., CHLP (2025). Retrieved from https://www.hivlawandpolicy.org/maps#:~:text=In%20the%20United%20States%2C%2032,knowledge%20of%20their%20HIV%20status.

[3] Center For HIV Law and Policy (CHLP). (2025, May 20). Maryland Repeals HIV Criminalization Law. Retrieved from https://hivlawandpolicy.org/news/maryland-repeals-hiv-criminalization-law

[4] Cisneros, N., Tentindo, W., Sears, B., Macklin, M., Bendana, D. (2024, January). Enforcement of HIV Criminalization in Maryland. Retrieved from https://williamsinstitute.law.ucla.edu/wp-content/uploads/HIV-Criminalization-MD-Jan-2024.pdf

[5] Medina, J. (2024, June 24). The Life and Work of Carlton Smith. Retrieved from https://www.freestate-justice.org/the-life-and-work-of-carlton-smith

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.   

Maryland and North Dakota Take Steps to Kick Their HIV Criminalizations Back to the 1980s

By: Ranier Simons, ADAP Blog Guest Contributor

HIV criminalization laws represent the worst of society’s response to the AIDS epidemic, rooted in fear, homophobia, and hysteria…and a lot of misinformation. The United States was the first nation to enact HIV-specific criminal laws, dating back to 1986-87. HIV criminalization laws still exist, but the wheels of progress are slowly chipping away at them as medical advances have changed HIV/AIDS from a death sentence to a manageable chronic disease. Equally important is the growing acceptance of the science behind “Undetectable Equals Untransmittable” (U=U), which has weakened the argument for these outdated, inhuman laws. Recently, two states, Maryland and North Dakota, passed bills to remove HIV criminalization laws from their statutes.

Photo Source: CHLP | The Marshall Project

Yet, many states still have active HIV criminalization laws in place. From 2008 to 2013, at least 180 people living with HIV/AIDS (PLWHA) were arrested or charged under HIV criminalization laws (Tang, 2024). These HIV statutes have not been updated to reflect evidence-based science and are predatory towards PLWHA. As of February 2025, 32 states have offenses that criminalize exposure to and/or transmission of HIV (CHLP, 2025). In 1994, Texas was the first state to repeal its HIV criminalization law (CHLP, 2020). The reality is that much work remains to kick HIV criminalization laws back to the 1980s, and some states are doing it!

In February of this year, Senate Bill 356 and House Bill 39 passed in both Maryland chambers. Both bills are repeals of a section of the Maryland code that specifically criminalized the intentional transfer of HIV from one person to another. The statute declared the knowing transmission of or attempted transmission of HIV a misdemeanor subject to a fine of up to $2,500 or a jail term with a maximum of three years, or both. Legislators passed the bills with the understanding that the law was not an effective means of protecting public health. Delegate Kris Fair stated (seen below), “The law was, for right or wrong, thought to help curb the transmission of HIV…What public health experts and criminal justice organizations have taught us … is that we’ve actually seen the exact opposite.” (Brown, 2025).

Photo Source: Maryland Matters | Photo by Danielle J. Brown

Also, on February 20, 2025, North Dakota passed House Bill 1217. This repeals a section of the code regarding the willful transfer of bodily fluid containing HIV. ‘Transfer’ here is defined as “engage in sexual activity by genital-genital contact, oral-genital contact, or anal-genital contact, or to permit the reuse of a hypodermic syringe, needle, or similar device without sterilization.” The law being repealed states that a person who knowingly transfers HIV to another person without their knowledge can be charged with a Class A felony with a maximum penalty of 20 years in prison and a maximum fine of $20,000. The bill changes the crime from a felony to a misdemeanor (Gall, 2025). In North Dakota, HIV is the only disease attributed to a felony charge, whereas other STI transmission crimes are misdemeanors. The bill now needs to be considered in the House.

Both states acknowledge that HIV criminalization is discriminatory. Singularly carving out HIV as a disease requiring enhanced criminal penalties increases stigma, is a disincentive for the public to normalize testing, and disproportionately affects specific populations. Fear of potential criminal prosecution means that people will be more hesitant to seek testing and subsequently must disclose their status to their partners (Yang, 2018). Additionally, it can adversely affect the trust within the doctor-patient relationship, resulting in delayed antiretroviral treatment initiation, poorer treatment outcomes, and adversely affecting public health. 

Medical science has made the possibility of HIV transmission effectively non-existent by PLWHA, who are undetectable on treatment. “U=U” is not a catchy slogan – it is an evidence-based scientific reality. Requiring an individual to indisputably prove their disclosure of their status if accused of exposure without consent is virtually impossible (Lazzarini, 2013). When HIV criminalization laws are in place, people can nefariously use them against people, such as a spurned partner retaliating against a former partner when a relationship does not end on good terms. Predatory laws harm PLWHA because being convicted does not even require actual HIV transmission to occur or proof of intent to deliberately pass the virus on to someone. 

Photo Source: Red Bubble

HIV criminalization laws also disproportionately affect marginalized groups, such as communities of color, specifically black men. Racial inequities and social determinants of health have already been shown to increase the likelihood of black male exposure to the criminal legal system (AIDS Vu, 2021). When HIV criminalization laws add enhanced sentencing or create violations that otherwise would not exist, they exacerbate targeted adverse outcomes. In Maryland, for example, Black people are 30% of the population, 71% of those who are PLWHA, and 82% of HIV-related criminal cases. Black men, specifically, are 68% of those accused in HIV-related cases despite comprising only 14% of the state population and 44% of Maryland PLWHA (UCLA, 2024).

Maryland and North Dakota’s recent bills to eliminate HIV criminalization are positive steps, but much more needs to be done. The number of states that currently have laws specifically targeting HIV for violations outside of standard communicable disease statutes or heightened sentencing is unacceptable. The stigma and hindrance to widespread testing of HIV criminalization add to the numerous barriers to ending the HIV epidemic in the United States. It would be easily conquerable if laws would catch up to science.

[1]  AIDSVu. (2021, May 10). HIV Criminalization. Retrieved from https://aidsvu.org/news-updates/hivcriminalization/#:~:text=HIV%20criminalization%20laws%20have%20also,transgender%20women%2C%20and%20sex%20workers.

[2] Brown, J. (2025, February 22). Bills to repeal ‘antiquated’ law criminalizing transfer of HIV sail through House, Senate. Retrieved from https://marylandmatters.org/2025/02/22/bills-to-repeal-antiquated-law-criminalizing-transfer-of-hiv-sail-through-house-senate

[3] The Center for HIV Law and Policy (CHLP). (2020). HIV CRIMINAL LAW REFORM: BEFORE & AFTER: Texas. Retrieved from https://www.hivlawandpolicy.org/sites/default/files/HIV%20Criminal%20Law%20Reform%20Before%20and%20After%20Texas%2C%20CHLP%202020.pdf

[4] The Center for HIV Law and Policy (CHLP). (February, 2025). Mapping HIV Criminalization Laws in the U.S. Retrieved from https://www.hivlawandpolicy.org/sites/default/files/2025-02/Mapping%20HIV%20Criminalization%20Laws%20in%20the%20US%2C%20CHLP%202025.pdf

[5] Gall, P. (2025, February 20). House Bill to reduce HIV transmission penalty advances in North Dakota. Retrieved from https://www.ksjbam.com/2025/02/20/intentional-hiv-transmission-charge-may-be-lowered-from-felony-to-misdemeanor/#:~:text=House%20Bill%201217%20passed%20on,to%20the%20Senate%20for%20consideration.

[6] Lazzarini, Z., Galletly, C. L., Mykhalovskiy, E., Harsono, D., O'Keefe, E., Singer, M., & Levine, R. J. (2013). Criminalization of HIV transmission and exposure: research and policy agenda. American Journal of Public Health, 103(8), 1350–1353. https://doi.org/10.2105/AJPH.2013.301267

[7] UCLA School of Law Williams Institute. (2024, January). Enforcement of HIV Criminalization in Maryland. Retrieved from https://williamsinstitute.law.ucla.edu/wp-content/uploads/HIV-Criminalization-MD-Jan-2024.pdf

[8] Tang, Catherine (2024). Our country's dark history of persecuting people with HIV. HIV Plus Magazine. Retrieved from https://www.hivplusmag.com/stigma/us-history-hiv-criminalization.

[9] Yang, Y. T., & Underhill, K. (2018). Rethinking Criminalization of HIV Exposure — Lessons from California’s New Legislation. New England Journal of Medicine, 378(13), 1174–1175. https://doi.org/10.1056/nejmp1716981

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.