A deadly exception to the rule: the politics of HIV/AIDS

Professor Patrick Derr's research

“Some of the more flagrant instances of AIDS exceptionalism are almost comic. The claim that the AIDS epidemic was sent by God to punish homosexuals, for example, replaces ‘God is dead’ theology with ‘God is inept’ theology: what bungling deity aiming thunderbolts at a few thousand adult males in San Francisco would miss by 10,000 miles and kill 5 million children in Sub-Saharan Africa?”

Philosopher Patrick Derr devotes much of his time to investigating questions concerning medical and environmental ethics. In his chapter "The AIDS Pandemic" in Homosexuality and American Public Life Derr argues that if Americans persist in ignoring the truth about how HIV/AIDS is transmitted and in seeing HIV/AIDS as a punishment from God for homosexual behavior, we as a society will avoid our moral duty to do what we can to halt the spread of HIV/AIDS both at home and abroad.

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AIDS exceptionalism is a phrase coined to characterize how U. S. social attitudes about HIV/AIDS have caused the disease to be treated differently by public health officials and others concerned with containing its spread. Fears in the gay community about homophobia combined with homophobic prejudice that sees HIV/AIDS as a "gay disease" have made the treatment of HIV/AIDS a politically difficult issue. Such attitudes have prevented the disease from being treated effectively in the U. S., and hampered U. S. efforts to control the spread of the disease abroad where it has reached epidemic proportions.

In his chapter "The AIDS Pandemic" in Homosexuality and American Public Life (ed. Christopher Wolfe,1999), Professor Derr presents extensive statistics that emphatically counteract the stereotype of HIV/AIDS as a "gay" disease. His statistics reveal the appalling degree to which HIV/AIDS afflicts children, prostitutes, heterosexual men and women, and intravenous drug users throughout the world. He also discusses the implications of different types of HIV/AIDS on the way the disease is transmitted. There are two types of HIV, HIV-1 and HIV2, and HIV-1 has been classified into 9 subtypes. Different types of sexual practices seem to favor the transmission of different strains of the disease, further contradicting the notion of HIV/AIDS as a disease resulting solely from homosexual encounters.

What are the ethical questions that apply to the treatment and prevention of HIV/AIDS? Are the wealthy to be favored over the poor? Are Americans to be favored over other members of the global community? Should IV drug users be provided with sterile needles to help contain the spread of HIV? Derr points out several examples of how social attitudes have negatively impacted treatment of HIV/AIDS and threatened the survival of millions of people around the world:

Vaccine development for the prevention of HIV/AIDS has been under-funded in the U. S. compared to drug treatment for persons already suffering from the disease. Expensive drug treatment, while helpful to sufferers in the developed world who can afford it, is too costly to be available in the developing world. From the perspective of the global community, a development of a vaccine would be a better use of limited resources.
The condoning of prostitution, particularly child prostitution, by many persons in both the developed and developing worlds has grave negative implications for the spread of HIV/AIDS. Prostitution is an important industry, notably in many Asian countries, and "sex tours" to that region are patronized by U. S. and European businessmen.
Despite the fact that demographers familiar with the HIV/AIDS epidemic no longer see overpopulation as a risk in the countries of Africa south of the Sahara, the Clinton administration placed priority on population control there at the expense of HIV control.