Medicine, University of Washington, Seattle, Washington, USA
Global Health, University of Washington, Seattle, Washington, USA.
J Med Ethics. 2021 Nov;47(11):727-728. doi: 10.1136/medethics-2020-106908. Epub 2021 Jan 27.
During the AIDS epidemic in the 1980s, it was crucial that providers take steps to protect patients by managing HIV with the perspective of 'HIV exceptionalism'. However, in 2020, the social and historical barriers erected by this concept, as demonstrated in this patient's case, are considerably impeding progress to end the epidemic. With significant medical advances in HIV treatment and prevention, the policies informed by HIV exceptionalism now paradoxically perpetuate stigma and inequities, particularly for people of colour. To improve overall HIV care, the medical community must move past HIV exceptionalism by liberalising diagnostics, instituting clinician implicit bias training and advocating to fully decriminalise HIV non-disclosure.
在 20 世纪 80 年代的艾滋病流行期间，医生采取措施，从“艾滋病例外论”的角度管理艾滋病毒，以保护患者，这一点至关重要。然而，到 2020 年，正如这个病例所表明的那样，这一概念所造成的社会和历史障碍极大地阻碍了终结艾滋病流行的进展。随着艾滋病毒治疗和预防方面取得重大医学进步，现在，受“艾滋病例外论”影响的政策反而使耻辱感和不平等现象长期存在，尤其是在有色人种中。为了改善整体艾滋病毒护理，医学界必须摒弃艾滋病例外论，放宽诊断标准，实施临床医生隐性偏见培训，并倡导全面非刑事化艾滋病毒不披露。
