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Sub-national estimates of HIV prevalence can inform the design of policy responses to the HIV epidemic. Such responses also benefit from a better understanding of the correlates of HIV status, including the association between HIV and geographical characteristics of localities. In recent years, several countries in Africa have implemented household surveys (such as Demographic and Health Surveys) that include HIV testing of the adult population, providing estimates of HIV prevalence rates at the sub-national level. These surveys are known to suffer from non-response bias, but are nonetheless thought to represent a marked improvement over alternatives such as sentinel surveys. At present, however, most countries are not in a position to regularly field such household surveys. This paper proposes a new approach to the estimation of HIV prevalence for relatively small geographic areas in settings where national population-based surveys of prevalence are not available. The proposed approach aims to overcome some of the difficulties with prevailing methods of deriving HIV prevalence estimates (at both national and sub-national levels) directly from sentinel surveys. The paper also outlines some of the limitations of the proposed approach.
"Knowing your epidemic" is essential for everyone involved in the response to HIV. Extensively illustrated with graphs and charts, this biennial report presents concise but comprehensive summaries of major issues in the global AIDS response. Annexes provide HIV estimates and data 2001 and 2007, and also country progress indicators.
Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease. The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining: How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use. Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine. The potential risk of HIV infection to and from health care workers. How AIDS activists have brought about major change in the way new drugs are brought to the marketplace. The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization. Coping with HIV infection in prisons. Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future. This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.
The 1918-19 influenza epidemic killed more than fifty million people worldwide. The SARS epidemic of 2002-3, by comparison, killed fewer than a thousand. The success in containing the spread of SARS was due largely to the rapid global response of public health authorities, which was aided by insights resulting from mathematical models. Models enabled authorities to better understand how the disease spread and to assess the relative effectiveness of different control strategies. In this book, Lisa Sattenspiel and Alun Lloyd provide a comprehensive introduction to mathematical models in epidemiology and show how they can be used to predict and control the geographic spread of major infectious diseases. Key concepts in infectious disease modeling are explained, readers are guided from simple mathematical models to more complex ones, and the strengths and weaknesses of these models are explored. The book highlights the breadth of techniques available to modelers today, such as population-based and individual-based models, and covers specific applications as well. Sattenspiel and Lloyd examine the powerful mathematical models that health authorities have developed to understand the spatial distribution and geographic spread of influenza, measles, foot-and-mouth disease, and SARS. Analytic methods geographers use to study human infectious diseases and the dynamics of epidemics are also discussed. A must-read for students, researchers, and practitioners, no other book provides such an accessible introduction to this exciting and fast-evolving field.
No single book tracks, on an annual basis, the evolution of the pandemic, its effects, and the worldwide response. To fill this gap, Jonathan Mann, founding director of the World Health Organization's Global Program on AIDS, has assembled a team of experts to produce this collection of information, data, and thinking about AIDS. 100 illustrations.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.
This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.
In this book ethnographic, historical and epidemiologic data are brought to bear on the subject of the Acquired Immune Deficiency Syndrome (AIDS) in Haiti. The forces that have helped to determine rates and pattern of spread of Human Immunodeficiency Virus (HIV) are examined, as are social responses to AIDS in rural and urban Haiti, and in parts of North America. History and its calculus of economic and symbolic power also help to explain why residents of a small village in rural Haiti came to understand AIDS in the manner that they did. Drawing on several years of fieldwork, the evolution of a cultural model of AIDS is traced. In a small village in rural Haiti, it was possible to document first the lack of such a model, and then the elaboration over time of a widely shared representation of AIDS. The experience of three villagers who died of complications of AIDS is examined in detail, and the importance of their suffering to the evolution of a cultural model is demonstrated. Epidemiologic and ethnographic studies are prefaced by a geographically broad historical analysis, which suggests the outlines of relations between a powerful center (the United States) and a peripheral client state (Haiti). These relations constitute an important part of a political-economic network termed the "West Atlantic system." The epidemiology of HIV and AIDS in Haiti and elsewhere in the Caribbean is reviewed, and the relation between the degree of involvement in the West Atlantic system and the prevalence of HIV is suggested. It is further suggested that the history of HIV in the Dominican Republic, Jamaica, Trinidad and Tobago, and the Bahamas is similar to that documented here for Haiti.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.