Texas Officials Sue HIV-Positive Woman To Compel Her To Seek Treatment, Cease Having Unprotected Sex

Local officials in Amarillo, Texas, last week filed suit against an HIV-positive woman to compel her to seek treatment and stop having unprotected sex, the Amarillo Globe-News reports. The Amarillo City Attorney's Office on Wednesday in Potter County filed the civil action, which claims that the woman -- identified as T.T. -- has refused "repeated efforts" from local public health officials to "get her to act responsibly and seek treatment," according to the Globe-News. Health officials also have traced one HIV case to T.T., who did not inform her partner of her status. "We believe that by her conduct, she poses a health threat to the community, and so we're going to have to try to get the court to intervene and help," Amarillo City Attorney Marcus Norris said, adding, "[The suit is] extremely rare. In fact, to our knowledge, it's the first one." According to Dr. J. Rush Pierce, public health authority for the Amarillo Bi-City-County Health Department, the suit is a "last-ditch effort." He added, "We would not be doing this if we had been able to get this woman to behave responsibly with regard to sexual activity any other way." Pierce said that he has been working with T.T. for more than a year "with no success," the Globe-News reports.

Suit Details
According to court documents, T.T. was diagnosed as HIV-positive in January 2000 and received counseling from the health department on how to prevent the spread of HIV, the Globe-News reports. However, a 2001 HIV case was traced to T.T., and the patient told health officials that T.T. had not disclosed her status before sexual contact. Health officials also issued a warning letter in early 2003 ordering T.T. to enroll in treatment after learning that she was engaging in commercial sex work in to support her illicit drug use. After attending counseling for "several months," T.T. dropped out and again began engaging in commercial sex work and using illicit drugs, according to the Globe-News. Since she met with Pierce on June 15, T.T. has "refused to meet with officials, enter drug treatment or receive [HIV] treatment," the Globe-News reports (Cunningham, Amarillo Globe-News, 9/25). Under Texas law, judges or juries are allowed to "force people into treatment if they are infected with diseases that threaten the health of others and have failed to follow orders from health authorities," according to the AP/Houston Chronicle (AP/Houston Chronicle, 9/25). It is "extremely rare" for an individual to "refuse to take proper precautions after being exposed to a disease as serious and deadly as HIV/AIDS," according to Pierce, the Globe-News reports. He added that other HIV-positive people who seek assistance from the health department "would not be subject to the same kind of action, except in a case as extraordinary as that of T.T.," according to the Globe-News.

Individual Rights, Public Safety
The Texas law that allows judges and juries to force people with diseases that threaten the health of others into treatment "exists at an odd junction between a person's rights and the responsibility for a society to protect itself," according to Jennifer Bard, an associate professor of public health law at Texas Tech University School of Law, the Globe-News reports. "This is an interesting law issue because, under the United States Constitution, everybody has the right to liberty and the right to refuse medical treatment if they're competent," Bard said, adding, "However, the state has a right to protect society. This is what you get when those two rights conflict with each other." In the past, this type of conflict has been decided in favor of a state's right to protect the public, according to Bard. However, this case is unusual because there is no cure for HIV/AIDS, and the case "has the potential to detain T.T. indefinitely without a conviction for a crime," Bard said, the Globe-News reports. "She has a 100% right to refuse treatment, but she does not have the right to be a danger to society," Bard said, adding, "If the facts of the case are true, she's just as dangerous as if she was running around with a knife. The part that seems problematic, though, is the mandatory treatment. If she doesn't agree to stop spreading the disease, this could be a real standoff, and she could be locked up for life." However, according to Norris and Pierce, they have indicated that is not their desire in this case, the Globe-News reports. The suit seeks 12 months of confinement, during which Pierce said he hopes T.T. will be assigned to receive HIV treatment and drug counseling in an inpatient facility in Forth Worth, Texas. A judge eventually will determine the length of T.T.'s confinement. "I do believe in my heart that this is the best thing for this patient," Pierce said, adding, "I believe that if this patient would go and get away from Amarillo and receive counseling for her addiction and self-esteem issues, she could have a chance to really improve her life" (Amarillo Globe-News, 7/25).