HIV exceptionalism and the South African HIV and AIDS epidemic: perspectives of health care workers in Pietermaritzburg

Abstract

The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake.