Q & A with Ayako Miyashita

August 26, 2015
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Williams Institute and affiliated researchers answer questions about the role of data in law and policy.

For our most recent Q & A, we hear from Ayako Miyashita, the Inaugural Brian Belt HIV Law & Policy Fellow at the Williams Institute. She currently works on law and policy matters that impact people living with HIV.  In her previous positions, Ayako provided direct legal services to low-income clients living with HIV/AIDS at AIDS Legal Referral Panel and Inner City Law Center.  Her dedication to HIV-related matters began as a law student with the HIV-Immigration unit at the East Bay Community Law Center, where Ayako helped clients with immigration-related matters and obtained U Visa relief for clients and their families. She has most recently been involved with the Los Angeles HIV Law and Policy Project, a new collaboration between Disability Rights Law Center, Inner City Law Center, Los Angeles County Bar Association’s AIDS Legal Services Project, and UCLA School of Law’s Williams Institute.

Can you tell us a little about how you see data playing a part in HIV/AIDS policy conversations in the coming year?

Data is incredibly important in the current law and policy conversations about HIV criminalization. For those unfamiliar with HIV criminalization, this term refers to the use of criminal laws to specifically target people living with HIV. These laws vary state by state and aim to criminalize actions or behaviors which are perceived to be exposing other individuals to HIV. Many are based on mistaken beliefs about the routes, risks and transmission of HIV, and most laws have not been updated despite advances in HIV prevention and treatment.*

While we may hear individual stories where people have been subjected to HIV criminalization laws, we lack the data in most jurisdictions to paint an accurate picture of how often states use these laws against people living with HIV and who exactly are the individuals and communities most often impacted by these laws. In the coming year, thanks to collaborative funding from the California HIV/AIDS Research Program (CHRP), we will be analyzing individual offender data from the California Department of Justice to begin answering this question. These data will allow us to uncover, for the very first time, the story of HIV criminalization in California.

Ayako MiyashitaWhich public policy debates or legal approaches do you think have benefitted the most by available HIV/AIDS data?

Specific data focused on regional communities (e.g. South), racial/ethnic minorities, and sexual and gender minorities have been key in discussing disparities in HIV. These data help us to have a discussion about the intersectionality of HIV—how HIV status may be but one spoke on the wheel of a person’s lived experiences. These data also remind us that the value of data is limited so long as we remain unprepared to grapple with the complexity of what the data demonstrate. In this case, for example, we have to be mindful that the data are leading us to understand HIV disparities through examination of other drivers of inequality, including historical regional differences, racism, homophobia, and transphobia.

Are there any recent developments or new data that you think will make an impact on policy conversations regarding HIV/AIDS?

While we do not yet have a cure for HIV/AIDS, many believe we have the biomedical tools to bring an end to HIV through curbing new infections. This involves two strategies: 1) the use of antiretroviral medication to prevent a person from acquiring HIV in the first place; and 2) the use of antiretroviral medication for people living with HIV, which has the ability to lower the viral load to undetectable levels thereby reducing the risk of HIV transmission to others. Unfortunately, these scientific advances, and the hope they represent, have yet to pierce the legacy of stigma and discrimination faced by people living with HIV. I remain hopeful that the more people understand about HIV, the more likely they will be to contribute to establishing modernized laws and policies that treat people living with HIV fairly.

In what way is your approach to promoting the rights of PLWH similar or different from approaches to promoting the rights of other communities, and how is your approach informed by your experience?

In many ways my approach to addressing issues related to the rights of PLWH is similar to my approach to addressing the rights of other communities. This is because PLWH are not identified by their HIV status alone. Their struggles can often be grounded in multiple movements. I identify with this on a personal level. While I am not HIV-positive, I do identify as a racial minority, a woman in a male-dominated profession, a person living with multiple disabilities, and a child of immigrant parents. This helps me to realize that there is great strength in coming together and celebrating the ways our lives intersect, and to discover the locations where we can find common ground.

How did you start working on HIV/AIDS issues? What were some of your goals at the onset? How have your goals shifted over time?

As a law student, I clerked with the East Bay Community Law Center representing immigrant clients living with HIV. My very first client was a survivor of domestic violence who was seeking legal status through application for a U visa. As part of the application process, I was required to spend countless hours asking my client to recount the most intimate details of the horrifying and traumatic events she survived. Because my client had little choice but to trust me with her life story, her sacrifice required me to do everything in my power to get her the immigration relief she needed and to bring light to her story so that it might lead the way for others struggling to survive and thrive.

My goal since that time has not changed much. While my current position is not in the role as an advocate for individual clients, my work continues to be focused on bringing light to the stories of many individuals and communities infected and affected by HIV. When personal stories are combined with data, we get a full picture of the current realities for PLWH. Thus, data is a key tool which enables us to be effective at the law and policy level.

In the past year, Miyashita has provided an analysis of the blood donation bans on men who have sex with men and an evaluation of the legal needs of people living with HIV in Los Angeles.  You can read some of her work here and here. You can also take a look at her recent presentations about HIV criminalization and the intersection of health equity and the law.

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*A recent example is the case of Nick Rhoades, a man in Iowa who is living with HIV.  Mr. Rhoades had a consensual sexual encounter with another man in 2008.  At the time of the incident, Mr. Rhoades had an undetectable viral load (meaning there was so little of the HIV virus present in his blood that it was undetectable), and he used a condom.  Because his sex partner successfully claimed that Mr. Rhoades did not disclose his HIV status to him, Mr. Rhoades was charged under Iowa’s felony criminal transmission law.  Even though Mr. Rhoades’ sex partner did not seroconvert, Mr. Rhoades was convicted and placed on a lifetime sex offender registry and sentenced to 25 years in prison.

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By: Angeliki Kastanis