The AIDS Exception: Privacy vs. Public Health

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

The AIDS Exception: Privacy vs. Public Health

Atlantic Monthly (06/97) Vol. 279, No. 6, P. 57
Burr, Chandler

Abstract: In the Atlantic Monthly, author Chandler Burr asserts that HIV and AIDS have largely been exempted from the normal standards of epidemiological study out of concern for civil rights. These standards generally include routine testing, reporting, contact tracing, and notification. He claims that while measures are being taken in various forms around the United States, the efforts form a "chaotic patchwork" that is insufficient to stem the spread of the disease. According to Burr, this so-called AIDS exceptionalism first became evident in the 1980s, when activists started fighting for an end to AIDS discrimination and pressured the Food and Drug Administration and the Centers for Disease Control and Prevention on privacy issues related to HIV testing. Ultimately, there was essentially a suspension of the standard public-health practices for AIDS, including no routine HIV testing, varying reporting of HIV-infected individuals, and limited contact tracing and notification policies. Many cases of HIV infection have gone undetected as a result. In conclusion, Burr notes that upcoming legislation, such as Rep. Tom Coburn's (R-Okla) HIV Prevention Act of 1997, will likely escalate the debate about AIDS, testing, and privacy. He also asserts that a recent CDC report on the annual decline in AIDS deaths serves as proof of the efficacy of medical intervention and highlights the need to make the disease subject to more systematic standards.

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