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With insightful discussion of program evaluation and the efforts of the Centers for Disease Control, this book presents a set of clear-cut recommendations to help ensure that the substantial resources devoted to the fight against AIDS will be used most effectively. This expanded edition of Evaluating AIDS Prevention Programs covers evaluation strategies and outcome measurements, including a realistic review of the factors that make evaluation of AIDS programs particularly difficult. Randomized field experiments are examined, focusing on the use of alternative treatments rather than placebo controls. The book also reviews nonexperimental techniques, including a critical examination of evaluation methods that are observational rather than experimentalâ€"a necessity when randomized experiments are infeasible.
During the two years since the publication of the first edition of this book, the global spread of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has continued. HIV was estimated by the World Health Organization (WHO) in 1993 to have at least 13 million individuals worldwide, with 1 million infected infected in the United States. HIV/AIDS in the United States has become the leading cause of death among men 25 to 44 years of age and the fifth leading cause of death among women of the same age group. Prevention of HIV infection remains a global challenge. Testing for HIV is the cornerstone for surveillance and prevention programs and for the provision of appropriate medical care for those who are infected. Such testing is equally essential to the search for effective antivirus drugs and vaccines. This second edition of AIDS Testing incorporates the most current thinking on test methodology and interpretation, some of which has changed considerably over the past two years. This edition also has been expanded to include a section consisting of six chapters on test applica tions and a section consisting of four chapters on management issues. This edition, like the first, describes in clear terms all the complex ele ments of testing, including applications, scientific principles, quality assurance, safety, and medical, ethical, and legal considerations.
During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.
Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.
The essential work in HIV for providers and pharmacists -- updated with everything they need to know in 2019! Assembled by the leading educational organization in HIV medicine, AAHIVM's Fundamentals of HIV Medicine 2019 is an end-to-end clinical resource for the treatment of individuals with HIV/AIDS. It offers state-of-the-art practical advice for physicians, pharmacists, nurse practitioners, and other professionals working in the care of HIV patients. Along with updates to the classic domains of HIV medicine, this new edition features expanded coverage of emerging topics, including: behavioral and therapeutic interventions to HIV prevention; updates on the pursuit of a cure; new DHHS and IAS guidelines and their clinical implications; and the myriad issues around aging with HIV. Embodying the American Academy of HIV Medicine's commitment to excellence in the care of seropositive patients, Fundamentals of HIV Medicine 2019 is must-have for health professionals across HIV care, treatment, and prevention.
Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS. Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January
Given the continuing high level of concern among health professionals and the general public about issues related to AIDS, this volume on testing for AIDS and related viruses is extremely timely. The book has been written by experts in the area of AIDS testing, many of whom are at the Centers for Disease Control. The book includes several chapters which compare the different laboratory tests available for detecting the AIDS virus (HIV). It also addresses such topics as ethical considerations in AIDS testing, HIV infection in children, testing for other human viruses related to HIV, safety practices in HIV-testing laboratories, and managing occupational exposure to HIV. The book is intended for public health officials involved in HIV testing, hospital administrators and clinical laboratory directors responsible for setting up HIV testing programs, and physicians concerned with testing for AIDS.
Civil liberties, private sector perspectives, and public health and safety issues are critical in an attempt to establish a national policy on mandatory testing for AIDS and drug abuse. This latest volume in the Brookings Dialogues on Public Policy is the product of two Brookings conferences on AIDS and drug testing. The first conference was held in Washington, DC, October 20-21, 1987, and the second in Racine, Wisconsin, March 8-10, 1988. Participants attempted to confront the intense political controversy and public fear engendered by the spread of AIDS and the use of illicit drugs in the Untied States. Though no single policy recommendation emerged from the meeting, the experts reached some points of consensus on possible approaches to testing that would respect the needs, values, and circumstances of affected communities. We are grateful to the countless individuals who participated in the planning meetings and studies that preceded the conferences. We are also thankful for the encouragement of Brookings trustee James D. Wolfensohn to examine the policy issues connected with drug abuse in the United States.
More than 200,000 people in the United States living with HIV/AIDS do not know they are infected. The Institute of Medicine's Committee on HIV Screening and Access to Care held a workshop and reviewed literature to explore barriers and facilitators to more widespread HIV testing. This book contains the committee's conclusions.
The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk". In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.