With the passage of House Bill 1217 last year, North Dakota became the fourth state to remove HIV-specific charging language from its books.
GRAND FORKS — Whether it’s because of recent legislation or a part of a broader trend, one thing is apparent to Megan Evjen: More North Dakotans are speaking out about living with HIV.
It’s a trend she hopes will continue.
“People are more willing to share their story — come forward and say, ‘I’m a person living with HIV, it can happen to anyone, this is my story,’ ” said Evjen, a Fargo-based social worker who works with people living with HIV.
It’s been a year since House Bill 1217, a bipartisan act repealing outdated language from Century Code, took effect. The repealed state law made it a Class A felony, punishable by up to 20 years in prison, to knowingly transmit HIV to another person.
In the law’s roughly 30 years on the books, no one was ever prosecuted using that charge, according to the North Dakota ACLU.
What the law did do was contribute to stigma against people living with HIV, and for some, created a fear of getting tested. Jason Grueneich, chair of the North Dakota HIV Advisory Board, cited national data showing that states with outdated HIV laws on the books have lower testing rates. In his experience, that’s because some people are afraid that knowing their status will open them up to being charged with a crime.
Ultimately, he said, reducing HIV stigma is a public health issue — and the Legislature agreed. With the passage of HB 1217, North Dakota became the fourth state to remove HIV charging language from state law. It was followed shortly thereafter by Maryland.
Grueneich is proud to see North Dakota at the forefront of the issue.
“We were at the front edge of what I believe is going to be a national conversation about this,” he said. “It’s overdue.”
HIV (human immunodeficiency virus), a disease attacking the body’s immune system, is spread only through contact with certain bodily fluids. Transmission typically occurs via unprotected sex, sharing needles, or from mother to baby during pregnancy. Advances in modern medicine mean HIV is no longer considered a fatal diagnosis.
The standard antiretroviral therapy treatment is capable of reducing the virus to undetectable levels, so that it cannot be transmitted to sexual partners. Medications such as PrEP are also highly effective at preventing transmission.
According to data from the North Dakota HIV Advisory Board, there were 671 people living with HIV in North Dakota in 2024. That year, counseling, testing and referral program providers — including local public health units — administered 5,809 HIV tests, up from 3,200 in 2020, according to the state Department of Health and Human Services.
Based on anecdotal evidence from advocates and caseworkers in the last year, Grueneich said he’s expecting an increase in testing to appear in statewide 2025 data, which will be released later this summer. If that increase manifests, he says it will be due in no small part to HB 1217 and the education campaigns that followed.
There’s work to be done, Evjen and Grueneich agree. Of the some 670 people living with HIV in North Dakota, roughly 380 are enrolled in case management and regularly accessing services.
Reaching those 300-odd people who aren’t enrolled in case management is among the major goals of Shine Bright and Live, North Dakota’s only HIV nonprofit, which Grueneich also founded.
Evjen said more education on resources is needed for hospital and clinic staff administering tests.
“It can be a pretty life-changing moment when someone finds out they are HIV positive,” Evjen said. “(Staff) need to be aware of the right referral path, so people aren’t just sent out the door.”
Local HIV organizations and programs nationwide are facing the possibility of lost funding, Grueneich said. President Donald Trump’s proposed 2027 budget includes roughly $2 billion in cuts to global and domestic HIV programming, including slashing or eliminating HIV prevention funding for the Centers for Disease Control and eliminating the Housing Opportunities for Persons with AIDS program. Congress will consider the president’s proposed budget in the fall.
Despite challenges, Grueneich believes North Dakota is moving the needle on HIV.
The state HIV Advisory Board is guided by the 2022-2026 North Dakota Integrated HIV Prevention and Care Plan, a map to address HIV. The 2022-2026 plan focused on preventative care, improving education and decreasing stigma — including removing the state’s outdated HIV law.
Grueneich estimates the state successfully met 80 to 90% of the benchmarks laid out in the 2022-2026 plan. The board will release the updated 2027-2033 plan this year.
He highlighted one statewide statistic he’s particularly proud of: In the last two years, there were nine infants born to mothers living with HIV — and none were born with the virus.
“Because of the science and medicine, people living with HIV can have families, can lead productive lives, and I love that,” Grueneich said.
“It’s not a death sentence,” she said. “With the medications today, you can live a long, healthy life, if you stay on your medications.”
That’s why connecting people with services is important, she said. According to AHEAD — a national HIV data dashboard — just over 50% of North Dakotans living with HIV had achieved viral suppression as of 2024, meaning the virus is undetectable.
She wants that number to be 100%. The first step is getting tested. The second is staying on medication — people who stay on their medications long enough will eventually suppress their viral load to the point that it’s undetectable. People living with HIV typically have lab work done every six months to ensure it stays that way.
She urged people to seek preventative healthcare, such as talking to doctors about PrEP, and encouraged people living with HIV to seek community through peer support.
Following the passage of HB 1217 last year, Grueneich went on a statewide education tour with Shine Bright and Live. For Grueneich — a Bismarck native who has lived with HIV since 2006 — seeing the shift as more people have become willing to talk about their status, and the positive response from people across the state, has been nothing short of moving.
“To be able to talk about living with HIV in a small Lutheran church out in Epping, North Dakota, and to have people come up afterward and thank me for sharing that story, and to donate toward the nonprofit to help other people — I just never thought I’d be living to see that in North Dakota,” he said.
For years after being diagnosed, he didn’t talk about his status due to the stigma, and fear of harming his career or embarrassing his family. He never expected to be a leading HIV advocate in his home state.
“To be able to, over the last 10 years, see how the state has started opening up and trying to do what they can to reduce stigma and become more educated has been amazing,” he said. “I mean, to get the support of the governor, and bipartisan support in the passing of the modernizing of our state law was unbelievable. That was wild to me, that we had support from everybody,” he said.
“It made me proud to be a North Dakotan. We get a bad rap a lot from people about being rural or disconnected,” he continued. “I don’t think that at all. I think we have a strong community who cares about each other, and it’s just taken a little pushing to start making that more public.”
Resources
Evjen’s employer, Canopy Medical Clinic, a Fargo clinic specializing in LGBTQ+ populations, offers a number of peer-led support groups for people living with HIV. Canopy also offers one-on-one peer support with staff members living with HIV.
Bismarck-based Shine Bright and Live is the state’s first HIV nonprofit in approximately 30 years. The group helps provide direct care to people and their families through donations and contributions from the public. Grueneich also highlighted Bismarck’s annual World AIDS Day celebration, a speakers bureau for people living with HIV to share their stories across the state, and in-person support groups.
North Dakotans living with HIV who have an income at or below 500% of the federal poverty level can access comprehensive support through the state-funded Ryan White program, also known as ND CARES. ND CARES helps participants access medical care, treatment, coverage and services such as non-medical case management.
According to AHEAD, more than 91% of people accessing services through Ryan White were virally suppressed nationwide in 2024, compared to roughly 67% of all people in the United States diagnosed with HIV.
More information about public health, prevention and testing can be found on the North Dakota Health and Human Services HIV Program website.
