In bio-behavioural surveys measuring prevalence of infection with human immunodeficiency virus (HIV), respondents should
be asked the results of their last HIV test. However, many government authorities, nongovernmental organizations, researchers and other
civil society stakeholders have stated that respondents involved in such surveys should not be asked to self-report their HIV status. The
reasons offered for not asking respondents to report their status are that responses may be inaccurate and that asking about HIV status
may violate the respondents’ human rights and exacerbate stigma and discrimination. Nevertheless, we contend that, in the antiretroviral
therapy era, asking respondents in bio-behavioural surveys to self-report their HIV status is essential for measuring and improving access
to – and coverage of – services for the care, treatment and prevention of HIV infection. It is also important for estimating the true size of the
unmet needs in addressing the HIV epidemic and for interpreting the behaviours associated with the acquisition and transmission of HIV
infection correctly. The data available indicate that most participants in health-related surveys are willing to respond to a question about
HIV status – as one of possibly several sensitive questions about sexual and drug use behaviours. Ultimately, normalizing the self-reporting
of HIV status could help the global community move from an era of so-called exceptionalism to one of destigmatization – and so improve
the epidemic response worldwide.