The Impact of HIV/AIDS on the Development of Public Health Law

Historically, public health law has been shaped by the social response to serious epidemics. Boards of health and full-fledged health departments were created in the late 18 and 19th centuries in response to yellow fever and cholera. Disease reporting, mandatory screening, and compulsory treatment became common in the law in response to TB and syphilis. HIV proved to be no exception. The need to respond, and the special role of law as a medium for resolving social disputes in the U.S., gave public health law a renewed importance. Advocates turned to law as a tool for promoting their desired HIV policies. Lawyers, judges, policy-makers and public health officials were challenged to adapt old practices to new needs, and develop new solutions to new problems. In the process, public health law has re-emerged as a vital discipline of public health, with a stronger connection to practice and a deeper intellectual foundation. After a brief overview of the statutes and cases arising from the epidemic, the chapter describes how HIV/AIDS perfected a change in the use of public health power. In the face of HIV/AIDS, public health has accepted the limits of law as a means to coerce behavior change among people with or at risk of communicable disease; at the same time, it has become more interested in understanding and addressing how law contributes to the social conditions in which people would be most likely to behave in healthy ways. The chapter focuses on two examples of this change in practice: the effort to use law to reduce social risk, and the development and application of a human rights framework in public health practice. The chapter concludes with some thoughts on the influence of HIV/AIDS on the future course of law in public health