艾滋病傳播已成為當代社會一個不容忽視的重要社會問題。由于其負面的社會和經濟后果，聯合國于2000年首次將艾滋病毒列為安全?；℉affejee，Ports and Mosavel，2016年）。為了解決艾滋病傳播問題，各國政府和學者提出了各種解決辦法，這些方法可以簡單地分為兩類，一類是采取法律手段懲罰艾滋病傳播行為（Gable、Gostin和Hodge，2009年），另一類是采取干預性非懲罰性手段（ve）。Rgidis和Falagas，2009年）。關于這兩種方法的優缺點，人們一直在討論，尚未得出結論。本文探討了采取何種手段控制艾滋病傳播的利弊。
HIV transmission has become an important social problem that can not be neglected in contemporary society. Because of its negative social and economic consequences, the United Nations first classified HIV as a security crisis in 2000 (Haffejee, Ports and Mosavel, 2016). In order to solve the problem of HIV transmission, governments and scholars of different countries have proposed various solutions, these methods can be simply divided into two kinds, one is to take law-based means to punish behavior of HIV transmission (Gable, Gostin and Hodge, 2009), the other is to take intervention-based non-punitive means (Vergidis and Falagas, 2009). There is constant discussion about the pros and cons of the two kinds of methods and no conclusion has been determined. In this essay, it explores the pros and cons to propose what kind of means should be adopted to control HIV transmission.
2.1 Means of punishment處罰方式
Physiologically, once people with HIV infection develop into AIDS patients, their health condition will deteriorate rapidly and they will bear great pain physically, until their lives are claimed by the disease later. Considering from a psychological, social perspective, once HIV-infected people know that they are infected with HIV, psychologically great pressure will be generated. In addition, HIV-infected people are vulnerable to social discrimination, it is difficult for them to get the care and attention of their relatives and friends. Social discrimination against people living with HIV will bring disaster to them and their families, they have to bear heavy psychological burden, which easily leads to family discord and even family breakdown, because the majority of AIDS patients and infected persons are at the age of supporting family, they often provide the main source of family funds. When they themselves can no longer work and they also need to pay high medical expenses, the economic situation of their family will soon deteriorate. For families with AIDS patients, their result is generally leaving unsupported orphans, or leaving their parents alone (Balisanga et al., 2016).
HIV mainly violates prime adults of 20-45 years old, and these adults are social producers, those who support a family, a country's defenders. HIV has weakened social productivity, slowed economic growth, reduced life expectancy, reduced national quality and weakened national strength. Social discrimination and unfair treatment make HIV-infected people be separated from a society, causing social unrest, increased crime effect, destroyed social order and social stability. HIV orphan children and make innocent children suffer from the loss of their loved parents, and they often endure discrimination, school dropouts, malnutrition and heavy labor burdens (Weber and Grant, 2015). It is precisely because of so many negative results that HIV transmission brings, many countries have included spreading HIV in criminal law. Although there are differences in the specific criminal charge of intentional transmission of HIV between different countries, it is common to identify such "acts" of intentional transmission of HIV as criminal offenses and to hold them accountable (Brown, Hanefeld and Welsh, 2009).
The intentional spread of HIV is a new crime. In this regard, some scholars are in accordance with the crime of deliberately transmitting sexual diseases to define acts of deliberately spreading HIV. The so-called intentional transmission of HIV refers to that those who know that they are AIDS patients or HIV carriers are through deliberate sexual intercourse, blood transfusion, shared syringes, organ transplantation to spread HIV to other people.
Governments of different countries have developed the provisions of criminal responsibility on deliberate transmission of HIV to others, so as to prevent spreading HIV (Sanon et al., 2009). In the United States, Georgia law provides that people with behavior of intentional spread of HIV will face 10 years imprisonment and penal sum of 5 million dollars. In Russia, people who knowingly spread HIV are punishable by imprisonment of up to five years; in Latin America, those who have acts of intentional transmission of HIV will be punished with three to five years of imprisonment; in Senegal, intentional transmission of HIV will bring a person to prison for 10 years, coupled with heavy fine (Gostin and Hodge, 2009).
Of course, it should also be notified that there are many shortcomings in the use of legal means to control spreading HIV. Firstly, the use of legal penalties is likely to cause social discrimination against AIDS patients, resulting in the stereotype that AIDS patients will be equivalent to perpetrators, and AIDS patients’ legal rights such as: privacy protection will be violated (Dodds, Bourne and Weait, 2009). Secondly, there is not enough evidence to show that the legal means of punishment can bring about public health benefits, but undermine existing public health efforts. For example, it undermines the relationship between AIDS patients and health professionals and researchers, so that many HIV transmission behaviors become underground and it is difficult to be found and managed, which on the one hand increases the cost of management of HIV transmission, on the other hand, it prompts underground HIV transmission (Gable, Gostin and Hodge, 2009). Finally, the use of legal penalties is likely to result in spreading HIV in prisons, because sexual intercourse with high risk are likely to happen in prisons and it is difficult to have an access to needles and condoms in prisons (Graham, Treadwell and Braithwaite, 2008).
2.2 Non-punitive measures
The legal governance of people at high risk of HIV agrees with the objective of establishing social order. However, there is an important objective for a country's strategy for governance of people at high risk of HIV, namely, the goal of public health through behavioral interventions towards a high-risk population of people living with HIV to achieve the goal of reducing the harm caused by HIV and other diseases to achieve the purpose of prevention and control of the spread of diseases to create a favorable public health environment (Mayer, Mimiaga and Safren, 2017).
The 100% condom promotion program in Thailand, which began in 1991, has resulted in a significant reduction in HIV prevalence among sex workers. It is considered to be "an effective measure to prevent and control the spread of HIV through sex, and it is also a low-input, high-yield intervention" approach adopted by UNAIDS and promoted worldwide (Chidrawi, Greeff, Temane and Doak, 2016).
Methadone and other appropriate drugs are used for maintaining treatment towards drug addicts to reduce dependence on drugs, so as to reduce HIV infection and spread caused by injecting drug to reduce disease, death and crime caused by drug addiction (Chidrawi, Greeff, Temane and Doak, 2016).
The importance of needle exchange in the spread of HIV has been recognized by many governments and organizations, and they have taken certain measures to intervene. In the United States, efforts to prevent the spread of blood-borne diseases among drug addicts rely on a network of more than 100 needle exchange programs (SEPs). SEPs are through providing clean needles to reduce AIDS and other blood-borne diseases (Chidrawi, Greeff, Temane and Doak, 2016).