A dual approach to the AIDS epidemic

Article Abstract:

June 5, 1991, marks, in a sense, the 10th anniversary of AIDS. It was on that date in 1981 that the Morbidity and Mortality Weekly Report, the newsletter of the Centers for Disease Control, published the cases of five homosexual men with severe immune deficiency and opportunistic infections such as Pneumocystis carinii pneumonia. Shortly thereafter, numerous case reports began to appear from many areas of the United States and the world. Homosexual men, long familiar with social prejudice, were quick to realize that a fatal disease carried by homosexual men could have drastic political consequences. They were quick to organize in a fashion that would have been impossible if the AIDS epidemic arose among drug users or any other less educated and less sophisticated group. When testing for HIV (the AIDS virus) became available in 1985, it was not used routinely. Indeed, the current policy is that testing for HIV may only be done with the patient's consent. Likewise, there is no systematic requirement for the notification of the sexual partners of infected individuals, as there is for syphilis. Now, however, the pendulum is swinging back from this strict emphasis on privacy and individual rights. In the May 23, 1991 issue of The New England Journal of Medicine, one researcher discusses how HIV infection is beginning to be treated more like syphilis and other sexually transmitted diseases. However, the concerns that were originally raised by the homosexual community have some validity. There are compelling reasons why sexual contacts of HIV-infected persons should be traced, why hospitalized patients should be tested, and why pregnant women and newborns should be tested. Perhaps the wisest approach, however, would be to couple these efforts with legislation to guarantee health care, jobs, and housing to all persons with HIV infection. These guarantees would probably cost no more than is already being spent on AIDS. The public would be served by increased testing and surveillance, while for the affected individuals, a small sacrifice in privacy would be compensated for by the guarantee of fundamental human needs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Beliefs, opinions and attitudes, HIV patients

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Public health policy and the AIDS epidemic: an end to HIV exceptionalism?

Article Abstract:

AIDS is a reportable disease in all 50 states; this means that physicians are required to report all occurrences of the disease to health authorities. However, HIV infection (the cause of AIDS) is not reportable in many states, and in only 11 states is AIDS or HIV infection classed as a sexually transmitted disease. They are classified as infectious diseases in only 22 states. Curiously, New York, New Jersey, and California, the states most severely affected by the AIDS epidemic, are not included in this group. AIDS and HIV infection are not treated in the same manner as previous epidemics, nor are they treated like other sexually transmitted diseases, such as syphilis. For instance, there is generally no systematic tracing of the sexual contacts of AIDS patients or HIV-infected individuals. This lack of tracing has resulted from concerns that the AIDS epidemic would provide an excuse for discrimination against homosexual men and black Americans. However, a shift in policies concerning AIDS and HIV infection is taking place. At least part of this shift is related to the development of treatments that can extend the lives of HIV-infected individuals. Testing for HIV infection, therefore, is no longer simply a matter of data collection and epidemiological surveillance; it is also something that will directly help patients. AIDS will remain a serious health problem, affecting millions of people, for some time to come. However, slowly it will cease being an exceptional disease requiring exceptional measures. Testing for HIV infection will come into line with testing for other diseases; ironically, the testing for syphilis may change as a result of lessons learned from AIDS about mounting an effective public health campaign. The end of AIDS as an exceptional disease should not mean a return to public health practices of the past. The AIDS epidemic has provided an opportunity to scrutinize the effectiveness of the public health system, and incentive for healthy debate. Indeed, it continues to provide an opportunity for the revitalization of the public health system. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Changing the paradigm for HIV testing: The end of exceptionalism

Article Abstract:

The Centers for Disease Control and Prevention (CDC) is planning to issue new recommendations for testing HIV in adults, adolescents and pregnant women. The state and local health policymakers are considering the new CDC recommendations and it is very crucial that the assumptions informing the new testing paradigm be the subject of open, ethically informed and evidence-based discussion.

United States, Legal issues & crime, Government regulation (cont), Government domestic functions, Government regulation, Legal/Government Regulation, Administration of Public Health Programs, Centers for Disease Control, HIV testing, HIV tests, United States. Centers for Disease Control and Prevention, Health policy

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