When is a quarantine not a quarantine?
That is what lawmakers and LGBT advocates in Kansas are arguing about after both houses of the legislature passed a bill that would allow the state to quarantine people afflicted with dangerous infectious diseases. LGBT advocates fear the quarantined could include people with HIV or AIDS, while state officials and backers of the bill insist that it would not.
“It is not so far-fetched” that the bill could lead to the quarantine of AIDS patients, said Michael Weinstein, president of the AIDS Healthcare Foundation. Weinstein noted that when he got involved in advocacy on behalf of AIDS patients in 1986, Californians voted down a ballot measure that opponents said could have led to forced quarantine of those infected with the disease.
“Kansas is not the most progressive place in the world and there is a trend towards the criminalization of HIV,” he said. “We don’t want that to get a head of steam.”
But the Kansas Department of Health and the Environment has strongly disputed the notion that the measure, House Bill 2183, would lead to the rounding up of those infected with HIV.
“The concerns about quarantine and isolation related to HIV are completely unwarranted,” said Charlie Hunt, the state epidemiologist at KDHE. “Existing law states that any isolation or quarantine actions have to be reasonable and medically necessary, and neither of those are relevant for HIV. So our position all along has been that it wouldn’t be legal, and besides, that was never our intention behind the bill.”
Part of the confusion may stem from the convoluted sausage-making associated with the bill. HB2183 originally was intended to help first responders and emergency medical professionals who are exposed to bodily fluids discover if someone they are treating has an infectious disease. Ultimately, the bill stripped out language that would have the force of law around testing those who have received medical attention, instead leaving it up to the state Health Department to write regulations that would protect firefighters and paramedics. The notion of a quarantine, the bill’s backers say, is not to exile people to a wheat field in an abandoned part of the state but to prevent those with communicable, airborne diseases from handling food or from leaving a hospital room.
But Kansas does have a law on the books dating back to 1988 that bans quarantining those diagnosed with AIDS. HB2183 would invalidate that.
“It does strike the language that excludes HIV, but you have to look at the rest of the language of the bill,” Hunt said. “If you look at that one statute then you are missing the context. The other statutes that are in that article also deal with isolation and quarantine, and again it states very explicitly that isolation and quarantine has to be medically necessary…The media reports have been completely untrue.”
(“Completely wrong,” chimed in a spokeswoman for the agency who was on the call with Hunt.)
Indeed, speculation that Kansas is considering quarantining people with HIV has ricocheted around the Internet, with Jezebel calling it “Beyond Fucking Words” and LGBT-focused blogs asking readers to call Kansas lawmakers.
“If this passes, we intend to make Kansas the poster child of AIDS discrimination. We wouldn’t hesitate to call for a boycott.”
As of 2010, Kansas had 2,750 residents living with HIV, according to the state health department.
Hunt said the state is seeking to treat the disease as all other communicable diseases are treated.
“It is an attempt to manage all infectious diseases and not to have a special carve-out to handle one infectious disease differently from everyone else,” he said. “By stating explicitly that a certain infectious disease, in this case HIV, deserves special protection, some would argue that it actually perpetuates the exceptionalism, the potential for discrimination that the advocacy community that has spoken out in opposition to this bill say they are concerned about.”
Thomas Witt, executive director of the Kansas Equality Coalition, said people with HIV are not likely to be subjected to a quarantine. But he added that state health officials are ignoring the risk that county officials could use the new law to threaten and intimidate HIV-positive men and women in the state’s rural precincts.
“This gives the power to local health officials to harass people,” he said. “States that don’t have specific protections built into their law see individual officials harassing people because of their HIV status or sexual orientation.”
As he spoke to The Daily Beast, Witt was walking the corridors of the state capitol, trying to lobby lawmakers to amend the bill as it was being negotiated in conference. It could be, he said, “a pretty hostile environment.” And he noted that anti-sodomy laws are still on the books in Kansas, despite such laws being ruled unconstitutional by the Supreme Court.
“It is still a crime in Kansas to be gay,” he said. “We get calls from people all the time. They aren’t being prosecuted, but they are being harassed.”
Asked about the possibility that local health officials could use the law even to attempt to quarantine HIV patients, Hunt said: “I reject this outright. I don’t think a public health officials would do this.” If a local official were to try, he added, he or she would be stopped by the courts and by the state health agency.
The proposal even has LGBT advocates in Kansas divided. Cody Patton, the executive director of the sexual health charity Positive Directions, said those who are concerned should read the bill. They would then learn that it calls for quarantine only when medically necessary, he said: “And there is no medical reason ever to have to quarantine HIV.” He added that his level of concern about the bill “was maybe a three” on a scale of 10.
But Weinstein, of the Los Angeles-based AIDS Healthcare Foundation, said local advocates who are not alarmed by the bill are “suffering from a kind of Stockholm Syndrome where they get too close to the people that are oppressing them.”
At minimum, he added, the bill could keep people suffering from AIDS from receiving treatment, as they would be reticent to disclose their status in a state that they perceive as hostile to them.
“If this passes, we intend to make Kansas the poster child of AIDS discrimination. We wouldn’t hesitate to call for a boycott,” he said.
“It is 2013. Why is it necessary to raise the specter of a quarantine?”