No Risk, Severe Consequence: Hepatitis C Criminalization in Indiana Involves Only Non-Transmissible Exposures

Abstract This study analyzes the enforcement of viral hepatitis criminalization in the United States. Indiana is one of nine states with laws criminalizing viral hepatitis exposure. Using a legal epidemiological approach, we reviewed court records and probable cause affidavits to identify prosecutions involving people living with hepatitis C virus (HCV) under Indiana’s Battery by Bodily Fluid and Waste law between 2011 and 2025. We identified 94 cases involving 98 HCV exposure incidents and assessed transmission risk using a novel HCV Transmission Risk Classification Framework. None of the incidents alleged conduct posing a plausible risk of HCV transmission; most involved saliva exposure through spitting (72.5%). Defendants were primarily white (94.7%), male (61.7%), and 18–68 years old. Case filings peaked in 2018–2019 but persisted through 2025. Hepatitis prosecutions operated largely independently of HIV criminalization. Our findings suggest the need for infectious disease law reform to align with current transmission science.