HIV exceptionalism

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HIV exceptionalism is the term given to the trend to treat HIV/AIDS in law and policy differently from other diseases, including other sexually transmitted, infectious, lethal diseases. The term first appeared in print in an article in the New England Journal of Medicine in 1991.^[1]

HIV exceptionalists emphasize the human rights of people living with HIV/AIDS, particularly their rights to privacy, confidentiality, and autonomy. They also believe that all people seeking an HIV test always require special services, such as counseling with every HIV test, special informed consent paperwork, and guaranteed anonymity in public health reporting. In many places, it is illegal to disclose HIV test results over the phone or over the Internet.

That is motivated partly by a desire to reduce the likelihood of suicide in recently diagnosed people. Other goals include encouraging people to consent to the test by, for example, preventing the government from associating a positive test result with an identifiable individual and preventing other healthcare professionals from learning that the individual has ever been tested, even if the test result is negative.

As treatment regimes, understanding of the pandemic, and awareness about HIV/AIDS stigma and discrimination evolve, more scholars argue for an end to HIV exceptionalism.^[2] HIV exceptionalism in testing increases bureaucratic burden, reduces the availability of HIV testing, and stigmatizes it as something "special," rather than a normal part of healthcare.