TL;DR

• Black Americans represent 12% of the U.S. population but nearly 40% of new HIV diagnoses.
• They are less likely to receive HIV care, medication, or insurance coverage.
• Black Americans face disproportionately high HIV-related arrests and harsher penalties, including sex-offender registration.
• Advocates warn outdated HIV criminal laws deepen stigma and discourage testing.
• Experts call for nationwide reform as criminalization continues to hit Black communities hardest.

A Public Health Crisis Intensified by the Criminal Legal System

Black Americans have long been disproportionately affected by HIV — but the story doesn’t end with infection rates. According to new findings from the Williams Institute, Black people in the U.S. are significantly more likely to be criminalized for their HIV status. That means more surveillance, more arrests, and harsher punishments, even when no harm occurred.

While Black Americans made up about 12% of the population in 2023, they accounted for 38% of new HIV diagnoses and 39% of people living with HIV. Those numbers alone reflect a public health system still shaped by racial inequity.

But the criminal legal disparities are even more alarming.

Arrest Rates Far Outpace Infection Rates — Especially in Key States

In 64% of states analyzed, Black Americans were arrested for HIV-related offenses at rates far higher than their share of HIV cases. The example from California is staggering:

• Black residents: 6% of state population
• Black residents living with HIV: 18%
• Black residents arrested for HIV-related offenses: 39%

In Tennessee, the disparity extends into post-conviction punishment. Though Black residents make up 17% of the population and 55% of people living with HIV, they account for a staggering 74% of people on the sex-offender registry for HIV-related convictions.

These punishments aren’t just draconian — they’re rooted in a legal framework that predates modern HIV science.

Outdated Laws, Outdated Logic — Modern Harm

Many HIV criminalization laws were crafted in the 1980s and early 1990s, before effective treatment, before viral suppression, and before we understood that HIV cannot be transmitted when someone is undetectable.

Yet states still criminalize behaviors that pose little to no risk — and disproportionately target Black people.

Nathan Cisneros of the Williams Institute explained it clearly:
“These laws can discourage testing, increase stigma, and deepen disparities — especially for Black Americans.”

If knowing your status can land you on a sex-offender registry because of a decades-old statute, why would people seek testing or treatment? Criminalization is not just unjust — it is dangerous to public health.

Structural Racism Meets Health Inequity

These disparities don’t happen in a vacuum. Black Americans are:

• Less likely to receive HIV care — only 64% are engaged in treatment.
• Less likely to achieve viral suppression — just 53%.
• More likely to be uninsured — 12.3% of Black adults lack health coverage, compared to 6.8% of white adults.

This perfect storm—higher risk, fewer resources, and deeper surveillance—reinforces a system in which Black people are punished for surviving.

And when queer Black people are involved, the risks heighten even further, blending health inequity with homophobia and transphobia.

A Call for Reform — and Justice

More states are beginning to modernize HIV laws, aligning them with scientific reality. But progress is uneven, and the criminal legal system continues to weaponize health status against Black communities.

Reforming HIV criminalization isn’t just a legal issue. It’s a racial justice issue. It’s a public health necessity. And most importantly, it’s a matter of survival.

Impact on the LGBTQ Community

For Black LGBTQ people — particularly gay and bisexual men and trans women — these disparities are multiplied. They face the highest rates of HIV diagnoses, the fewest avenues for care, and the greatest risk of criminalization.

Modern science has made HIV entirely manageable. Criminalization has not caught up — and Black queer communities bear the brunt of that failure.

Ending HIV criminalization is essential to reducing stigma, expanding care, and dismantling the racist structures that determine who gets punished and who gets protected.

This isn’t just about justice. It’s about ensuring Black people living with HIV are treated as what they are: people deserving of dignity, safety, and full humanity.