Persons living with human immunodeficiency virus (HIV) (hereinafter, “PLHIV”) face barriers at each stage of the criminal justice process, including prosecution for non-disclosure of HIV status. Justice institutions reinforce the stigma of HIV, which has perverse consequences for HIV prevention and treatment services. This article takes a critical criminological approach to “HIV criminalization,” using the frames of queer criminology and epidemiological criminology to analyze both the punishment of “deviant” sex and the public health consequences of HIV stigma. Finally, this article offers a comprehensive consideration of the criminal justice barriers that PLHIV face in light of current criminological research, providing both mainstream and critical criminologists new insights into the social construction of deviance, legitimacy of institutions, definition of victims, and purposes of punishment.