JEFFERSON CITY, Mo. - A bill that went into effect over the weekend makes the first reforms to Missouri's HIV criminalization laws since they were passed in the 1980s.

Among other measures related to prosecutors and police, the bill requires prosecutors to prove someone knowingly exposed someone else who contracted HIV before getting a felony conviction, and reduces the minimum sentence from 10 to three years.

Rico Bush, communications director at Empower Missouri, said research shows HIV criminalization laws do not reduce the spread of HIV, but they do increase stigma and discourage people from getting tested - if they worry knowing their status could leave them vulnerable to conviction.

"It actually was deterring from people getting tested and actually knowing their true status," said Bush. "And then once you know your status, then you can get the help that's needed. We really want people to be educated about how HIV is passed, and also to get rid of the stigma surrounding HIV."

Bush said while there's more to be done, these reforms are an important step. He added that Empower Missouri and other advocates for reducing the stigma around HIV are working to educate people about medications they can take to curb the spread.

More than 13,000 Missourians currently live with HIV. Bush added there also are disparities in enforcement of criminalization laws.

"Since 1990, we know that more than 100 people in Missouri have been convicted of, you know, an HIV crime," said Bush. "And Black men account for half of HIV crime arrests and convictions in the state, of course, this despite being only 5.5% of the state population."

A bill introduced in Congress would incentivize states to eliminate their HIV criminalization laws, the REPEAL HIV Discrimination Act.

Earlier this year, Missouri became the third state to allow pharmacists to dispense HIV medication, like PrEP and PEP, without a prescription from a doctor.

Today is National Black HIV/AIDS Awareness Day, and advocates say barriers remain when it comes to testing and social stigma. More than 40% percent of people currently living with HIV are Black, despite accounting for only 12% of the U.S. population.

Laura Cheever, associate administrator with the HIV/AIDS Bureau, Health Resources and Services Administration, said viral suppression treatment, in the form of daily medication, has allowed most HIV patients to live a successful and near-normal lives.

"So it's no longer a death sentence," Cheever said. "So, that's really important. And second, that person cannot transmit HIV sexually to other people. So it's important both for their health and for our work towards ending the HIV epidemic."

More than 87% of Black Americans living with HIV/AIDs are receiving medical care and viral suppression drugs, according to federal data. Cheever added that is a huge increase from the number of Black patients receiving treatment in 2010.

In 2020, North Carolina ranked in the top ten states for new HIV cases among adults and adolescents, with more than 1,000 residents newly diagnosed, most of whom are Black men, according to the Centers for Disease Control and Prevention.

Cheever said an ongoing challenge, especially in rural areas and in the South, is encouraging people to get tested.

"One in eight people living with HIV don't know they have it," Cheever said. "So, we need better testing. And we need people to come in here and stay in care, we estimate that of the 1.2 million people with HIV in this country, 250,000 are out of care. "

According to research focused on the deep South, common barriers to testing include transportation, cost, not knowing where to receive specialty care, stigma, and fear of others in the community finding out.

Today is National HIV Testing Day, and doctors and advocates for people living with HIV and AIDS are urging everyone to make sure they know their status by getting tested regularly.

People living with HIV can take medication to suppress their viral load to undetectable levels, at which point, they cannot sexually transmit the virus to someone else.

Dr. Laura Cheever, an infectious disease physician and associate administrator of the HIV/AIDS Bureau in the Health Resources and Services Administration, said about 1.2 million people in the U.S. have HIV according to the Centers for Disease Control and Prevention, but one in eight does not know it.

"For a lot of people, there's still a lot of stigma around HIV," Cheever acknowledged. "They just don't want to know or don't want to have to deal with it. So, it is important to understand that HIV is a highly treatable disease."

Cheever added another reason some people do not get tested is, they assume their primary-care doctor takes care of it at their annual checkup, or when getting blood tests done at an urgent-care clinic or emergency room. But she cautioned most times, HIV testing is not a part of those appointments.

The New Hampshire Department of Health and Human Services receives funding from the Ryan White HIV/AIDS program, as do cities and community-based organizations, to make sure testing and care are available. Cheever pointed out the funds go to providing medical care, doctors' visits, medication, lab work and essential support services, such as transportation or emergency housing.

"You can go to the CDC website, gettested.cdc.gov, and there you can put in your ZIP code and find a place to get tested near you," Cheever explained. "There are many places now where you can go to get free or low-cost testing mailed to your home, so you can do self-testing in the privacy of your own home."

For many people living with HIV, Cheever said treatment is one pill a day, and she added for those who may not have insurance or be able to afford the prescription, the Ryan White program can help.

CLEVELAND, Ohio -- Today marks World AIDS Day, observed internationally to remember those lost to the HIV/AIDS epidemic and raise awareness about the disease.

In one of Ohio's most populous counties, health professionals are working to ensure people living with HIV have the services they need. Cuyahoga County's "Ryan White HIV/AIDS Part A" program has provided health services to those who do not have adequate insurance or financial resources since 1996.

Zach Levar, grant supervisor for the Cuyahoga County Board of Health, said one silver lining of the pandemic was learning how providers could reach more people through telemedicine.

"Clients that may not have wanted care in person might have found it a little bit more convenient to FaceTime with their doctor and check in with them that way," Levar explained. "Our clients have definitely appreciated it, we've heard anecdotally that different clients that may have been out of care are now linked to care because they've been able to access via telehealth."

Twenty-one percent of Ohioans who have been diagnosed with HIV live in Cuyahoga County, according to state data.

Levar said in honor of World AIDS Day, the county Board of Health has launched its first newsletter dedicated to HIV-related news and resources. It also plans to launch a social media campaign to help fight the stigma associated with HIV/AIDS.

Services the Ryan White program provides in the Greater Cleveland area include help applying for housing and benefits support, mental health resources, and group education for people recently diagnosed. Levar said the Board of Health has received two grants focused on HIV care and prevention, to help connect with at-risk residents.

"We've started working with the state to figure out who is not in care and trying to figure out ways to best reach those individuals," Levar outlined. "Figure out what their barriers are, really meet them where they are, and get them engaged in care, so that they can achieve the best health outcomes for themselves."

The two grants, totaling about $2 million, were awarded by the Health Resources and Services Administration and the Centers for Disease Control and Prevention.