Paramedic Jonathan Paz takes blood from a patient at the University of Miami Hospital's Emergency Department on April 30, 2012 in Miami, Florida. As people wait to hear from the United States Supreme Court on its decision of the constitutionality of the Affordable Care Act, some experts say that if the act is overturned, a decision expected later this year, people that now have insurance will no longer be eligible and will be kicked back into a system where the emergency department is their first visit when sick. (Photo by Joe Raedle/Getty Images)

Know your status. Know your status. Know your status.

The message comes at us from community organizations, government-sponsored health initiatives, signage at bus terminals and nightclubs, and even more increasingly, from the pulpits of churches. It’s everywhere. And black women are responding and being more empowered about their health because of it. There’s been a significant increase in HIV testing within that group in just the last three years. That’s a good thing — a fantastic thing.

With that awareness, however, comes what some consider unfortunate consequence. In an effort to derail the purposeful transmission of HIV—and there have been an appalling number of such cases—37 states have enacted criminalization laws making the deliberate spread of HIV illegal. In some states, it’s as punishable as carrying a concealed weapon without a license.

In Montana, it’s a misdemeanor to consciously expose another person to any sexually transmitted disease, which basically limits an infected person’s ability to have intercourse at all.

In California, it’s felonious to knowingly have HIV and engage in unprotected sex with the intent to infect, punishable by five to nine years in prison.

Those laws don’t take into consideration her partner’s HIV status. It also doesn’t consider whether the partner knew that the women was HIV-positive but consented anyway.

Being unaware of her status can affect a woman’s health, but being aware and attempting to live a normal life can legally intimidate her and, in the most perverse instances, make her susceptible to blackmail by abusive partners.

What lawmakers initially created as an effort to protect citizens and control the epidemic has become a control mechanism for some black women living with HIV.

“There are some states that have expanded their laws to the point where anyone who is HIV-positive is subject to a broader legal interpretation, and that can jeopardize women’s reproductive rights,” explains Valerie Rochester, director of programs and training for the Black Women’s Health Imperative.

“When it comes to how these laws are applied, women of color [living in impoverished situations] tend to be the most at risk and most vulnerable to having criminalization laws applied to them.”

Those limitations can range anywhere from being arrested for having sex with her partner knowing she’s HIV positive — regardless of their agreement or her partner’s status — to being threatened with Child Protective Services.

Some women face the real possibly of having her children taken away or being forced to stay in abusive situations or relationships with the possibility of criminalization hanging over her head.

“The law has been taken and, in many cases, abused itself so that can be used to coerce or force women to make decisions that they wouldn’t have to make otherwise,” Rochester adds. With their options limited, Black women—especially those who live under the restrictions of lower incomes—become two-time victims of the disease.

One in 32 black women will be diagnosed with HIV, and 83 percent of the women already infected with it are African-American. The laws need to be changed because fear of criminalization could be a deterrent to testing and, ultimately, to treatment for those women, Rochester stresses.

They also threaten to shorten lives that could be virtually normal with proper medication and medical supervision.

“The fear that could come about as a result of potential criminalization should not be a factor,” says Rochester. “It’s still much better to know, to be able to get into treatment so that infection rates are not only reduced, but these women get the benefit of proper health care.”